title: Evaluation of therapeutic response to donepezil by positron emission tomography.
abstract: BACKGROUND
  Donepezil hydrochloride (Donepezil) is an acetylcholinesterase inhibitor (AChEI) that is used for the symptomatic treatment of Dementia of the Alzheimer's Type (DAT). Recently, the effects of AChEI in patients with DAT have been investigated using positron emission tomography (PET) or single photon emission computed tomography (SPECT). This study is to evaluate the usefulness of fluorine-18-fluorodeoxyglucose (FDG)-PET in assessing the therapeutic response of Donepezil to DAT using Regions of Interest (ROI) analysis.
  
  
  METHODS
  The participants included eleven outpatients diagnosed as having DAT according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The patients were performed FDG-PET before initiating Donepezil therapy and after 12 weeks of medication. Cognitive change was measured using the Japanese version of the Alzheimer's disease Assessment Scale cognitive subscale (ADAS-J cog) and the group was divided into Responders and Non-responders based on these results. We used FDG-PET to investigate glucose metabolism of the brain and measured FDG uptake in the ROI set in each lobe of the brain. Then the ratios of the post-treatment uptake to pre-treatment uptake were determined.
  
  
  RESULTS
  In the Responders, the mean ratios in the frontal, temporal, occipital, parietal, and temporoparietal lobes were 2.18, 1.62, 1.15, 1.12, and 1.09 respectively. The mean ratios of the Non-responders were 0.69, 0.88, 0.75, 0.98, and 0.68 respectively. Significant differences were found between the ratios of the Responders and Non-responders in the frontal and occipital lobes (p < 0.05).
  
  
  CONCLUSIONS
  These findings suggest that FDG-PET could be useful for the evaluation for monitoring response to Donepezil.
authors: Departments of Neuropsychiatry, Osaka City University, Graduate School of Medicine, Japan.
authors: Aiko
authors: A
authors: Shimada
authors: Hiroshi
authors: H
authors: Hashimoto
authors: Joji
authors: J
authors: Kawabe
authors: Shigeaki
authors: S
authors: Higashiyama
authors: Toshihiro
authors: T
authors: Kai
authors: Kouhei
authors: K
authors: Kataoka
authors: Ryo
authors: R
authors: Tagawa
authors: Youjirou
authors: Y
authors: Kawarada
authors: Aki
authors: A
authors: Nakanishi
authors: Koki
authors: K
authors: Inoue
authors: Susumu
authors: S
authors: Shiomi
authors: Nobuo
authors: N
authors: Kiriike
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism; D016009:Chi-Square Distribution; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D000077265:Donepezil; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018697:Nootropic Agents / Q000627:therapeutic use*; D010880:Piperidines / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000077265:Donepezil; D005947:Glucose