Cholinergic system changes in Parkinson's disease: emerging therapeutic approaches.
Cholinergic system changes in Parkinson's disease: emerging therapeutic approaches.
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DOI：
10.1016/s1474-4422(21)00377-x
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发表时间：
2022-04
期刊：
影响因子：
--
通讯作者：
Albin RL
中科院分区：
文献类型：
--
作者：
Bohnen NI;Yarnall AJ;Weil RS;Moro E;Moehle MS;Borghammer P;Bedard MA;Albin RL
在帕金森病患者中，不同脑区可发生不均匀的胆碱能系统变化。这些变化与一系列临床特征相关，包括运动和非运动特征，这些特征对多巴胺能治疗是难治的，并且可以在系统水平框架内概念化，其中节点缺陷可以产生电路功能障碍。胆碱能变化的地形与涉及睡眠、认知、运动、视-听知觉和自主神经功能的神经回路重叠。认知网络中枢的胆碱能缺陷比脑总胆碱能变化更能预测认知缺陷。体位不稳定和步态困难与丘脑、尾状、边缘、新皮质和小脑淋巴结的胆碱能系统改变有关。胆碱能系统缺陷也可累及外周器官。在孤立的快速眼动（REM）睡眠行为障碍患者以及认知正常的帕金森病患者的海马体中，中桥质胆碱能神经元的高胆碱能活性表明，在帕金森病的前驱和早期阶段存在早期代偿。新的药理和神经刺激方法可以针对胆碱能系统治疗帕金森病的运动和非运动特征。
In patients with Parkinson’s disease, heterogeneous cholinergic system changes can occur in different brain regions. These changes correlate with a range of clinical features, both motor and non-motor, that are refractory to dopaminergic therapy, and can be conceptualised within a systems-level framework in which nodal deficits can produce circuit dysfunctions. The topographies of cholinergic changes overlap with neural circuitries involved in sleep and cognitive, motor, visuo-auditory perceptual, and autonomic functions. Cholinergic deficits within cognition network hubs predict cognitive deficits better than do total brain cholinergic changes. Postural instability and gait difficulties are associated with cholinergic system changes in thalamic, caudate, limbic, neocortical, and cerebellar nodes. Cholinergic system deficits can involve also peripheral organs. Hypercholinergic activity of mesopontine cholinergic neurons in people with isolated rapid eye movement (REM) sleep behaviour disorder, as well as in the hippocampi of cognitively normal patients with Parkinson’s disease, suggests early compensation during the prodromal and early stages of Parkinson’s disease. Novel pharmacological and neurostimulation approaches could target the cholinergic system to treat motor and non-motor features of Parkinson’s disease.
影响因子：
3.4
作者：
Kucinski A;Sarter M
通讯作者：
Sarter M