Sunderland T, Tariot P N, Cohen R M, Weingartner H, Mueller E A, Murphy D L
Arch Gen Psychiatry. 1987 May;44(5):418-26. doi: 10.1001/archpsyc.1987.01800170032006.
We compared the cognitive and behavioral responses to three intravenous doses of scopolamine (0.1, 0.25, and 0.5 mg) and placebo of ten patients with dementia of the Alzheimer type (DAT) and ten age- and sex-matched elderly control subjects. The patients with DAT showed significant behavioral and cognitive but not physiologic changes at a lower scopolamine dose (0.25 mg) than did the normal elderly controls. Cognitive tests of new learning and semantic knowledge revealed significant impairments at the 0.25-mg scopolamine dose in the patients with DAT, while the responses of the control population were essentially unchanged. Behaviorally, mild euphoria, motor incoordination, and hostility occurred in the patients with DAT but not the controls at the 0.25-mg dose. These differences were unrelated to peripheral physiologic changes produced by the different scopolamine doses. These results indicate that central nervous system functions such as cognition and certain elements of behavior are more sensitive to temporary cholinergic blockade in patients with DAT than in normal age-matched controls. We review implications concerning the status of central cholinergic function in patients with DAT in light of neuropathologically demonstrated cholinergic system lesions in DAT.
我们比较了10例阿尔茨海默型痴呆（DAT）患者和10例年龄及性别匹配的老年对照受试者对三种静脉注射剂量东莨菪碱（0.1、0.25和0.5毫克）及安慰剂的认知和行为反应。与正常老年对照相比，DAT患者在较低剂量东莨菪碱（0.25毫克）时即出现显著的行为和认知变化，但生理变化不明显。新学习和语义知识的认知测试显示，0.25毫克剂量东莨菪碱使DAT患者出现显著损伤，而对照人群的反应基本未变。行为方面，0.25毫克剂量时，DAT患者出现轻度欣快感、运动不协调和敌意，而对照者未出现。这些差异与不同剂量东莨菪碱引起的外周生理变化无关。这些结果表明，与年龄匹配的正常对照相比，DAT患者的中枢神经系统功能如认知和某些行为要素对短暂性胆碱能阻滞更为敏感。我们根据DAT神经病理学证实的胆碱能系统损伤，综述了DAT患者中枢胆碱能功能状态的相关影响。
