The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.
Cholinergic Deficiency Hypothesis in Delirium: A Synthesis of Current Evidence
Open accessAbstract
Deficits in cholinergic function have been postulated to cause delirium and cognitive decline. This review examines current understanding of the cholinergic deficiency hypothesis in delirium by synthesizing evidence on potential pathophysiological pathways. Acetylcholine synthesis involves various precursors, enzymes, and receptors, and dysfunction in these components can lead to delirium. Insults to the brain, like ischemia and immunological stressors, can precipitously alter acetylcholine levels. Imbalances between cholinergic and other neurotransmitter pathways may result in delirium. Furthermore, genetic, enzymatic, and immunological overlaps exist between delirium and dementia related to the cholinergic pathway. Important areas for future research include identifying biomarkers, determining genetic contributions, and evaluating response to cholinergic drugs in delirium. Understanding how the cholinergic pathway relates to delirium may yield innovative approaches in the diagnosis, prevention, and treatment of this common, costly, and morbid condition.
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Cites
The cholinergic hypothesis of geriatric memory dysfunction
Bartus, R. T., Dean, R. L., Beer, B., & Lippa, A. S. (1982) · Science · doi:10.1126/science.7046051 · Cited by 5,545
J Neuropsychiatry Clin Neurosci
Yudofsky, S. C., & Hales, R. E. (1992) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/jnp.4.4.359 · Cited by 3,818
Cytokines and the Brain: Implications for Clinical Psychiatry
Kronfol, Z., & Remick, D. G. (2000) · American Journal of Psychiatry · doi:10.1176/appi.ajp.157.5.683 · Cited by 784
Effects of Cytokines on Cerebral Neurotransmission: Comparison with the Effects of Stress
Dunn, A. J., Wang, J., & Ando, T. (1999) · Advances in Experimental Medicine and Biology · doi:10.1007/978-0-585-37970-8_8 · Cited by 316
Cited by
Inouye, S. K., Westendorp, R. G., & Saczynski, J. S. (2014) · The Lancet · doi:10.1016/s0140-6736(13)60688-1 · Cited by 3,722
Self-citationNeuropathogenesis of Delirium: Review of Current Etiologic Theories and Common Pathways
Maldonado, J. R. (2013) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2013.09.005 · Cited by 745
Delirium pathophysiology: An updated hypothesis of the etiology of acute brain failure
Maldonado, J. R. (2018) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4823 · Cited by 617
The interface between delirium and dementia in elderly adults
Fong, T. G., Davis, D., Growdon, M. E., Albuquerque, A., & Inouye, S. K. (2015) · The Lancet Neurology · doi:10.1016/s1474-4422(15)00101-5 · Cited by 595
Self-citationMolecular and functional neuroscience in immunity
Pavlov, V. A., Chavan, S. S., & Tracey, K. J. (2018) · Annual Review of Immunology · doi:10.1146/annurev-immunol-042617-053158 · Cited by 444
Metadata
- Authors
- Hshieh, T. T., Fong, T. G., Marcantonio, E. R., & Inouye, S. K.
- Venue
- The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-07-01
- Volume
- 63
- Issue
- 7
- Pages
- 764-772
- ISSN
- 1079-5006 (ISSN-L)
- 1758-535X
- OpenAlex
- W2114943413
- Cited by
- 553
- References
- 4
- FWCI
- 15.07
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Hshieh, T. T., Fong, T. G., Marcantonio, E. R., & Inouye, S. K. (2008). Cholinergic Deficiency Hypothesis in Delirium: A Synthesis of Current Evidence. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. https://doi.org/10.1093/gerona/63.7.764
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