Psychiatry #199911091

Dr. Schultz

Novel uses of cognitive enhancers explored with PET imaging

Abstract:

The proposed research responds to NIMH Exploratory/Development Grants for Intervention Pilot Research: PA – 99-134: The purpose of this study is to conduct a placebo-controlled trial of the cholinesterase inhibitor donepezil in the treatment of age-associated cognitive decline, and to test whether augmentation with another agent, ginkgo biloba extract (GBE), may increase the therapeutic effects on cognition. This study will utilize outcome measures that include neuropsychological testing as well as measures of functional brain activity during a cognitive activation task using [15O] H2O positron emission tomography (PET). Treatment effects on cognition, cerebral blood flow (CBF) and cerebrovascular reserve capacity (CVR) in elderly adults (over 65 years) with early cognitive decline will be assessed. The PET imaging will assess brain activity during a specific memory activation task, and also during an acetazolamide challenge to measure total vasodilatory capacity. This will allow the investigators to determine whether treatment response is related to increased CBF during the cognitive task and whether clinical response is also related to changes in cerebrovascular reserve (CVR). Comparisons will be made across a one year trial of donepezil with placebo-controlled GBE augmentation.