title: The effects of rasagiline on cognitive deficits in Parkinson's disease patients without dementia: a randomized, double-blind, placebo-controlled, multicenter study.
abstract: Cognitive impairment can occur at all stages of Parkinson's disease. Rasagiline is a selective monoamine oxidase type-B inhibitor that enhances central dopaminergic transmission. Dopamine is thought to be involved in certain cognitive processes such as working memory. We assessed the effects of rasagiline on cognitive deficits in cognitively impaired, nondemented patients with Parkinson's disease. This was a randomized, double-blind, placebo-controlled prospective study. Patients with Parkinson's disease receiving stable dopaminergic treatment were assigned to receive rasagiline 1 mg/day or placebo for 3 months. Patients were eligible if they had impairment in 2 of 4 cognitive domains (attention, executive functions, memory, visuospatial functions) in the screening neuropsychological tests, yet did not fulfill criteria for Parkinson's disease dementia. Fifty-five patients were randomized; 48 patients completed the study. Patients in the rasagiline group showed significant improvement in digit span-backward compared with the placebo group (P = .04), with trends favoring rasagiline in digit span total and digit-ordering tests. Verbal fluency total score showed a significant difference in favor of rasagiline (P = .038), with trends favoring rasagiline in semantic fluency test and Stroop spontaneous corrections. The composite cognitive domain Z scores revealed a significant difference in favor of rasagiline compared with placebo in the attentional Z score (P < .005). There were no significant differences between the 2 groups in the other cognitive tests or cognitive domain Z scores. The monoamine oxidase type-B inhibitor rasagiline may exert beneficial effects on certain aspects of attention and executive functions in nondemented patients with Parkinson's disease with cognitive impairment.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey. hasmet@yahoo.com
authors.forename: Hasmet A
authors.initials: HA
authors.lastname: Hanagasi
authors.forename: Hakan
authors.initials: H
authors.lastname: Gurvit
authors.forename: Pınar
authors.initials: P
authors.lastname: Unsalan
authors.forename: Hilal
authors.initials: H
authors.lastname: Horozoglu
authors.forename: Nese
authors.initials: N
authors.lastname: Tuncer
authors.forename: Aynur
authors.initials: A
authors.lastname: Feyzioglu
authors.forename: Dilek Ince
authors.initials: DI
authors.lastname: Gunal
authors.forename: Gorsev G
authors.initials: GG
authors.lastname: Yener
authors.forename: Raif
authors.initials: R
authors.lastname: Cakmur
authors.forename: Huseyin A
authors.initials: HA
authors.lastname: Sahin
authors.forename: Murat
authors.initials: M
authors.lastname: Emre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology*; D003704:Dementia / Q000150:complications*; D004311:Double-Blind Method; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D007802:Language; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D014796:Visual Perception / Q000187:drug effects
chemical_list: D007189:Indans; D018696:Neuroprotective Agents; C031967:rasagiline