Short-Term Rivastigmine Treatment Reduces EEG Slow-Wave Power in Alzheimer Patients

Adler, Georg; Brassen, Stefanie

doi:10.1159/000054902

Cited by 63 publications

(41 citation statements)

References 26 publications

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“…In this regard, the mechanism explaining the present results might be different from that explaining the shortterm effects of therapy on the EEG rhythms. Indeed, previous studies in AD patients have shown that AChEIs mostly reduce the excess of cortical delta or theta rhythms but did not affect alpha rhythms, at least in the short run (Adler and Brassen, 2001;Adler et al, 2004;Brassen and Adler, 2003). The therapy would restore the typical abnormalities of the EEG rhythmicity around 2 -12 Hz in mild AD patients (Reeves et al, 2002;Brassen and Adler, 2003).…”

Section: Discussionmentioning

confidence: 94%

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Cassetta²,

et al. 2006

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Section: Discussionmentioning

confidence: 94%

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Cassetta²,

et al. 2006

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“…An improvement in classical qEEG parameters was reported after short-term [11], medium-term (e.g., 6 weeks) [12], and even long-term [13] therapy. Very recently, a power reduction in slow frequencies has been observed after 5 days of rivastigmine therapy as well [14]. Concerning donepezil, probably the most widely used AChEI, the only available data show an increased amplitude of hippocampal activity in rats [15] and a decrease in P300 latency by cognitive event-related potentials in AD patients [16].…”

Section: Introductionmentioning

confidence: 99%

Quantitative EEG Changes in Alzheimer Patients during Long-Term Donepezil Therapy

Rodriguez¹,

Vitali²,

Leo³

et al. 2002

Neuropsychobiology

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Twenty patients affected with probable mild-to-moderate Alzheimer’s disease (AD; NINCDS-ADRDA criteria; 14 women and 6 men, mean age 75.2 ± 7.1 years) who regularly received an oral acetylcholinesterase inhibitor (AChEI; donepezil 5 mg/day; Dz group) were compared with a control group of 11 AD patients (6 women and 5 men, mean age 73.5 ± 6.0 years) diagnosed and followed up in the pre-AChEIs era (C group). At basal evaluation (t₀), the 2 groups were comparable for age, education, and severity of disease (Global Deterioration Scale). All patients underwent quantitative EEG (qEEG, average reference, 10–20 International System), and were reexamined about 1 year later (t₁; i.e., after 12.3 ± 3.6 months the Dz group, and after 13.7 ± 3.9 months the C group). Log-transformed values of two qEEG bands, i.e. 2–6 and 6.5–12 Hz, were averaged between adjacent channels (frontal F3 and F7, F4 and F8; parietotemporal P3 and T7, P4 and T8) to obtain a qEEG ratio (6.5–12/2–6 Hz.) from one frontal and one temporoparietal region in each hemisphere. Neuropsychological impairment was summarized by the Mini-Mental Status Examination (MMSE). At t₀, both the MMSE score and the qEEG ratio values were somewhat higher in the C than in the Dz group, although nonsignificantly. Between t₀ and t₁, the MMSE score decreased significantly (p < 0.01) more in the C group (–4.36 ± 2.25) than in the Dz group (–1.45 ± 2.16), as did the qEEG ratio in the right frontal region (p < 0.01), whereas in the left frontal region the significance level was not reached (p = 0.02). Between t₀ and t₁, the qEEG ratio difference in both frontal regions and in the right temporoparietal region significantly correlated with the MMSE difference (p < 0.01), but neither with time between examinations nor with the difference on the Visual Search Test score. Long-term treatment with Dz led to a lesser deterioration of qEEG, paralleling a milder neuropsychological decline. The effect was significant in frontal regions, possibly because they are relatively spared during the mild-to-moderate phases of the disease.

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“…These results agree with previous quantitative EEG studies that showed a shift of the power spectral EEG towards 'normalization'. In particular, after short-term (5 days to 2 weeks) rivastigmine treatment, three previous studies showed a decrease of delta (Adler and Brassen 2001) and of theta (Adler and Brassen 2001;Adler et al 2004;Brassen and Adler 2003). To our knowledge, the present paper is the first long-term (3 months) study that used rivastigmine and that reports a stabilization of these electrophysiological effects.…”

Section: Discussionmentioning

confidence: 88%

“…Treatment with ChE-I has been shown to decrease the amount of slow EEG activity, i.e., to 'normalize' the EEG power spectrum (e.g., Adler and Brassen 2001;Balkan et al 2003;Jelic et al 1998;Kogan et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Rivastigmine effects on EEG spectra and three-dimensional LORETA functional imaging in Alzheimer’s disease

et al. 2008

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Objective The objective of the study is to investigate the electrocortical and the global cognitive effects of 3 months rivastigmine medication in a group of mild to moderate Alzheimer's disease patients. Materials and methods Multichannel EEG and cognitive performances measured with the Mini Mental State Examination in a group of 16 patients with mild to moderate Alzheimer's Disease were collected before and 3 months after the onset of rivastigmine medication. Results Spectral analysis of the EEG data showed a significant power decrease in the delta and theta frequency bands during rivastigmine medication, i.e., a shift of the power spectrum towards 'normalization'. Three-dimensional low resolution electromagnetic tomography (LORETA) functional imaging localized rivastigmine effects in a network that includes left fronto-parietal regions, posterior cingulate cortex, bilateral parahippocampal regions, and the hippocampus. Moreover, a correlation analysis between differences in the cognitive performances during the two recordings and LORETA-computed intracortical activity showed, in the alpha1 frequency band, better cognitive performance with increased cortical activity in the left insula. Conclusion The results point to a 'normalization' of the EEG power spectrum due to medication, and the intracortical localization of these effects showed an increase of cortical activity in frontal, parietal, and temporal regions that are well-known to be affected in Alzheimer's disease. The topographic convergence of the present results with the memory network proposed by Vincent et al. (J. Neurophysiol. 96:3517-3531, 2006) leads to the speculation that in our group of patients, rivastigmine specifically activates brain regions that are involved in memory functions, notably a key symptom in this degenerative disease.

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Short-Term Rivastigmine Treatment Reduces EEG Slow-Wave Power in Alzheimer Patients

Cited by 63 publications

References 26 publications

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Donepezil effects on sources of cortical rhythms in mild Alzheimer's disease: Responders vs. Non-Responders

Quantitative EEG Changes in Alzheimer Patients during Long-Term Donepezil Therapy

Rivastigmine effects on EEG spectra and three-dimensional LORETA functional imaging in Alzheimer’s disease

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