Center of Neurology, Department of Neurodegeneration, and Hertie Institute of Clinical Brain Research, University of Tübingen, Germany.
Alzheimers Dement. 2010 Jan;6(1):70-4. doi: 10.1016/j.jalz.2009.04.1231.
Cognitive decline and dementia are present in about 50% of patients with progressive supranuclear palsy (PSP). Based on the known involvement of the cholinergic system in PSP patients, and because rivastigmine, in contrast to other cholinesterase inhibitors, inhibits both acetylcholinesterase and butyrylcholinesterase, we discuss clinical observations of five patients suffering from PSP and dementia who were all treated with rivastigmine over a period of 3 to 6 months. We found a slight improvement in specific cognitive function that may justify further controlled studies. A calculation of sample size revealed that a study on the effect of rivastigmine in PSP should include about 31 patients to detect a significant effect. In subtests, meaningful results can be obtained with even lower numbers (five patients for a verbal fluency test, and 14 patients for a logical memory task).
认知衰退和痴呆症出现在约 50%的进行性核上性麻痹（PSP）患者中。鉴于已知胆碱能系统参与 PSP 患者的发病，并且加兰他敏与其他乙酰胆碱酯酶抑制剂不同，可同时抑制乙酰胆碱酯酶和丁酰胆碱酯酶，我们讨论了 5 例患有 PSP 和痴呆症的患者的临床观察结果，这些患者均接受了加兰他敏治疗，疗程为 3 至 6 个月。我们发现特定认知功能有轻微改善，这可能证明进一步的对照研究是合理的。样本量计算显示，针对加兰他敏对 PSP 影响的研究应纳入约 31 名患者，以检测出显著效果。在子测试中，即使患者人数较少（言语流畅性测试为 5 名患者，逻辑记忆任务为 14 名患者），也能获得有意义的结果。
