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 |