Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:3.1.1.7 (acetylcholinesterase)
 28,390 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dementia in Parkinson's disease has previously been attributed to the presence in the cerebral cortex of Alzheimer-type neuropathological abnormalities. New evidence suggests, however, that dementia in this disease usually occurs in the absence of substantial Alzheimer-type changes in the cortex and may be related to abnormalities in the cortical cholinergic system. Thus, in Parkinsonian patients with dementia there were extensive reductions of choline acetyltransferase and less extensive reductions of acetylcholinesterase in all four cortical lobes. Choline acetyltransferase reductions in temporal neocortex correlated with the degree of mental impairment assessed by a test of memory and information but not with the extent of plaque or tangle formation. In Parkinson's but not Alzheimer's disease the decrease in neocortical (particularly temporal) choline acetyltransferase correlated with the number of neurons in the nucleus of Meynert suggesting that primary degeneration of these cholinergic neurons may be related, directly or indirectly, to declining cognitive function in Parkinson's disease.
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PMID:Cholinergic correlates of cognitive impairment in Parkinson's disease: comparisons with Alzheimer's disease. 399 51

Dementia in Parkinson's disease (PDD) is a frequent and distressing complication with major consequences. Clinical and pathological features closely link PDD and dementia with Lewy bodies (DLB), suggesting they represent part of the same disease spectrum. Although dopaminergic deficiency primarily determines the akinetic-rigid symptoms of PDD and DLB, there is overwhelming evidence that cholinergic dysfunction underpins many of the cognitive impairments and psychotic features. Open-label studies have suggested that cholinesterase inhibitor drugs may exert positive effects upon all aspects of the neuropsychiatric syndrome in PDD and DLB but particularly apathy, anxiety, impaired attention, hallucinations, delusions, sleep disturbance, and cognitive test performance. Worsening of extrapyramidal motor features is reported only rarely. Initial double-blind, placebo-controlled studies in PDD and DLB have so far confirmed these encouraging results. Early identification of PD patients at greatest risk of developing dementia would permit early use of disease modifying treatments which represent the "golden fleece" management approach to these groups.
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PMID:Current treatment of dementia with Lewy bodies and dementia associated with Parkinson's disease. 1450 59