Journal of Neural Transmission

, Volume 113, Issue 11, pp 1787–1790

Brain perfusion effects of cholinesterase inhibitors in Parkinson’s disease with dementia

Authors

  • R. Ceravolo
    • Department of NeuroscienceNeurology Section and University of Pisa
  • D. Volterrani
    • Department of NeuroscienceNeurology Section and University of Pisa
    • Nuclear Medicine ServiceUniversity of Pisa
  • D. Frosini
    • Department of NeuroscienceNeurology Section and University of Pisa
  • S. Bernardini
    • Department of NeuroscienceNeurology Section and University of Pisa
  • C. Rossi
    • Department of NeuroscienceNeurology Section and University of Pisa
  • C. Logi
    • Department of NeuroscienceNeurology Section and University of Pisa
  • G. Manca
    • Department of NeuroscienceNeurology Section and University of Pisa
    • Nuclear Medicine ServiceUniversity of Pisa
  • L. Kiferle
    • Department of NeuroscienceNeurology Section and University of Pisa
  • G. Mariani
    • Department of NeuroscienceNeurology Section and University of Pisa
    • Nuclear Medicine ServiceUniversity of Pisa
  • L. Murri
    • Department of NeuroscienceNeurology Section and University of Pisa
  • U. Bonuccelli
    • Department of NeuroscienceNeurology Section and University of Pisa
Short Communication

DOI: 10.1007/s00702-006-0478-6

Cite this article as:
Ceravolo, R., Volterrani, D., Frosini, D. et al. J Neural Transm (2006) 113: 1787. doi:10.1007/s00702-006-0478-6

Summary.

Several evidences suggest that cholinergic deficits may significantly contribute to dementia in Parkinson’s disease (PDD) and acetylcholinesterase inhibitors (ChEIs) have been reported to improve cognitive symptoms in PDD, without worsening parkinsonism. Nineteen PDD patients underwent brain perfusion SPECT with 99mTc-ethyl cysteinate dimer after 6 months ChEIs treatment in order to evaluate the functional correlates of clinical improvement. A clear-cut cognitive improvement was reported in PDD patients with a significant improvement of ADAS-cog total score as well as of subscores exploring executive functions (p < 0.01). MMSE total score did not significantly change after ChEIs but the subscore of attention significantly improved after therapy (p < 0.01). No difference in motor performance as evaluated by UPDRS was reported. SPM analysis showed a significant increase of perfusion (p < 0.0001) in bilateral cingulate, and frontal regions after ChEIs. Our data confirm the efficacy of ChEIs in the treatment of dementia associated with PD mainly on attention and executive functions, and the functional findings indicate that this cognitive improvement could be associated with a sort of pharmacological frontal “re-afferentation”.

Keywords: Parkinson’s disease, dementia, SPECT, acetylcholinesterase inhibitors

Copyright information

© Springer-Verlag 2006