Executive dyscontrol in dementia, with emphasis on subcortical pathology and the role of butyrylcholinesterase.

摘要: Executive functions describe a variety of cognitive processes responsible for structuring behaviors around goals, and developing plans to achieve those goals in relation the environment. In addition deficits basal forebrain cholinergic neuronal input into frontal cortex, impaired control executive function has been associated with lesions cortex its ganglia-thalamic connections. dysfunction, features that imply fronto-subcortical pathology include profound slowing cognition, attentional deficits, apathy changes mood. Fronto-subcortical systems are vulnerable white matter change, atrophy, certain forms neurotransmitter depletion. The diffuse, likely non-cholinergic, projections acetylcholinesterase (AChE)-containing thalamic neurons innervate all cortical areas. Butyrylcholinesterase (BuChE) activity is relatively high nuclei project structures involved attention, function, behavior. However, largest pool BuChE brain found glia, particularly deeper subcortical structures. These findings suggest may also be an important therapeutic target management symptoms due pathology. Whereas 'pure' Alzheimer's disease (AD) involve significant pathology, AD cerebrovascular disease, vascular dementia (VaD), Parkinson's (PDD) Lewy bodies (DLB) generally greater degree subcortical, cortical, It hypothesized these types, which characterized by might derive particular benefits from cholinesterase inhibitors such as rivastigmine inhibit AChE.