Effects of cilostazol on cognition and regional cerebral blood flow in patients with Alzheimer's disease and cerebrovascular disease: a pilot study.
OBJECTIVE
It remains unknown whether antiplatelet agents have a preventive effect on cognitive decline in patients with Alzheimer's disease (AD). We investigated the effects of cilostazol, an antiplatelet agent and cyclic adenosine monophosphate phosphodiesterase 3 inhibitor, on cognition and regional cerebral blood flow (rCBF) in elderly patients with AD and cerebrovascular disease (CVD).


METHODS
A total of 20 patients with AD and CVD were randomly assigned to a cilostazol group (n=11, 100 mg daily) or control group (n=9, aspirin 100 mg or clopidogrel 50 mg-75 mg daily) for 6 months.


RESULTS
The cilostazol group did not show any statistically significant changes in cognitive function test scores, whereas the control group showed statistically significant cognitive decline on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (Japanese version), Revised Wechsler Memory Scale (logical memory-I) and Trail Making Test-A. Analysis of covariance of treatment effect revealed that the cilostazol group showed increased rCBF in the right anterior cingulate lobe compared with baseline, whereas the control group showed decreased rCBF in the left middle temporal gyrus compared with baseline.


CONCLUSIONS
These findings suggest that cilostazol might have a preventive effect on cognitive decline in patients with AD and CVD.
Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan. sakurah@tokyo-med.ac.jp
Hirofumi
H
Sakurai
Haruo
H
Hanyu
Tomohiko
T
Sato
Kazumasa
K
Kume
Kentaro
K
Hirao
Hidekazu
H
Kanetaka
Toshihiko
T
Iwamoto
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000503:physiopathology; D000704:Analysis of Variance; D001241:Aspirin / Q000627:therapeutic use; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D002561:Cerebrovascular Disorders / Q000188:drug therapy* / Q000503:physiopathology; D000077407:Cilostazol; D000077144:Clopidogrel; D003071:Cognition / Q000187:drug effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D018696:Neuroprotective Agents; D010975:Platelet Aggregation Inhibitors; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin