The Effect of Daily Low Dose Tadalafil on Cerebral Perfusion and Cognition in Patients with Erectile Dysfunction and Mild Cognitive Impairment
Jin Bong Choi 1, Kang Jun Cho 1, Joon Chul Kim 1, Chung Ho Kim 2, Yong-An Chung 3, Hyeonseok S. Jeong 3, Yong Soo Shim 4, Jun Sung Koh 1*
1Department of Urology, Bucheon ST. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea, 2Department of Nuclear Medicine, Bucheon ST. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea, 3Department of Radiology, Incheon ST. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea, 4Department of Neurology, Bucheon ST. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea
Received: November 27, 2018; Revised: December 14, 2018; Accepted: December 14, 2018; Published online: December 14, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The aims of this study were to investigate the effects of daily low-dose tadalafil on cognitive function and to examine whether there was a change in cerebral blood flow (CBF) in patients with erectile dysfunction (ED) and mild cognitive impairment.
Methods: Male patients aged 50 to 75 years with at least three months of ED (International Index of Erectile Function [IIEF]-5 score < 21) and mild cognitive impairment (Montreal Cognitive Assessment [MoCA] score ≤ 22) were included in the study. The subjects were prescribed a low-dose PDE5 inhibitor (tadalafil 5 mg) to be taken once daily for eight weeks. Changes in MoCA score and single-photon emission computed tomography (SPECT) study between the two time-points were assessed by paired t-tests.
Results: Overall, 30 male patients were assigned to the treatment group in this study and 25 patients completed the eight-week treatment course. Five patients were withdrawn due to adverse events such as myalgia and dizziness. Mean baseline IIEF and MoCA scores were 7.52 ± 4.84 and 18.92 ± 1.78. After the eight-week treatment, mean IIEF and MoCA scores were increased to 12.92 ± 7.27 (p < 0.05) and 21.8 ± 1.71 (p < 0.05), respectively. Patients showed increased relative regional CBF in the postcentral gyrus, precuneus, and brainstem after tadalafil administration versus at baseline (p < 0.001).
Conclusion: The results of this prospective clinical study suggest that daily use of tadalafil 5 mg increases some regional CBF and consequently improves cognitive function in patients with ED and mild cognitive impairment.
Keywords: Cerebral blood flow, Cognition, Phosphodiesterase


e-submission

Archives