This is a fascinating scientific abstract from Japan on using brain SPECT to help predict who with dementia might benefit from donepezil (Aricept), one of the main acetyl choline enhancing agents. It highlights emerging literature on using scans to help predict treatment response. Enjoy.
BACKGROUND/OBJECTIVE: We attempted to determine whether the pretreatment regional cerebral blood flow (rCBF) might predict cognitive changes in response to donepezil treatment, as assessed in terms of the Alzheimer Disease Assessment Scale cognitive subscale (ADAS-cog), and in relation to the severity of subcortical hyperintensities (SH).
METHOD: Forty-one patients with Alzheimer’s disease (AD) were treated with donepezil at baseline. All the patients underwent a single photon emission computed tomography examination before donepezil therapy. They also completed the ADAS-cog at baseline and after 24 weeks of donepezil therapy. SH were assessed semiquantitatively using a recently developed visual rating scale. We analyzed the correlation between the baseline rCBF and changes in the ADAS-cog score using statistical parametric mapping, including the severity of the SH as a covariate.
RESULTS: Lower pretreatment rCBF levels in the right orbitofrontal cortex (OFC) predicted a better improvement in the ADAS-cog score in response to donepezil therapy. The severity of SH did not appear to influence this correlation.
CONCLUSIONS: This effect may reflect the choline acetyltransferase activity associated with the OFC. The presence of SH did not appear to influence the effect of donepezil therapy on the cognitive function as assessed by ADAS-cog.
Hongo J, Nakaaki S, Shinagawa Y, Murata Y, Sato J, Tatsumi H, Tohyama J, Soma T, Iidaka T, Fukui T, Mimura M, Furukawa TA. SPECT-identified neuroanatomical predictor of the cognitive effects of donepezil treatment in patients with Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;26(6):556-66. Epub 2008 Dec 10.
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
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Hello! I am,now, 65 years “young”!! I just turned 65 May 2!! I have had a number of seizures ( about 10) both grand and petite. I am married with two daughters My husband will be 65 in August. I have had two major (grand mal) seizures in my life and many small “petite” in my life. I am currently taking and have been for many years, under medication. I seem to be fine yet, I feel,as a result of several seizures, to have lost(as expected/explained) some memory. I am taking Ariciept(sp) for about three months. I hope this will somewhat “stall off”…..THE INEVITIBLE! Is it possible that you could recommend some books or articles that YOU could/would reccommend!
Thank you
Sharon L. Wulf
slwulf@yahoo.com
I am currently 43 yrs. old with ADD (the zone-out type). I have been treated for ADD since 1993. I am an env. scientist, and in 1998 I was given Aricept for memory recall issues. It helped significantly, which really scared me with the thoughts of potentially having Alzheimers on top of the ADD. I stopped taking it – I suppose wanting to show myself I could manage my memory challenges without Aricept. I underwent the baseline 3-4 day evaluation at Dr. Amens Newport Beach clinic last September, and now that I have my spect scans in-hand, I would like to know more about this study and others like it. Can you provide me with direction on where I should begin looking to find such studies.
Thank You-
S.M. Steele
My wife, almost 75, had mini-strokes about ten years ago, probably because of hormone replacement therapy. She now has significant short-term memory problems as well as some cognitive impairment. She drives, is physically active, does crosswords better than I. I have to help her manage her medications and other responsibilities. She is trim and in good health otherwise. Should she be taking Aricept? What else could we do?
In Jan 1989 I suffered a closed head injury the right frontal lobe of my brain. I was unconscience for 30 days (part of which the trauma unit induced). I am now having pretty good results from a new (to me) medication Methylphenid (5MG). I’m curious have these 20 years impeded my recoverey or can I do anything that may help me?
I am now 48. At age 30 I had a R. frontal lobectomy to remove the foci of my seizures, which was found to be from trauma (skull fragments in brain). I have been involved in MANY major MVA,since, of each I have been hit with airbag. Last time I was incoherent (3 yrs ago),prior, I lost consciousness for short period.Prior to that, (2001), I was unconscious for days. I broke neck,shoulder,ribs, punctured lungs/abdomen, crushed/dislocated both knees, crushed R ankle. I was airlifted to trauma 1 cntr.This is the first serious trauma.I have seemed to be having memory loss, more so after each wreck. Is it too late for me to get any help? And, though I’ve never been offically diagnosed with TBI, I feel there is no doubt! Would your clinic be able to help or recommend anything? (my seizures are now under cntrl since 2002, with only a few “breakthoughs”). On multi-meds.Memory probs. are short-term, and seem to be worsening.
Patients with TBI need to contact Dr. Peter Mueller at Princeton who is treating these patients with amazing and rapid response with Meridia, currently only FDA approved for weight loss. It has totally transformed my daughter’s life, and there are a multitude of people whom he has treated who will say the same. He is a pioneer and visionary and a good friend of Daniel Amen’s.
I am on a potion of 5 tbs flaxseed oil, 1/4 cup of cottage cheese and 3 tbs of Cayenne pepper each morning before breakfast. I started with 1/2 tps cayenne pepper.
I walk 2.5 miles day least 5 or 6 days a week.
I take my vitamin’s and I am not any medications.
Hi. I was wondering if someone who does not have alzheimers but has significant memory problems along with lack of concentration and focus can benefit from taking arceipt? I have also suffered 3 closed head injuries in my life. I had a MRI which showed no structural defects. Thanks
I would appreciate your input on a question I have. If a person has had head injuries while playing football in college, could it effect the brain where he might go off the deep end and commit rape or even murder? Thank you very much for your response.
I enjoy watching job of MD Daniel Amen.
Absolutely brilliant man and doctor.
Can imagine his full greatness if not a fluoridation of his brain for 50 years by manager of all our affairs.
Many thanks, doctor Amen!