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Multiple neurotransmitter deficits found in recent autopsy studies of patients with Alzheimer's disease may militate against the success of "simple cholinergic replacement" as treatment. To study acetylcholine synthesis, we measured the incorporation of radiolabeled glucose into the transmitter in temporal-cortex specimens obtained at diagnostic craniotomy in 17 young patients with Alzheimer's disease. Synthesis of acetylcholine was significantly correlated with cognitive impairment. These results are consistent with the view that the deficit in the presynaptic cholinergic system is a relatively early change in the development of the clinical features of the disease. Other alterations in noradrenergic cells, some cortical neurons, postsynaptic cortical receptors, and possibly serotoninergic cells may not be closely associated with Alzheimer's disease.

Original publication

DOI

10.1056/NEJM198507043130102

Type

Journal article

Journal

N Engl J Med

Publication Date

04/07/1985

Volume

313

Pages

7 - 11

Keywords

Acetylcholine, Age Factors, Aged, Alzheimer Disease, Brain, Choline O-Acetyltransferase, Cholinergic Fibers, Cognition, Humans, Hydroxyindoleacetic Acid, Methoxyhydroxyphenylglycol, Middle Aged, Neurotransmitter Agents, Norepinephrine, Parasympathomimetics, Serotonin, Temporal Lobe