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The NMDA receptor antagonist memantine as a symptomatological and neuroprotective treatment for Alzheimer's disease: preclinical evidence
Author(s) -
Danysz Wojciech,
Parsons Chris G.
Publication year - 2003
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.938
Subject(s) - memantine , nmda receptor , neuroprotection , glutamate receptor , neuroscience , synaptic plasticity , neurotoxicity , excitotoxicity , neurodegeneration , alzheimer's disease , ampa receptor , agonist , pharmacology , medicine , receptor , psychology , disease , toxicity
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 Mg 2+ 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 Mg 2+ concentration produced deficits in synaptic plasticity ( in vivo : passive avoidance test and/or in vitro : LTP in the CA1 region). In both cases, memantine—an uncompetitive NMDA receptor antagonists with features of an ‘improved’ Mg 2+ (voltage‐dependency, kinetics, affinity)—attenuated this deficit. Synaptic plasticity was restored by therapeutically‐relevant concentrations of memantine (1 μM). 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 β‐amyloid injection to the hippocampus. As such, if overactivation of NMDA receptors 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 © 2003 John Wiley & Sons, Ltd.