The cognitive psychopharmacology of Alzheimer's disease: focus on cholinergic systems

Neurochem Res. 1998 May;23(5):787-94. doi: 10.1023/a:1022419712453.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acetylcholine / physiology*
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / physiopathology*
  • Alzheimer Disease / psychology*
  • Brain / pathology
  • Brain / physiopathology*
  • Cholinergic Agents / therapeutic use
  • Cholinergic Fibers / physiology
  • Cognition / physiology*
  • Cognition Disorders / drug therapy
  • Cognition Disorders / etiology
  • Humans
  • Neurotransmitter Agents / physiology


  • Cholinergic Agents
  • Neurotransmitter Agents
  • Acetylcholine