NMDA Neurotransmission Dysfunction in Behavioral and Psychological Symptoms of Alzheimer's Disease.
NMDA Neurotransmission Dysfunction in Behavioral and Psychological Symptoms of Alzheimer's Disease.
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DOI：
10.2174/157015912803217288
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发表时间：
2012-09
影响因子：
5.3
通讯作者：
Tsai GE
中科院分区：
文献类型：
--
作者：
Huang YJ;Lin CH;Lane HY;Tsai GE
痴呆症已成为一种非常重要的疾病，因为人口正在迅速老龄化，并且与痴呆症相关的医疗保健费用不断增加。除了认知功能障碍外，痴呆症相关的行为和心理症状 (BPSD) 还会恶化患者的生活质量并增加护理人员的负担。阿尔茨海默病是最常见的痴呆类型，阿尔茨海默病的行为障碍和认知障碍被认为与 N-甲基-D-天冬氨酸 (NMDA) 功能障碍有关，因为越来越多的证据表明，阿尔茨海默病的行为变化和认知能力下降存在谷氨酸能神经传递功能障碍。我们回顾了有关痴呆（特别是阿尔茨海默病）、BPSD 的文献以及谷氨酸能和 NMDA 神经传递的相关发现，包括美金刚（一种 NMDA 受体拮抗剂）和 NMDA 增强剂（如 D-丝氨酸和 D-环丝氨酸）的作用。文献表明，阿尔茨海默病的行为障碍和认知障碍可能与兴奋性神经毒性作用有关，从而导致神经元可塑性和退行性过程受损。美金刚在改善阿尔茨海默病患者的认知、功能、躁动/攻击性和妄想方面具有益处。另一方面，一些通过共激动剂结合位点增强NMDA功能的NMDA调节剂也可以改善认知功能和精神症状。我们认为调节 NMDA 神经传递可有效治疗阿尔茨海默病的行为和心理症状。需要对阿尔茨海默病和相关行为障碍患者使用 NMDA 增强剂进行前瞻性研究来验证这一假设。
Dementia has become an all-important disease because the population is aging rapidly and the cost of health care associated with dementia is ever increasing. In addition to cognitive function impairment, associated behavioral and psychological symptoms of dementia (BPSD) worsen patient’s quality of life and increase caregiver’s burden. Alzheimer’s disease is the most common type of dementia and both behavioral disturbance and cognitive impairment of Alzheimer’s disease are thought to be associated with the N-methyl-D-aspartate (NMDA) dysfunction as increasing evidence of dysfunctional glutamatergic neurotransmission had been reported in behavioral changes and cognitive decline in Alzheimer’s disease. We review the literature regarding dementia (especially Alzheimer’s disease), BPSD and relevant findings on glutamatergic and NMDA neurotransmission, including the effects of memantine, a NMDA receptor antagonist, and NMDA-enhancing agents, such as D-serine and D-cycloserine. Literatures suggest that behavioral disturbance and cognitive impairment of Alzheimer’s disease may be associated with excitatory neurotoxic effects which result in impairment of neuronal plasticity and degenerative processes. Memantine shows benefits in improving cognition, function, agitation/aggression and delusion in Alzheimer’s disease. On the other hand, some NMDA modulators which enhance NMDA function through the co-agonist binding site can also improve cognitive function and psychotic symptoms. We propose that modulating NMDA neurotransmission is effective in treating behavioral and psychological symptoms of Alzheimer’s disease. Prospective study using NMDA enhancers in patients with Alzheimer’s disease and associated behavioral disturbance is needed to verify this hypothesis.
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DOI：
10.1111/j.1532-5415.2011.03365.x
发表时间：
2011-05-01
影响因子：
6.3
作者：
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影响因子：
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作者：
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DOI：
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发表时间：
2008-08-06
期刊：
The Journal of neuroscience : the official journal of the Society for Neuroscience
影响因子：
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作者：
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通讯作者：
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影响因子：
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