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However, the neural effects of cholinesterase inhibitors on both apathy and executive dysfunction remain unclear. We examined whether baseline regional cerebral blood flow, as determined by using single\u2010photon emission computed tomography, is capable of predicting changes in apathy and executive dysfunction in response to AD<\/jats:styled-content> patients switching from donepezil to galantamine therapy.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a 24\u2010week, prospective, open\u2010label study of AD<\/jats:styled-content> patients treated with galantamine who did not respond to previous treatment with donepezil. Single\u2010photon emission computed tomography was performed at baseline, and behaviour and cognitive assessments including the M<\/jats:styled-content>ini\u2010M<\/jats:styled-content>ental S<\/jats:styled-content>tate E<\/jats:styled-content>xamination, the J<\/jats:styled-content>apanese version of the A<\/jats:styled-content>lzheimer's D<\/jats:styled-content>isease A<\/jats:styled-content>ssessment S<\/jats:styled-content>cale\u2010cognitive subscale, the F<\/jats:styled-content>rontal A<\/jats:styled-content>ssessment B<\/jats:styled-content>attery, the N<\/jats:styled-content>europsychiatry I<\/jats:styled-content>nventory B<\/jats:styled-content>rief Q<\/jats:styled-content>uestionnaire F<\/jats:styled-content>orm, and the D<\/jats:styled-content>ysexecutive Q<\/jats:styled-content>uestionnaire were conducted at three time points (baseline and after 12 and 24 weeks of galantamine therapy).<\/jats:p><\/jats:sec>Results<\/jats:title>After galantamine therapy, the N<\/jats:styled-content>europsychiatry I<\/jats:styled-content>nventory B<\/jats:styled-content>rief Q<\/jats:styled-content>uestionnaire F<\/jats:styled-content>orm scores (apathy, irritability, and aberrant motor symptoms) and the D<\/jats:styled-content>ysexecutive Q<\/jats:styled-content>uestionnaire score improved significantly. The single\u2010photon emission computed tomography findings showed that lower baseline regional cerebral blood flow values in several frontal areas, including the dorsolateral and ventrolateral prefrontal cortex, the anterior cingulate, and the orbitofrontal cortex, predicted greater reductions in the score for apathy (distress) on the N<\/jats:styled-content>europsychiatry I<\/jats:styled-content>nventory B<\/jats:styled-content>rief Q<\/jats:styled-content>uestionnaire F<\/jats:styled-content>orm and the D<\/jats:styled-content>ysexecutive Q<\/jats:styled-content>uestionnaire score after patients switched from donepezil to galantamine therapy.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our study suggests that galantamine therapy, unlike donepezil, is characterized by a dual mechanism of action that may increase acetylcholine and the nicotinic receptor\u2010modulation effect within the frontal lobe, both of which are associated with apathy and executive dysfunction in AD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/psyg.12132","type":"journal-article","created":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T11:39:58Z","timestamp":1435318798000},"page":"121-134","source":"Crossref","is-referenced-by-count":9,"title":["Predicting the neural effect of switching from donepezil to galantamine based on single\u2010photon emission computed tomography findings in patients with A<\/scp>lzheimer's disease"],"prefix":"10.1111","volume":"16","author":[{"given":"Mizuki","family":"Oka","sequence":"first","affiliation":[{"name":"Department of Neuropsychiatry Keio University School of Medicine Shinjuku\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shutaro","family":"Nakaaki","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry Keio University School of Medicine Shinjuku\u2010ku 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