期刊
INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY
卷 18, 期 -, 页码 S23-S32出版社
JOHN WILEY & SONS LTD
DOI: 10.1002/gps.938
关键词
NMDA receptors; Alzheimer's dementia; memantine; neuroprotection; cognitive enhancement
There is increasing evidence for the involvement of glutamate-mediated neurotoxicity in the pathogenesis of Alzheimer's disease (AD). We suggest that glutamate receptors of the N-methyl-D-aspartate (NMDA) type are overactivated in a tonic rather than a phasic manner in this disorder. This continuous mild activation may lead to neuronal damage and impairment of synaptic plasticity (learning). It is likely that under such conditions Mg2+ ions, which block NMDA receptors under normal resting conditions, can no longer do so. We found that overactivation of NMDA receptors using a direct agonist or a decrease in Mg2+ concentration produced deficits in synaptic plasticity (in vivo: passive avoidance test and/or in vitro: LTP in the CAl region). In both cases, memantine-an uncompetitive NMDA receptor antagonists with features of an 'improved' Mg2+ (voltage-dependency, kinetics, affinity)-attenuated this deficit. Synaptic plasticity was restored by therapeutically-relevant. concentrations of memantine (1 muM). Moreover, doses leading to similar brain/serum levels provided neuroprotection in animal models relevant for neurodegeneration in AD such as neurotoxicity produced by inflammation in the NBM or beta-amyloid injection to the hippocampus. As such, if overactivation of NMDA receptor, is present in AD, memantine would be expected to improve both symptoms (cognition) and to slow down disease progression because it takes over the physiological function of magnesium. Copyright (C) 2003 John Wiley Sons, Ltd.
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