Neurotransmitter deficits in behavioural and psychological symptoms of Alzheimer's disease.
Behavioural and psychological symptoms of dementia (BPSD) occur in 50-90% of Alzheimer's disease (AD) patients. Imbalance of different neurotransmitters (acetylcholine, dopamine, noradrenaline and serotonin), involvement of specific brain regions responsible for emotional activities (parahippocampal gyrus, dorsal raphe and locus coeruleus) and cortical hypometabolism have been proposed as neurobiological substrate of BPSD. Compared to with respect to the neurochemical component, the cholinergic dysfunction seems to play a major role in contributing to BPSD occurrence. This view is also supported by the findings of recent trials with cholinesterase inhibitors, showing that these drugs are effective in controlling and/or improving BPSD, independent on effects on cognitive dysfunction. On the site of psychotropic drugs, atypical or novel antipsychotics represent the reference drugs for treating BPSD, whereas classic antipsychotic drugs for their profile and the potential side effects should be avoided.
Lanari
Alessia
A
Dipartimento di Neuroscienze, Università di Perugia, Perugia, Italy.
Amenta
Francesco
F
Silvestrelli
Giorgio
G
Tomassoni
Daniele
D
Parnetti
Lucilla
L
D000544:Alzheimer Disease / Q000188:drug therapy / Q000378:metabolism* / Q000523:psychology*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001526:Behavioral Symptoms / Q000188:drug therapy / Q000378:metabolism* / Q000523:psychology*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D002802:Cholinesterases / Q000378:metabolism; D002986:Clinical Trials as Topic; D006801:Humans; D018377:Neurotransmitter Agents / Q000172:deficiency* / Q000378:metabolism
D014150:Antipsychotic Agents; D002800:Cholinesterase Inhibitors; D018377:Neurotransmitter Agents; D002802:Cholinesterases