GOOD or BAD responder? Behavioural and neuroanatomical markers of clinical response to donepezil in dementia

Gabriella Bottini, Manuela Berlingeri, Stefania Basilico, Serena Passoni, Laura Danelli, Nadia Colombo, Maurizio Sberna, Massimo Franceschi, Roberto Sterzi, Eraldo Paulesu

Research output: Contribution to journalArticlepeer-review

Abstract

We explored the neuropsychological and neuromorphometrical differences between probable Alzheimer's disease patients showing a good or a bad response to nine months treatment with donepezil. Before treatment, the neuropsychological profile of the two patient groups was perfectly matched. By the ninth month after treatment, the BAD-responders showed a decline of the MMSE score together with a progressive impairment of executive functions. A voxel-based morphometry investigation (VBM), at the time of the second neuropsychological assessment, showed that the BAD-responders had larger grey and white matter atrophies involving the substantia innominata of Meynert bilaterally, the ventral part of caudate nuclei and the left uncinate fasciculus, brain areas belonging to the cholinergic pathways. A more widespread degeneration of the central cholinergic pathways may explain the lack of donepezil efficacy in those patients not responding to a treatment that operates on the grounds that some degree of endogeneous release of acetylcholine is still available.

Original languageEnglish
Pages (from-to)61-72
Number of pages12
JournalBehavioural Neurology
Volume25
Issue number2
DOIs
Publication statusPublished - 2012

Keywords

  • Acetilcholinesterase inhibitors
  • Alzheimer's disease
  • donepezil
  • MRI
  • voxel-based morphometry

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Clinical Neurology
  • Neurology

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