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• W2095668671 abstract "Rivastigmine is a cholinesterase inhibitor used for the treatment of Alzheimer disease (AD) that provides positive effects on cognition, behaviour, and function. Proton Magnetic Resonance Spectroscopy (1 H MRS) has been previously used to monitor metabolic changes in brain tissue following cholinesterase inhibitor treatment in subjects with AD. The purpose of this study was to compare metabolic changes in the posterior cingulate to changes in cognition in subjects with AD following rivastigmine treatment. Five subjects with AD (3 males, age 70 ± 11 years) were recruited. Cognition was measured with the MMSE and the ADAS-cog performed before beginning rivastigmine treatment via the Exelon Patch (4.6 mg/24 hours for the first month, 9.5 mg/24 hours thereafter), and again after four months of treatment. All MR imaging and spectroscopic data were acquired on a 3T Siemens whole-body MRI. T 2 -weighted images (0.7x0.7x4 mm 3 resolution, TR = 6s, TE = 84 ms) were acquired for MRS voxel placement. MRS data were acquired from an 8 cm 3 volume of interest (TR = 2s, TE = 135 ms) in the posterior cingulate at baseline and after four months of treatment. N -acetylaspartate (NAA), choline (Cho), myo-inositol (Myo), glutamate (Glu), and glutamine (Gln) were measured and normalized to creatine (Cr) for evaluation of changes over time. The ratio of Glu/Cr decreased by 27% (P = 0.062) following treatment, trending towards statistical significance. No other changes in metabolite ratios were observed. The average MMSE and ADAS-cog scores at baseline were 24.8 ± 2.9 and 11.2 ± 5.5, respectively, and were unchanged after 4 months of rivastigmine treatment. Changes in cognitive scores did not correlate with changes in Glu/Cr. Previous studies have found an increase in Glu/Cr in the hippocampus following galantamine treatment and no change in Glu in the hippocampus following donepezil treatment. Along with increasing choline levels there is evidence that rivastigmine modulates the glutamatergic system by increasing the expression of the Glu reuptake carrier resulting in reduced extracellular Glu. This preliminary observation of a trend toward a decrease in Glu/Cr in the posterior cingulate following rivastigmine treatment may be related to the effect of rivastigmine on glutamate uptake. Changes in average metabolite ratios (A) and cognitive scores (B) from baseline to four months (Error bars represent ± 1 standard deviation, # represents p<0.1)" @default.
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• W2095668671 date "2012-07-01" @default.
• W2095668671 modified "2023-09-27" @default.
• W2095668671 title "IC-P-067: 3T magnetic resonance spectroscopy of the posterior cingulate following rivastigmine treatment in Alzheimer's disease" @default.
• W2095668671 doi "https://doi.org/10.1016/j.jalz.2012.05.100" @default.
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