Kim Yong Wook, Kim Deog Young, Shin Ji-Cheol, Park Chang-il, Lee Jong Doo
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Clin Neuropharmacol. 2009 Mar-Apr;32(2):63-8. doi: 10.1097/WNF.0B013E31816F1BC1.
To determine the effects of treatment with donepezil on cortical metabolism in patients with traumatic brain injury using F-fluorodeoxyglucose positron emission tomography.
Twenty-six patients with cognitive impairment after traumatic brain injury were enrolled and randomly assigned into the donepezil-treated group and the control group. There was no significant difference between 2 groups in age, sex, education, and postinjury duration. Donepezil 5 mg was administered daily for 3 weeks and then 10 mg/d for 3 weeks to patients in the experimental groups. For both groups, we evaluated cognitive function with Mini-Mental State Examination, Wechsler Memory Test, Boston Naming Test, Colored Progressive Matrices upon initial evaluation and at the 6-week follow-up. An 18F-fluorodeoxyglucose positron emission tomography of the brain was performed before and after 6 weeks of the donepezil-treated group. Effects of donepezil treatment on cortical metabolism were analyzed using Statistical Parametric Mapping software (Institute of Neurology, University College London, UK).
There was no significance difference between the 2 groups in initial evaluation of cognitive functions. After 6 weeks, compared with the control group, donepezil-treated group showed enhanced cognitive functions (P < 0.05), and 18F-fluorodeoxyglucose positron emission tomography showed a statistically significant increase in the cerebral cortical metabolism for both of the frontal, parietal, occipital, and temporal cortices (P < 0.01) which are the key role of attention and object naming.
Cholinergic augmentation by donepezil therapy in traumatic brain injury shows a cortical metabolic effect on the both of the frontal, parietal, occipital, and temporal cortices associated with clinical response to treatment.
使用F-氟脱氧葡萄糖正电子发射断层扫描技术，确定多奈哌齐治疗对创伤性脑损伤患者皮质代谢的影响。
纳入26例创伤性脑损伤后认知障碍患者，随机分为多奈哌齐治疗组和对照组。两组在年龄、性别、教育程度和伤后病程方面无显著差异。对实验组患者每日给予5mg多奈哌齐，持续3周，然后每日10mg，持续3周。两组均在初始评估时及6周随访时，使用简易精神状态检查表、韦氏记忆测验、波士顿命名测验、彩色渐进矩阵评估认知功能。对多奈哌齐治疗组在治疗6周前后进行脑部18F-氟脱氧葡萄糖正电子发射断层扫描。使用统计参数映射软件（英国伦敦大学学院神经病学研究所）分析多奈哌齐治疗对皮质代谢的影响。
两组在认知功能初始评估时无显著差异。6周后，与对照组相比，多奈哌齐治疗组认知功能增强（P<0.05），18F-氟脱氧葡萄糖正电子发射断层扫描显示额叶、顶叶、枕叶和颞叶皮质的脑皮质代谢均有统计学显著增加（P<0.01），这些区域在注意力和物体命名中起关键作用。
多奈哌齐治疗创伤性脑损伤时增强胆碱能作用，对额叶、顶叶、枕叶和颞叶皮质均显示出皮质代谢效应，且与治疗的临床反应相关。
