Differential increase in cerebrospinal fluid-acetylcholinesterase after treatment with acetylcholinesterase inhibitors in patients with Alzheimer's disease

The clinical significance and the effects of pharmacological treatment of p atients with Alzheimer's disease (AD) were evaluated by measurement of acet ylcholinesterase (AChE) in the cerebrospinal fluid (CSF). CSF-AChE of AD pa tients was lower, not significantly, compared with controls. However, CSF-A ChE was significantly increased after treatment of AD patients with AChE in hibitors (donepezil and galantamine). The increase was higher in patients t reated with donezepil than in those treated with galantamine, which might b e related to different mechanisms for the substances. The increase was also dose-dependent, and was especially marked in patients showing a clinical r esponse. These data suggest that CSF biomarkers are capable not only of ide ntifying a biochemical effect of drugs, but also of differentiating between different compounds in a dose-dependent manner. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.