Rasagiline Potentiates Donepezil in Ameliorating Cognitive Deficits and Enhancing BDNF in Parkinson's Disease via Oxidative Stress Mitigation

Objective To investigate the effects of rasagiline combined with donepezil on oxidative stress injury, cognitive function, and serum brain-derived neurotrophic factor (BDNF) levels in patients with Parkinson’s disease (PD). Methods A total of 188 PD patients admitted to our hospital between October 2021 and October 2024 were enrolled and randomly assigned to either the control group (n = 94, treated with donepezil hydrochloride) or the combination group (n = 94, treated with rasagiline in addition to donepezil hydrochloride) using the random number table method. Both groups received continuous treatment for 4 months. Clinical efficacy and incidence of adverse events were compared between groups. Mini-Mental State Examination (MMSE) scores, Montreal Cognitive Assessment (MoCA) scores, serum malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), and BDNF levels were measured before and after treatment. Motor function was assessed using the Fugl-Meyer Assessment (FMA), daily living ability using the Barthel Index, and overall motor symptoms using the Webster Scale. Results The total clinical response rate was significantly higher in the combination group than in the control group (P < 0.05). Post-treatment MMSE and MoCA scores were significantly higher in the combination group (P < 0.05). MDA levels were lower, and SOD, GSH, and BDNF levels were higher, in the combination group compared with the control group after treatment (P < 0.05). Post-treatment FMA and Barthel Index scores were significantly higher, and Webster Scale scores significantly lower, in the combination group than in the control group (P < 0.05). No significant difference in the incidence of adverse events was observed between groups (P > 0.05). Conclusion Rasagiline combined with donepezil yields superior clinical efficacy in PD patients, effectively attenuating oxidative stress injury, increasing serum BDNF levels, and improving both cognitive and motor function, with a favorable safety profile. This regimen represents a promising therapeutic option for PD management.