Rivastigmine in Wernicke-Korsakoff's syndrome: Five patients with rivastigmine showed no more improvement than five patients without rivastigmine

Luykx, Han J.; Dorresteijn, Lucille D.A.; Haffmans, P.M.J.; Bonebakker, A; Kerkmeer, Margreet C.; Hendriks, Vincent M.

doi:10.1093/alcalc/agm158

Cited by 13 publications

(13 citation statements)

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“…Nevertheless, treatment with thiamine alone is not effective at treating the anterograde amnesia related to WKS (Thomson and Marshall, 2006). Acetylcholinesterase inhibitors have been used with partial success for the treatment of the cognitive impairment associated with WKS (Angunawela and Barker, 2001; Cochrane et al, 2005; Luykx et al, 2008). Although bicuculline itself may not be the appropriate therapeutic tool, drugs influencing the GABAergic-cholinergic interactions in the septohippocampal pathway could be beneficial for the treatment of amnestic disorders.…”

Section: Discussionmentioning

confidence: 99%

Blocking GABA-A receptors in the medial septum enhances hippocampal acetylcholine release and behavior in a rat model of diencephalic amnesia

Roland

Savage

2009

Pharmacology Biochemistry and Behavior

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Wernicke-Korsakoff syndrome (WKS), a form of diencephalic amnesia caused by thiamine deficiency, results in severe anterograde memory loss. Pyrithiamine-induced thiamine deficiency (PTD), an animal model of WKS, produces cholinergic abnormalities including decreased functional hippocampal acetylcholine (ACh) release and poor spatial memory. Increasing hippocampal ACh levels has increased performance in PTD animals. Intraseptal bicuculline (GABA A antagonist) augments hippocampal ACh release in normal animals and we found it (0.50μg/μl & 0.75μg/μl) also increased in-vivo hippocampal ACh release in PTD animals. However, the 0.75 μg/μl dose produced a greater change in hippocampal ACh release in control animals. The 0.50μg/μl dose of bicuculline was then selected to determine if it could enhance spontaneous alternation performance in PTD animals. This dose of bicuculline significantly increased hippocampal ACh levels above baseline in both PTD and control rats and resulted in complete behavioral recovery in PTD animals, without altering performance in control rats. This suggests that balancing ACh-GABA interactions in the septohippocampal circuit may be an effective therapeutic approach in certain amnestic syndromes.

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Section: Discussionmentioning

confidence: 99%

Blocking GABA-A receptors in the medial septum enhances hippocampal acetylcholine release and behavior in a rat model of diencephalic amnesia

Roland

Savage

2009

Pharmacology Biochemistry and Behavior

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“…Improvements in patients' subjective wellbeing and the ability to think clearly were also reported. In contrast, Luykx et al (2008) found that rivastigmine administered to five WKS patients over 6 months had no significant impact on cognitive functioning. Although slight memory improvements were found following rivastigmine treatment, the effects were not found to be significant.…”

Section: Acetylcholinesterase Inhibitorsmentioning

confidence: 72%

“…However, as this study was based on a single patient displaying frequent violent behavioural outbursts, this finding may not be generalizable to other individuals with ARBD. There was no evidence within this review to suggest that Desglycinamide Arginine Vasopressin (DGAVP; JennekinsSchinkel et al, 1985); Physostigmin (O'Donnell et al, 1986); Reboxetine (Reuster et al, 2003) and Rivastgmine (Luykx et al, 2008) should be used to treat patients with ARBD.…”

Section: Other Drug Treatmentsmentioning

confidence: 90%

“…Three of the pharmacological papers investigated the role of acetylcholinesterase inhibitors in the treatment of WKS (Iga et al, 2001;Cochrane et al, 2005;Luykx et al, 2008). Acetylcholinesterase inhibitors such as donepezil and rivastigmine are used in the treatment of Alzheimer's disease and act to increase the availability of the neurotransmitter acetylcholine, which plays an important role in the corticalhippocampal system, the neural substrate of memory (Luykx et al, 2008).…”

Section: Acetylcholinesterase Inhibitorsmentioning

confidence: 99%

“…Acetylcholinesterase inhibitors such as donepezil and rivastigmine are used in the treatment of Alzheimer's disease and act to increase the availability of the neurotransmitter acetylcholine, which plays an important role in the corticalhippocampal system, the neural substrate of memory (Luykx et al, 2008). Korsakoff's syndrome.…”

Section: Acetylcholinesterase Inhibitorsmentioning

confidence: 99%

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Horton

Duffy

Martin

2014

Drugs: Education, Prevention and Policy

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Rivastigmine in Wernicke-Korsakoff's syndrome: Five patients with rivastigmine showed no more improvement than five patients without rivastigmine

Abstract: Treatment with rivastigmine may not be effective in restoring memory in WKS patients.

Cited by 13 publications

References 12 publications

Blocking GABA-A receptors in the medial septum enhances hippocampal acetylcholine release and behavior in a rat model of diencephalic amnesia

Blocking GABA-A receptors in the medial septum enhances hippocampal acetylcholine release and behavior in a rat model of diencephalic amnesia

Interventions for alcohol-related brain damage (ARBD): Do specific approaches restrict the evolution of comprehensive patient care?

Alcohol Use Disorders

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