Neurophysiological predictors of long term response to AChE inhibitors in AD patients

Vincenzo Di Lazzaro, A. Oliviero, F. Pilato, E. Saturno, M. Dileone, C. Marra, S. Ghirlanda, F. Ranieri, G. Gainotti, P. Tonali

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Background: In vivo evaluation of cholinergic circuits of the human brain has recently been introduced using a transcranial magnetic stimulation (TMS) protocol based on coupling peripheral nerve stimulation with motor cortex TMS (short latency afferent inhibition, SAI). SAI is reduced in Alzheimer's disease (AD) and drugs enhancing cholinergic transmission increase SAI. Methods: We evaluated whether SAI testing, together with SAI test-retest, after a single dose of the acetylcholinesterase (AChE) inhibitor rivastigmine, might be useful in predicting the response after 1 year treatment with rivastigmine in 16 AD patients. Results: Fourteen AD patients had pathologically reduced SAI. SAI was increased after administration of a single oral dose of rivastigmine in AD patients with abnormal baseline SAI, but individual responses to rivastigmine varied widely, with SAI change ranging from an increase in inhibition of -50% of test size to no change. Baseline SAI and the increase in SAI after a single dose of rivastigmine were correlated with response to long term treatment. A normal SAI in baseline conditions, or an abnormal SAI in baseline conditions that was not greatly increased by a single oral dose of rivastigmine, were invariably associated with poor response to long term treatment, while an abnormal SAI in baseline conditions in conjunction with a large increase in SAI after a single dose of rivastigmine was associated with good response to long term treatment in most of the patients. Conclusions: Evaluation of SAI may be useful for identifying AD patients likely to respond to treatment with AChE inhibitors.

Original languageEnglish
Pages (from-to)1064-1069
Number of pages6
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume76
Issue number8
DOIs
Publication statusPublished - Aug 2005

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Cholinesterase Inhibitors
Rivastigmine
Alzheimer Disease
Inhibition (Psychology)
Transcranial Magnetic Stimulation
Cholinergic Agents
Therapeutics
Motor Cortex
Peripheral Nerves

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neuroscience(all)
  • Psychiatry and Mental health

Cite this

Di Lazzaro, V., Oliviero, A., Pilato, F., Saturno, E., Dileone, M., Marra, C., ... Tonali, P. (2005). Neurophysiological predictors of long term response to AChE inhibitors in AD patients. Journal of Neurology, Neurosurgery and Psychiatry, 76(8), 1064-1069. https://doi.org/10.1136/jnnp.2004.051334

Neurophysiological predictors of long term response to AChE inhibitors in AD patients. / Di Lazzaro, Vincenzo; Oliviero, A.; Pilato, F.; Saturno, E.; Dileone, M.; Marra, C.; Ghirlanda, S.; Ranieri, F.; Gainotti, G.; Tonali, P.

In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 76, No. 8, 08.2005, p. 1064-1069.

Research output: Contribution to journalArticle

Di Lazzaro, V, Oliviero, A, Pilato, F, Saturno, E, Dileone, M, Marra, C, Ghirlanda, S, Ranieri, F, Gainotti, G & Tonali, P 2005, 'Neurophysiological predictors of long term response to AChE inhibitors in AD patients', Journal of Neurology, Neurosurgery and Psychiatry, vol. 76, no. 8, pp. 1064-1069. https://doi.org/10.1136/jnnp.2004.051334
Di Lazzaro, Vincenzo ; Oliviero, A. ; Pilato, F. ; Saturno, E. ; Dileone, M. ; Marra, C. ; Ghirlanda, S. ; Ranieri, F. ; Gainotti, G. ; Tonali, P. / Neurophysiological predictors of long term response to AChE inhibitors in AD patients. In: Journal of Neurology, Neurosurgery and Psychiatry. 2005 ; Vol. 76, No. 8. pp. 1064-1069.
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abstract = "Background: In vivo evaluation of cholinergic circuits of the human brain has recently been introduced using a transcranial magnetic stimulation (TMS) protocol based on coupling peripheral nerve stimulation with motor cortex TMS (short latency afferent inhibition, SAI). SAI is reduced in Alzheimer's disease (AD) and drugs enhancing cholinergic transmission increase SAI. Methods: We evaluated whether SAI testing, together with SAI test-retest, after a single dose of the acetylcholinesterase (AChE) inhibitor rivastigmine, might be useful in predicting the response after 1 year treatment with rivastigmine in 16 AD patients. Results: Fourteen AD patients had pathologically reduced SAI. SAI was increased after administration of a single oral dose of rivastigmine in AD patients with abnormal baseline SAI, but individual responses to rivastigmine varied widely, with SAI change ranging from an increase in inhibition of -50{\%} of test size to no change. Baseline SAI and the increase in SAI after a single dose of rivastigmine were correlated with response to long term treatment. A normal SAI in baseline conditions, or an abnormal SAI in baseline conditions that was not greatly increased by a single oral dose of rivastigmine, were invariably associated with poor response to long term treatment, while an abnormal SAI in baseline conditions in conjunction with a large increase in SAI after a single dose of rivastigmine was associated with good response to long term treatment in most of the patients. Conclusions: Evaluation of SAI may be useful for identifying AD patients likely to respond to treatment with AChE inhibitors.",
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AU - Dileone, M.

AU - Marra, C.

AU - Ghirlanda, S.

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AU - Gainotti, G.

AU - Tonali, P.

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