Biological and Neuropsychological Characterization of Physostigmine Responders and Nonresponders in Alzheimer's Disease

Lindy E. Harrell, Richard S. Jope, Janet Falgout, Ross Callaway, Carol Avery, Mary Spiers, Dano Leli, Donna Morere, James H. Halsey

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

To assess the efficacy of oral physostigmine for the treatment of Alzheimer's disease, 20 patients were entered into a clinical trial. All patients underwent a dose-finding phase (two weeks), followed by an open trial (two weeks), and a double-blind crossover phase (two weeks drug, two weeks placebo). Extensive neuropsychological testing (Buschke Selective Reminding procedure, category generation, picture recognition, finger tapping) and measurement of systemic cholinergic parameters were measured during each of these phases. Patients were classified as physostigmine responders and nonresponders based on a priori established criteria. Using these, nine patients were found to respond to physostigmine, while 11 were classified as nonresponders. During baseline conditions, responders when compared to nonresponders were found to have higher concentrations of red blood cell (RBC) choline (Ch) and higher ratios of RBC Ch to plasma Ch. Neuropsychological tests were found to fall into one of three categories. The first group of tests were sensitive to drug effects and differentiated physostigmine responders from nonresponders; the second group was found to predict responsiveness; and the third group was neither predictive nor sensitive to drug effects.

Original languageEnglish (US)
Pages (from-to)113-122
Number of pages10
JournalJournal of the American Geriatrics Society
Volume38
Issue number2
DOIs
StatePublished - Feb 1990
Externally publishedYes

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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