Effect of ramipril therapy on cognitive functions in cases of mild to moderate essential hypertension.

Several studies have questioned the effect of hypertension on cognitive functions. Event related potentials (P300) have been used as a reliable and reproducible indicator of cognitive functions. In this non-randomized, open label study we investigated cognitive functions using event related potentials in newly diagnosed mild to moderate essential hypertensive patients and whether or not there was any effect of antihypertensive treatment with angiotensin converting enzyme inhibitor ramipril on the event related potentials. We selected twenty male patients of newly diagnosed mild to moderate essential hypertension by using ambulatory blood pressure monitoring who were previously untreated and compared their event related potentials with 10 normotensive controls. At the beginning of the study, the hypertensive group showed increased P300 and N2 wave latency as compared to the normotensive control subjects. After three months of Ramipril therapy at a dose of 5mg per day, there was a significant decrease in all the ambulatory blood pressure parameters and the mean P300 latency from the pretreatment values. But no significant change in the N2 latency was observed. Thus, treatment with Ramipril 5 mg daily for a period of three months can reverse some aspects of cognitive dysfunction associated with hypertension.

Effects of iron therapy on cognition in anemic school going boys.

The present study was conducted on 18 anemic and 34 control subjects (mean age 9.26 +/- 0.26 years) to observe the effect of anemia on cognition and to see effect of 3 months of iron therapy on it. Anemia was defined on the basis of hematological values and peripheral smear examinations. Cognitive data consisted of the recording of the P300 wave of Auditory Event Related Potentials (AERP), Ravens Progressive Matrices Test (RPMT), and Digit Span Attention Test (DSAT) under standard test conditions. RPMT scores were then converted to the intelligence quotient (IQ) scores for comparison. Both anemic and control boys were dewormed after recording pretreatment values and then anemic boys were given iron therapy for 3 months, after which the recordings were taken again. Pretreatment, anemic boys showed significantly lower hematological values, delayed P300 latency, and lower RPMT scores as compared to controls. Post therapy the hematological profile of anemic boys though significantly improved as compared to the pretreatment values, was still significantly lower than that of control boys. The P300 latency values of anemic boys showed improvement but were still significantly delayed than the control group. RPMT values and derived IQ scores of anemic boys were similar to control boys after therapy suggesting that though the 3 months iron therapy regime resulted in improvement in psychometric cognitive tests in anemic boys, the basic P300 defects persisted. This suggests that the P300 component of AERP in anemic children is relatively refractory to 3 months of iron therapy.

Event related evoked potentials in dementia: role of vitamin E.

Dementia is a common cognitive syndrome reflecting a wide spread chronic progressive disease as an extension to normal aging process. Oxidative stress has been implicated in dementia and antioxidants have become attractive therapeutic agents. Among the antioxidants vitamin E is the most potent in the treatment of dementia. Study was conducted in 20 patients suffering from dementia in the age group of 66-74 and in 20 age and sex matched controls. Latency of the P3 component of event related evoked potential (ERP) showed an increase from 338.65 +/- 42.22 msec in control group to 348.9 +/- 46.38 msec in patients of dementia. In control group P3 latency decreased from 338.65 +/- 42.22 msec to 331.6 +/- 38.75 msec after Vitamin E therapy. In patients of dementia latency decreased significantly from 348.9 +/- 46.38 msec to 324.62 +/- 44.25 msec after vitamin therapy for one month. P3 amplitude in controls and demented was 7.2 +/- 3.62 mu v and 7.07 +/- 3.73 mu v respectively. After vitamin E therapy a statistically significant increase in amplitude (P < 0.05) was observed in controls (9.34 +/- 5.04 mu v) and in patients of dementia (9.58 +/- 5.24 mu v). The study suggests that the latency and amplitude of P3 were not significantly different in control and dementia patients, while vitamin E supplementation (oral 800 mg per day for 30 days) decreased the latency and increased the P3 amplitude in both the control and dementia patients. Our study further supports that Vitamin E supplementation, because of its antioxidant property might be decreasing oxidative stress, which may lead to improvement in cognitive pool of generator neurons of P3.

P300 in newly diagnosed non-dementing Parkinson's disease: effect of dopaminergic drugs.

Changes in cognitive function are an integral part of the clinical presentation of Parkinson's Disease (PD). P300 potential studies in early stages of Parkinson's disease are lacking and effect of L-dopa therapy on these potentials is controversial. In this study, changes in P300 potentials in early stages of PD and effects of dopaminergic therapy were investigated. P300 waves were elicited by standard auditory 'odd ball' paradigm and were recorded before the start of therapy and 15 days, 3 and 6 months after the start of L-dopa therapy in 25 newly diagnosed patients with idiopathic PD. All patients were classified according to Hoehn and Yahr scale. Minimental status examination (MMSE) was done in all. Control group had 20 normal subjects. The P300 latency was not significantly increased in early Parkinson's disease. This latency was reduced with dopaminergic therapy on 15th day, but increased later. Implications of the data are discussed.