Drugs and Vascular Dementia

Allain, H.; Bentué-Ferrer, Danièle; Tribut, Olivier; Pinel, J

doi:10.1159/000069986

Cited by 10 publications

(5 citation statements)

References 66 publications

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“…The only drugs with evidence-based indications are used in AD, mainly cholinesterase inhibitors, because of their proven beneficial impact on working memory and attention. Extension of their indications to cognitive disorders associated with vascular dementia (Allain et al 2003), PD (Emre et al 2004), or Lewy body dementia is legitimate. Theoretically, cognitive stimulants and nootropics which have a more global action on neuronal metabolism, membrane fluidity, and the rate of information processing could be used for a variety of conditions involving altered cognition or attention.…”

Section: Perspectives–conclusionmentioning

confidence: 99%

Impaired cognition and attention in adults: pharmacological management strategies

Allain¹,

Akwa²,

Lacomblez³

et al. 2007

Neuropsychiatric Disease and Treatment

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Abstract:Cognitive psychology has provided clinicians with specific tools for analyzing the processes of cognition (memory, language) and executive functions (attention-concentration, abstract reasoning, planning). Neuropsychology, coupled with the neurosciences (including neuroimaging techniques), has authenticated the existence of early disorders affecting the "superior or intellectual" functions of the human brain. The prevalence of cognitive and attention disorders is high in adults because all the diseases implicating the central nervous system are associated with cognitive correlates of variable intensity depending on the disease process and the age of the patient. In some pathologies, cognitive impairment can be a leading symptom such as in schizophrenia, posttraumatic stress disorder or an emblematic stigmata as in dementia including Alzheimer's disease. Paradoxically, public health authorities have only recognized as medications for improving cognitive symptoms those with proven efficacy in the symptomatic treatment of patients with Alzheimer's disease; the other cognitive impairments are relegated to the orphanage of syndromes and symptoms dispossessed of medication. The purpose of this review is to promote a true "pharmacology of cognition" based on the recent knowledge in neurosciences. Data from adult human beings, mainly concerning memory, language, and attention processes, will be reported. "Drug therapeutic strategies" for improving cognition (except for memory function) are currently rather scarce, but promising perspectives for a new neurobiological approach to cognitive pharmacology will be highlighted.

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Section: Perspectives–conclusionmentioning

confidence: 99%

Impaired cognition and attention in adults: pharmacological management strategies

Allain¹,

Akwa²,

Lacomblez³

et al. 2007

Neuropsychiatric Disease and Treatment

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“…15 Demonstrating the therapeutic effect of these potential drugs is currently the main challenge, raising questions about experimental models of dementia, whether there are any markers (biological, genetic) of the disease, and the appropriate clinical assessment strategies to use. 15 Demonstrating the therapeutic effect of these potential drugs is currently the main challenge, raising questions about experimental models of dementia, whether there are any markers (biological, genetic) of the disease, and the appropriate clinical assessment strategies to use.…”

Section: A Return To the Mechanism Of Actionmentioning

confidence: 99%

“…15 In contrast, fronto-temporal dementias and a whole group of focal atrophies, with very varied symptomatic expressions, seem to be lagging behind, despite the hypotheses concerning cell death already mentioned, and should therefore be investigated as a priority using cohorts of patients identified within memory clinics. This process has started in vascular dementia with the observation, even though based on rather weak hypotheses, that memantine, rivastigmine and galantamine perform better than a placebo.…”

Section: What the Physician Needsmentioning

confidence: 99%

The Anti-Dementia Drugs: Myth, Hype or Reality?

Allain

Bentué-Ferrer

2006

Clinical Neuropharmacology

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The neurodegenerative diseases are in need of drugs that are capable of treating their many different presentations. Some drugs have recently been developed and approved by the authorities for use in Alzheimer's disease; their beneficial effects are no longer questionable. From the discussion about what to call these drugs (anti-dementia drugs?), it is apparent that pharmacology research has veered from pursuing the myth of the fountain of eternal youth back to the reality of the struggle for survival of neurons whenever they are attacked, long before the signs of dementia have developed (antiapoptotic drugs?). The neurosciences teach that there is a biology of cognition (hence a pharmacology of cognition), and that the brain is the permanent area of the confrontation between neurogenesis and apoptosis. Pharmacology has taken this new understanding on board, and has finally defined its objective as preventing the decline of the neuron as much as of cognitive performance. It remains for clinicians to confirm the authenticity of this worldwide project.

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“…This criticism is formulated in relation to a large number of experimental models, but is particularly important in the case of Alzheimer's disease because of the link between ageing and this disease. The presence of vascular risk factors also appears to play a considerable role, but is rarely taken into account in experimental models [8] . On the basis of these criticisms, the relevance of animal models of Alzheimer's disease is often questioned, especially as the investigation of these models is associated with considerable methodological problems.…”

Section: Which Models For Which Lesions?mentioning

confidence: 99%

“…7 The extension to other forms of dementia, particularly frontotemporal dementia, in which cholinesterase inhibitors are not indicated [4] . 8 The management of severe to very severe forms, not included in the MA, which nevertheless represent a large proportion of this population.…”

mentioning

confidence: 99%

Pharmacology of Alzheimer’s Disease: Appraisal and Prospects

Sellal¹,

Nieoullon²,

Michel

et al. 2005

Dement Geriatr Cogn Disord

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Ten years after the introduction of the first drug, tacrine, in the treatment of Alzheimer’s disease, it seems appropriate to reappraise the pharmacological processes of innovation in the research field of dementia. The aim of this review is to pinpoint concrete improvements achieved in this field, regarding experimental methods and clinical evaluation of the compounds, as well as the neurochemistry of the disease and cellular targets to consider in priority. This review deals with this objective in three parts: (1) assessment of current therapeutics, (2) discussion of the experimental models and clinical practices and (3) prospective drugs of the future. The implementation of considered strategies will require the involvement and close cooperation between political decisions, pharmaceutical companies and the scientific community.

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Drugs and Vascular Dementia

Cited by 10 publications

References 66 publications

Impaired cognition and attention in adults: pharmacological management strategies

Impaired cognition and attention in adults: pharmacological management strategies

The Anti-Dementia Drugs: Myth, Hype or Reality?

Pharmacology of Alzheimer’s Disease: Appraisal and Prospects

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