Drug improves brain structure in Alzheimer's patients

DURHAM, N.C. -- Researchers at Duke University Medical Center have determined that a medication commonly prescribed for mild to moderate Alzheimer's disease (AD) appears to cause physical improvements in the hippocampus and other brain regions of patients with the disease. These improvements could explain why the drug, donepezil (trade name Aricept), a cholinesterase inhibitor, is beneficial in treating the symptoms of some Alzheimer's patients, the researchers said.

The findings were made by using magnetic resonance (MR) technology to track brain changes among patients taking the drug. According to the researchers, this is the first time MR has been used to observe the effects of a medication on brain structures of patients living with AD. The feasibility of using MR for such studies is likely to improve future research into treatments for AD and other brain disorders, the researchers said.

The study results appear in the Nov. 1, 2003, issue of the American Journal of Psychiatry.

"We wanted to know if the drugs available for Alzheimer's disease alter the brain or the progression of the disease in any way," said Ranga Krishnan, M.D., lead author of the study and chairman of psychiatry at Duke University Medical Center. "We discovered that, among the patients taking donepezil, levels of a brain chemical called N-acetylaspartate increased and the hippocampus deteriorated more slowly than among the patients who received a placebo. The implication is that we may be able to do something to change the progression of this disease."

The researchers believe the drug may have a protective effect on the brains of Alzheimer's patients because it appears to slow the progression of the disease by reducing atrophy in the hippocampus, a region of the brain that is critical to memory function and is affected earliest in AD.

"When someone has Alzheimer's disease, the brain begins to deteriorate as the gray matter shrinks and the disease progres

Contact: Tracey Koepke
Duke University Medical Center

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