Thal L J, Fuld P A, Masur D M, Sharpless N S
Ann Neurol. 1983 May;13(5):491-6. doi: 10.1002/ana.410130504.
Eight patients with early Alzheimer disease were treated with gradually increasing multiple daily doses of oral physostigmine and supplemental lecithin. Six individuals showed improvement in total recall and retrieval from long-term storage (LTR), with a decrease in intrusions (a measure of inaccurate recall). The optimal individual dose was either 2.0 or 2.5 mg of physostigmine for each responding patient. Results of this open trial were subsequently replicated during a double-blind crossover trial comparing physostigmine treatment to placebo. All six patients again demonstrated improvement in total recall and LTR, with a decrease in intrusions. The decrease in intrusions was strongly correlated with increasing inhibition of cholinesterase activity in cerebrospinal fluid, suggesting that the degree of improvement in the patient's memory was related to the amount of physostigmine that reached the brain. Other neurotransmitters and metabolites in cerebrospinal fluid were unaffected by the physostigmine therapy, suggesting a specific effect of physostigmine on the cholinergic system. The results suggest that small oral doses of physostigmine combined with lecithin ingestion have therapeutic benefit for some patients with Alzheimer disease.
八名早期阿尔茨海默病患者接受了口服毒扁豆碱每日多次剂量逐渐增加及补充卵磷脂的治疗。六名患者在总回忆和从长期记忆存储（LTR）中提取方面有改善，错误回忆（不准确回忆的一种衡量指标）减少。对于每名有反应的患者，最佳个体剂量为2.0或2.5毫克毒扁豆碱。该开放试验的结果随后在一项将毒扁豆碱治疗与安慰剂进行比较的双盲交叉试验中得到重复。所有六名患者再次表现出总回忆和LTR方面的改善，错误回忆减少。错误回忆的减少与脑脊液中胆碱酯酶活性抑制的增加密切相关，这表明患者记忆改善的程度与到达大脑的毒扁豆碱量有关。脑脊液中的其他神经递质和代谢产物不受毒扁豆碱治疗的影响，这表明毒扁豆碱对胆碱能系统有特定作用。结果表明，小剂量口服毒扁豆碱联合摄入卵磷脂对一些阿尔茨海默病患者有治疗益处。
