Cholinergic-serotonergic imbalance contributes to cognitive and behavioral symptoms in Alzheimer's disease
Cholinergic-serotonergic imbalance contributes to cognitive and behavioral symptoms in Alzheimer's disease
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DOI：
10.1016/j.neuropsychologia.2004.06.007
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发表时间：
2005-01-01
期刊：
影响因子：
2.6
通讯作者：
Ramirez, M. J.
中科院分区：
文献类型：
--
作者：
Garcia-Alloza, M.;Gil-Bea, F. J.;Ramirez, M. J.
阿尔茨海默病（AD）中出现的神经精神症状不仅仅是神经退行性变的结果，而且可能是由不同的神经递质改变引起的，有些患者的风险更大。比其他人。因此，本研究的假设是，胆碱能和胆碱能系统之间的失衡与AD患者的认知症状和痴呆的心理综合征（BPSD）。对22例AD患者的额叶和颞叶皮层进行了胆碱能和多巴胺能神经功能的检测，这些患者均采用简易精神状态检查（MMSE）进行了认知功能的前瞻性评估，并采用现在行为检查（PBE）进行了BPSD（包括攻击行为、过度活动、抑郁和精神病）的前瞻性评估。不仅胆碱能缺陷，而且胆碱乙酰转移酶/5-羟色胺比值显着相关，最终MMSE评分在额叶和颞叶皮层。此外，胆碱能功能的下降与攻击行为因素相关，支持胆碱能系统在AD相关的认知和非认知障碍中的双重作用。肾上腺素能系统与过度活动和精神病有显著相关性。血清素与乙酰胆碱酯酶水平的比值也与精神病因素相关，至少在女性中是这样。结论：胆碱能-胆碱能系统之间的失衡可能是AD相关认知功能障碍的原因。此外，本研究的主要发现是胆碱能和胆碱能系统的神经化学标志物与痴呆患者的非认知行为障碍之间的关系。(c)2004爱思唯尔有限公司保留所有权利。
Neuropsychiatric symptoms seen in Alzheimer's disease (AD) are not simply a consequence of neurodegeneration, but probably result from differential neurotransmitter alterations, which some patients are more at risk. of than others. Therefore, the hypothesis of this study is that an imbalance between the cholinergic and serotonergic systems is related to cognitive symptoms and psychological syndromes of dementia (BPSD) in patients with AD. Cholinergic and serotonergic functions were assessed in post-mortem frontal and temporal cortex from 22 AD patients who had been prospectively assessed with the Mini-Mental State examination (MMSE) for cognitive impairment and with the Present Behavioral Examination (PBE) for BPSD including aggressive behavior, overactivity, depression and psychosis. Not only cholinergic deficits, but also the cholinacetyltransferase/serotonin ratio significantly correlated with final MMSE score both in frontal and temporal cortex. In addition, decreases in cholinergic function correlated with the aggressive behavior factor, supporting a dual role for the cholinergic system in cognitive and non-cognitive disturbances associated to AD. The serotonergic system showed a significant correlation with overactivity and psychosis. The ratio of serotonin to acetylcholinesterase levels was also correlated with the psychotic factor at least in women. It is concluded that an imbalance between cholinergic-serotonergic systems may be responsible for the cognitive impairment associated to AD. Moreover, the major findings of this study are the relationships between neurochemical markers of both cholinergic and serotonergic systems and non-cognitive behavioral disturbances in patients with dementia. (c) 2004 Elsevier Ltd. All rights reserved.