Neurochemical Research

, Volume 23, Issue 5, pp 787-794

First online:

The Cognitive Psychopharmacology of Alzheimer's Disease: Focus on Cholinergic Systems

  • Andrew D LawrenceAffiliated withDepartments of Psychiatry and Experimental Psychology, University of Cambridge
  • , Barbara J SahakianAffiliated withDepartments of Psychiatry and Experimental Psychology, University of Cambridge

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The primary pathology in Alzheimer's disease (DAT) occurs in the basal forebrain cholinergic system (BFCS), which provides the major cholinergic innervation to the neocortex, hippocampus and amygdala. Consistent with the 'cholinergic hypothesis' of dementia in DAT, the most effective treatments so far developed for DAT are drugs which act to boost the functions of the BFCS. These include the centrally acting cholinesterase inhibitor tacrine, and the cholinergic agonist nicotine, acute administration of which leads to an improvement in attentional functions, in line with recent animal studies of the role of the BFCS in cognition. We conclude that future research should include the development of more potent, longer-lasting, less toxic cholinergic agents, which appear to be the best candidates for alleviating the cognitive symptomatology of DAT. Such drugs may also be useful in the treatment of a number of other cognitive disorders, including Lewy body dementia, attention deficit/hyperactivity disorder, and schizophrenia.

Alzheimer's disease cholinergic attention memory psychopharmacology