Pharmacology · single question
Which neurotransmitter is most implicated in ALZHEIMER'S DISEASE?
Show answer and explanation
Correct answer: A. Acetylcholine (decreased)
Acetylcholine (A) — decreased is the primary neurotransmitter implicated in Alzheimer's Disease. The 'cholinergic hypothesis' of Alzheimer's: degeneration of cholinergic neurons in the basal forebrain (nucleus basalis of Meynert) leads to decreased ACh in the cerebral cortex and hippocampus, impairing memory and cognition.
• Treatment rationale: Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) increase ACh availability. Memantine (NMDA receptor antagonist) modulates glutamate.
• Glutamate (excitotoxicity) also plays a role — hence memantine use.
• Dopamine (D): implicated in Parkinson's and schizophrenia.
• Dental relevance: Alzheimer's patients have poor oral hygiene compliance, increased caries risk, dry mouth from medications, and difficult patient management.
• Treatment rationale: Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) increase ACh availability. Memantine (NMDA receptor antagonist) modulates glutamate.
• Glutamate (excitotoxicity) also plays a role — hence memantine use.
• Dopamine (D): implicated in Parkinson's and schizophrenia.
• Dental relevance: Alzheimer's patients have poor oral hygiene compliance, increased caries risk, dry mouth from medications, and difficult patient management.