A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease.
OBJECTIVE
The safety and efficacy of early acetylcholinesterase inhibitors therapy in patients with cognitive impairment no dementia (CIND) after a cerebrovascular accident have not been examined. In this study, we investigated the safety and efficacy of rivastigmine in cognition, particularly executive function in patients with CIND because of cerebrovascular disease.


METHODS
This study was a 24-week, double-blind, randomized, placebo-controlled trial of ischemic stroke patients seen at a tertiary hospital who had cognitive impairment no dementia because of cerebrovascular disease. The intervention was either rivastigmine or placebo up to 9 mg/day. The primary outcome of interest was mean change from baseline in the Ten-Point Clock Drawing and Color Trails 1 and 2.


RESULTS
Fifty patients were randomized into rivastigmine (n = 25) and placebo (n = 25) arms. Patients in the rivastigmine group showed statistically significant improvement (1.70 vs 0.13, P = 0.02) on the animal subtask of the verbal fluency measure compared with placebo. There was also a trend (non-significant) towards improvement in Color Trails II.


CONCLUSIONS
In this pilot study, we demonstrated that rivastigmine was well tolerated in patients with CIND because of cerebrovascular disease and may potentially improve executive functioning.
Narasimhalu
K
K
Center for Molecular Epidemiology, National University of Singapore, Singapore.
Effendy
S
S
Sim
C H
CH
Lee
J M
JM
Chen
I
I
Hia
S B
SB
Xue
H L
HL
Corrales
M P
MP
Chang
H M
HM
Wong
M C
MC
Chen
C P
CP
Tan
E K
EK
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology*; D003704:Dementia / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D056344:Executive Function / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D048448:Phenylcarbamates / Q000008:administration & dosage* / Q000009:adverse effects; D010865:Pilot Projects; D000068836:Rivastigmine; D020521:Stroke / Q000150:complications*; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine