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Arch Neurol. 2005 Nov;62(11):1718-22.

Neuroanatomical predictors of response to donepezil therapy in patients with dementia.

Author information

1
Alzheimer's Disease Research Center, and Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA. jgc@conte.wustl.edu

Abstract

BACKGROUND:

Patients with dementia of the Alzheimer type (DAT) respond variably to treatment with acetylcholinesterase inhibitors.

OBJECTIVE:

To determine whether measures of hippocampal volume and shape predict the response to donepezil in patients with DAT.

DESIGN:

T1-weighted, magnetic resonance images were obtained from patients with DAT, who subsequently underwent treatment with donepezil. Brain-mapping algorithms were used to quantify hippocampal volume and shape, and growth curves were used to estimate clinical outcome.

SETTING:

A referral outpatient center specializing in treatment of dementia.

PATIENTS:

Thirty-seven patients with very mild or mild DAT received donepezil therapy for up to 4 weeks before magnetic resonance imaging and for 24 to 96 weeks after magnetic resonance imaging.

INTERVENTION:

Donepezil, 10 mg/d.

MAIN OUTCOME MEASURE:

Rate of change in the cognitive portion of the Alzheimer's Disease Assessment Scale total scores.

RESULTS:

Smaller hippocampal volume and inward variation of the lateral and inferomedial portions of the hippocampal surface were correlated with a poorer response to donepezil therapy.

CONCLUSIONS:

Measures of hippocampal volume and surface variation can be used to predict the response of patients with DAT to the acetylcholinesterase inhibitor donepezil.

PMID:
16286546
DOI:
10.1001/archneur.62.11.1718
[Indexed for MEDLINE]
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