Donepezil and cognitive impairment in parkinsonism

S. Ruggieri, L. Vacca, M. F. De Pandis, M. Valente, L. Brusa, F. Stocchi

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Abstract

Today, it is currently accepted that mental decline frequently occurs in the course of Parkinson's disease. More often it is characterised by cognitive slowing, impaired abstract thinking and reasoning difficulties. These symptoms, generally subtle, do not interfere significantly with everyday activities but a progression of these neuropsychological deficits most likely leads to the manifestation of dementia related to frontal lobe dysfunction at a more advanced stage of the disease. Levodopa therapy has beneficial influence on certain neuropsychological symptoms of PD but fails to improve cognition in individuals with cognitive impairment. Cognitive functions in PD may be impaired by administration of anticholinergic drugs. The risk of precipitating difficulty with memory or concentration or worsening frontal lobe symptomatology is increased with high doses of anticholinergics. Therefore cognitive deficits may also be caused by the degeneration of nondopaminergic, catecholaminergic neurones. There is a concern to use cholinomimetic drugs in PD patients because of the role of ACH in the basal ganglia system. In this study the effect of the anticholinesterase drug donepezil has been tested in a group of PD patients with cognitive impairment. The main goal of the study was to observe the effect of donepezil on the motor symptoms of PD. The cognitive impairment of the patients and the possible benefit of the drug were also tested. Donepezil was administered at 5 mg/day after the baseline evaluation performed using UPDRS scale, On-off chart for parkinsonism and MMSE, ADAS-cog scale, PDQ39 and SF36-caregiver for the cognitive condition. Twenty patients were enrolled in the study. At the interim analysis there was not a detectable worsening of parkinsonism in our series of patients.

Original languageEnglish
Pages (from-to)268
Number of pages1
JournalItalian Journal of Neurological Sciences
Volume20
Issue number4
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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