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Thursday, March 23, 2017

'Suggestion' of Brain Changes on Statins by fMRI in STOMP

New research is weighing in on the "do statins impair cognition?" debate with a report of transient brain-activation changes on functional magnetic resonance imaging (fMRI) scans[1].

A substudy of the Effect of Statins on Muscle Performance (STOMP) study showed similar scores on several neuropsychological tests for statin-na├»ve patients (mean age 48 years) taking 80 mg/day of atorvastatin for 6 months and those taking matching placebo—echoing findings just released from the EBBINGHAUS trial of patients on the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab (Repatha, Amgen) plus statins vs placebo.

However, the STOMP analysis did find "small but significant" between-group differences in activation patterns in two brain areas. While on study treatment, the placebo group had greater activation in the right putamen/dorsal striatum during a verbal memory task than did the atorvastatin group. However, after the drug "washed out," the atorvastatin group had greater activation in that area.

While "on drug," the atorvastatin group had greater activation in the bilateral precuneus during a figural memory task vs the placebo group—but this pattern also reversed after the washout phase.

So what does this mean? "We aren't sure," admitted Dr Beth Taylor (University of Connecticut and Hartford Hospital) to heartwire from Medscape. "There was no convincing evidence of measurable verbal or nonverbal memory dysfunction due to statins."


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