Journal of Neurology

, Volume 253, Issue 9, pp 1154–1159

Utility of the Mattis dementia rating scale to assess the efficacy of rivastigmine in dementia associated with Parkinson’s disease

  • Kathy Dujardin
  • David Devos
  • Stéphane Duhem
  • Alain Destée
  • Rose-Marie Marié
  • Franck Durif
  • Lucette Lacomblez
  • Jacques Touchon
  • Pierre Pollak
  • Jean-Jacques Péré
ORIGINAL COMMUNICATION

Abstract

Introduction

The severe, cortical, cholinergic depletion accompanying Parkinson’s disease (PD) is considered as a highly probable correlate of cognitive and behavioural dysfunction. Recent studies have demonstrated that cholinesterase inhibitors (notably rivastigmine) are beneficial in patients suffering from dementia associated with PD (PDD). However, the primary efficacy variables used in such work came from scales designed for Alzheimer’s disease (AD), even though the cognitive symptoms in PD and AD dementia do not overlap completely. The aim of the present study (a double-blind, placebo-controlled clinical trial) was to determine the utility of the Mattis dementia rating scale - the most commonly used scale in PD patients - to assess the efficacy of a 24-week rivastigmine treatment.

Methods

Twenty-eight patients with PD, who constituted a subgroup of patients enrolled to the EXPRESS study (Emre et al, N Engl J Med 2004) participated in this study. They suffered from mild to moderately severe dementia (MMSE scores above 10 and below 24), with an onset of cognitive symptoms occurring at least two years after the diagnosis of PD. Patients were randomly assigned to treatment with rivastigmine (3 to 12 mg per day) or placebo. The Mattis dementia rating scale was administered to patients from six centres in France at the baseline and end-point visits.

Results

Compared with placebo, a 24-week rivastigmine treatment led to a significant improvement in the overall score on the Mattis dementia rating scale (p = 0.031), with a trend towards a significant improvement in the “Attention” subscale score (p = 0.061). Correlation analysis showed that in the rivastigmine group, performance on the Mattis “Attention” and “Initiation” subscales appeared to contribute heavily to the improvement in the overall score. Moreover, the latter was also related to an improvement in activities of daily living and a reduction in behavioural disturbances.

Discussion

By using the Mattis dementia rating scale (which comprises items that are sensitive to executive dysfunction), the present study confirmed that rivastigmine has a beneficial effect on cognitive function in PDD. Despite our study’s small sample size, the Mattis scale was able to detect this improvement and could thus be considered as an interesting outcome measure in further work.

Keywords

cognitive dysfunction in PD mattis dementia rating scale dementia cholinesterase inhibitors 

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Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Kathy Dujardin
    • 1
    • 8
  • David Devos
    • 1
  • Stéphane Duhem
    • 1
  • Alain Destée
    • 1
  • Rose-Marie Marié
    • 2
  • Franck Durif
    • 3
  • Lucette Lacomblez
    • 4
  • Jacques Touchon
    • 5
  • Pierre Pollak
    • 6
  • Jean-Jacques Péré
    • 7
  1. 1.Neurology and Movement Disorders UnitFaculty of Medicine and Lille University HospitalLilleFrance
  2. 2.Service de NeurologieCHU Côte de NacreCaenFrance
  3. 3.Service de NeurologieHôpital Gabriel MontpiedClermont-FerrandFrance
  4. 4.Fédération de NeurologieHôpital de la SalpetrièreParisFrance
  5. 5.Unité de Neurologie, Comportementale et DégénérativeCHU Gui-de-ChauliacMontpellierFrance
  6. 6.Service de NeurologieCHUGrenobleFrance
  7. 7.Novartis PharmaFrance
  8. 8.Centre Hospitalier UniversitaireHôpital SalengroLille CedexFrance

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