Bokde Arun L W, Karmann Michaela, Teipel Stefan J, Born Christine, Lieb Martin, Reiser Maximilian F, Möller Hans-Jürgen, Hampel Harald
Dementia and Neuroimaging Research Section, Alzheimer Memorial Center and Geriatric Psychiatry Branch, Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany.
J Clin Psychopharmacol. 2009 Apr;29(2):147-56. doi: 10.1097/JCP.0b013e31819a8f2e.
Visual perception has been shown to be altered in Alzheimer disease (AD) patients, and it is associated with decreased cognitive function. Galantamine is an active cholinergic agent, which has been shown to lead to improved cognition in mild to moderate AD patients. This study examined brain activation in a group of mild AD patients after a 3-month open-label treatment with galantamine. The objective was to examine the changes in brain activation due to treatment. There were 2 tasks to visual perception. The first task was a face-matching task to test the activation along the ventral visual pathway, and the second task was a location-matching task to test neuronal function along the dorsal pathway. Brain activation was measured using functional magnetic resonance imaging. There were 5 mild AD patients in the study. There were no differences in the task performance and in the cognitive scores of the Consortium to Establish a Registry for Alzheimer's Disease battery before and after treatment. In the location-matching task, we found a statistically significant decrease in activation along the dorsal visual pathway after galantamine treatment. A previous study found that AD patients had higher activation in the location-matching task compared with healthy controls. There were no differences in activation for the face-matching task after treatment. Our data indicate that treatment with galantamine leads to more efficient visual processing of stimuli or changes the compensatory mechanism in the AD patients. A visual perception task recruiting the dorsal visual system may be useful as a biomarker of treatment effects.
视觉感知在阿尔茨海默病（AD）患者中已被证明发生改变，且与认知功能下降有关。加兰他敏是一种活性胆碱能药物，已被证明可改善轻至中度AD患者的认知功能。本研究检测了一组轻度AD患者在接受为期3个月的加兰他敏开放标签治疗后的脑激活情况。目的是研究治疗引起的脑激活变化。有两项视觉感知任务。第一项任务是面部匹配任务，用于测试腹侧视觉通路的激活情况，第二项任务是位置匹配任务，用于测试背侧通路的神经元功能。使用功能磁共振成像测量脑激活情况。该研究中有5名轻度AD患者。治疗前后，阿尔茨海默病注册协会电池组的任务表现和认知评分均无差异。在位置匹配任务中，我们发现加兰他敏治疗后背侧视觉通路的激活有统计学意义的下降。先前的一项研究发现，与健康对照相比，AD患者在位置匹配任务中的激活更高。治疗后面部匹配任务的激活没有差异。我们的数据表明，加兰他敏治疗可使AD患者对刺激进行更有效的视觉处理或改变其代偿机制。一项招募背侧视觉系统的视觉感知任务可能作为治疗效果的生物标志物有用。
