Treatment of the mild cognitive impairment (MCI)

According to Evidence‐Based‐Medicine, any proposal for the rationale treatment of mild cognitive impairment (MCI) must be based on the results of double‐blind, randomized clinical trials (RCTs). However, since MCI at the present time does not constitute a homogeneous clinical syndrome, it is still i...

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Bibliographic Details
Published in:Human psychopharmacology 2007-06, Vol.22 (4), p.189-197
Main Authors: Allain, Hervé, Bentué-Ferrer, Danièle, Akwa, Yvette
Format: Article
Language:English
Subjects:
Aged
Amnesia - psychology
Amnesia - therapy
Amyloid - antagonists & inhibitors
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Antioxidants - therapeutic use
Central Nervous System Stimulants - therapeutic use
cholinesterase inhibitors
Cholinesterase Inhibitors - therapeutic use
clinical trials
Clinical Trials as Topic
Cognition Disorders - psychology
Cognition Disorders - therapy
cognitive disorders
Dopamine Agonists - pharmacology
Gonadal Steroid Hormones - blood
Humans
MCI
memory
psychostimulants
Randomized Controlled Trials as Topic
Receptors, Dopamine - drug effects
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Summary:According to Evidence‐Based‐Medicine, any proposal for the rationale treatment of mild cognitive impairment (MCI) must be based on the results of double‐blind, randomized clinical trials (RCTs). However, since MCI at the present time does not constitute a homogeneous clinical syndrome, it is still inappropriate to propose a specific drug treatment. Moreover, RCTs assessing the therapeutic value of acetylcholinesterase‐inhibitors (AChEIs) are negative either trying to improve symptoms (memory performance) or preventing the conversion from MCI to real Alzheimer's Disease (AD). The same negative results were obtained with drugs targeting some systems considered as the early steps of the pathophysiological cascade leading to dementia: non‐steroidal anti‐inflammatory compounds (rofecoxib), sex steroid hormones (testosterone, estrogens), or antioxidants (tocopherol). Either MCI is considered as the very early phase of development of AD (and then the treatments will aim at preventively antagonizing the hallmarks of the disease) or MCI is a new entity (and then the drugs will target the associated neurochemical disturbancies such as tau protein or soluble Aβ oligomers); MCI could also be considered as a monosymptomatic syndrome (amnesia) leading to the development of pure pro‐mnestic drugs. These three hypotheses will be presented on the basis of the neurobiology and the pharmacology, and examples of potentially active candidates will be discussed. Copyright © 2007 John Wiley & Sons, Ltd.
ISSN:0885-6222
1099-1077
DOI:10.1002/hup.838