Progression of Cognitive Deficit in Older People with Mild Cognitive Impairment Treated with Cerebrolysin

Objectives: Although people with amnestic mild cognitive impairment (aMCI) benefit from cerebrolysin treatment, some still develop dementia. The aim of the current study was to identify most informative clinical assessment tests to predict the therapy efficacy in aMCI subjects treated with cerebrolysin. Methods: We studied patients with amnestic mild cognitive impairment (aMCI;n = 53) who had regular neurocognitive and clinical psychiatric assessments and were treated with cerebrolysin i.v. infusions 20 × 30 ml twice a year over three years period. Data were analyzed using non-parametric statistics, cluster and linear discriminant analyses. Results: Combined mathematical modeling enabled to predict cognitive decline from aMCI to dementia in the cerebrolysin-treated patients based on their initial neurocognitive assessment scores. We identified a “dementia risk group” with fast cognitive decline (i.e. low efficacy of the treatment). Lower baseline scores in the Mattis Dementia Rating Scale Memory subtest, Mini-Mental State Examination (MMSE), 10 word list immediate recall, and Frontal Assessment Battery tests when accompanied by higher depression score (Hamilton Depression Rating Scale) suggest poor prognosis for aMCI patients treated with cerebrolysin. Changes in scores on the MMSE, Boston naming test, Digit span forward, and Wechsler scale subtest “Categorical associations” during the treatment course are more characteristic for patients who convert to dementia than their initial scores. Conclusions: aMCI subjects treated with cerebrolysin with lower baseline cognitive functioning and subclinical depression have poor prognosis in terms of converting to dementia. Changes in the MMSE, Boston naming test, Digit span forward, and Wechsler scale subtest “Categorical associations” scores during the treatment course are more informative to identify patients who will develop dementia than their initial scores.

Platelet cytochrome c-oxidase activity in patients with acute schizophrenia in the course of their treatment with risperidone

Objectives: Testing a hypothesis, that platelet cytochrome c-oxidase (COX) activities in patients with paranoid schizophrenia, acute episode, may be linked to dynamics of their clinical patterns and quality of cognitive functioning under antipsychotic treatment. Methods: Psychopatho-logical (PANSS, NSA-16) and cognitive assess-ments;platelet COX enzymatic activity determination, post-hoc nonparametric statistical analysis. Results: Psychopathological and cognitive assessments were done and blood was sampled in patients before (at baseline) and after treatment with risperidone. Following regu- larities were found after the treatment of patients: Significant elevation of COX, wherein the higher was COX at baseline, the more prominent was decrease in PANSSneg and NSA rates;significant negative correlation between COX and executive time in cognitive tests. When the patient group was divided by median of COX at baseline into two subgroups (greater or equal median, and 20% was assigned to the first subgroup;significantly larger amount of patients with PANSSneg by <20% was assigned to the second group. Conclusions: Therapy with risperidone seems to be more effective for patients with higher COX activity at baseline, but this fact requires further study.