Dementia: the neurochemical basis of putative transmitter orientated therapy

The neurotransmitter deficits of dementias, including Alzheimer's dementia, Lewy body dementia and Parkinson's disease are discussed in relation to cognitive and behavioural impairments together with neuropathological changes and available data on the status of receptor transmembrane signalling. Potential therapeutic strategies for dementia are outlined based on the following systems: excitatory amino acids, gamma-amino butyric acid, acetylcholine (muscarinic and nicotinic), noradrenaline, serotonin and peptides. These include the attenuation of transmitter deficits by agonists and agents inhibiting transmitter breakdown and support for surviving neurons by suppression of inhibitory inputs, trophic factors and neural implantation.