Sarter Martin, Parikh Vinay, Howe William M
Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109-1043, USA.
Biochem Pharmacol. 2009 Oct 1;78(7):658-67. doi: 10.1016/j.bcp.2009.04.019. Epub 2009 May 4.
The identification and characterization of drugs for the treatment of cognitive disorders has been hampered by the absence of comprehensive hypotheses. Such hypotheses consist of (a) a precisely defined cognitive operation that fundamentally underlies a range of cognitive abilities and capacities and, if impaired, contributes to the manifestation of diverse cognitive symptoms; (b) defined neuronal mechanisms proposed to mediate the cognitive operation of interest; (c) evidence indicating that the putative cognition enhancer facilitates these neuronal mechanisms; (d) and evidence indicating that the cognition enhancer facilitates cognitive performance by modulating these underlying neuronal mechanisms. The evidence on the neuronal and attentional effects of nAChR agonists, specifically agonists selective for alpha4beta2* nAChRs, has begun to support such a hypothesis. nAChR agonists facilitate the detection of signals by augmenting the transient increases in prefrontal cholinergic activity that are necessary for a signal to gain control over behavior in attentional contexts. The prefrontal microcircuitry mediating these effects include alpha4beta2* nAChRs situated on the terminals of thalamic inputs and the glutamatergic stimulation of cholinergic terminals via ionotropic glutamate receptors. Collectively, this evidence forms the basis for hypothesis-guided development and characterization of cognition enhancers.
由于缺乏全面的假说,用于治疗认知障碍的药物的识别和特性描述一直受到阻碍。这样的假说包括:(a)一个精确界定的认知操作,它是一系列认知能力和容量的根本基础,若其受损,则会导致多种认知症状的表现;(b)为介导相关认知操作而提出的明确的神经元机制;(c)表明假定的认知增强剂能促进这些神经元机制的证据;(d)以及表明认知增强剂通过调节这些潜在的神经元机制来促进认知表现的证据。关于烟碱型乙酰胆碱受体(nAChR)激动剂,特别是对α4β2* nAChRs具有选择性的激动剂的神经元和注意力效应的证据,已开始支持这样一种假说。nAChR激动剂通过增强前额叶胆碱能活性的短暂增加来促进信号检测,而这种增加是信号在注意力情境中获得对行为控制所必需的。介导这些效应的前额叶微回路包括位于丘脑输入终末的α4β2* nAChRs以及通过离子型谷氨酸受体对胆碱能终末的谷氨酸能刺激。总体而言,这些证据构成了假说导向的认知增强剂开发和特性描述的基础。