Cognitive effects of dopaminergic treatment in Alzheimer's disease: Systematic review and meta‐analysis

作者：Cristina Bonet Olivares, Michael David, Marta Estrada Obeso, Martina Del Giovane, Suzanne Reeves, Paresh Malhotra · 发表于：Alzheimer s & Dementia Translational Research & Clinical Interventions · 年份：2025 · DOI：10.1002/trc2.70142 · 被引用次数：3 · 研究领域：Dementia and Cognitive Impairment Research、Alzheimer's disease research and treatments、Neurotransmitter Receptor Influence on Behavior

Abstract INTRODUCTION Despite advances in disease‐modifying drugs, better treatments for symptomatic Alzheimer's disease (AD) are needed, with dopaminergic neurotransmission representing a potential target. The objective of this systematic review and meta‐analysis was to evaluate the efficacy of drugs with predominantly dopaminergic action in improving cognitive symptoms in AD. METHODS The MEDLINE, Embase, and ClinicalTrials.gov databases were searched from 1980 to January 2023. We used random effect models to generate pooled effect estimates RESULTS We included 19 prospective randomized controlled AD trials (1408 total participants), of which 7 were of “good” quality, 8 “fair,” and 4 “poor.” All were included in the analysis. The overall pooled effect was small but showed a significant positive effect of dopaminergic drugs compared to placebo (standardized mean difference [SMD]: 0.33, 95% confidence interval [CI]: 0.08 to 0.59, P = 0.01; I 2 = 79%). Significance remained after removing outliers to account for heterogeneity. When exploring subgroups (divided by mechanism of action), 5 trials of dopamine reuptake inhibitors did not show a significant effect on cognition, whereas 12 monoamine oxidase B (MAO‐B) inhibitor trials showed a moderately significant positive effect (SMD: 0.52, 95% CI: 0.13 to 0.90, P = 0.01; I 2 = 84%). DISCUSSION We show evidence of the benefit of dopaminergic medications, specifically MAO‐B inhibitors, on cognitive symptoms in AD. Several studies inc...