Abstract Details

Title Regained Functional Connectivity between the Hippocampus, Posterior Cingulate and Precuneus, and Right Frontal Cortex in MCI Treated with Rivastigmine

Topic Aging and Dementia

Presentation(s) P01 - (-)

Poster/Presentation
Number 015

Objective

Background Cholinesterase inhibitors (ChEIs) remain the first line of treatment in Alzheimer's disease (AD) and newer treatments have had no effect in clinical AD. It is possible that the effects of ChEIs have also been limited by intervention at a stage of the disease too advanced to interfere positively with the course of the disease. Preclinical evidence indicates that cholinesterase inhibition affects basic processes of AD pathogenesis and loss of cholinergic innervations contributes to an acceleration of AD pathological processes by jeopardizing the potential for neuroplasticity in the cerebral cortex.

Design/Methods Patients with Mild Cognitive Impairment (MCI) were treated for 12 weeks with the rivastigmine in a within subject design with clinical, cognitive and resting state fMRI assessments before and after treatment. Changes in brain activation and in functional connectivity were the primary outcome measures.

Results Increases in activity within areas of the Default Mode Network were observed following treatment and there also was regained functional connectivity between the hippocampus and the posterior cingulate, precuneus and right prefrontal cortex. All these regions of improved functional connectivity are essential components of a memory retrieval network. These improvements were paralleled by clinical and cognitive benefits.

Conclusions Treatment with a ChEI at an early preclinical MCI stage of AD triggered a neuroplastic effect and improved functional connectivity within crucial areas in the memory retrieval system. The findings indicate a different interpretation of a disease modifying effect of ChEI treatment and suggest that early intervention can successfully trigger the residual potential for neuroplasticity within the AD brain with substantial effects on patients' cognition and quality of life.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Daniel O. Claassen, MD, FAAN (Vanderbilt University Medical Center)	Dr. Claassen has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Alterity. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Claassen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AskBio. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Michigan. Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cognition Therapeutics . Dr. Claassen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amylyx. The institution of Dr. Claassen has received research support from NIH. The institution of Dr. Claassen has received research support from CHDI. The institution of Dr. Claassen has received research support from HDSA. The institution of Dr. Claassen has received research support from Department of Defense. The institution of Dr. Claassen has received research support from CHDI.
	No disclosure on file
	No disclosure on file

��ɫ��

��ɫ��