Effects of Rivastigmine on Cognitive Function in Dementia with Lewy Bodies: A Randomised Placebo-Controlled International Study Using the Cognitive Drug Research Computerised Assessment System

Abstract

This study was designed to assess the effects of rivastigmine (Exelon^®) on the cognitive functioning of patients suffering from dementia with Lewy bodies. This was a prospective, multi-centre, randomised, double-blind, placebo-controlled exploratory study conducted at sites in the UK, Spain and Italy. The treatment period was 20 weeks with a 3-week posttreatment follow-up. The primary outcome measures were the Cognitive Drug Research (CDR) computerised assessment system and the Neuropsychiatric Inventory. Testing was conducted prior to dosing and then again at weeks 12, 20 and 23. Analysis of the data from the 92 patients who completed the study identified a significant pattern of benefits of rivastigmine over placebo on the CDR system. These benefits were seen on tests of attention, working memory and episodic secondary memory. Taking attention for example, patients given placebo showed a significant deterioration from predosing scores at 12 and 20 weeks, whereas patients on rivastigmine performed significantly above their predosing levels. These effects were also large in magnitude, the decline under placebo at week 12 being 19%, while the improvement under rivastigmine was 23%. The clinical relevance of this 23% improvement was that it took the patients 33% towards being normal for their age on this assessment of attention. These benefits to cognitive function were accompanied by a significant improvement of the other primary outcome measure, the Neuropsychiatric Inventory. Three weeks after discontinuation of rivastigmine, most parameters of cognitive performance returned to predrug levels.

Acetylcholinesterase Inhibitors for Alzheimer’s Disease Treatment Ameliorate Acetaminophen-Induced Liver Injury in Mice via Central Cholinergic System Regulation

“…2B). According to earlier reports regarding the degradation of Hup A (metabolized via CYP1A2), Don (metabolized via CYP2D6), and Riv (Matsui et al, 1999;Wesnes et al, 2002;Ma et al, 2003a), these AChEIs should not interfere with CYP2E1 activity in mouse liver microsomes. Taken together, these data indicated that AChEI-induced hepatic protection was not accomplished by affecting GSH content and CYP2E1 activity, suggesting that this effect was not related to the production of NAPQI.…”

Characterizing mild cognitive impairment in incident Parkinson disease

“…Attention was measured using the Cognitive Drug Research computerized battery. 16 Mean response times of simple reaction time, choice reaction time, and digit vigilance were summed to produce a Power of Attention score. 16 Digit vigilance accuracy was also evaluated as part of this domain.…”

“…16 Mean response times of simple reaction time, choice reaction time, and digit vigilance were summed to produce a Power of Attention score. 16 Digit vigilance accuracy was also evaluated as part of this domain. Memory was assessed with Pattern Recognition Memory (PRM), Spatial Recognition Memory (SRM), and Paired Associates Learning (PAL) from the computerized Cambridge Neuropsychological Test Automated Battery (CANTAB) battery.…”

Acute consumption of Peppermint and Chamomile teas produce contrasting effects on cognition and mood in healthy young adults

“…The CDR system has a strong factor structure that has been demonstrated in both healthy and diseased populations (Wesnes et al, 2000(Wesnes et al, , 2002. The individual test scores from the battery load strongly onto four global outcome factors (Quality of memory; Speed of attention; Accuracy of attention; Speed of memory) and two sub-factors (Working memory; Secondary memory).…”