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Table 2 Summary of neurobiological correlates of neuropsychiatric symptoms of Alzheimer’s disease and their treatments

From: Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia

Neuropsychiatric symptoms of Alzheimer’s disease Neurotransmitter mechanisms Neuroimaging correlates Treatments
Depression Monoaminergic, noradrenergic, gamma amino butyric acid (GABA) neurotransmission dysfunction Reduced entorhinal cortex thickness; accelerated atrophy in anterior cingulum; decreased cerebral glucose in frontal and parietal cortex Serotonin (serotonin selective reuptake inhibitor, or SSRI), norepinephrine (serotonin-norepinephrine reuptake inhibitor, or SNRI), non-pharmacological treatments
Apathy Lower dopamine transporter binding; lower cholinergic receptor binding Decreased metabolic activity in anterior cingulate and orbitofrontal cortex; functional deficits in several medial and inferior frontal regions Methylphenidate, amantadine, d-amphetamine, modafanil, non-pharmacological treatments
Agitation and aggression Cholinergic neurotransmission deficits; increased D2/D3 receptor availability; monoaminergic (5-HT2A) transmission defects Cortical atrophy of cingulum and frontal gyrus; insula, amygdala, and hippocampal atrophy; lower metabolic activity in temporal frontal and cingulum; anterior salience network Citalopram, atypical anti-psychotics, anti-epileptic mood stabilizers, non-pharmacological treatments
Psychosis D2/D3 receptor availability, monoaminergic, cholinergic Lower regional cerebral blood flow in angular gyrus and occipital lobe; increased atrophy in neocortical, frontal, parietal and cingulum Atypical anti-psychotics, non-pharmacological treatments