Brain cholinergic system (BCS)

The brain cholinergic system is a diffuse network of neurons that utilize the neurotransmitter acetylcholine (ACh) to modulate essential central nervous system functions (StatPearls, 2023). It is primarily organized into two major subsystems: the basal forebrain cholinergic complex, which projects extensively to the neocortex and hippocampus, and the brainstem cholinergic system, which modulates the thalamus and midbrain (NIH, 2021). This system is a critical mediator of cognitive processes, including attention, learning, and memory, and it plays a significant role in maintaining arousal and the sleep-wake cycle (PubMed, 2022). Dysfunction of the brain cholinergic system is a hallmark of several neurodegenerative and neuropsychiatric disorders, most notably Alzheimer's disease, where the loss of cholinergic neurons in the nucleus basalis of Meynert is closely linked to cognitive impairment (Wikipedia, 2024). Therapeutic strategies often involve the use of acetylcholinesterase inhibitors to enhance endogenous ACh levels or the use of receptor-specific agonists and antagonists to restore balanced neurotransmission (PubChem, 2023).

Other names

Central cholinergic systemCholinergic neurotransmission systemCholinergic pathway

Drugs targeting the brain cholinergic system primarily act by inhibiting the enzyme acetylcholinesterase to increase synaptic acetylcholine levels, or by acting as agonists or antagonists at muscarinic and nicotinic acetylcholine receptors to modulate neurotransmission (StatPearls, 2023).