Regional brain activity after prolonged cholinergic enhancement in early Alzheimer's disease.
This functional magnetic resonance imaging (fMRI) study examined changes in brain activation after prolonged (20 weeks) and stabilized treatment with the cholinesterase inhibitor galantamine in a small group of patients with very mild Alzheimer's disease (AD). Two cognitive activation paradigms were chosen: one requiring semantic association and the other relying on attention and requiring target detection. A group of age- and education-matched healthy controls was also scanned for comparison. A modest (but not statistically significant) improvement in behavioral scores after treatment was observed in both fMRI tasks. There were brain activation increases in the semantic association task after treatment, and the differences in brain activation present in the comparison of AD patients' baseline images with those of controls were not detectable after treatment. In the target detection task, regions that were activated in the elderly controls but not in the baseline images of the AD group also showed significant activation after treatment. Overall, however, the increases were modest and might reflect the heterogeneity of clinical response to treatment in this small group. Future pharmacological fMRI studies should include clinical response as a factor in the analysis of cholinergic enhancement effects in AD patients.
Shanks
Michael F
MF
Clinical Neuroscience Centre, University of Hull, HU6 7RX Hull, UK.
McGeown
William J
WJ
Forbes-McKay
Katrina E
KE
Waiter
Gordon D
GD
Ries
Mario
M
Venneri
Annalena
A
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods*; D018678:Cholinergic Agents / Q000378:metabolism*; D003704:Dementia / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005702:Galantamine / Q000494:pharmacology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010277:Parasympathomimetics / Q000494:pharmacology; D015203:Reproducibility of Results
D018678:Cholinergic Agents; D010277:Parasympathomimetics; D005702:Galantamine