Rivastigmine in subcortical vascular dementia: An open 22-month study
Further to recent data indicating that patients with vascular dementia (VaD) show a cholinergic deficit, we aimed to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the symptoms of VaD. Patients aged 65–80, with a...
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| Veröffentlicht in: | Journal of the neurological sciences 2002-11, Vol.203, p.141-146 |
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| container_title | Journal of the neurological sciences |
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| creator | Moretti, Rita Torre, Paola Antonello, Rodolfo M Cazzato, Giuseppe Bava, Antonio |
| description | Further to recent data indicating that patients with vascular dementia (VaD) show a cholinergic deficit, we aimed to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the symptoms of VaD. Patients aged 65–80, with a diagnosis of dementia and probable VaD, received rivastigmine 3–6 mg/day (
n=8) or cardioaspirin (
n=8) in an open study for 22 months. At 22 months, patients treated with rivastigmine showed significant improvements in executive function and behavioural symptoms (both
p |
| doi_str_mv | 10.1016/S0022-510X(02)00280-0 |
| format | Article |
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n=8) or cardioaspirin (
n=8) in an open study for 22 months. At 22 months, patients treated with rivastigmine showed significant improvements in executive function and behavioural symptoms (both
p<0.05 vs. both baseline and control group), which were reflected in reduced caregiver stress (
p<0.05 vs. baseline and controls). Baseline scores of global response, cognition, word fluency and activities of daily living were maintained in patients receiving rivastigmine, and there was no increase in benzodiazepine or neuroleptic intake. In contrast, the control group showed no improvements in any domain, and significant deterioration in global response and executive function (both
p<0.05 vs. baseline and rivastigmine group). Side effects in both groups were tolerable and there were no study withdrawals. Long-term rivastigmine treatment appeared to be safe and effective in this patient population. In particular, improvements in domains particularly relevant to this condition were observed. These benefits may reflect the drug's dual inhibitory effects on the cholinergic system, and its particular activity in frontal areas of the brain. A large, double-blind study of rivastigmine in patients with VaD would be worthwhile.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/S0022-510X(02)00280-0</identifier><identifier>PMID: 12417373</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Behavior ; Behaviour ; Carbamates - adverse effects ; Carbamates - therapeutic use ; Caregivers - psychology ; Cholinesterase inhibition ; Cholinesterase Inhibitors - adverse effects ; Cholinesterase Inhibitors - therapeutic use ; Dementia, Vascular - drug therapy ; Executive function ; Female ; Follow-Up Studies ; Humans ; Male ; Neuroprotective Agents - adverse effects ; Neuroprotective Agents - therapeutic use ; Neuropsychological Tests ; Phenylcarbamates ; Psychiatric Status Rating Scales ; Rivastigmine ; Stress, Psychological - psychology ; Treatment Outcome ; Vascular dementia</subject><ispartof>Journal of the neurological sciences, 2002-11, Vol.203, p.141-146</ispartof><rights>2002 Elsevier Science B.V.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0022-510X(02)00280-0$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12417373$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moretti, Rita</creatorcontrib><creatorcontrib>Torre, Paola</creatorcontrib><creatorcontrib>Antonello, Rodolfo M</creatorcontrib><creatorcontrib>Cazzato, Giuseppe</creatorcontrib><creatorcontrib>Bava, Antonio</creatorcontrib><title>Rivastigmine in subcortical vascular dementia: An open 22-month study</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>Further to recent data indicating that patients with vascular dementia (VaD) show a cholinergic deficit, we aimed to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the symptoms of VaD. Patients aged 65–80, with a diagnosis of dementia and probable VaD, received rivastigmine 3–6 mg/day (
n=8) or cardioaspirin (
n=8) in an open study for 22 months. At 22 months, patients treated with rivastigmine showed significant improvements in executive function and behavioural symptoms (both
p<0.05 vs. both baseline and control group), which were reflected in reduced caregiver stress (
p<0.05 vs. baseline and controls). Baseline scores of global response, cognition, word fluency and activities of daily living were maintained in patients receiving rivastigmine, and there was no increase in benzodiazepine or neuroleptic intake. In contrast, the control group showed no improvements in any domain, and significant deterioration in global response and executive function (both
p<0.05 vs. baseline and rivastigmine group). Side effects in both groups were tolerable and there were no study withdrawals. Long-term rivastigmine treatment appeared to be safe and effective in this patient population. In particular, improvements in domains particularly relevant to this condition were observed. These benefits may reflect the drug's dual inhibitory effects on the cholinergic system, and its particular activity in frontal areas of the brain. A large, double-blind study of rivastigmine in patients with VaD would be worthwhile.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Behavior</subject><subject>Behaviour</subject><subject>Carbamates - adverse effects</subject><subject>Carbamates - therapeutic use</subject><subject>Caregivers - psychology</subject><subject>Cholinesterase inhibition</subject><subject>Cholinesterase Inhibitors - adverse effects</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Dementia, Vascular - drug therapy</subject><subject>Executive function</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Neuroprotective Agents - adverse effects</subject><subject>Neuroprotective Agents - therapeutic use</subject><subject>Neuropsychological Tests</subject><subject>Phenylcarbamates</subject><subject>Psychiatric Status Rating Scales</subject><subject>Rivastigmine</subject><subject>Stress, Psychological - psychology</subject><subject>Treatment Outcome</subject><subject>Vascular dementia</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kNtKAzEQhoMotlYfQcmlXqzOJOlu4o2UUg9QEDyAdyGbTDXS3S17KPTt3bbq1fAzHz8zH2PnCNcImN68AgiRjBE-LkFc9UFDAgdsiDrTyVhreciG_8iAnTTNNwCkWptjNkChMJOZHLLZS1y7po2fRSyJx5I3Xe6ruo3eLXm_8d3S1TxQQWUb3S2flLxaUcn74qIq2y_etF3YnLKjhVs2dPY7R-z9fvY2fUzmzw9P08k8IZHKNjHoM5WqBTlvQHsldIoGlUyVMB5zo2ihAEEbQKdTAUgiZDSWwQshciA5Yhf73lWXFxTsqo6Fqzf2758euNsD1F-xjlTbxkcqPYVYk29tqKJFsFuDdmfQbvVYEHZn0IL8AUTQYH4</recordid><startdate>20021115</startdate><enddate>20021115</enddate><creator>Moretti, Rita</creator><creator>Torre, Paola</creator><creator>Antonello, Rodolfo M</creator><creator>Cazzato, Giuseppe</creator><creator>Bava, Antonio</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20021115</creationdate><title>Rivastigmine in subcortical vascular dementia: An open 22-month study</title><author>Moretti, Rita ; Torre, Paola ; Antonello, Rodolfo M ; Cazzato, Giuseppe ; Bava, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e263t-91c7464feac908c4286191436429c1b94ef40108901a86201e2d7e53dc222b0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Behavior</topic><topic>Behaviour</topic><topic>Carbamates - adverse effects</topic><topic>Carbamates - therapeutic use</topic><topic>Caregivers - psychology</topic><topic>Cholinesterase inhibition</topic><topic>Cholinesterase Inhibitors - adverse effects</topic><topic>Cholinesterase Inhibitors - therapeutic use</topic><topic>Dementia, Vascular - drug therapy</topic><topic>Executive function</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Neuroprotective Agents - adverse effects</topic><topic>Neuroprotective Agents - therapeutic use</topic><topic>Neuropsychological Tests</topic><topic>Phenylcarbamates</topic><topic>Psychiatric Status Rating Scales</topic><topic>Rivastigmine</topic><topic>Stress, Psychological - psychology</topic><topic>Treatment Outcome</topic><topic>Vascular dementia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moretti, Rita</creatorcontrib><creatorcontrib>Torre, Paola</creatorcontrib><creatorcontrib>Antonello, Rodolfo M</creatorcontrib><creatorcontrib>Cazzato, Giuseppe</creatorcontrib><creatorcontrib>Bava, Antonio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moretti, Rita</au><au>Torre, Paola</au><au>Antonello, Rodolfo M</au><au>Cazzato, Giuseppe</au><au>Bava, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rivastigmine in subcortical vascular dementia: An open 22-month study</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2002-11-15</date><risdate>2002</risdate><volume>203</volume><spage>141</spage><epage>146</epage><pages>141-146</pages><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>Further to recent data indicating that patients with vascular dementia (VaD) show a cholinergic deficit, we aimed to determine whether rivastigmine, a dual inhibitor of acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE), has any effects on the symptoms of VaD. Patients aged 65–80, with a diagnosis of dementia and probable VaD, received rivastigmine 3–6 mg/day (
n=8) or cardioaspirin (
n=8) in an open study for 22 months. At 22 months, patients treated with rivastigmine showed significant improvements in executive function and behavioural symptoms (both
p<0.05 vs. both baseline and control group), which were reflected in reduced caregiver stress (
p<0.05 vs. baseline and controls). Baseline scores of global response, cognition, word fluency and activities of daily living were maintained in patients receiving rivastigmine, and there was no increase in benzodiazepine or neuroleptic intake. In contrast, the control group showed no improvements in any domain, and significant deterioration in global response and executive function (both
p<0.05 vs. baseline and rivastigmine group). Side effects in both groups were tolerable and there were no study withdrawals. Long-term rivastigmine treatment appeared to be safe and effective in this patient population. In particular, improvements in domains particularly relevant to this condition were observed. These benefits may reflect the drug's dual inhibitory effects on the cholinergic system, and its particular activity in frontal areas of the brain. A large, double-blind study of rivastigmine in patients with VaD would be worthwhile.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>12417373</pmid><doi>10.1016/S0022-510X(02)00280-0</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Activities of Daily Living Aged Aged, 80 and over Behavior Behaviour Carbamates - adverse effects Carbamates - therapeutic use Caregivers - psychology Cholinesterase inhibition Cholinesterase Inhibitors - adverse effects Cholinesterase Inhibitors - therapeutic use Dementia, Vascular - drug therapy Executive function Female Follow-Up Studies Humans Male Neuroprotective Agents - adverse effects Neuroprotective Agents - therapeutic use Neuropsychological Tests Phenylcarbamates Psychiatric Status Rating Scales Rivastigmine Stress, Psychological - psychology Treatment Outcome Vascular dementia |
| title | Rivastigmine in subcortical vascular dementia: An open 22-month study |
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