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

OBJECTIVE: 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 5mg 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 5mg/d Donepezil, and reached 20.6+/-3.9 after 4 more weeks at 10mg/d Donepezil. In the MCA, the difference in PSV and MFV values after 4 weeks of treatment with 10mg/d Donepezil was statistically significant compared with the baseline values. In PCA, the values of MFV and EDV after 4 weeks of treatment with 10mg/d Donepezil were statistically significant in comparison with the baseline value.

CONCLUSION: Donepezil (10mg/d) increased cerebral blood flow velocity and MMSE score in our AD patients, but more extensive trials are recommended.