Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan.
Department of Rehabilitation, China Medical University Hospital, Taichung 40402, Taiwan.
Int J Mol Sci. 2021 Feb 25;22(5):2283. doi: 10.3390/ijms22052283.
Alzheimer's disease (AD), the most common cause of dementia, is a progressive neurodegenerative disease. The number of AD cases has been rapidly growing worldwide. Several the related etiological hypotheses include atypical amyloid β (Aβ) deposition, neurofibrillary tangles of tau proteins inside neurons, disturbed neurotransmission, inflammation, and oxidative stress. During AD progression, aberrations in neurotransmission cause cognitive decline-the main symptom of AD. Here, we review the aberrant neurotransmission systems, including cholinergic, adrenergic, and glutamatergic network, and the interactions among these systems as they pertain to AD. We also discuss the key role of -methyl-d-aspartate receptor (NMDAR) dysfunction in AD-associated cognitive impairment. Furthermore, we summarize the results of recent studies indicating that increasing glutamatergic neurotransmission through the alteration of NMDARs shows potential for treating cognitive decline in mild cognitive impairment or early stage AD. Future studies on the long-term efficiency of NMDA-enhancing strategies in the treatment of AD are warranted.
阿尔茨海默病(AD)是最常见的痴呆症病因,是一种进行性神经退行性疾病。全球 AD 病例数量迅速增加。几个相关的病因假说包括非典型淀粉样β(Aβ)沉积、神经元内的 tau 蛋白神经原纤维缠结、神经传递紊乱、炎症和氧化应激。在 AD 进展过程中,神经传递异常导致认知能力下降——AD 的主要症状。在这里,我们回顾了异常的神经传递系统,包括胆碱能、肾上腺素能和谷氨酸能网络,以及这些系统之间的相互作用,因为它们与 AD 有关。我们还讨论了 -甲基-d-天冬氨酸受体(NMDAR)功能障碍在 AD 相关认知障碍中的关键作用。此外,我们总结了最近的研究结果,表明通过改变 NMDAR 增加谷氨酸能神经传递在治疗轻度认知障碍或早期 AD 相关认知能力下降方面具有潜力。有必要对 AD 治疗中 NMDA 增强策略的长期疗效进行进一步研究。