Galantamine combined with cognitive rehabilitation on post-stroke cognitive impairment: a proof-of-concept study.

Planton, Mélanie; Nemmi, Federico; Pages, Berengère; Albucher, Jean-François; Raposo, Nicolas; Danet, Lola; Péran, Patrice; Pariente, Jérémie

Purpose: We conducted a proof-of-concept study to evaluate the effects of galantamine treatment versus placebo combined to cognitive rehabilitation (CR) after stroke. Materials and methods: In this 12-week, double blinded, randomized, controlled trial, patients were assigned to either combined approach of galantamine and CR (G-CR) or placebo and CR (P-CR). Primary outcome was the proportion of patients who crossed over from vascular cognitive disorder (VCD) to no-VCD at 12 weeks. Secondary outcomes included changes in cognition, mood, quality of life and the N-back fMRI paradigm, assessed at baseline, 6 and 12 weeks and after an 8-week washout period. Results: Ten patients were allocated to G-RC group, 12 to the P-RC group. After 12 weeks, 40.1% of all patients converted to no-VCD with similar proportions between groups. Both groups showed improvements in episodic and working memory, executive and quality of life after 6 weeks of CR. Decreased depression and anxiety were noted, and all benefits persisted after the washout period. An interaction effect was observed in the right parietal lobule during the N-back task. Conclusions: Interventions lead to improved cognition and distinct cortical reorganization without being able to establish correlation between neural changes and behavioral measures.

COGNITIVE testing; CHOLINESTERASE inhibitors; STATISTICAL sampling; EPISODIC memory; EXECUTIVE function; TREATMENT effectiveness; RANDOMIZED controlled trials; ANXIETY; MAGNETIC resonance imaging; STROKE rehabilitation; COMBINED modality therapy; COGNITION disorders; NEUROPSYCHOLOGICAL tests; QUALITY of life; GALANTHAMINE; COGNITIVE therapy; COGNITIVE rehabilitation; MENTAL depression; EVALUATION

Brain Injury, 2025, Vol 39, Issue 2, p108

0269-9052

Academic Journal

10.1080/02699052.2024.2409355