Evaluation of the effect of donepezil on cerebral blood flow velocity in Alzheimer’s disease

OBJECTIVES: To evaluate the effect of Donepezil on cerebral blood flow velocity using non-invasive transcranial Doppler (TCD) sonography.METHODS: This clinical trial was carried out in the Department of Neurology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran from March 2008 to July 2009, on Alzheimer s disease (AD) patients in 2 groups of case and control, each consisting of 11 patients. The case group who received Donepezil medication was examined by TCD before (baseline), after 4 weeks of oral treatment with 5 mg per day Donepezil, and a further 4 weeks of 10mg per day Donepezil, orally. The control group comprised AD patients who did not receive any medications, and were examined by TCD only once. Peak systolic (PSV), end-diastolic (EDV), and mean flow (MFV) velocities of the posterior cerebral artery (PCA) and the middle cerebral artery (MCA) was assessed by TCD. Also, mini-mental state examination (MMSE) was carried out.RESULTS: There were no significant differences between the case and control groups, in terms of age and gender. In the case group, the mean MMSE score reached 20.2 +/- 2.8 from a baseline value of 15.8 +/- 3.3 after 4 weeks of oral treatment with 5 mg/d Donepezil, and reached 20.6 +/- 3.9 after 4 more weeks at 10 mg/d Donepezil. In the MCA, the difference in PSV and MFV values after 4 weeks of treatment with 10 mg/d Donepezil was statistically significant compared with the baseline values. In PCA, the values of MFV and EDV after 4 weeks of treatment with 10 mg/d Donepezil were statistically significant in comparison with the baseline value.CONCLUSION: Donepezil (10 mg/d) increased cerebral blood flow velocity and MMSE score in our AD patients, but more extensive trials are recommended