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Review
. 2019 Jun 21;704:36-44.
doi: 10.1016/j.neulet.2019.03.050. Epub 2019 Apr 1.

Serotonergic System, Cognition, and BPSD in Alzheimer's Disease

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Free PMC article
Review

Serotonergic System, Cognition, and BPSD in Alzheimer's Disease

Saikat Chakraborty et al. Neurosci Lett. .
Free PMC article

Abstract

Behavioral and Psychological Symptoms of Dementia (BPSD), present in almost 90% of patients with Alzheimer's Disease (AD), cause extensive impairment leading to reduced independence and inability to complete activities of daily living. Though BPSD includes a wide range of symptoms, such as agitation, aggression, disinhibition, anxiety, depression, apathy, delusions, and hallucinations. Certain BPSD in AD co-present and can be clustered into distinct domains based on their frequency of co-occurrence. As these BPSD are so pervasive in any stages of AD, the disease may be better characterized as a disorder of heterogeneous degenerative symptoms across a number of symptom domains, with the most prominent domain comprising memory and cognitive deficits. Importantly, there are no FDA-approved drugs to treat these BPSD, and new approaches must be considered to develop effective treatments for AD patients. The biogenic monoamine 5-hydroxytryptamine (5-HT), or serotonin, works as both a neurotransmitter and neuromodulator, which has been tied to cognitive decline and multiple BPSD domains. This review summarizes the evidence for specific serotonergic system alterations across some of the well-studied cognitive, behavioral, and psychiatric domains. Though differences in overall serotonergic transmission occur in AD, circuit-specific alterations in individual 5-HT receptors (5-HTRs) are likely linked to the heterogeneous presentation of BPSD in AD.

Keywords: 5-HT receptors (5-HTRs); 5-hydroxytryptamine (5-HT); Alzheimer's disease; Behavioral and psychological symptoms of dementia (BPSD).

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