Objective: The cholinergic deficit that occurs in Alzheimer’s disease (AD) is considered to be related not only to impairment in learning and memory, but also to attention deficits. Treatment with cholinesterase inhibitors might lead to an improvement of attention and to a reduction in reaction time. The goal of the present study was to investigate the effects of galantamine on the performance of patients with mild to moderate AD in a computerized neuropsychological test battery (CNTB).
Design: A prospective, open-label, multi-center study was conducted in patients with probable AD. Patients were treated with galantamine for three months.
Materials and Methods: Thirty-three patients were included in the study. The ADAS-COG and the CNTB were administered at baseline and after 12 weeks. The CNTB includes tests of episodic memory for faces and words, attention (simple and choice reaction times) and implicit memory. In each test, the percentage of correct responses and the reaction times were recorded. Statistical comparisons (Student’s t test and Wilcoxon) were performed between the results in week 12 versus baseline. Patients who did not reach the therapeutic doses (16 to 24 mg/day) were not included in the efficacy analysis, but took part of the safety report.
Results: Four patients (12.1%) were excluded from the analysis either because of having discontinued the treatment (n=3; only one due to adverse events) or because a therapeutic dose was not reached (n=1). The remaining 29 patients were treated with doses of 24 mg/day (n=22) and 16 mg/day (n=7). After three months of treatment, significant reductions in reaction time were seen in the test of episodic memory for faces (p=0.023) and in the test of choice reaction time (p=0.039) of the CNTB. A trend for reduction of the reaction time in the implicit memory test was also observed (p=0.053). In relation to the ADAS-Cog, a reduction in the global scores was observed, although without statistical significance.
Conclusion: Treatment with galantamine at doses of 16 to 24 mg/day produced improvement in computerized tests of episodic memory and attention after 12 weeks, leading to significant reduction in the reaction times.
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