March 27, 2006
An old anti-seizure drug offered promising results during a new safety and efficacy trial in 22 patients with HIV-related dementia (HRD). Valproic acid improved cognitive performance and restored nerve cell function, according to the study. Researchers from the University of Rochester School of Medicine (URSM) and the University of Nebraska Medical Center (UNMC) hope the study, which built on animal studies, could progress to a larger clinical trial.
Patients with HRD were randomly assigned to a placebo group or valproic acid group. Those patients taking valproic acid in a dose smaller than that used for seizures showed signs of mental function improvement. Brain scans also showed improved changes in brain metabolism. The drug showed no signs of increasing patients' HIV replication.
Valproic acid could protect the neurons from HIV dementia, researchers believe, and might be used for other neurodegenerative diseases.
"It's not proof positive," said Dr. Howard Gendelman, director for the Center of Neurovirology and Neurodegenerative Disorders at UNMC and a study coauthor. "But it's encouraging. It's more than encouraging."
"The bottom line is that not only is it safe and well-tolerated in this particular population of patients, but using a really small dose, we were actually able to restore nerve connections in an area of the brain that is really ravaged by HIV," said Dr. Harris Gelbard, URSM professor of neurology and lead study investigator.
Funded by the National Institute of Mental Health, the full study, "Valproic Acid Adjunctive Therapy for HIV-Associated Cognitive Impairment: A First Report," was published in Neurology (2006;66:919).