Kwon Jay Cheol, Kim Eung Gyu, Kim Jae Woo, Kwon Oh Dae, Yoo Bong Goo, Yi Hyon Ah, Choi Nack Cheon, Ahn Seon Young, Lee Byung Hwa, Kang Myong Jin, Choi Dae Seob
Department of Neurology, Changwon Fatima Hospital, Changwon, GyeongNam, 641-560, South Korea.
Am J Alzheimers Dis Other Demen. 2009 Aug-Sep;24(4):293-301. doi: 10.1177/1533317509334960. Epub 2009 Apr 21.
To evaluate the efficacy and tolerability of donepezil in patients with Binswanger type subcortical vascular dementia.
Patients (n = 34, mean age = 71.8 + 7.12) with Binswanger type subcortical vascular dementia from 8 multicenter, according to clinical and neuroradiological working criteria, were selected to receive donepezil 5 mg/day (n = 2) or donepezil 10 mg/day (n = 32, after 5 mg/day) for 24 weeks. Our primary endpoints were change from baseline to weeks 12 and 24 in the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D) and the Korean version of neuropsychiatric inventory (K-NPI).
A total of 24 patients received donepezil completed the study (mean age = 72.0 + 7.5 K-Mini-Mental State Examination [MMSE] = 21.0 + 5.1). After 12 weeks and 24 weeks, patients showed improvements in cognitive function on the SNSB-D compared baseline of 16.29 points at 12 weeks (P < .05) and 12.44 points at 24 weeks (P < .05). Significant improvements were shown in only memory domain, immediate verbal recall and delayed recall tests. Subgroup with better cognitive function (SNSB-D > 100) were more effective in frontal and memory domains than the other subgroup (SNSB-D < 100). Withdrawal rates due to adverse events were very low (4.16%).
Donepezil-treated patients with Binswanger type subcortical vascular dementia demonstrated significant improvement in cognition compared with baseline, and donepezil was well tolerated.
评估多奈哌齐治疗宾斯旺格型皮质下血管性痴呆患者的疗效和耐受性。
根据临床和神经放射学工作标准,从8个多中心选取34例宾斯旺格型皮质下血管性痴呆患者(平均年龄=71.8±7.12岁),给予5毫克/天的多奈哌齐(2例)或10毫克/天的多奈哌齐(32例,先给予5毫克/天,之后给予10毫克/天),治疗24周。我们的主要终点是首尔神经心理筛查量表-痴呆版(SNSB-D)和韩国版神经精神科问卷(K-NPI)从基线到第12周和第24周的变化。
共有24例接受多奈哌齐治疗的患者完成了研究(平均年龄=72.0±7.5岁;简易精神状态检查表[MMSE]=21.0±5.1)。在第12周和第24周时,与基线相比,患者在SNSB-D上的认知功能有所改善,第12周时改善了16.29分(P<.05),第24周时改善了12.44分(P<.05)。仅在记忆领域、即时言语回忆和延迟回忆测试中显示出显著改善。认知功能较好的亚组(SNSB-D>100)在额叶和记忆领域比另一亚组(SNSB-D<100)更有效。因不良事件导致的撤药率非常低(4.16%)。
与基线相比,多奈哌齐治疗的宾斯旺格型皮质下血管性痴呆患者的认知功能有显著改善,且多奈哌齐耐受性良好。