Objectives: To assess the possible responsiveness of blink reflex alterations present in dementia with Lewy bodies (DLB) to treatment with cholinesterase inhibitors.
Methods: Twenty-six patients with DLB and 20 patients with Alzheimer disease underwent clinical, neuropsychological (including assessment of cognitive fluctuations, with the Cognitive Assessment of Fluctuations and the One-Day Fluctuation Assessment questionnaires), and the blink reflex evaluation at baseline, 1 week after vitamin E administration (to assess test-retest reliability), and 1 and 2 weeks after donepezil administration at the dose of 10 mg/d. Results were compared with data obtained from 30 healthy controls treated with vitamin E capsules for 2 weeks.
Results: Treatment with donepezil did not cause modifications of cognitive or motor performances in both groups of patients. In DLB patients, One-Day Fluctuation Assessment scores were modified by donepezil treatment with a mean reduction of 2.8 ± 1.8 compared with baseline (P < 0.05). After 2 weeks of treatment with donepezil, R2 latency was significantly decreased in DLB patients. The mean R2 latency reduction was by 3.0 ± 3.2 milliseconds (P < 0.0001 compared with baseline). R2 mean latency reduction was significantly correlated with R2 mean latency delay at baseline (Spearman rho = 0.8).
Conclusions: Short-term donepezil administration can correct the alterations of the blink response together with the daily occurrence of cognitive fluctuations present in DLB patients.