Randomized placebo-controlled trial of donepezil in patients with progressive supranuclear palsy

Litvan, Irene; Phipps, Michael; Pharr, Victoria; Hallett, Mark; Grafman, Jordan; Salazar, Andres

doi:10.1212/wnl.57.3.467

Cited by 155 publications

(73 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…6,7 In PSP, anterior frontal lobe dysfunction is the most disabling cognitive deficit, partly due to marked deafferentation of the prefrontal areas, resulting from degeneration of striatothalamocortical pathways. 8,9 The circuits implicated in behavioral control involve the thalamus, mainly the medial thalamus connected to the fronto-orbital cortex and the anterior thalamus connected to the cingulate gyrus. 10 In CBD, cognitive and motor dysfunctions are frequent, and the most characteristic higher cortical disorders are limbkinetic apraxia, ideomotor apraxia, and alien limb phenomenon, probably related to damage to the perirolandic regions.…”

mentioning

confidence: 99%

Diffusion Tensor Imaging Shows Different Topographic Involvement of the Thalamus in Progressive Supranuclear Palsy and Corticobasal Degeneration

Erbetta¹,

Mandelli²,

Savoiardo³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

BACKGROUND AND PURPOSE:In progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), postmortem studies show different topographic involvement of the thalamus, basal ganglia, and their cortical connections. Diffusion tensor imaging (DTI) is an MR imaging technique sensitive to gray and white matter microstructure integrity. This study was performed to determine whether DTI may demonstrate microstructural differences between PSP and CBD, particularly within the thalamus and its cortical connections.

show abstract

mentioning

confidence: 99%

Diffusion Tensor Imaging Shows Different Topographic Involvement of the Thalamus in Progressive Supranuclear Palsy and Corticobasal Degeneration

Erbetta¹,

Mandelli²,

Savoiardo³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…Early clinical trials in PSP employed drug treatment to correct alterations in the dopaminergic, cholinergic, and gamma-amino butyric acid (GABA)ergic pathways and produced limited evidence of benefit. Trials with both physostigmine and donepezil were employed with a poor response in memory as well as motor function [31,32]. As about GABAergic agonists, trials with zolpidem [33] and gabapentin [34] found, respectively, transient improvement in eye movements and inhibitory frontal function.…”

Section: Current Pharmacological Chances In Apsmentioning

confidence: 99%

Possible Treatments of Atypical Parkinsonism

Vito¹

2016

Challenges in Parkinson's Disease

View full text Add to dashboard Cite

Success in treating patients with atypical parkinsonism remains exceedingly low. It is particularly important for both neurologists and general practitioners to have a guideline in the actual possible cure options. This study reviews the limited available literature reporting treatment trials about treatment in parkinsonism. Various therapeutical approaches have been tried with rasagiline, immunoglobulin, autologous mesenchymal stem cells, davunetide, lithium, and tideglusib. Recently, transdermal rotigotine (RTG) has been proposed for the treatment of atypical parkinsonism, as well as deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) alone or combined with globus pallidus internus (Gpi) stimulation. The outcomes reviewed here highlight the need for the development of randomized, placebo-controlled trials to validate outcomes about rotigotine, DBS, and all other new therapies directed at altering the underlying biological mechanisms involved in the disease process.

show abstract

“…One [141] double-blind placebo-controlled randomized crossover trial (level I of evidence) randomized 22 patients (mean age: 66 years). One patient dropped out before the treatment had started.…”

Section: The Efficacy Of Donepezil In Pspmentioning

confidence: 99%

“…Thus, in this study it was impossible to differentiate whether worsening in motor ADL function was primarily caused by insufficient drug medication or due to progression of parkinsonian syndromes. Litvan et al [141] reported 3 patients who did not tolerate the full dose of donepezil because of considerable deterioration of motor functions. The frequency of diarrhoea was higher in the donepezil phase compared with the placebo period.…”

Section: The Efficacy Of Donepezil In Pspmentioning

confidence: 99%

Treatment of Dementia in Parkinsonian Syndromes with Cholinesterase Inhibitors

Liepelt

Maetzler

Blaicher

et al. 2007

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

In Parkinsonian syndromes behavioural symptoms and dementia can be even more debilitating than motor symptoms and are an important predictor for nursing home placement and mortality. Neuropathologically, dementia seems to be primarily related to cortical changes rather than to subcortical alterations. Concerning neurotransmitter systems, the cholinergic system has been proposed to play a key role in cognitive disturbances. Based on studies with patients with Alzheimer disease, the application of cholinesterase inhibitors is vividly discussed also for dementia associated with parkinsonian syndromes. This review focuses on the specific symptoms of dementia in different parkinsonian syndromes and critically questions the effect of cholinergic treatment on cognitive functions in patients with extrapyramidal syndromes and dementia. There is evidence that medication with some cholinesterase inhibitors can enhance cognition as well as activities of daily living in dementia with Parkinson’s disease and seems to reduce behavioural disturbances in both dementia with Parkinson’s disease and dementia with Lewy bodies. The effect of treatment with cholinesterase inhibitors in progressive supranuclear palsy and corticobasal degeneration warrants carefully designed studies including a sufficient number of patients and symptom-adopted dementia scales.

show abstract

Randomized placebo-controlled trial of donepezil in patients with progressive supranuclear palsy

Abstract: The findings suggest that acetylcholinesterase inhibitors such as donepezil have at best selective, modest effects on cognition in patients with PSP. In light of its deleterious effects on ADL/mobility, donepezil is not recommended for this patient population.

Cited by 155 publications

References 45 publications

Diffusion Tensor Imaging Shows Different Topographic Involvement of the Thalamus in Progressive Supranuclear Palsy and Corticobasal Degeneration

Diffusion Tensor Imaging Shows Different Topographic Involvement of the Thalamus in Progressive Supranuclear Palsy and Corticobasal Degeneration

Possible Treatments of Atypical Parkinsonism

Treatment of Dementia in Parkinsonian Syndromes with Cholinesterase Inhibitors

Contact Info

Product

Resources

About