Orbital and dorsolateral frontal perfusion defect associated with behavioral response to cholinesterase inhibitor therapy in Alzheimer's disease

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 baselin e [Tc-99m] HMPAO SPECT. Thirty AD patients were divided into three groups ( Responders, Nonresponders, and Unchanged) based on their behavioral respons e to donepezil. Responders had significantly (P less than or equal to 0.01) move pretreatment irritability, disinhibition (P less than or equal to 0.0 5), and euphoria (P=0.05) than Nonresponders and significantly lower latera l orbital frontal (P<0.00001) and dorsolateral frontal (P less than or equa l to 0.0005) perfusion bilaterally. A pretreatment orbitofrontal syndrome m ay predict behavioral response to cholinesterase inhibitor therapy in AD.