Functional Magnetic Resonance Imaging (fMRI) is a relatively recently developed non-invasive technique with good spatial and temporal resolution which allows the investigation of brain functions in the living brain. It does not involve any radioactivity and thus facilitates longitudinal research investigating the course of a disorder, the impact of medication, and the neural mechanisms underlying therapeutic effects of medication. It can be used not only to ascertain the initial location of dysfunction during specific cognitive processes in AD and to monitor disease progression, but also to elucidate the consequences of drug therapy with the current treatments e.g. AChE inhibitors on neural dysfunctions and disease progression. There are some data available on fMRI of cognitive processes which demonstrate altered brain activation patterns in AD, but the data from fMRI of drug effects in this condition are yet to emerge. The knowledge gained from such studies should facilitate the development of better drugs for this condition. Our group has been using fMRI to link cognitive dysfunction, the core symptom of the illness, with underlying functional changes in the brain. We have recently characterized the ‘nicotinic signature’ in a double blind cross-over fMRI study of modulation of working memory with subcutaneous nicotine. This will allow us to delineate the possible nicotinic action of drugs that are marketed or are in development. In this talk data will be presented from a blinded placebo controlled fMRI study of pharmacological treatment in early AD where the effects of the cognitive enhancer drugs used to treat AD were monitored thus shedding light on the neural mechanisms of drug treatment response in AD.
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