Cerebral perfusional effects of cholinesterase inhibitors in Alzheimer disease Journal Article


Authors: Ceravolo, R.; Volterrani, D.; Tognoni, G.; Dell' Agnello, G.; Manca, G.; Kiferle, L.; Rossi, C.; Logi, C.; Strauss, H. W.; Mariani, G.; Murri, L.
Article Title: Cerebral perfusional effects of cholinesterase inhibitors in Alzheimer disease
Abstract: Cholinesterase (ChE) inhibitors improve or stabilize cognitive impairment in patients with Alzheimer disease (AD). However, the regional metabolic and perfusion correlates of treatment with ChE inhibitors are not fully known. Twenty-four patients with mild to moderate AD were evaluated with 99mTc-ethyl cysteinate dimer (ECD) single-photon-emission CT scanning (SPECT), before and after 4.3 ± 1.1 months of treatment with ChE inhibitors (donepezil, rivastigmine). Clinical evaluations included the Mini-Mental State Examination (MMSE) as well as the Neuropsychiatric Inventory (NPI). Inclusion criterion was a clear favorable response to therapy with ChE inhibitors (MMSE improvement of at least 2 points; total NPI improvement of at least 4 points). SPECT data were analyzed by Statistical Parametric Mapping (SPM 99, Wellcome, Department of Cognitive Neurology, London, UK). SPM analysis showed a significant increase (P < 0.01) of regional cerebral perfusion (rCBF) after short-term ChE inhibitor therapy with respect to baseline in the right anterior cingulate, the dorsolateral prefrontal, and the temporoparietal areas bilaterally. These data suggest that cognitive or behavioral benefits after ChE inhibitor therapy are related to a clear increase of rCBF in crucial areas specifically involved in the attentional and limbic networks.
Keywords: adult; clinical article; aged; middle aged; radiopharmaceuticals; image analysis; donepezil; rivastigmine; brain; neuropsychological tests; rating scale; cognitive defect; daily life activity; piperidines; brain mapping; single photon emission computer tomography; cerebrovascular circulation; alzheimer disease; carbamates; cingulate gyrus; parietal lobe; tomography, emission-computed, single-photon; prefrontal cortex; cysteine ethyl ester tc 99m; brain perfusion; temporal cortex; mini mental state examination; mental status schedule; indans; cholinesterase inhibitor; cholinesterase inhibitors; regional cerebral blood flow; humans; human; male; female; priority journal; article; brain single-photon-emission ct; phenylcarbamates; technetium tc 99m exametazime
Journal Title: Clinical Neuropharmacology
Volume: 27
Issue: 4
ISSN: 0362-5664
Publisher: Lippincott Williams & Wilkins  
Date Published: 2004-07-01
Start Page: 166
End Page: 170
Language: English
DOI: 10.1097/01.wnf.0000138636.42121.45
PROVIDER: scopus
PUBMED: 15319702
DOI/URL:
Notes: Clin. Neuropharmacol. -- Cited By (since 1996):33 -- Export Date: 16 June 2014 -- CODEN: CLNED -- Source: Scopus
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  1. Harry W Strauss
    164 Strauss