title: 3DSRT evaluation of responses of Alzheimer type dementia to donepezil hydrochloride therapy.
abstract: BACKGROUND
  Dementia of Alzheimer type (DAT) has been diagnosed objectively by using single photon emission tomography (SPECT). Donepezil hydrochloride (donepezil) is available for the symptomatic treatment of DAT. In a quantitative evaluation of therapeutic response in DAT, to compare with regional cerebral blood flows (rCBF) of various lesions before and after treatment, uptake in some sorts of cerebral regions of interests (ROIs) were used to be measured. But ROI analysis has problems such as poor reproducibility and lack of objectivity. The aim of this study was to investigate the evaluation of therapeutic response by three-dimensional stereotaxic ROI template (3DSRT), fully automated ROI analysis software, which can objectively estimate rCBF.
  
  
  METHODS
  SPECT studies and Alzheimer's Disease Assessment Scale Japan cognitive Subscale function test ADAS-Jcog, as recognitive function test were performed for 22 patients (16 females, 6 males mean age = 73.6 years) who were diagnosed as DAT. On 3DSRT, we compared ratios of the rCBF values of the parietal lobes, temporo-occipital lobes, hippocampus, corpus callosum and the frontal lobes/cerebellar hemispheres before and after medical treatment. To determine a cut-off number of areas exhibiting improved blood flow optimal as an indicator of improvement in cognitive function in response to treatment, receiver operating characteristics (ROC) analysis of number of areas improved blood flow was performed.
  
  
  RESULTS
  The number of cases exhibiting changes in cognitive function was greatest when the cut-off number of areas exhibiting improved blood flow was set at 5.
  
  
  CONCLUSIONS
  The possibility of evaluation of therapeutic response to Donepezil in patients with DAT using 3DSRT was thus demonstrated by our study.
authors.affiliation: Department of Radiology, Osaka City University, Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka 545-8585, Japan. YQW10673@nifty.ne.jp
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Higashiyama
authors.forename: Joji
authors.initials: J
authors.lastname: Kawabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Hisanori
authors.initials: H
authors.lastname: Akiyama
authors.forename: Etsushi
authors.initials: E
authors.lastname: Kawamura
authors.forename: Kenji
authors.initials: K
authors.lastname: Torii
authors.forename: Koki
authors.initials: K
authors.lastname: Inoue
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kiriike
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy*; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D000077265:Donepezil; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D010880:Piperidines / Q000627:therapeutic use*; D013238:Stereotaxic Techniques; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil