Neurotransmitter deficits in behavioural and psychological symptoms of Alzheimer's disease

Mech Ageing Dev. 2006 Feb;127(2):158-65. doi: 10.1016/j.mad.2005.09.016. Epub 2005 Nov 16.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / metabolism*
  • Alzheimer Disease / psychology*
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use
  • Behavioral Symptoms / drug therapy
  • Behavioral Symptoms / metabolism*
  • Behavioral Symptoms / psychology*
  • Cholinesterase Inhibitors / adverse effects
  • Cholinesterase Inhibitors / therapeutic use
  • Cholinesterases / metabolism
  • Clinical Trials as Topic
  • Humans
  • Neurotransmitter Agents / deficiency*
  • Neurotransmitter Agents / metabolism

Substances

  • Antipsychotic Agents
  • Cholinesterase Inhibitors
  • Neurotransmitter Agents
  • Cholinesterases