Effects of cholinesterase inhibition on brain white matter volume in Alzheimer's disease.
Brain white matter volume changes were quantified by using voxel-based morphometry in 26 minimal-to-mild Alzheimer's disease patients receiving cholinesterase inhibitors over 20 weeks. Patients treated with rivastigmine, an inhibitor of acetylcholinesterase and butyrylcholinesterase, did not show those reductions in white matter volume that were observed in patients treated with acetylcholinesterase-selective agents, donepezil and galantamine. This is the first time that dual cholinesterase inhibition has been shown to influence white matter volume specifically. The findings are consistent with a thesis that dual cholinesterase inhibition may have neuroprotective potential. Attenuated loss of brain volumes and delayed/slower long-term clinical decline in patients treated with agents such as rivastigmine may be due to less extensive white matter damage and loss of corticosubcortical connectivity.
Venneri
Annalena
A
Clinical Neuroscience Centre, University of Hull, UK. a.venneri@hull.ac.uk
Lane
Roger
R
D000110:Acetylcholinesterase / Q000187:drug effects / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology*; D001921:Brain / Q000187:drug effects* / Q000201:enzymology / Q000473:pathology*; D001931:Brain Mapping; D002800:Cholinesterase Inhibitors / Q000494:pharmacology*; D019610:Cytoprotection / Q000187:drug effects / Q000502:physiology; D018450:Disease Progression; D000077265:Donepezil; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005702:Galantamine / Q000494:pharmacology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007189:Indans / Q000494:pharmacology; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D009434:Neural Pathways / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D018696:Neuroprotective Agents / Q000494:pharmacology*; D048448:Phenylcarbamates / Q000494:pharmacology; D010880:Piperidines / Q000494:pharmacology; D000068836:Rivastigmine; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D007189:Indans; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000110:Acetylcholinesterase; D000068836:Rivastigmine