Shimizu Soichiro, Kanetaka Hidekazu, Hirose Daisuke, Sakurai Hirohumi, Hanyu Haruo
Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
Dement Geriatr Cogn Dis Extra. 2015 Apr 10;5(1):135-46. doi: 10.1159/000375527. eCollection 2015 Jan-Apr.
BACKGROUND/AIMS: The present study evaluated the differences in treatment outcomes and brain perfusion changes among 3 types of acetylcholinesterase inhibitors (AchEIs, i.e. donepezil, rivastigmine, and galantamine).
This was a prospective, longitudinal, randomized, open-label, 3-arm (donepezil, rivastigmine, or galantamine), parallel-group, 12-month clinical trial carried out in 55 patients with AD.
At 6 months, the results of the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT)-Part A showed an improvement versus baseline in the donepezil treatment group. All groups showed a significant increase in regional cerebral blood flow (rCBF), mainly in the frontal lobe. Significant rCBF reduction was observed in the temporal lobe and cingulate gyrus in all 3 groups.
AchEI treatment prevents the progression of cognitive impairment and increases the relative rCBF in the frontal lobe.
背景/目的：本研究评估了3种乙酰胆碱酯酶抑制剂（AChEIs，即多奈哌齐、卡巴拉汀和加兰他敏）在治疗效果和脑灌注变化方面的差异。
这是一项前瞻性、纵向、随机、开放标签、三臂（多奈哌齐、卡巴拉汀或加兰他敏）、平行组、为期12个月的临床试验，共纳入55例阿尔茨海默病患者。
在6个月时，多奈哌齐治疗组的简易精神状态检查表（MMSE）和连线测验（TMT）-A部分结果与基线相比有所改善。所有组的局部脑血流量（rCBF）均显著增加，主要在额叶。在所有3组中，颞叶和扣带回均观察到rCBF显著降低。
AChEI治疗可预防认知障碍的进展，并增加额叶的相对rCBF。
