Oral physostigmine and impaired memory in adults with brain injury.
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.
Cardenas
D D
DD
University of Washington, Department of Rehabilitation Medicine, Seattle.
McLean
A
A
Farrell-Roberts
L
L
Baker
L
L
Brooke
M
M
Haselkorn
J
J
D000279:Administration, Cutaneous; D000284:Administration, Oral; D000328:Adult; D000647:Amnesia / Q000188:drug therapy* / Q000523:psychology; D001925:Brain Damage, Chronic / Q000188:drug therapy* / Q000523:psychology; D001930:Brain Injuries / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010830:Physostigmine / Q000008:administration & dosage* / Q000009:adverse effects; D012601:Scopolamine / Q000008:administration & dosage / Q000009:adverse effects
D010830:Physostigmine; D012601:Scopolamine