Cardenas D D, McLean A, Farrell-Roberts L, Baker L, Brooke M, Haselkorn J
University of Washington, Department of Rehabilitation Medicine, Seattle.
Brain Inj. 1994 Oct;8(7):579-87. doi: 10.3109/02699059409151010.
The purpose of this study was to examine the effects of physostigmine, a cholinergic agonist, on memory loss after traumatic brain injury (TBI), as compared to placebo or scopolamine, a cholinergic antagonist, using a double-blind, placebo-controlled design. Each subject received each active drug and placebo. Neuropsychological measures (Wechsler Memory Scale I and II, Selective Reminding Test, Trail-Making Test, Parts A and B, Digit Symbol, and Memory Questionnaire) and measures of clinical balance were completed at baseline, after each drug phase, and at 1 month follow-up. Thirty-six subjects completed the study with results showing an improvement in memory scores in 44% of subjects (responders) while taking oral physostigmine. The most sensitive measure was the Selective Reminding Test, specifically Long-term Storage. The impact of drugs on standing balance as compared to placebo was improved standing time in the responders: (1) with physostigmine when standing tandem with eyes closed (p < 0.05), and (2) with scopolamine when standing on one foot with eyes closed (p < 0.05). Results support the potential benefit of cholinergic agonists on memory after TBI and the need for further research of possible clinical markers for the drug.
本研究的目的是采用双盲、安慰剂对照设计，将胆碱能激动剂毒扁豆碱与安慰剂或胆碱能拮抗剂东莨菪碱进行比较，以检验其对创伤性脑损伤（TBI）后记忆丧失的影响。每位受试者均接受每种活性药物和安慰剂。在基线、每个药物阶段后以及1个月随访时，完成神经心理学测量（韦氏记忆量表I和II、选择性提醒测试、连线测验A和B、数字符号测验以及记忆问卷）和临床平衡测量。三十六名受试者完成了研究，结果显示在服用口服毒扁豆碱时，44%的受试者（反应者）的记忆分数有所提高。最敏感的测量方法是选择性提醒测试，尤其是长期存储。与安慰剂相比，药物对站立平衡的影响在反应者中表现为站立时间改善：（1）服用毒扁豆碱时，闭眼双脚前后站立（p < 0.05）；（2）服用东莨菪碱时，闭眼单脚站立（p < 0.05）。结果支持胆碱能激动剂对TBI后记忆的潜在益处，以及对该药物可能的临床标志物进行进一步研究的必要性。
