Greater Responsiveness to Donepezil in Alzheimer Patients With Higher Levels of Acetylcholinesterase Based on Attention Task Scores and a Donepezil PET Study
Alzheimer Disease & Associated Disorders , 06/15/2012  Clinical Article

Kasuya M et al. – Higher baseline attention may predict responsiveness to donepezil in patients with AD, and higher acetylcholinesterase levels result in a greater clinical effect.

• The Mini–Mental State Examination, Digit Symbol subtest (DigSm) of Wechsler Adult Intelligence Scale Revised, and Trail–Making Test A were administered for 80 patients with AD to assess global function, attention, and executive function, respectively.
• The same tests and the Clinical Global Impression (CGI) scale were conducted after treatment with oral donepezil (5 mg/d) for 6 months (study 1).
• [11C]–Donepezil positron emission tomography examinations were conducted before and after treatment for 30 randomly selected patients.
• The distribution volume (DV), which indicates the density of donepezil–binding sites, was calculated using Logan graphical analysis (study 2).

• In study 1, 35 patients were identified as responders based on the CGI and Mini–Mental State Examination changes.
• These patients had higher baseline DigSm scores compared with nonresponders.
• In study 2, 15 patients were responders.
• DigSm correlated with DV at baseline.
• DV at baseline and %DV change in responders were higher than in nonresponders, and these variables correlated with ΔDigSm and CGI scores.