Some forms of behavioral perseveration may reflect the disruption of specific neurotransmitter systems including mesencephalic dopaminergic projection. We present an open-labeled trial of a dopamine agonist for treating perseveration in dementia. Eight patients with ischemic vascular or degenerative dementia completed a 25-day trial of bromocriptine with a maximum daily dose of 10 mg. Patients were assessed with neuropsychological scales and a test battery for detecting perseveration. Recurrent and stuck-in-set types of perseveration significantly improved during the treatment, whereas measures for general attention and overall cognitive function showed no significant changes. We assume that bromocriptine supplemented the mesolimbocortical or ventral mesostriatal dopamine system ameliorated a certain frontal lobe function such as focused attention or working memory and improved the patients' perseverations. Although this study is preliminary because of the small sample size and open-labeled design, the results underline the possibility of pharmacotherapy for perseveration and recommend a double-blind, placebo-controlled study.
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