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6.10 The Effect of Rivastigmine on Attention and Processing Speed Post ABI

Author

Year

Country

Research Design

PEDro

Sample Size

Methods

Outcome

Tenovuo et al.

(2009)

Finland

RCT

PEDro=10

N=102

Population: Mean age=45.5yr; Gender: Males=61, Female=39; Mean time post-injury=8yr; Mean GCS=11.

Intervention: Individuals were randomized to receive one of two dosing rivastigmine schedules (placebo then rivastigmine or rivastigmine then placebo). Treatment lasted 8 weeks once a max dose of 12mg per day was reached.

Outcome Measures: Computer-based reaction time (CRT), subtraction test, vigilance test (0-5mins, 5-10mins, 10-15mins, correct responses), Symptom Checklist-90 (SC), Diener satisfaction of life scale, Finnish Traumatic Brain Injury Questionnaire (FITBIQ).

1.        The percentage of right answers in the subtraction tests were significantly different between groups (p<0.05), with the

2.        Vigilance scores were significantly higher during periods of rivastigmine treatment compared to placebo treatments (p<0.05).

3.        There were no other significant differences between groups on any other measures.

Silver et al.

(2009)

USA

RCT

PEDro=9

N=127

 

Population: TBI. Ex-Rivastigmine (n=65): Mean Age=36.9 yr; Gender: Male=43, Female=22; Time Post Injury=73.5 mo.

Ex-placebo (n=62): Mean Age=38 yr; Gender: Male=42, Female=20; Time Post Injury=100.1 mo.

Intervention: Participants were randomized to receive rivastigmine injections (1.5 mg 2x/d to a max of 12 mg/d) or placebo injection.

Outcome Measures:  Trails A and B, Hopkins verbal learning test (HVLT), Cambridge Neuropsychological Test Automated Batter Rapid Visual Information Processing (CANTAB RVIP A).

1.        The mean final dose of rivastigmine was 7.9 mg/day.

2.        40% of patients were responders on CANTAB RVIP A’ or HVLT score at week 38.

1.        At the end of the study period all (n=98) were seen to improve of the CANTAB RVIP A’ (p<0.001), the HVLT (P<0.001), and the Trails A and B (p<0.001).

2.        Further sub-analysis controlling for order effects demonstrated no significant differences between groups.

Silver et al.

(2006)

USA

RCT

PEDro=9

N=123

 

Population: TBI. Rivastigmine (n=80): Mean Age=37 yr; Gender: Male=53, Female=27. Placebo (n=77): Mean Age=37.1 yr; Gender: Male=53, Female=24.

Intervention: Participants were randomized to receive either rivastigmine (3-6 mg/d) or placebo. At the end of the first 4 wk, rivastigmine doses were increased to 3.0 mg, 2x/d. If necessary, doses were decreased to 1.5 mg or 4.5 mg 2x/d.

Outcome Measures: Trails A and B, Hopkins verbal learning test (HVLT), Cambridge Neuropsychological Test Automated Batter Rapid Visual Information Processing (CANTAB RVIP A).

3.        Results of the CANTAB RVIP A’ and HVLT found no significant differences between the placebo group and the treatment group.

4.        Rivastigmine was found to be well tolerated and safe.