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Donepezil treatment and changes in hippocampal structure in very mild Alzheimer disease

Lei Wang1, Michael P Harms, Jarrod M Staggs

  • 1Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. leiwang1@northwestern.edu

Archives of Neurology
|January 13, 2010
PubMed
Abstract

Insights

Donepezil treatment did not change hippocampal structure progression in very mild Alzheimer's disease. Untreated patients showed significant hippocampal changes compared to controls, suggesting donepezil may not halt early-stage disease progression.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Pharmacology

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • The hippocampus is crucial for memory and is significantly affected in AD.
  • Donepezil hydrochloride is a commonly prescribed acetylcholinesterase inhibitor for AD.

Purpose of the Study:

  • To compare longitudinal changes in hippocampal structure in very mild dementia of the Alzheimer type (DAT) patients treated with donepezil versus untreated patients and healthy controls.
  • To assess the effect of donepezil on hippocampal volume and subfield deformation over approximately two years.

Main Methods:

  • Longitudinal MRI (MPRAGE sequences) collected ~2 years apart on 1.5-T scanners.
  • Large-deformation, high-dimensional brain mapping to compute hippocampal subfield deformation.
  • Comparison of treated DAT, untreated DAT, and control groups.

Main Results:

  • No significant difference in the rate of hippocampal volume change or subfield deformation between donepezil-treated DAT patients and controls.
  • Untreated DAT patients showed significantly greater rates of hippocampal volume loss and deformation in CA1 and subiculum compared to controls.
  • Treated DAT patients did not differ from untreated DAT patients in the rate of hippocampal changes.

Conclusions:

  • Donepezil treatment did not alter the progression of hippocampal deformation in very mild DAT patients in this study.
  • The lack of observed effect may be attributed to a small sample size.
  • Further research with larger cohorts is warranted to confirm these findings.

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