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Published Online: 1 May 2000

Orbital and Dorsolateral Frontal Perfusion Defect Associated With Behavioral Response to Cholinesterase Inhibitor Therapy in Alzheimer's Disease

Michael S. Mega, M.D., Ph.D., Ivo D. Dinov, Ph.D., Linda Lee, B.S., Susan M. O'Connor, R.N.C., Donna M. Masterman, M.D., Barry Wilen, M.D., Fred Mishkin, M.D., Arthur W. Toga, Ph.D., and Jeffrey L. Cummings, M.D.Authors Info & Affiliations
Publication: The Journal of Neuropsychiatry and Clinical Neurosciences
Volume 12, Number 2
https://doi.org/10.1176/jnp.12.2.209
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Abstract

The authors retrospectively explored the behavioral and functional imaging profile of Alzheimer's disease (AD) patients who respond to cholinesterase inhibitor therapy by using the Neuropsychiatric Inventory (NPI) and baseline [99mTc]HMPAO SPECT. Thirty AD patients were divided into three groups (Responders, Nonresponders, and Unchanged) based on their behavioral response to donepezil. Responders had significantly (P≤0.01) more pretreatment irritability, disinhibition (P≤0.05), and euphoria (P=0.05) than Nonresponders and significantly lower lateral orbital frontal (P<0.00001) and dorsolateral frontal (P≤0.0005) perfusion bilaterally. A pretreatment orbitofrontal syndrome may predict behavioral response to cholinesterase inhibitor therapy in AD.

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Information & Authors

Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Volume 12 • Number 2 • May 2000
Pages: 209 - 218
PubMed: 11001599

History

Published online: 1 May 2000
Published in print: May 2000

Authors

Details

Michael S. Mega, M.D., Ph.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Ivo D. Dinov, Ph.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Linda Lee, B.S.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Susan M. O'Connor, R.N.C.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Donna M. Masterman, M.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Barry Wilen, M.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Fred Mishkin, M.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Arthur W. Toga, Ph.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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Jeffrey L. Cummings, M.D.
Received August 4, 1999; revised October 26, 1999; accepted November 19, 1999. From the Departments of Neurology, Nuclear Medicine Harbor/UCLA, Laboratory of Neuro Imaging, Alzheimer's Disease Center, and Department of Psychiatry and Biobehavioral Science, UCLA School of Medicine, Los Angeles, California. Address correspondence to Dr. Mega, Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769.
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