6.10 The Effect of Rivastigmine on Attention and Processing Speed Post ABI
Author Year Country Research Design PEDro Sample Size |
Methods |
Outcome |
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. |
(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. |
(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. |