Brain Acetylcholine — A View From the Cerebrospinal Fluid

Abstract

Is acetylcholine (ACh) metabolism in brain reflected by changes in the cerebrospinal fluid (CSF)? Are there specific changes in enzyme activities associated with ACh synthesis and hydrolysis, levels of the precursor (choline) and the neurotransmitter, which can be related to physiological and pathological conditions of the central cholinergic nervous system? This question has become more acute as several authors have reported a selective impairment of the cholinergic system with a marked decrease of cholineacetyltransferase (ChAc) and acetylcholinesterase (AChE) activity in several cortical and subcortical areas of the brain of patients affected by presenile (AD) and senile dementia of Alzheimer type (SDAT) (Davies, 1979; Perry et al., 1977; Rossor et al., 1982; Whitehouse et al., 1981). We have recently reported (Giacobini et al., 1985) changes in choline (Ch), AChE and ChAc activity in the CSF of a group of SDAT patients showing characteristic symptoms of dementia of different grades of severity, as compared to the CSF of healthy age-matched controls. In this review, we shall examine and discuss our recent results and some data found in the literature which might answer, although not completely, the question posed by the title of this paper.