16Activation of the muscarinic M 1 receptor is a promising approach to improve cognitive 17 deficits associated with cholinergic dysfunction in Alzheimer's disease, dementia with Lewy 18 bodies, and schizophrenia. TAK-071 is an M 1 -selective positive allosteric modulator that improves 19 cognitive deficits induced by scopolamine, a non-selective muscarinic receptor antagonist, with 20 reduced side effects on gastrointestinal function in rats. In this study, we explored changes in 21 quantitative electroencephalography (qEEG) power bands, with or without scopolamine challenge, 22 as a non-invasive translational biomarker for the effect of TAK-071 in cynomolgus monkeys.
23Scopolamine has been reported to increase theta and delta power bands and decrease alpha power 24 band in healthy volunteers. In line with the clinical observations, scopolamine (25-100 μg/kg, 25 subcutaneous administration [s.c.]) increased theta and delta power bands in cynomolgus monkeys 26 in a dose-dependent manner, whereas it had the opposite effect on alpha power band. The effects of 27 TAK-071 on scopolamine (25 μg/kg, s.c.)-induced qEEG spectral changes were examined using an 28 acetylcholinesterase inhibitor donepezil and a muscarinic M 1 /M 4 receptor agonist xanomeline as 29 comparative cholinomimetics. TAK-071 (0.3-3 mg/kg, oral administration [p.o.]), donepezil (3 30 mg/kg, p.o.), and xanomeline (1 mg/kg, s.c.) suppressed the scopolamine-induced increases in 31 alpha, theta, and delta power bands. These results suggest that changes in specific qEEG power 32 bands, in particular theta and delta power bands in the context of scopolamine challenge, could be 33 used as translational biomarkers for the evaluation of TAK-071 in clinical studies. 3 34 35 36 4 53 correlated with their α-values, indices of binding cooperativity between ACh and M 1 R [10]. 54 Furthermore, M 1 PAMs with low α-values caused less diarrhea side effects [10]. Based on this 55 report, we sought M 1 PAMs with lower α-values, and identified TAK-071 56 (4-fluoro-2-[(3S,4S)-4-hydroxytetrahydro-2H-pyran-3-yl]-5-methyl-6-[4-(1H-pyrazol-1-yl)benzyl]-57 2,3-dihydro-1H-isoindol-1-one) with sufficient cognitive efficacy and milder GI side effects in both 58 monotherapy and combination therapy with AChE inhibitors such as donepezil and rivastigmine 59 [11]. 60 The main goals of early-phase drug development are demonstration of substantial target 61 engagement at doses that are safe and tolerable and determination of a therapeutic dose range. To 62 facilitate drug development, translational research requires minimally invasive and quantifiable 63 biomarkers that can be obtained in both preclinical and clinical studies. Positron emission 64 tomography (PET) is commonly used for drug development of the central nervous system (CNS) as 65 it allows assessment of ligand-target binding and its distribution in the brain. The use of PET 66 imaging is limited by the requirement for a well-characterized PET radioligand suitable for 67 demonstration of target engagement. Recently, direct...