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2005 Grant - Foldi
Detecting an Early Response to Donepezil With Measures of Visual Attention
Nancy S. S. Foldi, Ph.D.
Queens College and the Research Foundation
City University of New York
Flushing, New York
2005 Investigator-Initiated Research Grant
Cholinesterase inhibitors are drugs that prevent the breakdown of an important messenger chemical in the brain called acetylcholine. These medications are a mainstay for treating symptoms of Alzheimer's disease, yet objective measures to determine the effectiveness of the drugs are lacking. This problem has frustrated families and physicians and raised questions about the medications' efficacy, cost and overall benefit to an individual's thinking and functional skills. One factor that has largely been overlooked as a potential measure of response is attention. Studies with animals that develop an Alzheimer-like disorder have shown that attention improves with increased acetylcholine levels and deteriorates when acetylcholine levels are lowered.
Nancy Foldi, Ph.D., and colleagues have found in preliminary clinical trials that measures of attention change even after a few weeks of treatment with the cholinesterase inhibitor donepezil (Aricept«), whereas traditional measures of overall cognitive function do not show significant change. To test the hypothesis that attention may serve as an indicator of positive outcomes for this class of drugs, the investigators have developed an experimental visual task tool that they will test against a standard battery of cognitive measures in a six-month study.
The investigators hope to establish (1) that measures of attention are a sensitive indicator of the efficacy of cholinesterase inhibitors, (2) that the drug affects attention early in the course of treatment and (3) that measurements of attention can help determine whether someone is likely to benefit from cholinesterase inhibitor treatment.