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Titolo:
The spectrum of behavioral responses to cholinesterase inhibitor therapy in Alzheimer disease
Autore:
Mega, MS; Masterman, DM; OConnor, SM; Barclay, TR; Cummings, JL;
Indirizzi:
Univ Calif Los Angeles, Sch Med, Dept Neurol, Lab Neuro Imaging, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Calif Los Angeles, Sch Med, Alzheimers Dis Res Ctr, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA Univ Calif Los Angeles Los Angeles CA USA 90095 Los Angeles, CA 90095 USA
Titolo Testata:
ARCHIVES OF NEUROLOGY
fascicolo: 11, volume: 56, anno: 1999,
pagine: 1388 - 1393
SICI:
0003-9942(199911)56:11<1388:TSOBRT>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; PHYSOSTIGMINE; TOMOGRAPHY; DONEPEZIL; DEMENTIA; TACRINE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Mega, MS Univ Calif Los Angeles, Sch Med, Dept Neurol, Lab Neuro Imaging, 710 Westwood Plaza,Rm 4-238 Reed, Los Angeles, CA 90095 USA Univ Calif Los Angeles 710 Westwood Plaza,Rm 4-238 Reed Los Angeles CA USA 90095
Citazione:
M.S. Mega et al., "The spectrum of behavioral responses to cholinesterase inhibitor therapy in Alzheimer disease", ARCH NEUROL, 56(11), 1999, pp. 1388-1393

Abstract

Background: Behavioral abnormalities are common in Alzheimer disease (AD);cholinergic treatment reduces the behavioral disturbances of some patientswith AD. Characterizing the pretreatment profile of patients who are likely to respond to cholinergic therapy will aid the efficient use of clinical resources. Objective: To determine the baseline behavioral profile for 86 patients with AD treated with the cholinesterase inhibitor donepezil hydrochloride. Methods: Open-label retrospective study of treatment-related behavioral assessments. Based on previous double-blind placebo-controlled experience using the Neuropsychiatric Inventory (NPI), patients were divided into responder (greater than or equal to 4-point total NPI score decrease, indicating improvement), unchanged (+/-3-point total NPI score change),or nonresponder (greater than or equal to 4-point total NPI score increaser indicating worsening) groups. The Mini-Mental State Examination assessed cognitive response. Results: Behavioral improvement was seen in 35 patients (41%), worsening in 24 (28%), and no change in 27 (31%). Comparison of profiles in behavioralresponders vs nonresponders revealed significantly worse delusions (P = .04), agitation (P = .04): depression (P = .006) anxiety (P = .02), apathy (P= .003); disinhibition (P = .02), and irritability (P < .001) at baseline in responders. Five behaviors changed significantly from baseline, improving for the responders and worsening for the nonresponders: delusions (P = .003 for nonresponders, P = .004 fbr responders), agitation (P = .01), anxiety (P = .006 for nonresponders, P = .004 for responders), disinhibition (P =.02 for nonresponders, P = .05 for responders), and irritability (P = .003for nonresponders, P = .001 for responders). The behavioral changes were dose dependent. Cognition did not change significantly with donepezil treatment within any group. Conclusions: Donepezil has psychotropic properties, and pretreatment behaviors help predict patients' responses to treatment.

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Documento generato il 12/07/20 alle ore 13:02:42