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The changes of cortical metabolism associated with the clinical response to donepezil therapy in traumatic brain injury

 Yong Wook Kim  ;  Deog Young Kim  ;  Ji-Cheol Shin  ;  Chang-il Park  ;  Jong Doo Lee 
 CLINICAL NEUROPHARMACOLOGY, Vol.32(2) : 63-68, 2009 
Journal Title
Issue Date
Adult ; Brain Injuries/drug therapy ; Brain Injuries/pathology* ; Cerebral Cortex/drug effects* ; Cerebral Cortex/metabolism* ; Drug Administration Schedule ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Indans/pharmacology* ; Indans/therapeutic use ; Male ; Mental Status Schedule ; Middle Aged ; Neuropsychological Tests ; Nootropic Agents/pharmacology* ; Nootropic Agents/therapeutic use ; Piperidines/pharmacology* ; Piperidines/therapeutic use ; Positron-Emission Tomography/methods
donepezil ; cortical metabolism ; traumatic brain injury ; cognitive impairment ; cerebral neural network
OBJECTIVES: To determine the effects of treatment with donepezil on cortical metabolism in patients with traumatic brain injury using F-fluorodeoxyglucose positron emission tomography. METHODS: Twenty-six patients with cognitive impairment after traumatic brain injury were enrolled and randomly assigned into the donepezil-treated group and the control group. There was no significant difference between 2 groups in age, sex, education, and postinjury duration. Donepezil 5 mg was administered daily for 3 weeks and then 10 mg/d for 3 weeks to patients in the experimental groups. For both groups, we evaluated cognitive function with Mini-Mental State Examination, Wechsler Memory Test, Boston Naming Test, Colored Progressive Matrices upon initial evaluation and at the 6-week follow-up. An 18F-fluorodeoxyglucose positron emission tomography of the brain was performed before and after 6 weeks of the donepezil-treated group. Effects of donepezil treatment on cortical metabolism were analyzed using Statistical Parametric Mapping software (Institute of Neurology, University College London, UK). RESULTS: There was no significance difference between the 2 groups in initial evaluation of cognitive functions. After 6 weeks, compared with the control group, donepezil-treated group showed enhanced cognitive functions (P < 0.05), and 18F-fluorodeoxyglucose positron emission tomography showed a statistically significant increase in the cerebral cortical metabolism for both of the frontal, parietal, occipital, and temporal cortices (P < 0.01) which are the key role of attention and object naming. CONCLUSIONS: Cholinergic augmentation by donepezil therapy in traumatic brain injury shows a cortical metabolic effect on the both of the frontal, parietal, occipital, and temporal cortices associated with clinical response to treatment.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deog Young(김덕용) ORCID logo https://orcid.org/0000-0001-7622-6311
Kim, Yong Wook(김용욱) ORCID logo https://orcid.org/0000-0002-5234-2454
Park, Chang Il(박창일)
Shin, Ji Cheol(신지철) ORCID logo https://orcid.org/0000-0002-1133-1361
Lee, Jong Doo(이종두)
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