title: Evaluation of the regional cerebral blood flow changes during long-term donepezil therapy in patients with Alzheimer's disease using 3DSRT.
abstract: BACKGROUND
  We attempt to evaluate objectively the regional cerebral blood flow (rCBF) changes during long-term donepezil therapy and the relationship between the clinical response and rCBF change in patients with Alzheimer's disease (AD).
  
  
  METHODS
  Thirty-one patients with mild-to-moderate AD (11 men, 20 female; mean age, 76.2 ± 6.7 years) were treated with donepezil and underwent brain perfusion single-photon emission computed tomography (SPECT) twice with an interval of 24.5 ± 4.2 months. The rCBF was calculated using 3-dimensional stereotaxic region of interest template, a fully automated each region of interest technique. We compared the differences in rCBF between baseline and follow-up SPECT studies. Moreover, all patients were divided into stabilized (n = 14) and nonstabilized subgroups (n = 17) based on Mini-Mental State Examination (MMSE) score changes and the changes in rCBF were compared between two subgroups.
  
  
  RESULTS
  The mean MMSE score significantly decreased from 20.7 ± 4.6 at baseline to 16.5 ± 6.5 after 2 years. The mean rCBF significantly decreased in the widespread brain regions between the baseline and follow-up SPECT studies. The nonstabilized subgroup showed a significant decrease in rCBF of the parietal and temporal segments compared to the stabilized subgroup.
  
  
  CONCLUSIONS
  The progression of cognitive deterioration may be related to rCBF affected by the neuropathologic changes of AD.
authors.affiliation: Department of Internal Medicine III, Oita University, Faculty of Medicine, Yufu, Oita, Japan. noriyuki@med.oita-u.ac.jp
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kimura
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kumamoto
authors.forename: Teruaki
authors.initials: T
authors.lastname: Masuda
authors.forename: Takuya
authors.initials: T
authors.lastname: Hanaoka
authors.forename: Toshio
authors.initials: T
authors.lastname: Okazaki
authors.forename: Ryuki
authors.initials: R
authors.lastname: Arakawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D000077265:Donepezil; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007189:Indans / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000008:administration & dosage; D010880:Piperidines / Q000008:administration & dosage*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil