Mesulam Marsel
Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Learn Mem. 2004 Jan-Feb;11(1):43-9. doi: 10.1101/lm.69204.
A profound loss of cortical cholinergic innervation is a nearly invariant feature of advanced Alzheimer's disease (AD). The temporal course of this lesion and its relationship to other aspects of the disease have not yet been fully clarified. Despite assertions to the contrary, a review of the evidence suggests that a perturbation of cholinergic innervation is likely to be present even in the very early stages of AD. This cholinergic lesion is unlikely to be a major determinant of the clinical symptoms or of the neuropathological lesions. Nonetheless, it almost certainly contributes to the severity of the cognitive and behavioral deficits, especially in the areas of memory and attention. The cholinergic lesion may also influence the progression of the neuropathological process through complex interactions with amyloidogenesis, tau phosphorylation and neuroplasticity.
大脑皮质胆碱能神经支配的严重丧失是晚期阿尔茨海默病（AD）几乎不变的特征。这种损伤的时间进程及其与疾病其他方面的关系尚未完全阐明。尽管有相反的说法，但对证据的回顾表明，即使在AD的极早期阶段，胆碱能神经支配也可能受到干扰。这种胆碱能损伤不太可能是临床症状或神经病理损伤的主要决定因素。然而，它几乎肯定会导致认知和行为缺陷的严重程度，尤其是在记忆和注意力方面。胆碱能损伤还可能通过与淀粉样蛋白生成、tau蛋白磷酸化和神经可塑性的复杂相互作用影响神经病理过程的进展。
