The effects of cognitive training combined with donepezil hydrochloride on T2 signal intensity in the MRIs of patients with mild Alzheimer's disease

Abstract

Objective To investigate the effects of cognitive training and donepezil hydrochloride on the intensity of the T2 signal in the MRIs of patients with mild Alzheimer's disease (AD) and on their clinical symptoms.Methods Sixty patients with mild AD were divided randomly into 3 groups:20 were treated with cognitive training (the cognitive training group),20 with oral donepezil hydrochloride (5mg daily,the donepezil group),and 20 with both cognitive training and donepezil hydrochloride (the combination group).In addition,20 age-and gendermatched healthy volunteers were recruited as a control group and given no treatment except verbal stimulation by means of conversation.The treatment lasted for a whole year.All of the subjects were examined by MRI using the FSE-T2 sequence at baseline after 3,6 and 12 months of treatment.At the same time points the Mini-mental Status Examination (MMSE) was administered.Results All 3 treatment groups showed T2 signal intensity at baseline significantly different from the control group.After treatment the cognitive training group showed no significant improve-ment in T2 signal intensity compared with the baseline values.In the other two treatment groups T2 signal intensity from the head of the hippocampus showed significant improvement at all of the time points.The T2 signal intensity from the body and tail of the hippocampus showed no significant improvement compared with baseline in any group.The MMSE scores of the AD patients were significantly lower than those of the control group at baseline.After treatment the average scores of all 3 treatment groups had improved significantly compared to their baseline values.Conclusion Both cognitive training and donepezil hydrochloride can improve the cognitive ability of patients with mild Alzheimer's disease,but cognitive training alone did not correct abnormal MRI signal intensity.Combined use of cognitive training and donepezil hydrochloride had the best effect. Key words: Alzheimer's disease ; Hippocampus ; Magnetic resonance imaging; Donepezil hydrochloride