Werber_2001_J.Neural.Transm_108_1319

Patients suffering from Parkinson's disease PD often develop dementia PDD Their brain histology reveals Alzheimer's disease AD like changes and decreased cholin-acetyl transferase ChAT activity in addition to typical PD changes This cholinergic deficiency has been related to the degree of mental decline As centrally acting cholinesterase inhibitors ChEIs provide cognitive and non-cognitive improvement for AD patients the same therapeutic effect was hypothesized for PDD patients as well The goal of this study was to assess the effect of ChEIs on both the cognitive and motor state of PDD patients An open study was conducted Eleven consecutive PDD patients M/F 6/5 mean age 75 y were found eligible for inclusion They were treated for 26 weeks with tacrine 7 patients and donepezil 4 patients as add-on to their regular anti PD drugs Cognitive assessment was performed at baseline and endpoint by Mini-Mental-State-Examination MMSE and Alzheimer's-Disease-Assessment-Scale ADAS-cog Global Deterioration Scale GDS was performed to evaluate active daily living ADL Motor evaluation was performed using Short Parkinson Evaluation Scale SPES at baseline and end-point Statistical analysis used Student's paired t-test ANOVA with repeated measures and Pearson correlation coefficient ChEIs treated PDD patients showed improvement in their cognitive state Mean ADAS-cog improved significantly by 3.2 points p 0.012 Mean MMSE and GDS improved non-significantly by 1.2 and 0.2 points respectively There was no change in motor function as evident by mean SPES scores 16.5 at baseline and endpoint Five individuals actually demonstrated motor improvement under ChEIs We conclude that ChEIs have a beneficial effect on the cognitive state of PDD patients without aggravating motor function