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Brain choline acetyltransferase and mental function in Alzheimer disease
D S Baskin1, J L Browning, F J Pirozzolo
1Neurosurgery Section, Department of Surgery, Veterans Affairs Medical Center, Houston, Texas, USA. dbaskin@tmh.tmc.edu
Objective:
To determine whether higher brain levels of choline acetyltransferase (ChAT) are associated with improved neuropsychological function in patients with Alzheimer disease (AD).
Design:
Case series with single-blind post hoc analysis of biopsy specimens.
Setting:
Urban hospital and medical school.
Patients:
A consecutive sample of 8 patients with AD undergoing brain biopsy and surgical implantation of intraventricular pumps for administration of potential chemotherapeutic agents.
Interventions:
Brain biopsy, surgical implantation of intraventricular pumps, and, in 1 patient, ventriculoperitoneal shunt placement.
Main Outcome Measures:
All patients underwent neuropsychological testing no more than 2 weeks before surgical biopsy. Levels of ChAT were determined in fresh brain tissue from biopsy samples.
Results:
Significant positive correlations were found between ChAT levels and 2 neuropsychological test scores, Mini-Mental State Examination and the Logical Memory subtest of the Wechsler Memory Scale.
Conclusion:
Degeneration of the cholinergic system in vivo correlates with decreasing cognitive function in patients with AD.