Tetrahydroaminoacridine in Alzheimer's dementia: Clinical and biochemical results of a double-blind crossover trial

Objective:Recent studies suggest that cholinergic dysfunction does not provide a complete account of age-related cognitive deficits and other neuronal systems like monoaminergic hypofunction are involved. In several studies selective serotonin reuptake inhibitors demonstrated promotion in neurogenesis in the hippocampus and enhanced memory and cognition. The aim of this study is to survey the effect of serotonin augmentation on cognition and activities of daily living in patients with Alzheimer's disease.Method:The trial was designed as a 12-week randomized, placebo-controlled, double-blind study. One hundred and twenty two patients aged 55-85 years, suffering from mild to moderate alzheimer's dementia were randomly allocated in one of the three treatment group: fluoxetine plus rivastigmine, rivastigmine alone or placebo group. Efficacy measures comprised assessments of cognition, activities of daily living and global functioning. Hamilton Depression Scale also was used to assess changes in mood throughout study.Result:Fluoxetine plus rivastigmine and rivastigmine groups demonstrated improvement on measures of cognitive and memory without any significant difference; however, the former group did better in their activities of daily living and global functioning. Patients taking placebo had significant deterioration in all the efficacy measures. Patients taking rivastigmine or rivastigmine plus fluoxetine had improvements in Hamilton Depression Scale without significant differences.Conclusion:Concomitant use of selective serotonin enhancing agents and acetyl cholinesterase inhibitors can provide greater benefit in activities of daily living and global functioning in patients with cognitive impairment. Although our study is preliminary and larger double blind studies are needed to confirm the results.

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Comments on the article by Mazza et al. concerning Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study

European Journal of Neurology ◽

10.1111/j.1468-1331.2007.01710.x ◽

2007 ◽

Vol 14 (9) ◽

pp. e9-e9 ◽

Cited By ~ 2

Author(s):

Amos D. Korczyn

Keyword(s):

Ginkgo Biloba ◽

Alzheimer’S Dementia ◽

Blind Study ◽

Double Blind Study ◽

Double Blind ◽

Alzheimer's Dementia

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Proof-of-Concept Randomized Controlled Study of Cognition Effects of the Proprietary ExtractSceletium tortuosum(Zembrin) Targeting Phosphodiesterase-4 in Cognitively Healthy Subjects: Implications for Alzheimer’s Dementia

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2014/682014 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 9

Author(s):

Simon Chiu ◽

Nigel Gericke ◽

Michel Farina-Woodbury ◽

Vladimir Badmaev ◽

Hana Raheb ◽

...

Keyword(s):

Healthy Subjects ◽

Rating Scale ◽

Vital Signs ◽

Camp Response Element Binding ◽

Alzheimer’S Dementia ◽

Controlled Study ◽

Double Blind ◽

Alzheimer's Dementia ◽

Female Ratio ◽

Element Binding Protein

Introduction. Converging evidence suggests that PDE-4 (phosphodiesterase subtype 4) plays a crucial role in regulating cognition via the PDE-4-cAMP cascade signaling involving phosphorylated cAMP response element binding protein (CREB).Objective. The primary endpoint was to examine the neurocognitive effects of extractSceletium tortuosum(Zembrin) and to assess the safety and tolerability of Zembrin in cognitively healthy control subjects.Method. We chose the randomized double-blind placebo-controlled cross-over design in our study. We randomized normal healthy subjects (totaln=21) to receive either 25 mg capsule Zembrin or placebo capsule once daily for 3 weeks, in a randomized placebo-controlled 3-week cross-over design. We administered battery of neuropsychological tests: CNS Vital Signs and Hamilton depression rating scale (HAM-D) at baseline and regular intervals and monitored side effects with treatment emergent adverse events scale.Results. 21 subjects (mean age: 54.6 years ± 6.0 yrs; male/female ratio: 9/12) entered the study. Zembrin at 25 mg daily dosage significantly improved cognitive set flexibility (P<0.032) and executive function (P<0.022), compared with the placebo group. Positive changes in mood and sleep were found. Zembrin was well tolerated.Conclusion. The promising cognitive enhancing effects of Zembrin likely implicate the PDE-4-cAMP-CREB cascade, a novel drug target in the potential treatment of early Alzheimer’s dementia. This trial is registered with ClinicalTrials.govNCT01805518.

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[P-204]: A 5 year double blind, randomised trial on EGb 761® efficacy on the prevention of Alzheimer's dementia in patients over 70 with memory complaint. Guidage study

Alzheimer s & Dementia ◽

10.1016/j.jalz.2005.06.262 ◽

2005 ◽

Vol 1 ◽

pp. S73-S73 ◽

Cited By ~ 1

Author(s):

Bruno Vellas ◽

Sandrine Andrieu ◽

Pierre-Jean Ousset ◽

Mehemed Ouzid ◽

Hélène Mathiex-Fortunet ◽

...

Keyword(s):

Randomised Trial ◽

Alzheimer’S Dementia ◽

Egb 761 ◽

Double Blind ◽

Alzheimer's Dementia ◽

Memory Complaint ◽

With Memory

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314 - Effects of Transcranial Direct Current Stimulation (tDCS) on Cognitive Function in Alzheimer’s Dementia

International Psychogeriatrics ◽

10.1017/s1041610220002148 ◽

2020 ◽

Vol 32 (S1) ◽

pp. 72-72

Author(s):

Carol Sheei-Meei Wang ◽

Kuo-Sheng Cheng ◽

Chia-Hung Tang ◽

Nien-Tsen Hou ◽

Pei-Fang Chien ◽

...

Keyword(s):

Synaptic Plasticity ◽

Controlled Trial ◽

Long Term Potentiation ◽

Alzheimer’S Dementia ◽

Active Group ◽

Double Blind ◽

Alzheimer's Dementia ◽

Before And After ◽

Conceptual Ability

Introduction:Identifying effective treatments is a critical issue for Alzheimer’s dementia (AD). The pathological amyloid deposits of AD result in disruption of the balance between long-term potentiation (LTP) and long-term depression (LTD) of neuronal cells and synaptic plasticity. Brain stimulation in dementia research, especially with relatively safe tDCS, has been taken seriously recently. In theory, tDCS affects long-term synaptic plasticity through LTP and LTD, thereby improving cognitive ability. Recently, an increasing number of studies have been conducted to evaluate the efficacy of tDCS in AD and concluded a positive therapeutic effect. Currently, there are no studies of tDCS for AD in Taiwan. In this study, we investigate the effects of tDCS in AD.Method:Using a double-blind, randomized and sham- controlled trial design, Sixteen AD aged 55-90 years (8 active, mean age 73.88 and 8 sham, mean age 74.75) were included in the study. AD diagnostics is according to DSM-5 criteria. The CDR ratings of AD participants ranged from 0.5 to 2. All subjects completed ten consecutive daily sessions in which they received either an active or a sham tDCS over the left dorsal lateral prefrontal cortex (anodal) and a cathodal electrode on the right supraorbital area. In each session, we applied a current intensity of 2 mA and an electrode size of 35 cm2 for 30 min in the active group. All subjects received a series of neuropsychological tests, which included CDR, MMSE, CASI and WCST, before and after these treatment sessions on the first day and 4 weeks later. Chi- square test, Wilcoxon signed ranks test and Mann-Whitney U test were used to assess the differences in participant demographic characteristics and to compare the differences among groups.Results:The active group showed significant improvement in total correct item, Conceptual level Responses (reflecting insight into the correct sorting principles), Categories Completed (reflecting overall success), and Trials to complete first categories (reflecting initial conceptual ability) of WCST 4 weeks later after the final stimulation. There were no statistically significant differences between before and after the 10-session course for the sham group.Conclusion:tDCS stimulation improves cognitive operation and Conceptual Ability of AD.

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