CLINICAL INVESTIGATIONS Donepezil Hydrochloride Preserves Regional Cerebral Blood Flow in Patients with Alzheimer’s Disease

The aim of this SPECT study was to investigate the effects of donepezil on regional cerebral blood flow (rCBF) in patients with mild to moderate Alzheimer’s disease (AD) using statistical parametric mapping. Methods: rCBF was noninvasively measured using 99mTc-ethyl cysteinate dimer in 35 AD patients with a Mini-Mental State Examination score . 16 on initial evaluation. Baseline and follow-up SPECT studies with a mean interval of 12 mo were performed on these patients. We used the adjusted rCBF images in the relative flow distribution (normalization of global cerebral blood flow for each patient to 50 mL/100 g/min with proportional scaling) to compare these groups through statistical parametric mapping. Results: In the follow-up study, the adjusted rCBF was significantly preserved in the right and left anterior cingulate gyri, right middle temporal gyrus, right inferior parietal lobules, and prefrontal cortex of donepezil-treated AD patients, compared with placebo-treated AD patients. Conclusion: Treatment with donepezil for 1 y appears to reduce the decline in rCBF, suggesting preservation of functional brain activity.