Effects of cholinesterase inhibition on attention and working memory in Lewy body dementias.

Autor:	Fallon SJ; Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK.; School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK., Plant O; Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK., Tabi YA; Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK., Manohar SG; Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK.; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK., Husain M; Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK.; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Jazyk:	angličtina
Zdroj:	Brain communications [Brain Commun] 2023 Jul 27; Vol. 5 (4), pp. fcad207. Date of Electronic Publication: 2023 Jul 27 (Print Publication: 2023).
DOI:	10.1093/braincomms/fcad207
Abstrakt:	Cholinesterase inhibitors are frequently used to treat cognitive symptoms in Lewy body dementias (Parkinson's disease dementia and dementia with Lewy bodies). However, the selectivity of their effects remains unclear. In a novel rivastigmine withdrawal design, Parkinson's disease dementia and dementia with Lewy bodies patients were tested twice: once when taking rivastigmine as usual and once when they had missed one dose. In each session, they performed a suite of tasks (sustained attention, simple short-term recall, distractor resistance and manipulating the focus of attention) that allowed us to investigate the cognitive mechanisms through which rivastigmine affects attentional control. Consistent with previous literature, rivastigmine withdrawal significantly impaired attentional efficacy (quicker response latencies without a change in accuracy). However, it had no effects on cognitive control as assessed by the ability to withhold a response (inhibitory control). Worse short-term memory performance was also observed when patients were OFF rivastigmine, but these effects were delay and load independent, likely due to impaired visual attention. In contrast to previous studies that have examined the effects of dopamine withdrawal, cognitively complex tasks requiring control over the contents of working memory (ignoring, updating or shifting the focus of attention) were not significantly impaired by rivastigmine withdrawal. Cumulatively, these data support that the conclusion that cholinesterase inhibition has relatively specific and circumscribed-rather than global-effects on attention that may also affect performance on simple short-term memory tasks, but not when cognitive control over working memory is required. The results also indicate that the withdrawal of a single dose of rivastigmine is sufficient to reveal these impairments, demonstrating that cholinergic withdrawal can be an informative clinical as well as an investigative tool. Competing Interests: The authors report no competing interests. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.)
Databáze:	MEDLINE
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