The brain cholinergic system forms an extensive network of projection neurons, which innervate several brain areas. These neurons, defined as cholinergic because they contain the machinery for synthesizing and releasing acetylcholine (ACh) for neurotransmission, are grouped in nuclei. They include:
Fig.1 Schematic representation of some cholinergic pathways in the postnatal rat brain. (Shabani, 2020)
Post-mortem studies and in vivo neuroimaging investigations demonstrated that in Alzheimer's disease (AD), a loss of forebrain cholinergic nuclei from Ch1 to Ch4 is associated with cognitive deficits, ranging from MCI to dementia. A similar neuropathological situation characterizes alcoholic and post-traumatic dementia. Conversely, in Parkinson's disease (PD) without dementia, the forebrain cholinergic neurons are spared but there is a substantial loss of midpontine cholinergic neurons (C5 and C6), which contributes to the motor and sleep disturbances of this disease. Between these two conditions, there are Lewy body dementia (LBD), PD with dementia, and the Parkinsonian syndromes in which both forebrain and midpontine cholinergic nuclei are affected with the possible involvement of striatal cholinergic neurons.
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Reference
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