SPECT-identified neuroanatomical predictor of the cognitive effects of donepezil treatment in patients with Alzheimer's disease

Jin Hongo, Shutaro Nakaaki, Yoshihiro Shinagawa, Yoshie Murata, Junko Sato, Hiroshi Tatsumi, Junko Tohyama, Tsutomu Soma, Tetsuya Iidaka, Toshiya Fukui, Masaru Mimura, Toshiaki A. Furukawa

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Background/Objective: We attempted to determine whether the pretreatment regional cerebral blood flow (rCBF) might predict cognitive changes in response to donepezil treatment, as assessed in terms of the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), and in relation to the severity of subcortical hyperintensities (SH). Method: Forty-one patients with Alzheimer's disease (AD) were treated with donepezil at baseline. All the patients underwent a single photon emission computed tomography examination before donepezil therapy. They also completed the ADAS-cog at baseline and after 24 weeks of donepezil therapy. SH were assessed semiquantitatively using a recently developed visual rating scale. We analyzed the correlation between the baseline rCBF and changes in the ADAS-cog score using statistical parametric mapping, including the severity of the SH as a covariate. Results: Lower pretreatment rCBF levels in the right orbitofrontal cortex (OFC) predicted a better improvement in the ADAS-cog score in response to donepezil therapy. The severity of SH did not appear to influence this correlation. Conclusions: This effect may reflect the choline acetyltransferase activity associated with the OFC. The presence of SH did not appear to influence the effect of donepezil therapy on the cognitive function as assessed by ADAS-cog.

Original languageEnglish
Pages (from-to)556-566
Number of pages11
JournalDementia and Geriatric Cognitive Disorders
Issue number6
Publication statusPublished - 2008 Dec
Externally publishedYes


  • Alzheimer Disease Assessment Scale, cognitive subscale
  • Alzheimer's disease
  • Donepezil
  • Regional cerebral blood flow
  • Single photon emission computed tomography
  • Subcortical hyperintensities

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cognitive Neuroscience
  • Psychiatry and Mental health


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