Effect of Acetylcholinesterase Inhibitors on Cerebral Perfusion and Cognition: A Systematic Review

Perfusion imaging has the potential to identify neurodegenerative disorders in a preclinical stage. However, to correctly interpret perfusion-derived parameters, the impact of perfusion modifiers should be evaluated. In this systematic review, the impact of acute and chronic intake of four acetylcho...

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Veröffentlicht in:Journal of Alzheimer's disease Jg. 93; H. 4; S. 1211
Hauptverfasser: Moyaert, Paulien, Beun, Soetkin, Achten, Eric, Clement, Patricia
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Netherlands 13.06.2023
Schlagworte:
Acetylcholinesterase
Alzheimer Disease - drug therapy
Cerebrovascular Circulation
Cholinesterase Inhibitors - pharmacology
Cholinesterase Inhibitors - therapeutic use
Cognition
Dementia - drug therapy
Galantamine - pharmacology
Galantamine - therapeutic use
Humans
Indans - therapeutic use
Parkinson Disease - drug therapy
Perfusion
Phenylcarbamates - therapeutic use
Piperidines - therapeutic use
Rivastigmine - therapeutic use
alzheimer’s disease
Acetylcholinesterase inhibitors
diagnosis
perfusion
biological variation
ISSN:1875-8908, 1875-8908
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Zusammenfassung:Perfusion imaging has the potential to identify neurodegenerative disorders in a preclinical stage. However, to correctly interpret perfusion-derived parameters, the impact of perfusion modifiers should be evaluated. In this systematic review, the impact of acute and chronic intake of four acetylcholinesterase inhibitors (AChEIs) on cerebral perfusion in adults was investigated: physostigmine, donepezil, galantamine, and rivastigmine. Chronic AChEI treatment results in an increase of cerebral perfusion in treatment-responsive patients with Alzheimer's disease, dementia with Lewy bodies, and Parkinson's disease dementia in the frontal, parietal, temporal, and occipital lobes, as well as the cingulate gyrus. These effects appear to be temporary, dose-related, and consistent across populations and different AChEI types. On the contrary, further perfusion decline was reported in patients not receiving AChEIs or not responding to the treatment. AChEIs appear to be a potential perfusion modifier in neurodegenerative patients. More research focused on quantitative perfusion in both patients with and without a cholinergic deficit is needed to draw conclusions on whether AChEI intake should be considered when analyzing perfusion data.
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ISSN:1875-8908
1875-8908
DOI:10.3233/JAD-221125