RESUMEN
Episodic memory depends on a network of interconnected brain structures including the inferior temporal cortex, hippocampus, fornix, and mammillary bodies. We have previously shown that a moderate episodic memory impairment in monkeys with transection of the fornix is exacerbated by prior depletion of acetylcholine from inferotemporal cortex, despite the fact that depletion of acetylcholine from inferotemporal cortex on its own has no effect on episodic memory. Here we show that this effect occurs because inferotemporal acetylcholine facilitates recovery of function following structural damage within the neural circuit for episodic memory. Episodic memory impairment caused by lesions of the mammillary bodies, like fornix transection, was exacerbated by prior removal of temporal cortical acetylcholine. However, removing temporal cortical acetylcholine after the lesion of the fornix or mammillary bodies did not increase the severity of the impairment. This lesion order effect suggests that acetylcholine within the inferior temporal cortex ordinarily facilitates functional recovery after structural lesions that impair episodic memory. In the absence of acetylcholine innervation to inferotemporal cortex, this recovery is impaired and the amnesia caused by the structural lesion is more severe. These results suggest that humans with loss of cortical acetylcholine function, for example in Alzheimer's disease, may be less able to adapt to memory impairments caused by structural neuronal damage to areas in the network important for episodic memory.
Asunto(s)
Acetilcolina/fisiología , Amnesia/fisiopatología , Daño Encefálico Crónico/complicaciones , Fibras Colinérgicas/fisiología , Fórnix/lesiones , Tubérculos Mamilares/lesiones , Memoria Episódica , Lóbulo Temporal/fisiopatología , Acetilcolina/deficiencia , Enfermedad de Alzheimer/psicología , Amnesia/etiología , Amnesia/rehabilitación , Animales , Daño Encefálico Crónico/psicología , Modelos Animales de Enfermedad , Femenino , Fórnix/fisiología , Macaca fascicularis , Macaca mulatta , Masculino , Tubérculos Mamilares/fisiopatología , Plasticidad Neuronal , Reconocimiento Visual de Modelos , Desempeño Psicomotor/fisiología , RecompensaRESUMEN
The main pathological hallmarks of Alzheimer's disease (AD) consist of amyloid plaques and neurofibrillary tangles. Hippocampal cell loss, atrophy and cholinergic dysfunction are also features of AD. The present work is aimed at studying the interactions between cholinergic denervation, APP processing and hippocampal integrity. The cholinergic immunotoxin mu p-75-saporin was injected into the 3rd ventricle of 6- to 8-month-old Tg2576 mice to induce a cholinergic denervation. Four weeks after cholinergic immunolesion, a significant 14-fold increase of soluble Aß1-42 was observed. Cholinergically lesioned Tg2576 mice showed hippocampal atrophy together with degenerating FluoroJade-B-stained neurons and reduction of synaptophysin expression in CA1-3 pyramidal layers. We also found that cholinergic denervation led to reduced levels of ADAM17 in hippocampus of Tg2576 mice. Inhibition of ADAM17 with TAPI-2 (5 µM) decreased viability of hippocampal primary neurons from Tg2576 brains and decreased phosphorylation of downstream effectors of trophic signalling (ERK and Akt). The cholinergic agonist carbachol (100 µM) rescued these effects, suggesting that cholinergic deficits might render hippocampus more vulnerable to neurotoxicity upon certain toxic environments. The present work proposes a novel model of AD that worsens the patent amyloid pathology of Tg2576 mice together with hippocampal synaptic pathology and neurodegeneration. Drugs aimed at favoring cholinergic transmission should still be considered as potential treatments of AD.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad de Alzheimer/patología , Neuronas Colinérgicas/metabolismo , Modelos Animales de Enfermedad , Hipocampo/patología , Proteínas Amiloidogénicas , Animales , Atrofia , Western Blotting , Neuronas Colinérgicas/patología , Desnervación/métodos , Técnica del Anticuerpo Fluorescente , Inmunotoxinas/toxicidad , Hibridación in Situ , Ratones , Ratones Transgénicos , Saponinas/toxicidadRESUMEN
The cholinotrophic system, which is dependent upon nerve growth factor and its receptors for survival, is selectively vulnerable in Alzheimer's disease (AD). But, virtually nothing is known about how this deficit develops in relation to the hallmark lesions of this disease, amyloid plaques and tau containing neurofibrillary tangles. The vast majority of transgenic models of AD used to evaluate the effect of beta amyloid (Aß) deposition upon the cholinotrophic system over-express the amyloid precursor protein (APP). However, nothing is known about how this system is affected in triple transgenic (3xTg)-AD mice, an AD animal model displaying Aß plaque- and tangle-like pathology in the cortex and hippocampus, which receive extensive cholinergic innervation. We performed a detailed morphological and biochemical characterization of the cholinotrophic system in young (2-4 months), middle-aged (13-15 months) and old (18-20 months) 3xTg-AD mice. Cholinergic neuritic swellings increased in number and size with age, and were more conspicuous in the hippocampal-subicular complex in aged female than in 3xTg-AD male mice. Stereological analysis revealed a reduction in choline acetyltransferase (ChAT) positive cells in the medial septum/vertical limb of the diagonal band of Broca in aged 3xTg-AD mice. ChAT enzyme activity levels decreased significantly in the hippocampus of middle-aged 3xTg-AD mice compared to age-matched non-transgenic (or wild type) mice. ProNGF protein levels increased in the cortex of aged 3xTg-AD mice, whereas TrkA protein levels were reduced in a gender-dependent manner in aged mutant mice. In contrast, p75(NTR) protein cortical levels were stable but increased in the hippocampus of aged 3xTg-AD mice. These data demonstrate that cholinotrophic alterations in 3xTg-AD mice are age- and gender-dependent and more pronounced in the hippocampus, a structure more severely affected by Aß plaque pathology.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad de Alzheimer/metabolismo , Núcleo Basal de Meynert/metabolismo , Fibras Colinérgicas/fisiología , Envejecimiento/genética , Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/patología , Péptidos beta-Amiloides/genética , Animales , Núcleo Basal de Meynert/patología , Núcleo Basal de Meynert/fisiopatología , Fibras Colinérgicas/metabolismo , Fibras Colinérgicas/patología , Modelos Animales de Enfermedad , Femenino , Hipocampo/metabolismo , Hipocampo/patología , Hipocampo/fisiopatología , Humanos , Masculino , Ratones , Ratones Transgénicos , Placa Amiloide/genética , Placa Amiloide/metabolismo , Placa Amiloide/patología , Caracteres SexualesRESUMEN
Acetylcholine (ACh), the neurotransmitter of the cholinergic system, regulates inflammation in several diseases including pulmonary diseases. ACh is also involved in a non-neuronal mechanism that modulates the innate immune response. Because inflammation and release of pro-inflammatory cytokines are involved in pulmonary emphysema, we hypothesized that vesicular acetylcholine transport protein (VAChT) deficiency, which leads to reduction in ACh release, can modulate lung inflammation in an experimental model of emphysema. Mice with genetical reduced expression of VAChT (VAChT KDHOM 70%) and wild-type mice (WT) received nasal instillation of 50 uL of porcine pancreatic elastase (PPE) or saline on day 0. Twenty-eight days after, animals were evaluated. Elastase instilled VAChT KDHOM mice presented an increase in macrophages, lymphocytes, and neutrophils in bronchoalveolar lavage fluid and MAC2-positive macrophages in lung tissue and peribronchovascular area that was comparable to that observed in WT mice. Conversely, elastase instilled VAChT KDHOM mice showed significantly larger number of NF-κB-positive cells and isoprostane staining in the peribronchovascular area when compared to elastase-instilled WT-mice. Moreover, elastase-instilled VAChT-deficient mice showed increased MCP-1 levels in the lungs. Other cytokines, extracellular matrix remodeling, alveolar enlargement, and lung function were not worse in elastase-instilled VAChT deficiency than in elastase-instilled WT-controls. These data suggest that decreased VAChT expression may contribute to the pathogenesis of emphysema, at least in part, through NF-κB activation, MCP-1, and oxidative stress pathways. This study highlights novel pathways involved in lung inflammation that may contribute to the development of chronic obstrutive lung disease (COPD) in cholinergic deficient individuals such as Alzheimer's disease patients.
Asunto(s)
Acetilcolina/deficiencia , Enfisema/inmunología , Neumonía/etiología , Acetilcolina/metabolismo , Animales , Líquido del Lavado Bronquioalveolar/citología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Enfisema/metabolismo , Inflamación/patología , Pulmón/patología , Macrófagos/metabolismo , Masculino , Ratones , FN-kappa B/metabolismo , Neutrófilos/metabolismo , Elastasa Pancreática/efectos adversos , Elastasa Pancreática/farmacología , Neumonía/fisiopatología , Enfisema Pulmonar/metabolismo , Transducción de Señal , Proteínas de Transporte Vesicular de Acetilcolina/deficiencia , Proteínas de Transporte Vesicular de Acetilcolina/genética , Proteínas de Transporte Vesicular de Acetilcolina/metabolismoRESUMEN
We investigated the functional characteristics of pre- and postsynaptic cholinergic transmission in APPswe/PS1dE9 double transgenic mice at a young age (7-10 weeks) before the onset of amyloid plaque formation and at adult age (5-6 months) at its onset. We compared brain slices from cerebral cortex and hippocampus with amyloid deposits to slices from striatum with no amyloid plaques by 6 months of age. In young transgenic mice we found no impairments of preformed and newly synthesized [(3)H]-ACh release, indicating intact releasing machinery and release turnover, respectively. Adult transgenic mice displayed a significant increase in preformed [(3)H]-ACh release in cortex but a decrease in hippocampus and striatum. The extent of presynaptic muscarinic autoregulation was unchanged. Evoked release of newly synthesized [(3)H]-ACh was significantly reduced in the cortex and hippocampus but unchanged in the striatum. Carbachol-induced G-protein activation in cortical membranes displayed decreased potency but normal efficacy in adult animals and no changes in young animals. These results indicate that functional pre- and postsynaptic cholinergic deficits are not present in APPswe/PS1dE9 transgenic mice before 10 weeks of age, but develop along with beta-amyloid accumulation in the brain.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad de Alzheimer/metabolismo , Amiloide/metabolismo , Encéfalo/metabolismo , Fibras Colinérgicas/metabolismo , Degeneración Nerviosa/metabolismo , Factores de Edad , Envejecimiento/metabolismo , Enfermedad de Alzheimer/genética , Enfermedad de Alzheimer/fisiopatología , Precursor de Proteína beta-Amiloide/genética , Animales , Encéfalo/crecimiento & desarrollo , Encéfalo/fisiopatología , Química Encefálica/genética , Corteza Cerebral/crecimiento & desarrollo , Corteza Cerebral/metabolismo , Corteza Cerebral/fisiopatología , Agonistas Colinérgicos/farmacología , Fibras Colinérgicas/patología , Modelos Animales de Enfermedad , Regulación hacia Abajo/genética , Femenino , Proteínas de Unión al GTP/efectos de los fármacos , Proteínas de Unión al GTP/genética , Proteínas de Unión al GTP/metabolismo , Hipocampo/metabolismo , Hipocampo/patología , Hipocampo/fisiopatología , Ratones , Ratones Transgénicos , Degeneración Nerviosa/patología , Técnicas de Cultivo de Órganos , Presenilina-1/genética , Receptores Muscarínicos/metabolismoRESUMEN
Drugs have been strongly associated with the development of delirium, and they are one of the most easily reversible triggers. In addition to polypharmacy, physiological changes with aging including pharmacokinetic and pharmacodynamic changes as well as medical co-morbidities can increase the susceptibility to a drug induced delirium. Since it is widely accepted that delirium represents reversible impairment of cerebral oxidative metabolism and neurotransmission [37], it is not surprising that any drug interfering with the function, the supply or the use of substrates for neurotransmitter metabolism can cause delirium. Drugs with anticholinergic activity, especially those with muscarine receptor activity, constitute a considerable risk-group. Many different classes of drugs can induce delirium, but several studies have shown that it all comes down to the so-called anticholinergic burden, which becomes greater with each medication someone takes. In the elderly, polypharmacy and anticholinergic toxicity is common. Dementia, e.g. Alzheimer's disease, and, to a lesser extent, other chronic brain pathologies, predispose, through reduced integrity of the blood-brain barrier function, additionally to the development of delirium. Misinterpretation of an adverse drug reaction as another medical condition may lead to the prescription of additional medications with their own potential to cause side effects. To reduce the morbidity and mortality associated with drug induced delirium and also to prevent it, patients' medications should be closely monitored. Wherever possible, drugs with anticholinergic effects should be avoided in elderly patients, particularly in those suffering from dementia.
Asunto(s)
Delirio/inducido químicamente , Acetilcolina/deficiencia , Acetilcolina/fisiología , Anciano , Encéfalo/efectos de los fármacos , Encéfalo/fisiopatología , Antagonistas Colinérgicos/efectos adversos , Antagonistas Colinérgicos/uso terapéutico , Comorbilidad , Delirio/diagnóstico , Delirio/fisiopatología , Interacciones Farmacológicas , Humanos , Factores de RiesgoRESUMEN
Introduction: Cortical cholinergic denervation resulting from degeneration of the nucleus basalis of Meynert (NBM) is a primary contributor to cognitive impairment and neuropsychiatric symptoms in the Lewy body diseases Parkinson's disease (PD), Parkinson's disease dementia (PDD), and dementia with Lewy bodies (DLB). Considering the morbidity associated with cognitive impairment and neuropsychiatric symptoms in these diseases, it is important to investigate all potential therapies to improve these symptoms.Areas covered: The authors review the current landscape of pharmacological and surgical therapies for mitigating the cortical cholinergic deficiency in PD, PDD, and DLB.Expert opinion: The cholinesterase inhibitors rivastigmine, donepezil, and galantamine are currently the primary pharmacological treatments available to improve cognition and associated neuropsychiatric symptoms in Lewy body diseases. Other possible pharmacological strategies include increasing acetylcholine release with 5-HT4 agonists or directly stimulating cholinergic receptors with muscarinic and nicotinic agonists. The side effect profile of muscarinic agonists is a deterrent to their future study, but 5-HT4 and nicotinic agonists deserve further investigation. Targeting the basal forebrain with either deep brain stimulation (DBS)- or cell-based therapies is another strategy to mitigate cortical cholinergic deficiency. Before NBM DBS studies continue, it will be important to resolve issues related to targeting, stimulation pattern, and duration.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad por Cuerpos de Lewy , Neurotransmisores/uso terapéutico , Enfermedad de Parkinson , Humanos , Enfermedad por Cuerpos de Lewy/tratamiento farmacológico , Enfermedad por Cuerpos de Lewy/metabolismo , Enfermedad por Cuerpos de Lewy/cirugía , Enfermedad de Parkinson/tratamiento farmacológico , Enfermedad de Parkinson/metabolismo , Enfermedad de Parkinson/cirugíaRESUMEN
Since acute and chronic administration of the acetylcholinesterase inhibitors, namely donepezil, improves cognitive functions in patients afflicted by mild to moderate dementia and reverses memory deficits in experimental models of learning and memory, it seemed interesting to assess the effects of chronic donepezil treatment on cognitive functions in adult rats with forebrain cholinergic depletion. Lesions were performed by means of intracerebroventricular injections of the immunotoxin 192 IgG-saporin. The cognitive functions of lesioned animals treated or not treated with donepezil were compared with those of intact animals. Cholinergic depletion affected working memory functions, weakened procedural competencies, affected the acquisition of localizing knowledge, and evoked remarkable compulsive and perseverative behaviors. In lesioned animals, chronic donepezil treatment ameliorated localizatory capabilities, performances linked to cognitive flexibility and procedural abilities. Furthermore, it attenuated compulsive deficits. The present data indicate positive effects of chronic donepezil treatment on specific cognitive performances, suggesting that an aimed use of acetylcholinesterase inhibitors, targeting some symptoms more than others, may be beneficial in the case of cholinergic hypofunction. The animal model used in the present research may provide an efficient method for analyzing cognition-enhancing drugs before clinical trials.
Asunto(s)
Acetilcolina/deficiencia , Inhibidores de la Colinesterasa/administración & dosificación , Trastornos del Conocimiento/tratamiento farmacológico , Indanos/administración & dosificación , Piperidinas/administración & dosificación , Análisis de Varianza , Animales , Anticuerpos Monoclonales , Conducta Animal/efectos de los fármacos , Trastornos del Conocimiento/inducido químicamente , Modelos Animales de Enfermedad , Donepezilo , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Conducta Exploratoria/efectos de los fármacos , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Examen Neurológico , Ratas , Ratas Wistar , Proteínas Inactivadoras de Ribosomas Tipo 1 , Saporinas , Aprendizaje Seriado/efectos de los fármacosRESUMEN
Vascular dementia (VaD) is a progressive neurodegenerative disease with a high prevalence. Several studies have recently reported that VaD patients present cholinergic deficits in the brain and cerebrospinal fluid (CSF) that may be closely related to the pathophysiology of cognitive impairment. Moreover, cholinergic therapies have shown promising effects on cognitive improvement in VaD patients. The precise mechanisms of these cholinergic agents are currently not fully understood; however, accumulating evidence indicates that these drugs may act through the cholinergic anti-inflammatory pathway, in which the efferent vagus nerve signals suppress pro-inflammatory cytokine release and inhibit inflammation, although regulation of oxidative stress and energy metabolism, alleviation of apoptosis may also be involved. In this paper, we provide a brief overview of the cholinergic treatment strategy for VaD and its relevant mechanisms of anti-inflammation.Acta Pharmacologica Sinica (2009) 30: 879-888; doi: 10.1038/aps.2009.82.
Asunto(s)
Acetilcolina/deficiencia , Colinérgicos/uso terapéutico , Inhibidores de la Colinesterasa/uso terapéutico , Demencia Vascular/tratamiento farmacológico , Demencia Vascular/metabolismo , Alcaloides , Animales , Antiinflamatorios/uso terapéutico , Demencia Vascular/epidemiología , Demencia Vascular/fisiopatología , Modelos Animales de Enfermedad , Donepezilo , Galantamina/uso terapéutico , Humanos , Indanos/uso terapéutico , Inflamación/metabolismo , Inflamación/fisiopatología , Inflamación/terapia , Fármacos Neuroprotectores/uso terapéutico , Nootrópicos/uso terapéutico , Fenilcarbamatos/uso terapéutico , Piperidinas/uso terapéutico , Receptores Colinérgicos/metabolismo , Rivastigmina , Sesquiterpenos/uso terapéutico , Transducción de Señal/fisiologíaRESUMEN
PURPOSE: We aimed to explore the cognitive profiles of subarachnoid haemorrhage patients who returned to the community, along with the associated risk factors. METHODS: We recruited 40 Chinese patients with spontaneous subarachnoid haemorrhage 7-27 months after the initial presentation. They had all been discharged to their homes or to care homes for the elderly. For cognitive assessment, we employed the Cognitive Subscale of the Alzheimer Disease Assessment Scale (ADAS-cog) for global cognitive function, the Frontal Assessment Battery (FAB) for frontal lobe function, and the Rivermead Behavioural Memory Test (RBMT) for everyday memory function. RESULTS: An ADAS-cog of more than 21/85 (poor global cognitive function) was noted in 14 (35%) patients. A FAB of less than 12/18 (poor frontal lobe function) was noted in 13 (27.5%) patients. An RBMT score of less than 15/26 (poor everyday memory function) was noted in 17 (43.6%) patients. Poor cognitive function was found to be associated with chronic hydrocephalus (in terms of FAB), with clinical vasospasm (in terms of RBMT), and with cerebral infarction (in terms of RBMT). CONCLUSIONS: Poor cognitive function was common and occurred in up to 43.6% of the patients, with the verbal and behavioural memory aspects predominantly affected. We did not find a significant association between cholinergic dysfunction and cognitive dysfunction. Organization of future drug trials and cognitive rehabilitation should take into account the association between frontal lobe dysfunction and chronic hydrocephalus.
Asunto(s)
Acetilcolina/deficiencia , Trastornos del Conocimiento/etiología , Hemorragia Subaracnoidea/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Trastornos del Conocimiento/diagnóstico , Evaluación de la Discapacidad , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Factores de Riesgo , Adulto JovenRESUMEN
Neuroinflammation and cholinergic deficit are key detrimental processes involved in Alzheimer's disease. Hence, in the search for novel and effective treatment strategies, the multi-target-directed ligand paradigm was applied to the rational design of two series of new hybrids endowed with anti-inflammatory and anticholinesterase activity via triple targeting properties, namely able to simultaneously hit cholinesterases, cyclooxygenase-2 (COX-2) and 15-lipoxygenase (15-LOX) enzymes. Among the synthesized compounds, triazoles 5b and 5d, and thiosemicarbazide hybrid 6e emerged as promising new hits, being able to effectively inhibit human butyrylcholinesterase (hBChE), COX-2 and 15-LOX enzymes with a higher inhibitory potency than the reference inhibitors tacrine (for hBChE inhibition), celecoxib (for COX-2 inhibition) and both NDGA and Zileuton (for 15-LOX inhibition). In addition, compound 6e proved to be a submicromolar mixed-type inhibitor of human acetylcholinesterase (hAChE). The anti-neuroinflammatory activity of the three most promising hybrids was confirmed in a cell-based assay using PC12 neuron cells, showing decreased expression levels of inflammatory cytokines IL-1ß and TNF-α. Importantly, despite the structural resemblance to tacrine, they showed ideal safety profiles on hepatic and murine brain cell lines and were safe up to 100⯵M when assayed in PC12â¯cells. All three hybrids were also predicted to have superior BBB permeability than tacrine in the PAMPA assay, and good physicochemical properties, drug-likeness and ligand efficiency indices. Finally, molecular docking studies highlighted key structural elements impacting selectivity and activity toward the selected target enzymes. To the best of our knowledge, compounds 5b, 5d and 6e are the first balanced, safe and multi-target compounds hitting the disease at the three mentioned hubs.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad de Alzheimer/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Neuronas/patología , Enfermedad de Alzheimer/patología , Animales , Línea Celular , Inhibidores de la Colinesterasa/química , Inhibidores de la Ciclooxigenasa 2/química , Diseño de Fármacos , Humanos , Inhibidores de la Lipooxigenasa/química , Ratones , Simulación del Acoplamiento Molecular , Neuronas/efectos de los fármacos , Neuronas/enzimología , Células PC12 , Ratas , Semicarbacidas/química , Semicarbacidas/farmacología , Triazoles/química , Triazoles/farmacologíaRESUMEN
Activity-dependent and -independent signals collaborate to regulate synaptogenesis, but their relative contributions are unclear. Here, we describe the formation of neuromuscular synapses at which neurotransmission is completely and specifically blocked by mutation of the neurotransmitter-synthesizing enzyme choline acetyltransferase. Nerve terminals differentiate extensively in the absence of neurotransmitter, but neurotransmission plays multiple roles in synaptic differentiation. These include influences on the numbers of pre- and postsynaptic partners, the distribution of synapses in the target field, the number of synaptic sites per target cell, and the number of axons per synaptic site. Neurotransmission also regulates the formation or stability of transient acetylcholine receptor-rich processes (myopodia) that may initiate nerve-muscle contact. At subsequent stages, neurotransmission delays some steps in synaptic maturation but accelerates others. Thus, neurotransmission affects synaptogenesis from early stages and coordinates rather than drives synaptic maturation.
Asunto(s)
Acetilcolina/deficiencia , Diferenciación Celular/genética , Colina O-Acetiltransferasa/deficiencia , Unión Neuromuscular/anomalías , Terminales Presinápticos/metabolismo , Transmisión Sináptica/genética , Acetilcolina/biosíntesis , Animales , Colina O-Acetiltransferasa/genética , Diafragma/anomalías , Diafragma/inervación , Diafragma/ultraestructura , Feto , Eliminación de Gen , Inmunohistoquímica , Ratones , Ratones Noqueados , Microscopía Electrónica , Neuronas Motoras/metabolismo , Neuronas Motoras/ultraestructura , Mutación/genética , Unión Neuromuscular/metabolismo , Unión Neuromuscular/ultraestructura , Nervio Frénico/anomalías , Nervio Frénico/ultraestructura , Terminales Presinápticos/ultraestructuraRESUMEN
Impairment of cholinergic neurotransmission is a well-established fact in Alzheimer's disease (AD) but there is controversy about its relevance at the early stages of the disease. In the recent years new techniques for in vivo imaging of key components of the cholinergic system in humans have developed. They are beginning to be applied to the very early stages of AD. Preliminary results suggest that there is early impairment of presynaptic receptors and acetylcholine esterase, the main degrading enzyme for acetylcholine, in cerebral cortex. The relation of these findings to neuronal function and post-mortem findings is being discussed.
Asunto(s)
Acetilcolina/deficiencia , Enfermedad de Alzheimer/metabolismo , Enfermedad de Alzheimer/genética , HumanosRESUMEN
Deficits in cholinergic function have been postulated to cause delirium and cognitive decline. This review examines current understanding of the cholinergic deficiency hypothesis in delirium by synthesizing evidence on potential pathophysiological pathways. Acetylcholine synthesis involves various precursors, enzymes, and receptors, and dysfunction in these components can lead to delirium. Insults to the brain, like ischemia and immunological stressors, can precipitously alter acetylcholine levels. Imbalances between cholinergic and other neurotransmitter pathways may result in delirium. Furthermore, genetic, enzymatic, and immunological overlaps exist between delirium and dementia related to the cholinergic pathway. Important areas for future research include identifying biomarkers, determining genetic contributions, and evaluating response to cholinergic drugs in delirium. Understanding how the cholinergic pathway relates to delirium may yield innovative approaches in the diagnosis, prevention, and treatment of this common, costly, and morbid condition.
Asunto(s)
Acetilcolina/fisiología , Delirio/fisiopatología , Acetilcolina/deficiencia , Acetilcolina/metabolismo , Encéfalo/metabolismo , Delirio/etiología , Demencia/fisiopatología , Humanos , Neurotransmisores/fisiología , Receptores de Neurotransmisores/fisiologíaRESUMEN
Many conditions adversely affecting learning, memory, and cognition are associated with reductions in forebrain acetylcholine (ACh), most notably aging and Alzheimer's disease. In the current study, we demonstrate that bilateral depletion of neocortical and hippocampal ACh in rats produces deficits in a spatial learning task and in a recently described, delayed visual matching-to-sample task. Oral administration of the novel nitrate, GT1061 (4-methyl-5-(2-nitroxyethyl) thiazole HCl), and the acetylcholinesterase inhibitor, donepezil, reversed the cognitive deficits in both memory tasks in a dose-dependent manner. GT1061 was superior in the delayed matching-to-sample task. GT1061 was absorbed rapidly after oral administration, crossed the blood brain barrier, and achieved brain concentrations that were slightly higher than those found in plasma. The activity of GT1061 was NO mimetic: soluble guanylyl cyclase (sGC) was activated, but selectivity was observed for sGC in the hippocampus relative to the vasculature; and hippocampal levels of phosphorylated ERK1/2, which is a postulated intermediary in the formation of long-term memory, were increased. The beneficial effect on visual and spatial memory task performance supports the concept that stimulating the NO/sGC/cGMP signal transduction system can provide new, effective treatments for cognitive disorders. This approach may be superior to that of current drugs that attempt only to salvage the residual function of damaged cholinergic neurons.
Asunto(s)
Acetilcolina/deficiencia , Trastornos del Conocimiento/tratamiento farmacológico , Nitratos/uso terapéutico , Nootrópicos/uso terapéutico , Prosencéfalo/patología , Análisis de Varianza , Animales , Conducta Animal/efectos de los fármacos , Conducta de Elección/efectos de la radiación , Modelos Animales de Enfermedad , Donepezilo , Relación Dosis-Respuesta a Droga , Femenino , Indanos/farmacología , Masculino , Aprendizaje por Laberinto/efectos de los fármacos , Proteína Quinasa 3 Activada por Mitógenos/metabolismo , Nitratos/sangre , Nitratos/farmacocinética , Nootrópicos/sangre , Nootrópicos/farmacocinética , Fosforilación/efectos de los fármacos , Piperidinas/farmacología , Prosencéfalo/metabolismo , Unión Proteica/efectos de los fármacos , Pruebas Psicológicas , Ratas , Ratas Long-Evans , Ratas Sprague-Dawley , Tiempo de Reacción/efectos de los fármacosRESUMEN
UNLABELLED: The aim of this study was to determine if the results of visual and quantitative EEG (QEEG) parameters reveal a correlation with mental impairment in subcortical vascular dementia (SVD), one of the most frequent causes of cognitive impairment in the elderly. In SVD, like in Alzheimer's disease disturbances were found in cholinergic transmission. The cholinergic deficit as manifested in changes of synaptic potentials is reflected in EEG signals. MATERIAL: 31 patients with probable SVD (according to NINCDS-AIREN and T. Erkinjuntii's criteria) and mean age 72.3 yrs;(M--43%, F--57%) and 14 healthy control subjects with mean age of 72.3 yrs (M-57%, F-43%). According to the Mini Mental Scale Examination (MMSE) the SVD group was divided into two subgroups with mild and moderate dementia, their EEGs being recorded with a Medelec and Neuroscan 4.2 system. Visual EEG findings were classified with the use of eight-degree scale of pathological changes by the presence of slow waves. Then QEEGs were made. The following parameters were calculated: alpha/slow wave power ratios, the mean wave frequency in all and in some selected derivations. RESULTS: A significant difference was found between QEEGs in SVD subgroups with mild and moderate dementia (p<0.05), but there was no significant difference between visual EEGs. A significant correlation between QEEG parameters such as alpha/slow wave ratio or mean wave frequency and mental impairment (according to MMSE results) was found (p<0.001), but there was no significant correlation between degree of EEG abnormalities in visual analysis and MMSE results. CONCLUSION: Only QEEGs are correlated with mental impairment in SVD. Visual EEG technique as a less precise tool does not reflect the mental impairment in SVD due to cholinergic deficit.
Asunto(s)
Demencia Vascular/diagnóstico , Demencia Vascular/fisiopatología , Evaluación de la Discapacidad , Electroencefalografía/métodos , Trastornos Neurocognitivos/diagnóstico , Trastornos Neurocognitivos/fisiopatología , Acetilcolina/deficiencia , Anciano , Anciano de 80 o más Años , Núcleo Basal de Meynert/metabolismo , Núcleo Basal de Meynert/patología , Núcleo Basal de Meynert/fisiopatología , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Demencia Vascular/psicología , Progresión de la Enfermedad , Electroencefalografía/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fibras Nerviosas Mielínicas/metabolismo , Fibras Nerviosas Mielínicas/patología , Trastornos Neurocognitivos/etiología , Pruebas Neuropsicológicas , Estimulación Luminosa , Valor Predictivo de las Pruebas , Transmisión Sináptica/fisiología , Telencéfalo/irrigación sanguínea , Telencéfalo/patología , Telencéfalo/fisiopatologíaRESUMEN
Many developing neural circuits generate synchronized bursting activity among neighboring neurons, a pattern thought to be important for sculpting precise neural connectivity. Network output remains relatively constant as the cellular and synaptic components of these immature circuits change during development, suggesting the presence of homeostatic mechanisms. In the retina, spontaneous waves of activity are present even before chemical synapse formation, needing gap junctions to propagate. However, as synaptogenesis proceeds, retinal waves become dependent on cholinergic neurotransmission, no longer requiring gap junctions. Later still in development, waves are driven by glutamatergic rather than cholinergic synapses. Here, we asked how retinal activity evolves in the absence of cholinergic transmission by using a conditional mutant in which the gene encoding choline acetyltransferase (ChAT), the sole synthetic enzyme for acetylcholine (ACh), was deleted from large retinal regions. ChAT-negative regions lacked retinal waves for the first few days after birth, but by postnatal day 5 (P5), ACh-independent waves propagated across these regions. Pharmacological analysis of the waves in ChAT knock-out regions revealed a requirement for gap junctions but not glutamate, suggesting that patterned activity may have emerged via restoration of previous gap-junctional networks. Similarly, in P5 wild-type retinas, spontaneous activity recovered after a few hours in nicotinic receptor antagonists, often as local patches of coactive cells but not waves. The rapid recovery of rhythmic spontaneous activity in the presence of cholinergic antagonists and the eventual emergence of waves in ChAT knock-out regions suggest that homeostatic mechanisms regulate retinal output during development.
Asunto(s)
Acetilcolina/deficiencia , Tipificación del Cuerpo/fisiología , Retina/crecimiento & desarrollo , Retina/metabolismo , Acetilcolina/genética , Acetilcolina/metabolismo , Animales , Animales Recién Nacidos , Tipificación del Cuerpo/genética , Señalización del Calcio/fisiología , Colina O-Acetiltransferasa/deficiencia , Colina O-Acetiltransferasa/genética , Colina O-Acetiltransferasa/metabolismo , Técnicas In Vitro , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Retina/citología , Transmisión Sináptica/fisiologíaRESUMEN
Recent therapeutic investigations of Alzheimer's disease (AD) have been guided by two seemingly opposed hypotheses: the amyloid cascade theory, which favors the amyloid plaques as the cause of AD; and the cholinergic theory, which favors cholinergic neuron loss as the cause. New investigations indicate that the synthesis and processing of the amyloid precursor protein (APP) is linked to the trophic actions of nerve growth factor. A pathological cascade in both AD- and Down's syndrome-related memory loss could be triggered by alterations in APP processing or ACh-mediated neuronal function, or both, which in turn trigger the overexpression of amyloid beta, synaptic malfunction and trophic factor loss in target regions. This eventually leads to synaptic and dendritic loss with age.
Asunto(s)
Acetilcolina/metabolismo , Enfermedad de Alzheimer/metabolismo , Precursor de Proteína beta-Amiloide/metabolismo , Síndrome de Down/metabolismo , Sustancias de Crecimiento/metabolismo , Acetilcolina/deficiencia , Envejecimiento/metabolismo , Enfermedad de Alzheimer/etiología , Animales , Síndrome de Down/etiología , Hipocampo/metabolismo , Humanos , Potenciación a Largo Plazo , Receptores Colinérgicos/metabolismo , Sinapsis/metabolismoRESUMEN
AIM: To determine the clinical and electrophysiological (EEG) signs of cholinergic deficiency in the process of recovery of consciousness in patients with severe brain injury. MATERIAL AND METHODS: Thirty-seven people (24 men and 13 women, mean age 32±14 years) were studied. A comprehensive study included assessment of neurological status, mental activity, and EEG. RESULTS AND CONCLUSION: A set of neurological symptoms, including reduced muscle tone, autonomic disorders (dry mucous membranes and skin, tachycardia, hypotension, gastrointestinal tract), eye movement disorders, that were,in accordance with the literature, characteristicof the cholinergic deficiency syndrome was found. This syndrome was detected against the background of a comatose state, akinetic mutism and mutism with understanding of speech, disintegration of speech, disorientation and amnestic decline. EEG revealed stable over time (months) characteristic changes: slowing and asymmetric alpha activity, equivalent dipole sources of hippocampal and stem localization, persistent strengthening of intra-hemispheric coherent connections, especially on the left side. The regression of the cholinergic deficiency syndrome was accompanied by an increase of regularity, capacity and frequency of alpha-activity (from 7-8 to 9-10 Hz), prevalence of equivalent dipole sources in the hippocampus with their appearance in the occipital cortex, normalization of connections with right-brain coherence with the preservation of their pathologically high values on the left side.
Asunto(s)
Acetilcolina/deficiencia , Lesiones Encefálicas/complicaciones , Coma/etiología , Adolescente , Adulto , Lesiones Encefálicas/patología , Lesiones Encefálicas/fisiopatología , Lesiones Encefálicas/psicología , Corteza Cerebral/fisiopatología , Coma/diagnóstico , Coma/fisiopatología , Coma/psicología , Confusión/diagnóstico , Confusión/etiología , Confusión/fisiopatología , Estado de Conciencia , Electroencefalografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Habla , Síndrome , Adulto JovenRESUMEN
We examine the role of synaptic activity in the development of identified Drosophila embryonic motorneurons. Synaptic activity was blocked by both pan-neuronal expression of tetanus toxin light chain (TeTxLC) and by reduction of acetylcholine (ACh) using a temperature-sensitive allele of choline acetyltransferase (Cha(ts2)). In the absence of synaptic activity, aCC and RP2 motorneurons develop with an apparently normal morphology and retain their capacity to form synapses. However, blockade of synaptic transmission results in significant changes in the electrical phenotype of these neurons. Specifically, increases are seen in both voltage-gated inward Na(+) and voltage-gated outward K(+) currents. Voltage-gated Ca(2+) currents do not change. The changes in conductances appear to promote neuron excitability. In the absence of synaptic activity, the number of action potentials fired by a depolarizing ramp (-60 to +60 mV) is increased and, in addition, the amplitude of the initial action potential fired is also significantly larger. Silencing synaptic input to just aCC, without affecting inputs to other neurons, demonstrates that the capability to respond to changing levels of synaptic excitation is intrinsic to these neurons. The alteration to electrical properties are not permanent, being reversed by restoration of normal synaptic function. Whereas our data suggest that synaptic activity makes little or no contribution to the initial formation of embryonic neural circuits, the electrical development of neurons that constitute these circuits seems to depend on a process that requires synaptic activity.