title: Cognitive effects of donepezil therapy in patients with brain tumors: a pilot study.
abstract: Cognitive dysfunction is prevalent among brain tumor patients treated with radiotherapy (RT) and chemotherapy. However, there are no approved pharmacological interventions for cognitive dysfunction in cancer patients. The goal of this pilot study was to examine the efficacy of donepezil, an acetylcholinesterase inhibitor used to treat Alzheimer's disease, in improving cognitive functions in brain tumor patients previously treated with RT + chemotherapy or chemotherapy alone. Fifteen patients with a brain tumor received a single daily dose of donepezil for 24 weeks (5 mg for 4 weeks, then 10 mg for 20 weeks). Patients completed cognitive evaluations prior to initiating therapy (baseline), and about 12 weeks (mid-study) and 24 weeks (end-of-study) subsequent to initiation of donepezil therapy. The results of linear mixed models analysis, controlling for each patient's baseline cognitive test score, showed a significant post-baseline improvement in attention (WAIS-III digit span forward; p = 0.037), graphomotor speed (WAIS-III digit symbol; p = 0.035) and visual memory (BVMT-R-delay; p = 0.025). There was also an improvement in self-reported quality of life (FACT-Br, social well-being subscale; p = 0.01). The findings of this pilot study suggest that treatment with donepezil may improve some aspects of cognitive functions and quality of life in brain tumor patients. Similar findings were reported in two prior trials of donepezil in brain tumor survivors.
authors.affiliation: Department of Neurology, Weill Cornell Medical College, New York, NY, USA. corread@mskcc.org.|Department of Neurology & Neuroscience, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, 1275 York Avenue, New York, NY, 10021, USA. corread@mskcc.org.
authors.forename: Denise D
authors.initials: DD
authors.lastname: Correa
authors.affiliation: Department of Neurology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Kryza-Lacombe
authors.affiliation: Department of Epidemiology and Biostatistics, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Raymond E
authors.initials: RE
authors.lastname: Baser
authors.affiliation: Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Beal
authors.affiliation: Department of Neurology, Weill Cornell Medical College, New York, NY, USA.|Department of Neurology & Neuroscience, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, 1275 York Avenue, New York, NY, 10021, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: DeAngelis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced*; D000077265:Donepezil; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007189:Indans / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D010865:Pilot Projects; D010880:Piperidines / Q000009:adverse effects*; D011379:Prognosis; D015996:Survival Rate; D017741:Survivors
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil
keywords: Brain tumors; Chemotherapy; Cognitive; Donepezil; Radiotherapy