According to an article published in the April edition of The Lancet Neurology, donepezil may improve the executive function of patients who suffer from the CADASIL form of vascular dementia. However, researcher Martin Dichgans of Ludwig Maximilian University, Munich, Germany and colleagues found that donepezil did not improve patients’ cognitive score.
CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is a genetic form of vascular dementia (due to vascular lesions in the brain) and the most common form of hereditary stroke disorder. It tends to begin with migraine headaches and strokes in middle-aged patients. Executive functions are the high-level cognitive processes that facilitate new ways of behaving, and optimize one’s approach to unfamiliar circumstances.
Donepezil is a type of cholinesterase inhibitor (CI) that can benefit functions of brain, body, and daily living activities in patients with mild to moderate Alzheimer’s disease (AD). In the elderly, it is quite common to have AD along with vascular dementia. One of the difficulties in testing CI drugs is due to the fact that it is not clear whether the drug benefits have been caused by improvement in the vascular dementia or the AD. Since CADASIL has early onset in patients, it is possible to study people who only have CADASIL, without overlapping AD symptoms.