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Greater responsiveness to donepezil in Alzheimer patients with higher levels of acetylcholinesterase based on attention task scores and a donepezil PET study


Kasuya, Masashi, Meguro, Kenichi, Okamura, Nobuyuki, Funaki, Yoshihito, Ishikawa, Hiroyasu, Tanaka, Naofumi, Iwata, Ren, Yanai, Kazuhiko


Alzheimer Disease And Associated Disorders, Volume: 26, No.: 2, Pages.: 113-118

Year of Publication



The aim of the study was to predict donepezil responders among patients with Alzheimer disease (AD) based on cognitive tests and positron emission tomography. The Mini-Mental State Examination, Digit Symbol subtest (DigSm) of Wechsler Adult Intelligence Scale Revised, and Trail-Making Test A were administered for 80 patients with AD to assess global function, attention, and executive function, respectively. The same tests and the Clinical Global Impression (CGI) scale were conducted after treatment with oral donepezil (5 mg/d) for 6 months (study 1). [C]-Donepezil positron emission tomography examinations were conducted before and after treatment for 30 randomly selected patients. The distribution volume (DV), which indicates the density of donepezil-binding sites, was calculated using Logan graphical analysis (study 2). In study 1, 35 patients were identified as responders based on the CGI and Mini-Mental State Examination changes. These patients had higher baseline DigSm scores compared with nonresponders. In study 2, 15 patients were responders. DigSm correlated with DV at baseline. DV at baseline and %DV change in responders were higher than in nonresponders, and these variables correlated with ΔDigSm and CGI scores. Higher baseline attention may predict responsiveness to donepezil in patients with AD, and higher acetylcholinesterase levels result in a greater clinical effect.;

Bibtex Citation

@article{Kasuya_2012, doi = {10.1097/wad.0b013e3182222bc0}, url = {}, year = 2012, publisher = {Ovid Technologies (Wolters Kluwer Health)}, volume = {26}, number = {2}, pages = {113--118}, author = {Masashi Kasuya and Kenichi Meguro and Nobuyuki Okamura and Yoshihito Funaki and Hiroyasu Ishikawa and Naofumi Tanaka and Ren Iwata and Kazuhiko Yanai}, title = {Greater Responsiveness to Donepezil in Alzheimer Patients With Higher Levels of Acetylcholinesterase Based on Attention Task Scores and a Donepezil {PET} Study}, journal = {Alzheimer Disease {&} Associated Disorders} }


acetylcholinesterase, aged, aged, 80 and over, alzheimer disease, attention, cholinesterase inhibitors, donepezil, drug therapy, enzymology, female, humans, indans, male, metabolism, middle aged, neuropsychological tests, physiology, physiopathology, piperidines, positronemission tomography, radionuclide imaging, therapeutic use

Countries of Study


Types of Dementia

Alzheimer’s Disease

Types of Study

Before and After Study

Type of Outcomes


Type of Interventions

Pharmaceutical Interventions

Pharmaceutical Interventions

Anti-Alzheimer medications, e.g.: donezepil, galantamine, rivastigmine, memantime