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Role of cholinesterase inhibitors in Parkinson's disease and dementia with Lewy bodies

Lookup NU author(s): Dr Dag Aarsland, Dr Urs Mosimann, Professor Ian McKeith


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This article reviews the cholinergic changes in Parkinson's disease and dementia (PDD) and dementia with Lewy bodies (DLB), their potential clinical implications, and the available evidence for cholinesterase inhibitors in the treatment of PDD and DLB. Marked neuronal loss of cholinergic nuclei, reduced cholinergic markers in the neocortex, hippocampus, and selected thalamic nuclei, and receptor changes have been reported. One large and 2 small placebo-controlled trials and nearly 20 open-label studies suggest that cholinesterase inhibitors have a positive effect on cognition, psychiatric symptoms, and global function in patients with DLB and PDD. The treatment is well tolerated in most patients without any apparent worsening of extrapyramidal motor features. Given the high risk of severe sensitivity reactions and increased risk of cerebrovascular incidents during treatment with neuroleptics, more clinical trials of cholinesterase inhibitors are encouraged to establish their precise role in DLB and PDD.

Publication metadata

Author(s): Aarsland D, Mosimann UP, McKeith IG

Publication type: Article

Publication status: Published

Journal: Journal of Geriatric Psychiatry and Neurology

Year: 2004

Volume: 17

Issue: 3

Pages: 164-171

ISSN (print): 0891-9887

ISSN (electronic): 1552-5708

Publisher: Sage


DOI: 10.1177/0891988704267463


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