Clin Psychopharmacol Neurosci.  2019 Aug;17(3):432-437. 10.9758/cpn.2019.17.3.432.

The Effect of Daily Low Dose Tadalafil on Cerebral Perfusion and Cognition in Patients with Erectile Dysfunction and Mild Cognitive Impairment

• Choi JB
• Cho KJ
• Kim JC
• Kim CH
• Chung YA
• Jeong HS
• Shim YS
• Koh JS

• KMID: 2457407
• DOI: http://doi.org/10.9758/cpn.2019.17.3.432

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 Five patients were withdrawn due to adverse events such as myalgia and dizziness.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 improves cognitive function in patients with ED and mild cognitive impairment.

Keyword

Cerebrovascular circulation; Cognition; Phosphodiesterase inhibitors

MeSH Terms

Brain Stem
Cerebrovascular Circulation
Clinical Study
Cognition*
Dizziness
Erectile Dysfunction*
Humans
Male
Methylenebis(chloroaniline)
Mild Cognitive Impairment*
Myalgia
Parietal Lobe
Perfusion*
Phosphodiesterase Inhibitors
Prospective Studies
Somatosensory Cortex
Tadalafil*
Tomography, Emission-Computed
Methylenebis(chloroaniline)
Phosphodiesterase Inhibitors
Tadalafil