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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
04 Feb 2019
The carbon-chain length of saturated fatty acids appears to be an important factor in determining its role in cardiovascular health, a recent study has found.
5 days ago
Olanzapine confers a modest therapeutic effect on weight compared with placebo in adult outpatients with anorexia nervosa, a study has shown. However, it does not appear to offer significant benefit for psychological symptoms.
Pearl Toh, 2 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.
Jairia Dela Cruz, 04 Feb 2019
Treatment with secukinumab results in a higher rate of remission or low-disease activity at week 16 in patients with psoriatic arthritis as compared with placebo, according to a posthoc analysis of the FUTURE 2 study. This effect is sustained at 2 years and is evident in both tumour necrosis factor inhibitor-experienced and -naïve patients.