Clinical efficacy of donepezil combined with nerve growth factor in the treatment of patients with Parkinson's disease dementia and its impact on adiponectin and soluble tumor necrosis factor-alpha receptor-1.

Abstract

Objective: To explore clinical efficacy of donepezil combined with nerve growth factor (NGF) in the treatment of Parkinson's disease dementia (PDD) and its potential impact on serum levels of adiponectin (APN) and soluble tumor necrosis factor receptor-1 (sTNFR-1).

Methods: Clinical data of 140 patients with PDD treated in Taizhou First People's Hospital from March 2021 to December 2023 were retrospectively analyzed. Patients were grouped based on the treatment received. Patients who received donepezil alone (n=68) comprised the Donepezil group, and patients who were treated with a combination of donepezil and NGF (n=72) were assigned into the Donepezil & NGF group. Treatment effects, symptom improvement before and after the treatment, APN and sTNFR-1 levels, and incidence of adverse reactions were compared between two groups.

Results: The overall efficacy of the combination therapy was higher than that of donepezil regimen alone (P<0.05). After treatment, symptom improvement in the Donepezil & NGF group was significantly better than that in the Donepezil group (P<0.05). Post-treatment serum levels of APN in the Donepezil & NGF group were significantly higher than that of Donepezil group, while the level of sTNFR-1 was significantly lower (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion: Combined regimen of donepezil and NGF is more effective than donepezil monotherapy in improving cognitive function, neurological function, and severity of the condition of patients with PDD, and is associated with the suppression of the inflammatory response without a significant increase in the incidence of adverse reactions. The study provides a basis for the clinical application of the combined regimen, but it still needs to be confirmed by more basic and clinical research.