Changes in Memory Function and Neuronal Activation Associated with Atorvastatin Therapy

A small number of case studies have reported statin‐induced dementia or memory loss that resolves with cessation of statin therapy. However, such reports have not, to our knowledge, been substantiated by objective measures of changes in brain function during statin treatment and after discontinuation of the drug. We describe a 65‐year‐old man who reported cognitive complaints (memory complaints and mood changes) after taking atorvastatin 10 mg/day for 1 year. He had no history of alcohol consumption, major head trauma, psychiatric problems, or memory impairment. Cognitive testing (Hopkins Verbal Learning Test‐Revised, Brief Visuospatial Memory Test‐Revised, and Wechsler Adult Intelligence Scale, third edition, digit symbol coding and digit span tests) and assessment of neuronal activation using functional magnetic resonance imaging (fMRI) were performed during a working memory task (Sternberg Task) while he was receiving atorvastatin therapy. The patient demonstrated altered neuronal activation (reduced activation of the dorsolateral prefrontal cortex during the encoding task phase and hyperactivation of multiple areas of the prefrontal cortex during the recognition task phase) and reduced performance on the cognitive tests, which was consistent with his cognitive symptoms. These measurements were repeated 2 months after discontinuation of the drug. The patient exhibited improved cognitive test performance and fMRI patterns similar to those expected in a healthy individual. The patient also reported subjective improvement of his cognitive complaints within days of cessation of atorvastatin, which persisted at follow‐up 5 months later (while refraining from any statin use in the interim). To our knowledge, this is the first case report to describe objective cognitive and fMRI findings substantiating statin‐associated effects on the central nervous system, and it provides preliminary evidence that fMRI may be a useful technique for evaluating cognitive function in adults treated with statins.