A comparison of the efficacy of donepezil in Parkinson's disease with Dementia and Dementia with Lewy bodies
Background Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) overlap in phenomenology and neurochemical deficits. We hypothesised they would not differ in their response to the cholinesterase inhibitor donepezil. Methods We recruited 70 subjects, 30 DLB and 40 PDD, in...
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| Veröffentlicht in: | International journal of geriatric psychiatry 2005-10, Vol.20 (10), p.938-944 |
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| container_title | International journal of geriatric psychiatry |
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| creator | Thomas, Alan J. Burn, David J. Rowan, Elise N. Littlewood, Elizabeth Newby, Jane Cousins, David Pakrasi, Sanjeet Richardson, Jonathan Sanders, Jonathan McKeith, Ian G. |
| description | Background
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) overlap in phenomenology and neurochemical deficits. We hypothesised they would not differ in their response to the cholinesterase inhibitor donepezil.
Methods
We recruited 70 subjects, 30 DLB and 40 PDD, in an open label study to compare the efficacy of donepezil in these two patient groups. They were assessed at baseline, 4, 12 and 20 weeks. The main outcome measures were the Mini‐Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI) and motor sub‐section of the Unified Parkinson's Disease Rating Scale (UPDRS III).
Results
PDD patients were younger than DLB and had more severe parkinsonism at baseline. The groups were similar on all other variables of interest. By 20 weeks the mean MMSE score increased by 3.9 points in the DLB group and by 3.2 points in PDD. The mean NPI score reduced by 14.6 points for DLB and 12.0 points for PDD. These treatment effects were all significant compared to baseline (p |
| doi_str_mv | 10.1002/gps.1381 |
| format | Article |
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Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) overlap in phenomenology and neurochemical deficits. We hypothesised they would not differ in their response to the cholinesterase inhibitor donepezil.
Methods
We recruited 70 subjects, 30 DLB and 40 PDD, in an open label study to compare the efficacy of donepezil in these two patient groups. They were assessed at baseline, 4, 12 and 20 weeks. The main outcome measures were the Mini‐Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI) and motor sub‐section of the Unified Parkinson's Disease Rating Scale (UPDRS III).
Results
PDD patients were younger than DLB and had more severe parkinsonism at baseline. The groups were similar on all other variables of interest. By 20 weeks the mean MMSE score increased by 3.9 points in the DLB group and by 3.2 points in PDD. The mean NPI score reduced by 14.6 points for DLB and 12.0 points for PDD. These treatment effects were all significant compared to baseline (p < 0.001) but there were no significant between‐group treatment differences (MMSE p = 0.56, NPI p = 0.39). UPDRS III motor scores did not change significantly from baseline values in either group. Although adverse effects were common (69%) they were usually mild and 64 patients (91%) completed the study. The four patients who did withdraw with adverse effects all had a PDD diagnosis.
Conclusions
Donepezil produced similar improvements in cognition and behaviour in DLB and PDD. This supports the hypothesis that the two disorders are closely related clinically and neurobiologically. Larger scale, placebo controlled clinical trials are needed to provide an evidence base to guide the clinical use of cholinesterase inhibitors in Lewy body disease. Copyright © 2005 John Wiley & Sons, Ltd.</description><identifier>ISSN: 0885-6230</identifier><identifier>EISSN: 1099-1166</identifier><identifier>DOI: 10.1002/gps.1381</identifier><identifier>PMID: 16163744</identifier><identifier>CODEN: IJGPES</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Age Factors ; Aged ; Biological and medical sciences ; cholinesterase inhibitors ; Cholinesterase Inhibitors - adverse effects ; Cholinesterase Inhibitors - therapeutic use ; Comparative studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Dementia ; Dementia - complications ; Dementia - drug therapy ; Dementia - psychology ; DLB ; donepezil ; Drug therapy ; Female ; Fundamental and applied biological sciences. Psychology ; Geriatric psychiatry ; Geriatrics ; Humans ; Indans - adverse effects ; Indans - therapeutic use ; Inhibitor drugs ; Lewy Body Disease - drug therapy ; Lewy Body Disease - psychology ; Male ; Medical sciences ; Neurological disorders ; Neurology ; Neuropsychological Tests ; Parkinson Disease - complications ; Parkinson Disease - drug therapy ; Parkinson Disease - psychology ; Parkinson's disease ; Piperidines - adverse effects ; Piperidines - therapeutic use ; Psychoanalysis ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Severity of Illness Index ; Treatment Outcome</subject><ispartof>International journal of geriatric psychiatry, 2005-10, Vol.20 (10), p.938-944</ispartof><rights>Copyright © 2005 John Wiley & Sons, Ltd.</rights><rights>2005 INIST-CNRS</rights><rights>Copyright (c) 2005 John Wiley & Sons, Ltd.</rights><rights>Copyright John Wiley and Sons, Limited Oct 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4451-e56dc85bb13007b0a1618d655ddd02406698ee14749b18c50eb558c9f87219ca3</citedby><cites>FETCH-LOGICAL-c4451-e56dc85bb13007b0a1618d655ddd02406698ee14749b18c50eb558c9f87219ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fgps.1381$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fgps.1381$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27915,27916,45565,45566</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17142700$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16163744$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thomas, Alan J.</creatorcontrib><creatorcontrib>Burn, David J.</creatorcontrib><creatorcontrib>Rowan, Elise N.</creatorcontrib><creatorcontrib>Littlewood, Elizabeth</creatorcontrib><creatorcontrib>Newby, Jane</creatorcontrib><creatorcontrib>Cousins, David</creatorcontrib><creatorcontrib>Pakrasi, Sanjeet</creatorcontrib><creatorcontrib>Richardson, Jonathan</creatorcontrib><creatorcontrib>Sanders, Jonathan</creatorcontrib><creatorcontrib>McKeith, Ian G.</creatorcontrib><title>A comparison of the efficacy of donepezil in Parkinson's disease with Dementia and Dementia with Lewy bodies</title><title>International journal of geriatric psychiatry</title><addtitle>Int. J. Geriat. Psychiatry</addtitle><description>Background
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) overlap in phenomenology and neurochemical deficits. We hypothesised they would not differ in their response to the cholinesterase inhibitor donepezil.
Methods
We recruited 70 subjects, 30 DLB and 40 PDD, in an open label study to compare the efficacy of donepezil in these two patient groups. They were assessed at baseline, 4, 12 and 20 weeks. The main outcome measures were the Mini‐Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI) and motor sub‐section of the Unified Parkinson's Disease Rating Scale (UPDRS III).
Results
PDD patients were younger than DLB and had more severe parkinsonism at baseline. The groups were similar on all other variables of interest. By 20 weeks the mean MMSE score increased by 3.9 points in the DLB group and by 3.2 points in PDD. The mean NPI score reduced by 14.6 points for DLB and 12.0 points for PDD. These treatment effects were all significant compared to baseline (p < 0.001) but there were no significant between‐group treatment differences (MMSE p = 0.56, NPI p = 0.39). UPDRS III motor scores did not change significantly from baseline values in either group. Although adverse effects were common (69%) they were usually mild and 64 patients (91%) completed the study. The four patients who did withdraw with adverse effects all had a PDD diagnosis.
Conclusions
Donepezil produced similar improvements in cognition and behaviour in DLB and PDD. This supports the hypothesis that the two disorders are closely related clinically and neurobiologically. Larger scale, placebo controlled clinical trials are needed to provide an evidence base to guide the clinical use of cholinesterase inhibitors in Lewy body disease. Copyright © 2005 John Wiley & Sons, Ltd.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>cholinesterase inhibitors</subject><subject>Cholinesterase Inhibitors - adverse effects</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Comparative studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Dementia</subject><subject>Dementia - complications</subject><subject>Dementia - drug therapy</subject><subject>Dementia - psychology</subject><subject>DLB</subject><subject>donepezil</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Geriatric psychiatry</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Indans - adverse effects</subject><subject>Indans - therapeutic use</subject><subject>Inhibitor drugs</subject><subject>Lewy Body Disease - drug therapy</subject><subject>Lewy Body Disease - psychology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurological disorders</subject><subject>Neurology</subject><subject>Neuropsychological Tests</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - psychology</subject><subject>Parkinson's disease</subject><subject>Piperidines - adverse effects</subject><subject>Piperidines - therapeutic use</subject><subject>Psychoanalysis</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><issn>0885-6230</issn><issn>1099-1166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10dtu1DAQBmALgehSkHgCZCFxuEmZSWLHuawKXUBLKSqHS8uxJ9RtTsRZLcvT42UjVkLiyhrNp5nRb8YeI5wgQPrq-xBOMFN4hy0QyjJBlPIuW4BSIpFpBkfsQQg3ALGH6j47QokyK_J8wZpTbvt2MKMPfcf7mk_XxKmuvTV2u6td39FAv3zDfccvzXjruyhfBO58IBOIb_x0zV9TS93kDTedOxR_WivabHnVO0_hIbtXmybQo_k9Zl_O33w-e5usPi7fnZ2uEpvnAhMS0lklqgozgKICE89VTgrhnIM0BylLRYR5kZcVKiuAKiGULWtVpFhakx2z5_u5w9j_WFOYdOuDpaYxHfXroFPENMtyiPDpP_CmX49dvE2nKQhEhWVEL_fIjn0II9V6GH1rxq1G0Lv4dYxf7-KP9Mk8b1215A5wzjuCZzMwwZqmHk1nfTi4AvO0gN1hyd5tfEPb_y7Uy8urefHsfZjo518fv0vLIiuE_nax1J_OYXX1_usHfZH9BtErqSs</recordid><startdate>200510</startdate><enddate>200510</enddate><creator>Thomas, Alan J.</creator><creator>Burn, David J.</creator><creator>Rowan, Elise N.</creator><creator>Littlewood, Elizabeth</creator><creator>Newby, Jane</creator><creator>Cousins, David</creator><creator>Pakrasi, Sanjeet</creator><creator>Richardson, Jonathan</creator><creator>Sanders, Jonathan</creator><creator>McKeith, Ian G.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope></search><sort><creationdate>200510</creationdate><title>A comparison of the efficacy of donepezil in Parkinson's disease with Dementia and Dementia with Lewy bodies</title><author>Thomas, Alan J. ; Burn, David J. ; Rowan, Elise N. ; Littlewood, Elizabeth ; Newby, Jane ; Cousins, David ; Pakrasi, Sanjeet ; Richardson, Jonathan ; Sanders, Jonathan ; McKeith, Ian G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4451-e56dc85bb13007b0a1618d655ddd02406698ee14749b18c50eb558c9f87219ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>cholinesterase inhibitors</topic><topic>Cholinesterase Inhibitors - adverse effects</topic><topic>Cholinesterase Inhibitors - therapeutic use</topic><topic>Comparative studies</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Dementia</topic><topic>Dementia - complications</topic><topic>Dementia - drug therapy</topic><topic>Dementia - psychology</topic><topic>DLB</topic><topic>donepezil</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Geriatric psychiatry</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Indans - adverse effects</topic><topic>Indans - therapeutic use</topic><topic>Inhibitor drugs</topic><topic>Lewy Body Disease - drug therapy</topic><topic>Lewy Body Disease - psychology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurological disorders</topic><topic>Neurology</topic><topic>Neuropsychological Tests</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - psychology</topic><topic>Parkinson's disease</topic><topic>Piperidines - adverse effects</topic><topic>Piperidines - therapeutic use</topic><topic>Psychoanalysis</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Alan J.</creatorcontrib><creatorcontrib>Burn, David J.</creatorcontrib><creatorcontrib>Rowan, Elise N.</creatorcontrib><creatorcontrib>Littlewood, Elizabeth</creatorcontrib><creatorcontrib>Newby, Jane</creatorcontrib><creatorcontrib>Cousins, David</creatorcontrib><creatorcontrib>Pakrasi, Sanjeet</creatorcontrib><creatorcontrib>Richardson, Jonathan</creatorcontrib><creatorcontrib>Sanders, Jonathan</creatorcontrib><creatorcontrib>McKeith, Ian G.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>International journal of geriatric psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Alan J.</au><au>Burn, David J.</au><au>Rowan, Elise N.</au><au>Littlewood, Elizabeth</au><au>Newby, Jane</au><au>Cousins, David</au><au>Pakrasi, Sanjeet</au><au>Richardson, Jonathan</au><au>Sanders, Jonathan</au><au>McKeith, Ian G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A comparison of the efficacy of donepezil in Parkinson's disease with Dementia and Dementia with Lewy bodies</atitle><jtitle>International journal of geriatric psychiatry</jtitle><addtitle>Int. J. Geriat. Psychiatry</addtitle><date>2005-10</date><risdate>2005</risdate><volume>20</volume><issue>10</issue><spage>938</spage><epage>944</epage><pages>938-944</pages><issn>0885-6230</issn><eissn>1099-1166</eissn><coden>IJGPES</coden><abstract>Background
Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) overlap in phenomenology and neurochemical deficits. We hypothesised they would not differ in their response to the cholinesterase inhibitor donepezil.
Methods
We recruited 70 subjects, 30 DLB and 40 PDD, in an open label study to compare the efficacy of donepezil in these two patient groups. They were assessed at baseline, 4, 12 and 20 weeks. The main outcome measures were the Mini‐Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI) and motor sub‐section of the Unified Parkinson's Disease Rating Scale (UPDRS III).
Results
PDD patients were younger than DLB and had more severe parkinsonism at baseline. The groups were similar on all other variables of interest. By 20 weeks the mean MMSE score increased by 3.9 points in the DLB group and by 3.2 points in PDD. The mean NPI score reduced by 14.6 points for DLB and 12.0 points for PDD. These treatment effects were all significant compared to baseline (p < 0.001) but there were no significant between‐group treatment differences (MMSE p = 0.56, NPI p = 0.39). UPDRS III motor scores did not change significantly from baseline values in either group. Although adverse effects were common (69%) they were usually mild and 64 patients (91%) completed the study. The four patients who did withdraw with adverse effects all had a PDD diagnosis.
Conclusions
Donepezil produced similar improvements in cognition and behaviour in DLB and PDD. This supports the hypothesis that the two disorders are closely related clinically and neurobiologically. Larger scale, placebo controlled clinical trials are needed to provide an evidence base to guide the clinical use of cholinesterase inhibitors in Lewy body disease. Copyright © 2005 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>16163744</pmid><doi>10.1002/gps.1381</doi><tpages>7</tpages></addata></record> |
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| subjects | Age Factors Aged Biological and medical sciences cholinesterase inhibitors Cholinesterase Inhibitors - adverse effects Cholinesterase Inhibitors - therapeutic use Comparative studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Dementia Dementia - complications Dementia - drug therapy Dementia - psychology DLB donepezil Drug therapy Female Fundamental and applied biological sciences. Psychology Geriatric psychiatry Geriatrics Humans Indans - adverse effects Indans - therapeutic use Inhibitor drugs Lewy Body Disease - drug therapy Lewy Body Disease - psychology Male Medical sciences Neurological disorders Neurology Neuropsychological Tests Parkinson Disease - complications Parkinson Disease - drug therapy Parkinson Disease - psychology Parkinson's disease Piperidines - adverse effects Piperidines - therapeutic use Psychoanalysis Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Severity of Illness Index Treatment Outcome |
| title | A comparison of the efficacy of donepezil in Parkinson's disease with Dementia and Dementia with Lewy bodies |
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