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Pearl Toh, 2 days ago
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Methylphenidate shows early promise in vascular cognitive impairment

Jackey Suen
26 Nov 2018
Dr Jolien Leijenaar

Methylphenidate was found to improve executive functioning in patients with vascular cognitive impairment (VCI) in the STREAM-VCI study.

“Executive dysfunction and memory impairment are the most common symptoms in patients with VCI,” noted investigator Dr Jolien Leijenaar of the Amsterdam University Medical Center, the Netherlands. “Executive functioning is modulated by the monoaminergic neurotransmitter system, while memory is modulated by the cholinergic neurotransmitter system. Drugs that can modulate these two systems may therefore represent potential treatment options for VCI symptoms.”

STREAM-VCI is a proof-of-concept, single-centre, double-blind study that investigated the efficacy of methylphenidate, a monoaminergic neurotransmitter, and galantamine, a cholinergic neurotransmitter, in 30 patients with VCI. The patients received treatment with methylphenidate 10 mg, galantamine 16 mg and placebo in a randomized sequence in three follow-up visits.

Results showed significant improvement in executive functioning after methylphenidate administration (p=0.0021 vs galantamine; p=0.0016 vs placebo).

“No serious adverse events [AEs] occurred in any of the patients,” reported Leijenaar. “More patients experienced blood pressure increase, dizziness, nausea, vomiting, fatigue, diarrhoea and hyperhidrosis after administration of galantamine. Methylphenidate’s AE profile was generally comparable to that of placebo, except for a higher incidence of hypervigilance [14 percent vs 0 percent].”

“We also found that patients’ performance in delayed word recall worsened after the administration of galantamine, which may be due to AEs,” noted Leijenaar.

“Our next step is to correlate the response to methylphenidate and galantamine with structural and functional MRI,” she added.

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Most Read Articles
Pearl Toh, 2 days ago
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
5 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 07 Dec 2018
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.
Yesterday
Rates of major bleeding events are similar across cancer patients taking direct oral anticoagulants (DOAC), low-molecular-weight heparin (LMWH) or vitamin K antagonist (VKA), with gastrointestinal bleeding being the most frequent event, a recent study has shown. In addition, DOAC and LMWH recorded higher rates of venous thromboembolism than earlier studies.