Cholineacetyltrasnferase (ChAT) is a key enzyme that facilitates synthesis of acetylcholine affecting the memory, learning, awakening and sleep process of the cerebrum. The object of this study was to test the hypothesis that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with Alzheimer's disease (AD) susceptibility, and galantamine response. To elucidate a genetic predisposition of AD, we studied ChAT-gene 2384G>A (rs3810950) polymorphism in 52 AD patients in 93 normal controls. We also examined the association of this polymorphism and galantamine therapeutic response in 52 AD patients who received a 24-week galantamine treatment. There were no significant differences in the genotype or allele frequency of the ChAT polymorphism between the AD and control groups. However, we found that the allele-carrier distributions, allele frequency for the ChAT polymorphism differed significantly between responders and non-responders. The frequency of A-allele carriers (GA+AA) was higher in responders than in non-responders (chi-square=4.282, df=1, p=0.039), as was the A-allele frequency (chi-square=5.216, df=1, p=0.022). These results suggest that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with galantamine therapeutic response.
Acetylcholine ; Alzheimer Disease ; Cerebrum ; Galantamine ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Learning ; Memory

Among the Acetylcholinesterase inhibitors as used for Alzheimer's disease treatment, Galantamine has been recently developed and widely used owing to proven its clinical efficacy and safety. However, it has reported that prolonged QT interval, which can lead to ventricular arrythimias such as Torsade de points, has developed in Galantamine-treated patients. A 74-year-old female Alzheimer's patient been treated with galantamine for 8 months visited the hospital complaining about frequent dizziness. ECG monitor was performed promptly, it was informed that the prolonged QTc interval was increased 450 ms to 486 ms. So, we made her stop taking the galantamine, and after that QTc interval has normalized to 406 ms. In this article, we reported the first case on prolonged QT interval associated with galantamine in Korea.
Aged ; Alzheimer Disease ; Cholinesterase Inhibitors ; Dizziness ; Electrocardiography ; Female ; Galantamine ; Humans ; Korea ; Organothiophosphorus Compounds

OBJECTIVES: The purpose of this study was to compare the efficacy of galantamine treatment, especially attention ability between patients with pure Alzheimer's disease (AD) and Mixed dementia (MD) during a 24-week trial. METHODS: A total of 40 patients were recruited for this 24-week study. The effect of galantamine on attention was measured using Seoul Computerized NeuroCognitive Function Test (SCNT) and frontal functions test of Seoul Neuropsychological Screening Battery (SNSB). Patients'activities of daily living using the Seoul-Activities of Daily Living (S-ADL) and the Seoul-Instrumental Activities of Daily Living (S-IADL) ; behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline and 24-week. RESULTS: 17 pure AD patients and 23 MD patients were analyzed in this study. Attention as measured by SCNT was not significantly different from baseline after 24 weeks of treatment in both groups. There was no significant difference between two groups in mean change from baseline in the SCNT, S-ADL, S-IADL and K-NPI scores at 24-week. CONCLUSION: Galantamine showed a therapeutic effect on cognition, activities of daily living, neuropsychiatric symptoms in pure AD and MD. Furthermore, Galantamine may specifically help to maintain attention and it may have positive effects on other cognitive and functional abilities.
Activities of Daily Living ; Alzheimer Disease ; Attention ; Behavioral Symptoms ; Cognition ; Dementia ; Galantamine ; Humans ; Mass Screening

BACKGROUND AND PURPOSE: The positive effects of galantamine on cognition and activities of daily living (ADL) in Alzheimer's disease (AD) are thought to be mediated via improvements in attention. The purpose of this study was to determine the effect of galantamine on attention in AD patients using a computerized attention test and to elucidate the relationship between improvements in attention and change in cognition and ADL. METHODS: In this multicenter, open-label, prospective study, patients with mild to moderate AD received galantamine and then submitted to computerized attention tests, the Alzheimer's Disease Assessment Scale-cognitive subscale, and instrumental ADL (IADL) at baseline, 4 weeks, and 12 weeks. The differences in reaction time on computerized tests were explored relative to the changes in cognition and IADL. RESULTS: After 12 weeks of taking the trial medication there was a significant reduction from baseline levels in the choice reaction time (baseline, 5,216+/-3,650 sec; 12 weeks, 4,139+/-2,920 sec; p<0.01) and the simple reaction time (baseline, 1,089+/-782 sec; 12 weeks, 908+/-606 sec; p<0.01). Correlation analyses of changes in choice or simple reaction times relative to cognition and ADL measures yielded no significant associations. The improvement in attention observed at 4 weeks of galantamine treatment was not associated with any significant changes in outcome measures at the end of trial. CONCLUSIONS: This study found no significant association between the improvement in attention after treatment with galantamine and changes in cognition and ADL in patients with mild to moderate AD, despite the significant improvement in attention over the course of the treatment.
Activities of Daily Living* ; Alzheimer Disease* ; Cognition* ; Galantamine* ; Humans ; Outcome Assessment (Health Care) ; Prospective Studies ; Reaction Time

OBJECTIVE: This study aims to investigate the effect of galantamine on caregiver time and activities of daily living(ADLs) in patients with mild to moderate Alzheimer's disease(AD) in a Korean population. DESIGN: Quasi-experimental study: A rndomized, double-blind, parallel-group clinical trial and a naturalistic longitudinal community study METHOD: For this 1-year prospective study, 138 patients residing in the community were recruited(baseline MMSE score of. 10-22). The two groups were composed of 72 patients treated with galantamine and 66 patients selected as the control group from an untreated community cohort of AD patients. The primary efficacy outcome was the caregiver time and the secondary efficacy measure was the Korean version of the Disability Assessment for Dementia(DAD-K) scale. RESULTS: The results of a mixed model analyses demonstrated reduced caregiver time and improved ADLs in galantamine group relative to baseline and compared with the community control group in this 1-year prospective study. Significant improvement in galantamine group observed in the DAD scores demonstrated beneficial effects of galantamine on delaying functional deterioration in patients with mild to moderate AD. Difference in caregiver time between two groups was equivalent to additional 9.5 working days per month or 113 working days per year. CONCLUSION: Treatment with Galantamine is associated with a significantly slower decline in basic and instrumental ADLs in patients with mild to moderated AD. These benefits on functional capacity in patients with AD treated with galantamine were associated with less caregiver time, lower caregiver burden and higher economic benefits.
Activities of Daily Living* ; Alzheimer Disease* ; Caregivers* ; Cohort Studies ; Galantamine* ; Humans ; Prospective Studies*

OBJECTIVE: This study compares the efficacy of the cholinesterase inhibitor (ChEI) galantamine on cognition in patients with mild-to-moderate Alzheimer's dementia (AD) who were either naïve to ChEI drugs or who had failed a trial of the ChEI donepezil. METHODS: Outpatients with AD were sequentially referred for screening and enrollment. Current outpatients who had taken donepezil for at least 6 months without demonstrated efficacy on cognition were switched to galantamine (switched group). New outpatients with no ChEI prescription history were classified as the naïve group and were given galantamine. The primary outcome measures for the between-group comparison were response rate on cognition at 26 and 52 weeks (categorical) and change on the Korean version of the Alzheimer's Disease Assessment Scale-cognitive subscale (dimensional). Secondary cognitive outcomes were measured using the subset of frontal executive function and the Korean Mini-Mental State Examination. RESULTS: Seventy outpatients were enrolled and 66 were analyzed by Intent-to-treat (ITT). There were 42 cases in the naïve group and 24 in the switched group. Response rates did not differ at 26 weeks (71.4% naïve vs. 58.3% switched; p=0.277) or at 52 weeks (59.5% naïve vs. 41.6% switched; p=0.162). No significant differences were observed in the pattern of change over the 52 weeks on the primary and secondary cognitive scales. CONCLUSION: As the efficacy of galantamine on cognition was not inferior in the switched group compared to that in the naïve group, switching ChEI drugs is clinically feasible for non-responding patients with mild-to-moderate AD.
Alzheimer Disease ; Cholinesterases ; Cognition* ; Dementia* ; Executive Function ; Galantamine* ; Humans ; Mass Screening ; Outcome Assessment (Health Care) ; Outpatients ; Prescriptions ; Weights and Measures

BACKGROUND: The hydrolysis of mivacurium and succinylcholine is impaired in the presence of defects of pseudocholinesterase. Clinical reports are conflicting as to the utility of anticholinesterases, in the reversal of mivacurium- or succinylcholine-induced paralysis. In this study, the role of exogenous bovine pseudocholinesterases (BpChE) and/or neostigmine, pyridostigmine, edrophonium or galanthamine in the reversal of mivacurium- or succinylcholine-induced paralysis, were investigated with the rat phrenic nerve-diaphragm preparation. METHODS: Ninety five Sprague-Dawley rats (200 g, male) were divided into 14 groups (n = 10). The phrenic nerve-diaphragm preparation mounted in a bath containing oxygenated Krebs' solution. Twitch response from diaphragmatic muscle evoked by phrenic nerve stimulation were measured. After stabilization of the twitch responses, mivacurium (0.1 microgram/mlml) or succinylcholine (0.1 microgram/ml) was administered incrementally in the preparation to obtain more than 95% twitch inhibition. BpChE (0.1, 1.0 u/ml), and/or neostigmine (0.1, 1.0 microgram/ml), pyridostigmine (0.5, 5 microgram/ml), edrophonium (0.01, 0.1 microgram/ml) or galanthamine (0.1, 1.0 microgram/ml) were added for the reversal of mivacurium- and/or succinylcholine-induced block in each group and the twitch responses (0.1 Hz) were monitored for 60 min. The effect of BpChE (0.1 u/ml), in combination with each of the above four anticholinesterases at lower concentrations also were examined. Twitch heights more than 75% was considered an adequatereversal. RESULTS: BpChE 0.1 and 1.0 u/ml were effective in reversal of mivacurium-induced paralysis. When anticholinestrases were added, there was no effective improvement of twitch height at the end of 60 minutes. In succinylcholine-induced paralysis, BpChE was effective for reversal, but when anticholinesterases were added, BpChE potency was inhibited. CONCLUSIONS: BpChE will reverse mivacurium-induced block more effectively than anticholinesterase. BpChE is effective in reversing succinylcholine block. The addition of anticholinesterases inhibits the activity of pseudocholinesterase.
Animals ; Baths ; Cholinesterase Inhibitors ; Edrophonium* ; Galantamine* ; Hydrolysis ; Neostigmine* ; Oxygen ; Paralysis* ; Phrenic Nerve ; Pseudocholinesterase* ; Pyridostigmine Bromide* ; Rats ; Rats, Sprague-Dawley ; Succinylcholine

OBJECTIVETo establish a method for determination of galanthamine in Lycoris radiata.

METHODHPLC separation was carried on a column of ODS (4.6 mm x 150 mm, 5 microm), with the mobile phase of phosphate buffer (pH = 3-4)-methanol (93:7) at the flow rate of 1.0 mL x min(-1), and the detection wavelength was set at 289 nm.

RESULTGalanthamine revealed linearity within the range of 3-30 microg x mL(-1) (r = 0.9997), the detection limit was 0.3 ng. The average recovery was 99.5% (RSD = 0.5%).

CONCLUSIONThe method is easy to operate and the results of the determination are accurate, it can be used to evaluate the quality of L. radiata.

Chromatography, High Pressure Liquid ; methods ; Galantamine ; analysis ; Lycoris ; chemistry ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control

Alzheimer's disease (AD) is the most common cause of dementia in the elderly. AD afflicts 0.3 to 0.5 million people in Korea, and the number is projected to increase to 2 million by the year of 2050. This article provides a brief overview of the most popular drug therapies in the treatment of AD including cholinesterase inhibitors (AchEIs) (donepezil, galantamine, rivastigmine), NMDA receptor antagonist (memantine), acetyl-l-carnitine, antioxidant vitamins, and Ginko biloba. Based on a review of relevant papers in the literature, this article presents pharmacological and clinical safety profiles of these agents and prescribing tips as well as a final summary on the effectiveness, safety, and alerts for clinicians. AchEIs as well as memantine will continue to play an important role in the treatment armamentarium for AD, even though newer strategies are being explored. There is not enough evidence supporting the continuous use of other drugs such as acetyl-l-carnitine, antioxidant vitamins, and Ginko biloba for the treatment of AD.
Acetylcarnitine ; Aged ; Alzheimer Disease* ; Cholinesterase Inhibitors ; Dementia ; Drug Therapy* ; Galantamine ; Ginkgo biloba ; Humans ; Korea ; Memantine ; N-Methylaspartate ; Vitamins

BACKGROUND: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. PURPOSE: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. METHOD: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. RESULTS: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. CONCLUSION: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.
Alzheimer Disease ; Choline ; Classification ; Dementia ; Female ; Galantamine ; Glycerylphosphorylcholine ; Humans ; International Classification of Diseases ; Male ; Memantine ; Methods ; Prescriptions ; Rivastigmine