A short review of cognitive and functional neuroimaging studies of cholinergic drugs: implications for therapeutic potentials

被引:61
作者
Freo, U
Pizzolato, G
Dam, M
Ori, C
Battistin, L
机构
[1] Univ Padua, Dept Neurol, Padua, Italy
[2] Univ Padua, Dept Psychiat, Padua, Italy
[3] Univ Padua, Dept Anesthesiol, Padua, Italy
关键词
cerebral glucose metabolism; cerebral blood flow; cholinergic; dementia; donepezil; rivastigmine; PET; SPECT;
D O I
10.1007/s007020200070
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
In the last 20 years a cholinergic dysfunction has been the major working hypothesis for the pharmachology of memory disorders. Cholinergic antagonists and lesions impair and different classes of cholinomimetics (i.e. acetylcholine precursors, cholinergic agonists and acetylcholinesterase inhibitors) enhance attention and memory in experiment animals, healthy human subjects and Alzheimer disease patients. In addition, acetylcholinesterase inhibitors improve different cognitive (i.e. visuospatial and verbal) functions in a variety of unrelated disorders such as dementia with Lewy bodies, Parkinson disease, multiple sclerosis, schizoaffective disorders, iatrogenic memory loss, traumatic brain injury, hyperactivity attention disorder and, as we recently reported, vascular dementia and mild cognitive impairment. In animals, different cholinomimetics dose-dependently increased regional cerebral metabolic rates for glucose (rCMRglc) and regional blood flow (rCBF), two indices of neuronal function, more markedly in subcortical regions (i.e. thalamus, hippocampus and visual system nuclei). In both healthy human subjects and Alzheimer disease patients acetylcholinesterase inhibitors increased rCMRglc and rCBF in subcortical and cortical brain regions at rest but attenuated rCBF increases during cognitive performances. Hence, acetylcholinesterase inhibitors may enhance cognition and rCMRglc by acting primarily on subcortical regions that are involved in attentional (i.e. thalamus) and memory (i.e. hippocampus) processes; such an effect probably is not specific for Alzheimer disease and can be beneficial in patients suffering from a wide array of neuropsychiatric disorders.
引用
收藏
页码:857 / 870
页数:14
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