Rivastigmine Shows Promise for Patients With Parkinson’s Disease Dementia: Presented at ADI
By Jenny Powers
THESSALONIKI, Greece -- March 15, 2010 -- Patients with Parkinson’s disease dementia (PDD) respond to 2 weeks of treatment with rivastigmine by demonstrating improved short-term memory and decreased theta activity, according to preliminary results presented here on March 11 at the 25th Conference of Alzheimer’s Disease International (ADI).
Georg Adler, MD, Clinical Studies, Institut für Studien zur psychischen Gesundheit (ISPG), Mannheim, Germany, and colleagues are conducting an ongoing open study to determine the response to treatment with rivastigmine on 150 outpatients (Mini-Mental State Exam [MMSE] score 15-27) with PDD and cognitive impairment.
Rivastigmine acts on decreased cholinergic levels, which are associated with disrupted attention ability, impaired short-term memory, visual hallucinations, and increased electroencephalogram (EEG) theta activity.
This analysis assessed patients’ attention, short-term memory, and quantitative EEG before rivastigmine treatment (beginning dose 3 mg once daily, ongoing doses of 6-9 mg daily) and at 2 weeks post treatment.
Patients are receiving levodopa treatment for PD physical symptoms. Response to treatment will also be evaluated at 6 and 12 months of treatment. The endpoint is an increase in MMSE score and a decrease in EEG theta activity.
Data from 32 of the patients in the treatment group have been analysed. At 2 weeks after treatment with rivastigmine, patients displayed improved delayed recall (P = .02), improved attention as quantified by the Alterskonzentrationstest (P = .04), and an increase in MMSE score (P = .02). EEG theta activity was reduced (P = .08).
The researchers concluded that short-term cholinergic treatment with rivastigmine is effective for the treatment of PDD because it improved PD symptoms and decreased theta activity. Furthermore, Dr. Adler remarked that because PDD is characterised by a stronger cholinergic deficit than seen in most Alzheimer’s disease patients, rivastigmine could be expected to be effective in this group. He added that an investigation of rivastigmine in patients with Alzheimer’s disease is warranted.
[Presentation title: Prediction of Treatment Response to Rivastigmine in Parkinson’s Disease Dementia. Abstract OC056]
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