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Eur Neurol. 2012;68(3):137-43. Epub 2012 Jul 25.

Cholinergic deficit and response to donepezil therapy in Parkinson's disease with dementia.

Author information

1
Division of Cyclotron Nuclear Medicin, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan. khiraoka@cyric.tohoku.ac.jp

Abstract

BACKGROUND:

Although donepezil, an acetylcholinesterase inhibitor, has been proved to be effective in ameliorating cognitive impairment in Parkinson's disease with dementia (PDD), the responsiveness of patients to donepezil therapy varies. [5-(11)C-methoxy]donepezil, the radiolabeled form of donepezil, is a ligand for positron emission tomography (PET), which can be exploited for the quantitative analysis of donepezil binding to acetylcholinesterase and for cholinergic imaging.

OBJECTIVES:

To investigate the deficits of the cholinergic system in the brain in PDD and its association with response to donepezil therapy.

METHODS:

Twelve patients with PDD and 13 normal control subjects underwent [5-(11)C-methoxy]donepezil-PET imaging. For patients with PDD, daily administration of donepezil was started after [5-(11)C-methoxy]donepezil-PET imaging and continued for 3 months.

RESULTS:

In the PDD group, the mean total distribution volume of the cerebral cortices was 22.7% lower than that of the normal control group. The mean total distribution volume of the patients with PDD was significantly correlated with improvement of visuoperceptual function after 3 months of donepezil therapy.

CONCLUSION:

The results suggest that donepezil therapy is more effective in patients with less decrease in acetylcholinesterase, a binding site of donepezil, at least in the specific cognitive domain.

PMID:
22832236
DOI:
10.1159/000338774
[Indexed for MEDLINE]

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