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J Neurol Neurosurg Psychiatry 2005;76:305 doi:10.1136/jnnp.2004.048405
  • Cholinesterase inhibitors
  • Editorial commentary

Action of cholinesterase inhibitors in patients’ brains

  1. K Herholz
  1. Correspondence to:
 K Herholz
 Department of Neurology, University of Cologne, and Max-Planck-Institute for Neurological Research, Gleuler Str. 50, 50931 Cologne, Germany; karl.herholzpet.mpin-koeln.mpg.de

    Cholinesterase inhibitors in patients’ brains

    Cholinesterase (ChE) inhibitors are the only class of drug that have consistently shown improvement in cognitive function in patients with mild to moderate Alzheimer’s disease. Unfortunately, improvement is generally rather small.1 Recent clinical trials have caused considerable controversy about their actual benefit and indications. On one hand, some studies suggest more extensive use because improvement of cognitive function has also been observed in vascular dementia, dementia with Lewy bodies, and Parkinson’s disease with dementia. However, on the other hand a recent study in community resident patients with mild to moderate Alzheimer’s disease concluded that benefits were “below minimally relevant thresholds.”2

    On the …

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