title: Left frontal lobe hypoperfusion and depressive symptoms in Alzheimer's disease patients taking cholinesterase inhibitors.
abstract: Depressive symptoms are common in patients with Alzheimer's disease (AD) and increase the caregiver burden. Many studies have reported dorsolateral prefrontal hypometabolism or hypoperfusion in AD patients with depressive symptoms, most of whom did not take acetylcholinesterase inhibitors (AChEI). It is not clear, however, whether a similar condition is present in patients taking AChEI medication. Fifty-seven consecutive AD patients taking AChEI were recruited at a memory clinic. Objective depressive symptoms were evaluated using the depression domain of the Neuropsychiatric Inventory (NPI-dep). All patients underwent brain single photon emission computed tomography (SPECT) with (99m)Tc-ethylcysteinate dimer, and the SPECT images were analyzed using the Statistical Parametric Mapping 8 program. No significant differences between groups with positive and negative NPI-dep scores were found with respect to age, sex, years of education, and cognitive function. Compared with patients with negative NPI-dep scores, patients with NPI-dep scores ≥1 showed significant hypoperfusion in the left middle frontal region. Our results indicate that the dorsolateral prefrontal area is significantly involved in the pathogenesis of depressive symptoms in AD patients being treated with AChEI. The area on the left side especially may be closely related to the depressive symptoms evaluated using the NPI.
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Oshima
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan. Electronic address: terada@cc.okayama-u.ac.jp.
authors.forename: Seishi
authors.initials: S
authors.lastname: Terada
authors.affiliation: Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Ikeda
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Oda
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Kawada
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokota
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003863:Depression / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Acetylcholine esterase inhibitor (AChEI); Alzheimer׳s disease; Depression; Neuropsychiatric inventory (NPI); Regional cerebral blood flow (rCBF)