Original ArticlesGreater Responsiveness to Donepezil in Alzheimer Patients With Higher Levels of Acetylcholinesterase Based on Attention Task Scores and a Donepezil PET StudyKasuya, Masashi PhD*; Meguro, Kenichi MD, PhD*; Okamura, Nobuyuki MD, PhD†; Funaki, Yoshihito PhD‡; Ishikawa, Hiroyasu MD*; Tanaka, Naofumi MD, PhD*; Iwata, Ren PhD‡; Yanai, Kazuhiko MD, PhD†Author Information Departments of *Geriatric Behavioral Neurology †Pharmacology, Tohoku University Graduate School of Medicine ‡Cyclotron Radioisotope Center, Tohoku University, Sendai, Japan This study was supported by grants from the Japanese Ministry of Education, Culture, Sports, Science, and Technology, C-21591543. The authors declare no conflict of interest. Reprints: Kenichi Meguro, MD, PhD, Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-machi, Aoba-ku, 980-8575 Sendai, Japan (e-mail: email@example.com). Received August 23, 2010 Accepted December 2, 2010 Alzheimer Disease & Associated Disorders: April-June 2012 - Volume 26 - Issue 2 - p 113-118 doi: 10.1097/WAD.0b013e3182222bc0 Buy Metrics Abstract The aim of the study was to predict donepezil responders among patients with Alzheimer disease (AD) based on cognitive tests and positron emission tomography. The Mini-Mental State Examination, Digit Symbol subtest (DigSm) of Wechsler Adult Intelligence Scale Revised, and Trail-Making Test A were administered for 80 patients with AD to assess global function, attention, and executive function, respectively. The same tests and the Clinical Global Impression (CGI) scale were conducted after treatment with oral donepezil (5 mg/d) for 6 months (study 1). [11C]-Donepezil positron emission tomography examinations were conducted before and after treatment for 30 randomly selected patients. The distribution volume (DV), which indicates the density of donepezil-binding sites, was calculated using Logan graphical analysis (study 2). In study 1, 35 patients were identified as responders based on the CGI and Mini-Mental State Examination changes. These patients had higher baseline DigSm scores compared with nonresponders. In study 2, 15 patients were responders. DigSm correlated with DV at baseline. DV at baseline and %DV change in responders were higher than in nonresponders, and these variables correlated with ΔDigSm and CGI scores. Higher baseline attention may predict responsiveness to donepezil in patients with AD, and higher acetylcholinesterase levels result in a greater clinical effect. © 2012 Lippincott Williams & Wilkins, Inc.