Three patients with Alzheimer's disease, a 68-year-old woman with mild dementia and 2 men (aged 64 and 72 years) with moderate dementia were treated orally with the cholinesterase inhibitor tacrine (tetrahydroaminoacridine), 80 mg daily, for several months. The patients were investigated using positron emission tomography (PET) prior to, and after 3 weeks and 3 months of treatment. The PET studies involved a multi-tracer system consisting of [18F]-fluoro-deoxy-glucose (18F-FDG) (tracer for glucose metabolism); 11C-butanol (cerebral blood flow) and (S)(-)- and (R)(+)-[N-11C-methyl]-nicotine (nicotinic receptors; cholinergic neural activity). Tacrine treatment increased the uptake of 11C-nicotine to the brain. Significant reduced difference in uptake between the two enantiomers (S)(-)- and (R)(+)11C-nicotine was observed in the frontal and temporal cortices after tacrine treatment in all three patients. The kinetic analysis indicated increased binding of (S)(-)11C-nicotine in brain compatible with a restoration of nicotinic cholinergic receptors. The most pronounced effect was observed after 3 weeks and 3 months treatment in the patient with mild dementia. An increase in cerebral glucose utilization was found in the 68-year-old patient with mild dementia but also slightly in the 64-year-old man with moderate dementia when treated with tacrine for 3 months. Tacrine administration did not affect cerebral blood flow. The PET data obtained after 3 weeks of tacrine treatment was paralleled by improvement in neuropsychological performance. This study shows in vivo by PET neurochemical effects induced in brain by treatment with tacrine to Alzheimer patients. Intervention with tacrine in the early course of the disease might be necessary for clinical improvement.

Aged↗

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The cognitive profile of anorexia nervosa: a comparative study including a community-based sample.

A community-based sample of adolescent-onset anorexia nervosa (AN) cases (n = 51) was contrasted with an age-, sex-, and school-matched comparison group [comp] (n = 51) on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) at a mean age of 21 years. There were no study dropouts. Fewer than 10% of AN cases were underweight at the time of testing. Overall, there were few differences across the two groups, even though the COMP group performed significantly better on the object assembly subtest. A small subgroup of AN cases showed autism-spectrum disorders. This subgroup tended toward test profiles similar to those observed in autism and Asperger syndrome. These findings are discussed in relation to the clinical need for subgrouping of AN cases with a view to improving treatment programs/interviews.

Adolescent↗