A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease

Authors


Dr Tan Eng King, Department of Neurology, NNI, Singapore General Hospital, Blk 6 Level 8, Outram Road, S (169608), Singapore
Tel.: +65 6326 5003
Fax: +65 6220 3221
e-mail:tan.eng.king@sgh.com.sg

Abstract

Narasimhalu K, Effendy S, Sim CH, Lee JM, Chen I, Hia SB, Xue HL, Corrales MP, Chang HM, Wong MC, Chen CP, Tan EK. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease.
Acta Neurol Scand: 2010: 121: 217–224.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard.

Objectives –  The safety and efficacy of early acetylcholinesterase inhibitors therapy in patients with cognitive impairment no dementia (CIND) after a cerebrovascular accident have not been examined. In this study, we investigated the safety and efficacy of rivastigmine in cognition, particularly executive function in patients with CIND because of cerebrovascular disease.

Methods –  This study was a 24-week, double-blind, randomized, placebo-controlled trial of ischemic stroke patients seen at a tertiary hospital who had cognitive impairment no dementia because of cerebrovascular disease. The intervention was either rivastigmine or placebo up to 9 mg/day. The primary outcome of interest was mean change from baseline in the Ten-Point Clock Drawing and Color Trails 1 and 2.

Results –  Fifty patients were randomized into rivastigmine (n = 25) and placebo (n = 25) arms. Patients in the rivastigmine group showed statistically significant improvement (1.70 vs 0.13, P = 0.02) on the animal subtask of the verbal fluency measure compared with placebo. There was also a trend (non-significant) towards improvement in Color Trails II.

Conclusions –  In this pilot study, we demonstrated that rivastigmine was well tolerated in patients with CIND because of cerebrovascular disease and may potentially improve executive functioning.

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