TY - JOUR
T1 - Greater responsiveness to donepezil in alzheimer patients with higher levels of acetylcholinesterase based on attention task scores and a donepezil PET study
AU - Kasuya, Masashi
AU - Meguro, Kenichi
AU - Okamura, Nobuyuki
AU - Funaki, Yoshihito
AU - Ishikawa, Hiroyasu
AU - Tanaka, Naofumi
AU - Iwata, Ren
AU - Yanai, Kazuhiko
PY - 2012/4
Y1 - 2012/4
N2 - The aim of the study was to predict donepezil responders among patients with Alzheimer disease (AD) based on cognitive tests and positron emission tomography. The Mini-Mental State Examination, Digit Symbol subtest (DigSm) of Wechsler Adult Intelligence Scale Revised, and Trail-Making Test A were administered for 80 patients with AD to assess global function, attention, and executive function, respectively. The same tests and the Clinical Global Impression (CGI) scale were conducted after treatment with oral donepezil (5 mg/d) for 6 months (study 1). [C]-Donepezil positron emission tomography examinations were conducted before and after treatment for 30 randomly selected patients. The distribution volume (DV), which indicates the density of donepezil-binding sites, was calculated using Logan graphical analysis (study 2). In study 1, 35 patients were identified as responders based on the CGI and Mini-Mental State Examination changes. These patients had higher baseline DigSm scores compared with nonresponders. In study 2, 15 patients were responders. DigSm correlated with DV at baseline. DV at baseline and %DV change in responders were higher than in nonresponders, and these variables correlated with ΔDigSm and CGI scores. Higher baseline attention may predict responsiveness to donepezil in patients with AD, and higher acetylcholinesterase levels result in a greater clinical effect.
AB - The aim of the study was to predict donepezil responders among patients with Alzheimer disease (AD) based on cognitive tests and positron emission tomography. The Mini-Mental State Examination, Digit Symbol subtest (DigSm) of Wechsler Adult Intelligence Scale Revised, and Trail-Making Test A were administered for 80 patients with AD to assess global function, attention, and executive function, respectively. The same tests and the Clinical Global Impression (CGI) scale were conducted after treatment with oral donepezil (5 mg/d) for 6 months (study 1). [C]-Donepezil positron emission tomography examinations were conducted before and after treatment for 30 randomly selected patients. The distribution volume (DV), which indicates the density of donepezil-binding sites, was calculated using Logan graphical analysis (study 2). In study 1, 35 patients were identified as responders based on the CGI and Mini-Mental State Examination changes. These patients had higher baseline DigSm scores compared with nonresponders. In study 2, 15 patients were responders. DigSm correlated with DV at baseline. DV at baseline and %DV change in responders were higher than in nonresponders, and these variables correlated with ΔDigSm and CGI scores. Higher baseline attention may predict responsiveness to donepezil in patients with AD, and higher acetylcholinesterase levels result in a greater clinical effect.
KW - Alzheimer disease
KW - PET
KW - attention
KW - donepezil
UR - http://www.scopus.com/inward/record.url?scp=84861457274&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861457274&partnerID=8YFLogxK
U2 - 10.1097/WAD.0b013e3182222bc0
DO - 10.1097/WAD.0b013e3182222bc0
M3 - Article
C2 - 21666432
AN - SCOPUS:84861457274
VL - 26
SP - 113
EP - 118
JO - Alzheimer Disease and Associated Disorders
JF - Alzheimer Disease and Associated Disorders
SN - 0893-0341
IS - 2
ER -
