Cheng Jianan, Yang Hua, Zhang Jiangtao
Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China.
Clin Neuropharmacol. 2019 Mar/Apr;42(2):42-48. doi: 10.1097/WNF.0000000000000324.
Donepezil is known to increase cholinergic synaptic transmission in Alzheimer disease (AD), although how it affects cortical brain activity and how it consequently affects brain functions need further clarification. To investigate the therapeutic mechanism of donepezil underlying its effect on brain function, regional homogeneity (ReHo) technology was used in this study.
This study included 11 mild-to-moderate AD patients who completed 24 weeks of donepezil treatment and 11 matched healthy controls. All participants finished neuropsychological assessment and resting-state functional magnetic resonance imaging scanning to compare whole-brain ReHo before and after donepezil treatment.
Significantly decreased Alzheimer's Disease Assessment Scale-Cognitive Subscale scores (P = 0.010) and increased Mini-Mental State Examination scores (P = 0.043) were observed in the AD patients. In addition, in the right gyrus rectus (P = 0.021), right precentral gyrus (P = 0.026), and left superior temporal gyrus (P = 0.043) of the AD patients, decreased ReHo was exhibited.
Donepezil-mediated improvement of cognitive function in AD patients is linked to spontaneous brain activities of the right gyrus rectus, right precentral gyrus, and left superior temporal gyrus, which could be used as potential biomarkers for monitoring the therapeutic effect of donepezil.
多奈哌齐已知可增强阿尔茨海默病(AD)中的胆碱能突触传递,尽管其如何影响大脑皮质活动以及如何进而影响脑功能仍需进一步阐明。为研究多奈哌齐对脑功能影响的治疗机制,本研究采用了局部一致性(ReHo)技术。
本研究纳入了11例完成24周多奈哌齐治疗的轻至中度AD患者以及11名匹配的健康对照者。所有参与者均完成神经心理学评估和静息态功能磁共振成像扫描,以比较多奈哌齐治疗前后的全脑ReHo。
AD患者的阿尔茨海默病评估量表认知分量表得分显著降低(P = 0.010),简易精神状态检查表得分升高(P = 0.043)。此外,AD患者的右侧直回(P = 0.021)、右侧中央前回(P = 0.026)和左侧颞上回(P = 0.043)表现出ReHo降低。
多奈哌齐介导的AD患者认知功能改善与右侧直回、右侧中央前回和左侧颞上回的自发脑活动有关,这些脑区可作为监测多奈哌齐治疗效果的潜在生物标志物。