Ventricular measurements in computed tomography of responders and non-responders to donepezil in the treatment of Alzheimer's disease

INTRODUCTION: We attempt to see whether the ventricular measurements in routine CT scans performed prior to commencing donepezil differed in patients who duly responded well and those who did not, and to explore the potential application of the findings in clinical practice. METHOD: The study included all patients who were prescribed donepezil during a 2-year period in Warrington ( n =59). Two groups of patients were compared in respect of their baseline CT scan ventricular measurements: those who improved or remained stable cognitively on donepezil ( n =43) and those who declined while on donepezil (MMSE < 10) during the study period ( n =16). RESULTS: Significant differences in means between the two groups were found in relation to the bicaudate span and bicaudate ratio. Of ventricular measurements, only the bicaudate parameters were significantly correlated with the baseline Mini Mental State Examination (MMSE) score as well as the rate of decline in cognitive function during the study period ( P < 0.05). CONCLUSION: Baseline bicaudate diameter and ratio may be of some value if included in the initial assessment of patients on donepezil. These measurements, in conjunction with other cognitive and functional assessments, may prove helpful in deciding whether to commence treatment, and give a rough guide to the outcome. Future studies, with sufficient statistical power, are necessary to explore the use of ventricular parameters in predicting and monitoring patients' response to current and future pharmacological treatment in Alzheimer's disease.