title: Differential effects of acetylcholinesterase inhibitors on clinical responses and cerebral blood flow changes in patients with Alzheimer's disease: a 12-month, randomized, and open-label trial.
abstract: OBJECTIVE
  The present study evaluated the differences in treatment outcomes and brain perfusion changes among 3 types of acetylcholinesterase inhibitors (AchEIs, i.e. donepezil, rivastigmine, and galantamine).
  
  
  METHODS
  This was a prospective, longitudinal, randomized, open-label, 3-arm (donepezil, rivastigmine, or galantamine), parallel-group, 12-month clinical trial carried out in 55 patients with AD.
  
  
  RESULTS
  At 6 months, the results of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT)-Part A showed an improvement versus baseline in the donepezil treatment group. All groups showed a significant increase in regional cerebral blood flow (rCBF), mainly in the frontal lobe. Significant rCBF reduction was observed in the temporal lobe and cingulate gyrus in all 3 groups.
  
  
  CONCLUSIONS
  AchEI treatment prevents the progression of cognitive impairment and increases the relative rCBF in the frontal lobe.
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Shimizu
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Kanetaka
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hirose
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hirohumi
authors.initials: H
authors.lastname: Sakurai
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Hanyu
keywords: Acetylcholinesterase inhibitors; Alzheimer's disease; Donepezil; Galantamine; Regional cerebral blood flow; Rivastigmine; Single-photon emission computed tomography