title: The potentially protective effect of donepezil in Alzheimer's disease.
abstract: OBJECTIVE
  Donepezil is an acetylcholinesterase inhibitor used to treat Alzheimer's disease (AD). In this study, we used a voxel-based specific regional analysis system for AD (VSRAD) to analyze the hippocampal volume and to assess the pharmacologic effects of donepezil as a disease modifier.
  
  
  METHODS
  A total of 185 AD patients underwent MRI, 120 (43 men and 77 women, 77.8 ± 7.1 years) without and 65 (29 men and 36 women, 78.4 ± 6.0 years) with donepezil treatment. VSRAD was compared in both groups and against a database of 80 normal subjects. The Z-score was used to assess the degree of hippocampal atrophy.
  
  
  RESULTS
  No significant difference between the groups was found for age, sex, or Z-scores, but a significant difference was found for mean Mini-Mental State Examination (MMSE) scores (p = 0.02, Student's t test). Single regression analysis showed no significant association between Z-scores and MMSE scores in the treated group (p = 0.494), but a significant association in the untreated group (p = 0.001) was observed. This implies that the MMSE score becomes lower when the Z-score is higher in the untreated group, whereas there is no significant trend in the treated group.
  
  
  CONCLUSIONS
  Donepezil affects the relationship between hippocampal volume and cognitive function and may therefore have a pharmacologic effect as a disease modifier.
authors.affiliation: Department of Neurological Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishiwata
authors.forename: Sunao
authors.initials: S
authors.lastname: Mizumura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mishina
authors.forename: Mineo
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Katayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000473:pathology; D001284:Atrophy; D016022:Case-Control Studies; D000077265:Donepezil; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D009929:Organ Size; D010880:Piperidines / Q000627:therapeutic use*; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil