Orbital and dorsolateral frontal perfusion defect associated with behavioral response to cholinesterase inhibitor therapy in Alzheimer's disease

J Neuropsychiatry Clin Neurosci. Spring 2000;12(2):209-18. doi: 10.1176/jnp.12.2.209.

Abstract

The authors retrospectively explored the behavioral and functional imaging profile of Alzheimer's disease (AD) patients who respond to cholinesterase inhibitor therapy by using the Neuropsychiatric Inventory (NPI) and baseline [99mTc]HMPAO SPECT. Thirty AD patients were divided into three groups (Responders, Nonresponders, and Unchanged) based on their behavioral response to donepezil. Responders had significantly (P < or = 0.01) more pretreatment irritability, disinhibition (P < or = 0.05), and euphoria (P = 0.05) than Nonresponders and significantly lower lateral orbital frontal (P < 0.00001) and dorsolateral frontal (P < or = 0.0005) perfusion bilaterally. A pretreatment orbitofrontal syndrome may predict behavioral response to cholinesterase inhibitor therapy in AD.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Alzheimer Disease / diagnostic imaging
  • Alzheimer Disease / drug therapy*
  • Alzheimer Disease / physiopathology*
  • Behavior / drug effects
  • Behavior / physiology
  • Cerebrovascular Circulation / drug effects
  • Cerebrovascular Circulation / physiology*
  • Cholinesterase Inhibitors / therapeutic use*
  • Double-Blind Method
  • Female
  • Frontal Lobe / blood supply*
  • Frontal Lobe / diagnostic imaging
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Psychiatric Status Rating Scales
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Technetium Tc 99m Exametazime
  • Trichlorfon / therapeutic use

Substances

  • Cholinesterase Inhibitors
  • Radiopharmaceuticals
  • Technetium Tc 99m Exametazime
  • Trichlorfon