Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease
Identifieur interne : 000E21 ( Main/Corpus ); précédent : 000E20; suivant : 000E22Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease
Auteurs : Iracema Leroi ; Jason Brandt ; Stephen G. Reich ; Constantine G. Lyketsos ; Stephen Grill ; Richard Thompson ; Laura MarshSource :
- International Journal of Geriatric Psychiatry [ 0885-6230 ] ; 2004-01.
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- KwdEn :
Abstract
Objective: To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD). Methods: Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects. Results: Patients on donepezil showed selective and significant (p<0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases. Conclusion: Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. Copyright © 2004 John Wiley & Sons, Ltd.
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DOI: 10.1002/gps.993
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Lyketsos</name><affiliation><mods:affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</mods:affiliation></affiliation></author><author><name sortKey="Grill, Stephen" sort="Grill, Stephen" uniqKey="Grill S" first="Stephen" last="Grill">Stephen Grill</name><affiliation><mods:affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</mods:affiliation></affiliation></author><author><name sortKey="Thompson, Richard" sort="Thompson, Richard" uniqKey="Thompson R" first="Richard" last="Thompson">Richard Thompson</name><affiliation><mods:affiliation>Division of Biostatistics, Bloomberg School of Public Health and Hygiene, Johns Hopkins University, Baltimore, MD, USA</mods:affiliation></affiliation></author><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation><mods:affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Geriatric Psychiatry</title><title level="j" type="abbrev">Int. J. Geriat. Psychiatry</title><idno type="ISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2004-01">2004-01</date><biblScope unit="volume">19</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="1">1</biblScope><biblScope unit="page" to="8">8</biblScope></imprint><idno type="ISSN">0885-6230</idno></series><idno type="istex">8265EDC38D76DB29AD57ED76460E16871CB55CD3</idno><idno type="DOI">10.1002/gps.993</idno><idno type="ArticleID">GPS993</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-6230</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson' s disease</term><term>cholinesterase inhibitors</term><term>cognitive impairment</term><term>dementia</term><term>donepezil</term><term>neuropsychiatry</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD). Methods: Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects. Results: Patients on donepezil showed selective and significant (p<0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases. Conclusion: Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. Copyright © 2004 John Wiley & Sons, Ltd.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Iracema Leroi</name><affiliations><json:string>Department of Psychiatry, North Manchester General Hospital, Manchester, UK</json:string><json:string>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Jason Brandt</name><affiliations><json:string>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Stephen G. Reich</name><affiliations><json:string>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Constantine G. Lyketsos</name><affiliations><json:string>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Stephen Grill</name><affiliations><json:string>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Richard Thompson</name><affiliations><json:string>Division of Biostatistics, Bloomberg School of Public Health and Hygiene, Johns Hopkins University, Baltimore, MD, USA</json:string></affiliations></json:item><json:item><name>Laura Marsh</name><affiliations><json:string>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson' s disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dementia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cognitive impairment</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>donepezil</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cholinesterase inhibitors</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>neuropsychiatry</value></json:item></subject><articleId><json:string>GPS993</json:string></articleId><language><json:string>eng</json:string></language><abstract>Objective: To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD). Methods: Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects. Results: Patients on donepezil showed selective and significant (p>0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases. Conclusion: Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. Copyright © 2004 John Wiley & Sons, Ltd.</abstract><qualityIndicators><score>6.994</score><pdfVersion>1.3</pdfVersion><pdfPageSize>567 x 737 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1699</abstractCharCount><pdfWordCount>4138</pdfWordCount><pdfCharCount>28734</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>238</abstractWordCount></qualityIndicators><title>Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>19</volume><publisherId><json:string>GPS</json:string></publisherId><pages><total>8</total><last>8</last><first>1</first></pages><issn><json:string>0885-6230</json:string></issn><issue>1</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1099-1166</json:string></eissn><title>International Journal of Geriatric Psychiatry</title><doi><json:string>10.1002/(ISSN)1099-1166</json:string></doi></host><publicationDate>2004</publicationDate><copyrightDate>2004</copyrightDate><doi><json:string>10.1002/gps.993</json:string></doi><id>8265EDC38D76DB29AD57ED76460E16871CB55CD3</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/8265EDC38D76DB29AD57ED76460E16871CB55CD3/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/8265EDC38D76DB29AD57ED76460E16871CB55CD3/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8265EDC38D76DB29AD57ED76460E16871CB55CD3/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><availability><p>WILEY</p></availability><date>2004</date></publicationStmt><notesStmt><note>Eisai/Pfizer Inc.</note><note>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins - No. NIH P50‐NS‐58377;</note><note>General Clinical Research Center at Johns Hopkins University School of Medicine</note><note>National Center for Research Resources - No. NIH M01‐RR00052;</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title><author><persName><forename type="first">Iracema</forename><surname>Leroi</surname></persName><note type="correspondence"><p>Correspondence: North Manchester General Hospital, Department of Psychiatry, Park House, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK.</p></note><affiliation>Department of Psychiatry, North Manchester General Hospital, Manchester, UK</affiliation><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Jason</forename><surname>Brandt</surname></persName><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Stephen G.</forename><surname>Reich</surname></persName><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Constantine G.</forename><surname>Lyketsos</surname></persName><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Stephen</forename><surname>Grill</surname></persName><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Richard</forename><surname>Thompson</surname></persName><affiliation>Division of Biostatistics, Bloomberg School of Public Health and Hygiene, Johns Hopkins University, Baltimore, MD, USA</affiliation></author><author><persName><forename type="first">Laura</forename><surname>Marsh</surname></persName><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation></author></analytic><monogr><title level="j">International Journal of Geriatric Psychiatry</title><title level="j" type="abbrev">Int. J. Geriat. Psychiatry</title><idno type="pISSN">0885-6230</idno><idno type="eISSN">1099-1166</idno><idno type="DOI">10.1002/(ISSN)1099-1166</idno><imprint><publisher>John Wiley & Sons, Ltd.</publisher><pubPlace>Chichester, UK</pubPlace><date type="published" when="2004-01"></date><biblScope unit="volume">19</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="1">1</biblScope><biblScope unit="page" to="8">8</biblScope></imprint></monogr><idno type="istex">8265EDC38D76DB29AD57ED76460E16871CB55CD3</idno><idno type="DOI">10.1002/gps.993</idno><idno type="ArticleID">GPS993</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD). Methods: Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects. Results: Patients on donepezil showed selective and significant (p<0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases. Conclusion: Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. 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Psychiatry</title></titleGroup></publicationMeta><publicationMeta level="part" position="10"><doi origin="wiley" registered="yes">10.1002/gps.v19:1</doi><numberingGroup><numbering type="journalVolume" number="19">19</numbering><numbering type="journalIssue">1</numbering></numberingGroup><coverDate startDate="2004-01">January 2004</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="1" status="forIssue"><doi origin="wiley" registered="yes">10.1002/gps.993</doi><idGroup><id type="unit" value="GPS993"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2004 John Wiley & Sons, Ltd.</copyright><eventGroup><event type="manuscriptReceived" date="2003-03-03"></event><event type="manuscriptAccepted" date="2003-07-02"></event><event type="firstOnline" date="2004-01-05"></event><event type="publishedOnlineFinalForm" date="2004-01-05"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-26"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-23"></event></eventGroup><numberingGroup><numbering type="pageFirst">1</numbering><numbering type="pageLast">8</numbering></numberingGroup><correspondenceTo>North Manchester General Hospital, Department of Psychiatry, Park House, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:GPS.GPS993.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="47"></count></countGroup><titleGroup><title type="main" xml:lang="en">Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title><title type="short" xml:lang="en">DONEPEZIL IN COGNITIVE IMPAIRMENT IN PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Iracema</givenNames><familyName>Leroi</familyName></personName><contactDetails><email normalForm="wendy.heap@mail.nmanhc-tr.nwest.nhs.uk">wendy.heap@mail.nmanhc‐tr.nwest.nhs.uk</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Jason</givenNames><familyName>Brandt</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Stephen G.</givenNames><familyName>Reich</familyName></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Constantine G.</givenNames><familyName>Lyketsos</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Stephen</givenNames><familyName>Grill</familyName></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Richard</givenNames><familyName>Thompson</familyName></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Laura</givenNames><familyName>Marsh</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="GB" type="organization"><unparsedAffiliation>Department of Psychiatry, North Manchester General Hospital, Manchester, UK</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Division of Biostatistics, Bloomberg School of Public Health and Hygiene, Johns Hopkins University, Baltimore, MD, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson' s disease</keyword><keyword xml:id="kwd2">dementia</keyword><keyword xml:id="kwd3">cognitive impairment</keyword><keyword xml:id="kwd4">donepezil</keyword><keyword xml:id="kwd5">cholinesterase inhibitors</keyword><keyword xml:id="kwd6">neuropsychiatry</keyword></keywordGroup><fundingInfo><fundingAgency>Eisai/Pfizer Inc.</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins</fundingAgency><fundingNumber>NIH P50‐NS‐58377</fundingNumber></fundingInfo><fundingInfo><fundingAgency>General Clinical Research Center at Johns Hopkins University School of Medicine</fundingAgency></fundingInfo><fundingInfo><fundingAgency>National Center for Research Resources</fundingAgency><fundingNumber>NIH M01‐RR00052</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Objective</title><p>To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD).</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>Patients on donepezil showed selective and significant (<i>p</i><0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases.</p></section><section xml:id="abs1-4"><title type="main">Conclusion</title><p>Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. Copyright © 2004 John Wiley & Sons, Ltd.</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>DONEPEZIL IN COGNITIVE IMPAIRMENT IN PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Randomized placebo‐controlled trial of donepezil in cognitive impairment in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Iracema</namePart><namePart type="family">Leroi</namePart><affiliation>Department of Psychiatry, North Manchester General Hospital, Manchester, UK</affiliation><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><description>Correspondence: North Manchester General Hospital, Department of Psychiatry, Park House, Delaunays Road, Crumpsall, Manchester, M8 5RB, UK.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jason</namePart><namePart type="family">Brandt</namePart><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephen G.</namePart><namePart type="family">Reich</namePart><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Constantine G.</namePart><namePart type="family">Lyketsos</namePart><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephen</namePart><namePart type="family">Grill</namePart><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Richard</namePart><namePart type="family">Thompson</namePart><affiliation>Division of Biostatistics, Bloomberg School of Public Health and Hygiene, Johns Hopkins University, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Marsh</namePart><affiliation>Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2004-01</dateIssued><dateCaptured encoding="w3cdtf">2003-03-03</dateCaptured><dateValid encoding="w3cdtf">2003-07-02</dateValid><copyrightDate encoding="w3cdtf">2004</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">3</extent><extent unit="references">47</extent></physicalDescription><abstract lang="en">Objective: To evaluate the efficacy and safety of donepezil, an acetylcholinesterase inhibitor, as a treatment for cognitive impairment and dementia in patients with Parkinson' s disease (PD). Methods: Using a randomized, double‐blind, placebo‐controlled design, nine patients received placebo and seven patients received donepezil (2.5–10 mg/day) for a mean (SD) duration of 15.2 (3.4) weeks. The primary efficacy outcomes were derived from a neuropsychological battery that assessed global cognitive status as well as memory, attention, psychomotor speed, and visuospatial and executive functions. Secondary efficacy outcomes were psychiatric symptom and activities of daily living ratings. Primary safety measures were motor signs and assessments of adverse effects. Results: Patients on donepezil showed selective and significant (p<0.05) improvement on the memory subscale of the Dementia Rating Scale. There was also a trend toward improvement on a measure of psychomotor speed and attention. There were no group differences in psychiatric status, motor function, or activities of daily living as measured at baseline or end‐point. Adverse effects resulted in premature withdrawal of four patients on donepezil, two for peripheral cholinergic effects and one for increased parkinsonism. Side effects were associated with dosage increases. Conclusion: Donepezil has a beneficial effect on memory and may improve other cognitive deficits in patients with PD and cognitive impairment. However, variable tolerability in our sample underscores the need for careful monitoring when prescribing donepezil to patients with PD, especially with dosage increases. Copyright © 2004 John Wiley & Sons, Ltd.</abstract><note type="funding">Eisai/Pfizer Inc.</note><note type="funding">Morris K. Udall Parkinson's Disease Research Center of Excellence at Johns Hopkins - No. NIH P50‐NS‐58377; </note><note type="funding">General Clinical Research Center at Johns Hopkins University School of Medicine</note><note type="funding">National Center for Research Resources - No. NIH M01‐RR00052; </note><subject lang="en"><genre>Keywords</genre><topic>Parkinson' s disease</topic><topic>dementia</topic><topic>cognitive impairment</topic><topic>donepezil</topic><topic>cholinesterase inhibitors</topic><topic>neuropsychiatry</topic></subject><relatedItem type="host"><titleInfo><title>International Journal of Geriatric Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>Int. J. Geriat. Psychiatry</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-6230</identifier><identifier type="eISSN">1099-1166</identifier><identifier type="DOI">10.1002/(ISSN)1099-1166</identifier><identifier type="PublisherID">GPS</identifier><part><date>2004</date><detail type="volume"><caption>vol.</caption><number>19</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>1</start><end>8</end><total>8</total></extent></part></relatedItem><identifier type="istex">8265EDC38D76DB29AD57ED76460E16871CB55CD3</identifier><identifier type="DOI">10.1002/gps.993</identifier><identifier type="ArticleID">GPS993</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2004 John Wiley & Sons, Ltd.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Ltd.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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