{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:58:30Z","timestamp":1790697510146,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate if the cognitive benefit of rivastigmine is affected by the presence of orthostatic hypotension (OH) in patients with Parkinson's disease dementia (PDD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a post hoc analysis on 1,047 patients with PDD from 2 randomized controlled trials comparing rivastigmine versus placebo at week 24 (n = 501) and rivastigmine patch versus capsule at week 76 (n = 546). A drop \u2265\u200920\u2009mm Hg in systolic blood pressure (SBP) or \u2265\u200910 in diastolic blood pressure (DBP) upon standing classified subjects as OH positive (OH+); otherwise, OH negative (OH\u2010). The primary end point was the Alzheimer's Disease Assessment Scale \u2010 Cognitive subscale (ADAS\u2010Cog) at week 24 and the Mattis Dementia Rating Scale (MDRS) at week 76, using intention\u2010to\u2010treat with retrieved dropout at week 24 and observed cases at week 76, consistent with the original analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall safety was comparable between OH+ (n = 288, 27.5%) and OH\u2010 (n = 730, 69.7%), except for higher frequency of syncope (9.2%) in the OH+ placebo arm. The placebo\u2010adjusted effect of rivastigmine on ADAS\u2010Cog at week 24 was 5.6 \u00b1\u20091.2 for OH+ and 1.9 \u00b1\u20090.9 in OH\u2010 (\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.0165). Among subjects with OH, the MDRS change from baseline at week 76 was higher for rivastigmine capsules versus patch (10.6 \u00b1\u20092.9 vs \u20101.5 \u00b1\u20093.0,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.031). The overall prevalence of OH was lower for rivastigmine than placebo at week 24 (28.3% vs 44.6%,\n                      <jats:italic>p<\/jats:italic>\n                      =\u20090.0476).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The cognitive benefit from rivastigmine is larger in patients with PDD with OH, possibly mediated by a direct antihypotensive effect. ANN NEUROL 2021;89:91\u201398<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.25923","type":"journal-article","created":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T08:45:21Z","timestamp":1601887521000},"page":"91-98","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Rivastigmine in Parkinson's Disease Dementia with Orthostatic Hypotension"],"prefix":"10.1002","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-136X","authenticated-orcid":false,"given":"Alberto J.","family":"Espay","sequence":"first","affiliation":[{"name":"Gardner Family Center for Parkinson's Disease and Movement Disorders  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Marsili","sequence":"additional","affiliation":[{"name":"Gardner Family Center for Parkinson's Disease and Movement Disorders  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhimanyu","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Section of Movement Disorders Rush University Medical Center  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Sturchio","sequence":"additional","affiliation":[{"name":"Gardner Family Center for Parkinson's Disease and Movement Disorders  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidkhan","family":"Pathan","sequence":"additional","affiliation":[{"name":"Novartis Healthcare Private Limited  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2029-6606","authenticated-orcid":false,"given":"Andrea","family":"Pilotto","sequence":"additional","affiliation":[{"name":"Neurology Unit, Department of Clinical and Experimental Sciences University of Brescia  Brescia Italy"},{"name":"Parkinson's Disease Rehabilitation Centre, FERB ONLUS \u2013 S. Isidoro Hospital  Trescore Balneario (BG) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damodaran S.","family":"Elango","sequence":"additional","affiliation":[{"name":"Novartis Healthcare Pvt Ltd.  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Pezous","sequence":"additional","affiliation":[{"name":"Early Development Biostatistics, Novartis Pharma  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Masellis","sequence":"additional","affiliation":[{"name":"Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baltazar","family":"Gomez\u2010Mancilla","sequence":"additional","affiliation":[{"name":"Neuroscience Translational Medicine, Novartis Institutes for Biomedical Research, Neurology, and Neurosurgery McGill University  Montreal Quebec 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