McKeith Ian G, Wesnes Keith A, Perry Elaine, Ferrara Roberto
Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK.
Dement Geriatr Cogn Disord. 2004;18(1):94-100. doi: 10.1159/000077816. Epub 2004 Apr 14.
The aim of this analysis of the effects of cholinergic therapy in dementia with Lewy bodies was to determine whether rivastigmine-induced benefits in attention and memory could be predicted by the presence of visual hallucinations. At study entry, 74% of patients were hallucinators and 26% were non-hallucinators. The population was analyzed for two-factor scores: power of attention (PoA) and quality of memory (QoM). A significant effect over placebo on PoA was observed in hallucinators at weeks 12 (p = 0.023) and 20 (p = 0.0019), while no treatment effects were seen in non-hallucinators. Significant treatment effects on QoM were not observed in either subgroup. Visual hallucinations predicted greater improvements in PoA, but not QoM. This may reflect the greater cholinergic deficits in areas of the brain responsible for visual hallucinations, offering greater potential for attentional improvement.
这项对胆碱能疗法治疗路易体痴呆症效果的分析旨在确定，是否可通过视幻觉的存在来预测卡巴拉汀在注意力和记忆方面带来的益处。在研究开始时，74%的患者有幻觉，26%的患者无幻觉。对研究人群分析了两个因子得分：注意力强度（PoA）和记忆质量（QoM）。有幻觉的患者在第12周（p = 0.023）和第20周（p = 0.0019）时，PoA较安慰剂有显著改善，而无幻觉的患者未观察到治疗效果。两个亚组在QoM方面均未观察到显著的治疗效果。视幻觉预示着PoA有更大改善，但QoM并非如此。这可能反映出负责视幻觉的脑区存在更大的胆碱能缺陷，从而为注意力改善提供了更大潜力。
