Parkinson Hastalığı Demansında Rivastigminin Etkisi: Elektrofizyolojik Bir Çalışma

Parkinson Hastalığı Demansında Rivastigminin Etkisi: Elektrofizyolojik Bir Çalışma Amaç: Rivastigminin Parkinson hastalığı demansı (PDD) olan hastalarda motor fonksiyonlar üzerinde herhangi kayda değer olumsuz bir etkisi olmaksızın kognisyonu iyileştirdiği gösterilmiştir. Bu çalışmada, Parkinson demansında rivastigmin tedavisinin kognisyon üzerindeki olumlu etkisi klinik olarak kognisyonu değerlendiren nöropsikolojik testler, davranışsal envanter ve nörofizyolojik olarak da P300 ile değerlendirilmesi planlanmıştır. Ayrıca klinik olarak Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (UPDRS) ile ve elektrofizyolojik olarak da harekete ilişkin kortikal potansiyeller (HİKP) ve reaksiyon zamanı (RZ) ile de tedavi süresince ilacın motor fonksiyonlara herhangi bir olumsuz etkisinin olup olmadığı incelenmiştir. Gereç ve Yöntem: Dokuz Parkinson demansı hastası ve 10 idiopatik Parkinson hastası çalışmaya dahil edilmiştir. Demansı olan Parkinson hastalarına rivastigmin tedavisi öncesinde ve tedavinin 6. ayında bellek, yürütücü fonksiyonlar, dikkati değerlendiren nöropsikolojik test bataryası ve nörofizyolojik testler (P300, HİKP ve RZ) uygulanmıştır. Bulgular: Altıncı ayın sonunda Parkinson demansı hastalarında bellek ile ilgili nöropsikolojik testlerde anlamlı bir düzelme saptanmıştır. Nörofizyolojik testlerden kognisyon ve dikkati değerlendirdiğimiz P300'de de tedavi sonrasında latans kısalması görülmüştür. Bu bulgularla beraber rivastigminin olası motor yan etkileri açısından değerlendirdiğimiz HİKP ölçümlerinde ise kötüleşme saptanmamıştır. Sonuç: Rivastigmin Parkinson demansında kognitif fonksiyonları düzeltirken motor fonksiyonlar üzerinde olumsuz bir yan etki oluşturmamıştır

The Effects of Rivastigmine in Parkinson’s Disease Dementia

Objective: Rivastigmin has been shown to improve cognition in patients with Parkinson's disease dementia (PDD) without any remarkable negative effects on the motor function of the patients. In this study, we evaluated positive effects of rivastigmine therapy on cognition in PDD by means of behavioral inventory and neuropsychological tests and P300. In addition, we investigated the patients clinically and electrophysiologically using movement related cortical potentials (MRCP) and reaction time (RT) to show whether there are any negative effects of rivastigmin on motor function. Material and Method: Ten idiopathic Parkinson’s disease (PD) patients and 9 PDD patients were included to the study. Patients were assessed by neuropsychological test battery and also neurophysiological tests (P300, MRCP and RT) before rivastigmine treatment and after the sixth month of treatment. Results: PDD patients showed statistically significant improvement in neuropsychological tests related memory and shortening of P300 latency. However, we didn’t found any statistically significant changes in the measurements of MRCP and RT tests after therapy. Conclusion: Our study has suggested that while rivastigmine therapy improve cognitive functions in PDD, it doesn’t cause any side effects on motor function of patients

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