Alzheimer’s disease (AD) accounts for 80% of all dementia cases, making it the most common form of dementia. Aging serves as the main risk factor for AD, but early onset AD can also occur in individuals younger than 65 years. AD results from progressive neurodegeneration leading to dysfunctional synaptic transmission in the brain. The cascade hypothesis of AD states that amyloid precursor protein (APP) metabolism becomes impaired either by mutation or an interleukin-mediated stress response to injury, resulting in the splicing of harmful oligomeric forms of amyloid beta (Aβ). These oligomers disrupt extracellular receptor binding, intracellular function, and cellular membrane integrity. Yoga and meditative practices slow the progression of the cognitive decline associated with AD. However, the biological mechanisms underlying this therapeutic effect remain elusive. Here, we investigated the ability of neurotransmitters released during yoga and meditative practices to rescue neurons from synaptic dysfunction in an in vitro Alzheimer’s model created by culturing basal forebrain cholinergic neurons with physiologically relevant levels of the I-42 isoform of oligomeric Aβ (OΑβI-42). We found that the neurotransmitters dopamine and histamine produce a cooperative action with serotonin to reverse the loss of choline acetyltransferase (CHaT) by OΑβI-42. The loss of ChaT, the enzyme responsible for processing the cholinergic neurotransmitter acetylcholine, contributes to the synaptic dysfunction experienced during AD. These neurotransmitters inhibit nitric oxide synthesis caused by OΑβI-42, preventing oxidative and nitrosative stress. Serotonin activates an alternate cleavage of APP to produce a fragment with known neurotrophic effects, giving it the unique ability to inhibit the OΑβI-42 production cycle. We hypothesize here that these concerted actions lead to the protection of cholinergic synaptic transmission in AD.

1.
Acevedo
BP
,
Pospos
S
,
Lavretsky
H
.
The neural mechanisms of meditative practices: novel approaches for healthy aging
.
Curr Behav Neurosci Rep
.
2016
;
3
(
4
):
328
39
.
[PubMed]
2196-2979
2.
"
Drugs Approved for Alzheimer’s Disease.
" Alzheimer Society of Canada. Accessed September 19, 2018. http://alzheimer.ca/en/Home/About-dementia/Treatment-options/Drugs-approved-for-Alzheimers-disease
3.
"
Latest Information and Statistics.
" Alzheimer Society of Canada. Accessed September 19, 2018. http://alzheimer.ca/en/Home/Get-involved/Advocacy/Latest-info-stats
4.
"
Facts and Figures.
" Alzheimer's Association. Accessed September 19, 2018. https://www.alz.org/alzheimers-dementia/facts-figures
5.
"
Treatment Horizon.
" Alzheimer's Association. Accessed September 19, 2018. https://www.alz.org/alzheimers-dementia/research_progress/treatment-horizon
6.
"
Treatments.
" Alzheimer's Association. Accessed September 19, 2018. https://www.alz.org/alzheimers-dementia/treatments
7.
Armstrong
RA
.
The pathogenesis of Alzheimer’s disease: a reevaluation of the “amyloid cascade hypothesis”
.
Int J Alzheimers Dis
.
2011
Feb
;
2011
:
630865
.
[PubMed]
2090-0252
8.
Balaji
PA
,
Varne
SR
,
Ali
SS
.
Physiological effects of yogic practices and transcendental meditation in health and disease
.
N Am J Med Sci
.
2012
Oct
;
4
(
10
):
442
8
.
[PubMed]
2250-1541
9.
Bao
F
,
Wicklund
L
,
Lacor
PN
,
Klein
WL
,
Nordberg
A
,
Marutle
A
.
Different β-amyloid oligomer assemblies in Alzheimer brains correlate with age of disease onset and impaired cholinergic activity
.
Neurobiol Aging
.
2012
Apr
;
33
(
4
):
825.e1
13
.
[PubMed]
0197-4580
10.
Beesley
S
,
Olcese
J
,
Saunders
C
,
Bienkiewicz
EA
.
Combinatorial Treatment Effects in a Cell Culture Model of Alzheimer’s Disease
.
J Alzheimers Dis
.
2017
;
55
(
3
):
1155
66
.
[PubMed]
1387-2877
11.
Berridge
MJ
.
Calcium hypothesis of Alzheimer’s disease
.
Pflugers Arch
.
2010
Feb
;
459
(
3
):
441
9
.
[PubMed]
0031-6768
12.
Birks
J
.
Cholinesterase inhibitors for Alzheimer’s disease
.
Cochrane Database Syst Rev
.
2006
Jan
;(
1
):
CD005593
.
[PubMed]
1469-493X
13.
Birnbaum
JH
,
Bali
J
,
Rajendran
L
,
Nitsch
RM
,
Tackenberg
C
.
Calcium flux-independent NMDA receptor activity is required for Aβ oligomer-induced synaptic loss
.
Cell Death Dis
.
2015
Jun
;
6
(
6
):
e1791
.
[PubMed]
2041-4889
14.
Bissonnette
CJ
,
Lyass
L
,
Bhattacharyya
BJ
,
Belmadani
A
,
Miller
RJ
,
Kessler
JA
.
The controlled generation of functional basal forebrain cholinergic neurons from human embryonic stem cells
.
Stem Cells
.
2011
May
;
29
(
5
):
802
11
.
[PubMed]
1066-5099
15.
Bordji
K
,
Becerril-Ortega
J
,
Nicole
O
,
Buisson
A
.
Activation of extrasynaptic, but not synaptic, NMDA receptors modifies amyloid precursor protein expression pattern and increases amyloid-ß production
.
J Neurosci
.
2010
Nov
;
30
(
47
):
15927
42
.
[PubMed]
0270-6474
16.
Bredesen
DE
,
Amos
EC
,
Canick
J
,
Ackerley
M
,
Raji
C
,
Fiala
M
, et al
Reversal of cognitive decline in Alzheimer’s disease
.
Aging (Albany NY)
.
2016
Jun
;
8
(
6
):
1250
8
.
[PubMed]
1945-4589
17.
Bredesen
DE
.
Reversal of cognitive decline: a novel therapeutic program
.
Aging (Albany NY)
.
2014
Sep
;
6
(
9
):
707
17
.
[PubMed]
1945-4589
18.
Brown
RE
,
Haas
HL
.
On the mechanism of histaminergic inhibition of glutamate release in the rat dentate gyrus
.
J Physiol
.
1999
Mar
;
515
(
Pt 3
):
777
86
.
[PubMed]
0022-3751
19.
Chen
Q
,
Du
Y
,
Zhang
K
,
Liang
Z
,
Li
J
,
Yu
H
, et al
Tau-Targeted Multifunctional Nanocomposite for Combinational Therapy of Alzheimer’s Disease
.
ACS Nano
.
2018
Feb
;
12
(
2
):
1321
38
.
[PubMed]
1936-0851
20.
Chumakov
I
,
Nabirotchkin
S
,
Cholet
N
,
Milet
A
,
Boucard
A
,
Toulorge
D
, et al
Combining two repurposed drugs as a promising approach for Alzheimer’s disease therapy
.
Sci Rep
.
2015
Jan
;
5
(
1
):
7608
.
[PubMed]
2045-2322
21.
Coyle
JT
,
Price
DL
,
DeLong
MR
.
Alzheimer’s disease: a disorder of cortical cholinergic innervation
.
Science
.
1983
Mar
;
219
(
4589
):
1184
90
.
[PubMed]
0036-8075
22.
Cummings
J
,
Lee
G
,
Ritter
A
,
Zhong
K
.
Alzheimer’s disease drug development pipeline: 2018
.
Alzheimers Dement (N Y)
.
2018
May
;
4
:
195
214
.
[PubMed]
2352-8737
23.
De Felice
FG
,
Velasco
PT
,
Lambert
MP
,
Viola
K
,
Fernandez
SJ
,
Ferreira
ST
, et al
Abeta oligomers induce neuronal oxidative stress through an N-methyl-D-aspartate receptor-dependent mechanism that is blocked by the Alzheimer drug memantine
.
J Biol Chem
.
2007
Apr
;
282
(
15
):
11590
601
.
[PubMed]
0021-9258
24.
Dinamarca
MC
,
Ríos
JA
,
Inestrosa
NC
.
Postsynaptic receptors for amyloid-β oligomers as mediators of neuronal damage in Alzheimer’s disease
.
Front Physiol
.
2012
Dec
;
3
:
464
.
[PubMed]
1664-042X
25.
Ferreira
IL
,
Bajouco
LM
,
Mota
SI
,
Auberson
YP
,
Oliveira
CR
,
Rego
AC
.
Amyloid beta peptide 1-42 disturbs intracellular calcium homeostasis through activation of GluN2B-containing N-methyl-d-aspartate receptors in cortical cultures
.
Cell Calcium
.
2012
Feb
;
51
(
2
):
95
106
.
[PubMed]
0143-4160
26.
Ferreira-Vieira
TH
,
Guimaraes
IM
,
Silva
FR
,
Ribeiro
FM
.
Alzheimer’s disease: Targeting the Cholinergic System
.
Curr Neuropharmacol
.
2016
;
14
(
1
):
101
15
.
[PubMed]
1570-159X
27.
Flik
G
,
Folgering
JH
,
Cremers
TI
,
Westerink
BH
,
Dremencov
E
.
Folgering, Thomas IHF Cremers, Ben HC Westerink, and Eliyahu Dremencov. "Interaction between brain histamine and serotonin, norepinephrine, and dopamine systems: in vivo microdialysis and electrophysiology study
.
J Mol Neurosci
.
2015
Jun
;
56
(
2
):
320
8
.
[PubMed]
0895-8696
28.
Forner
S
,
Baglietto-Vargas
D
,
Martini
AC
,
Trujillo-Estrada
L
,
LaFerla
FM
.
Synaptic impairment in Alzheimer’s disease: a dysregulated symphony
.
Trends Neurosci
.
2017
Jun
;
40
(
6
):
347
57
.
[PubMed]
0166-2236
29.
Fu
QL
,
Dai
HB
,
Shen
Y
,
Chen
Z
.
“Reversing effect of histamine on neurotoxicity induced by beta-amyloid1-42.” Zhejiang da xue xue bao. Yi xue ban= Journal of Zhejiang University
.
Med Sci
.
2007
;
36
(
2
):
146
9
.0096-6800
30.
Ginsberg
SD
,
Che
S
,
Wuu
J
,
Counts
SE
,
Mufson
EJ
.
Down regulation of trk but not p75NTR gene expression in single cholinergic basal forebrain neurons mark the progression of Alzheimer’s disease
.
J Neurochem
.
2006
Apr
;
97
(
2
):
475
87
.
[PubMed]
0022-3042
31.
Godyń
J
,
Jończyk
J
,
Panek
D
,
Malawska
B
.
Therapeutic strategies for Alzheimer’s disease in clinical trials
.
Pharmacol Rep
.
2016
Feb
;
68
(
1
):
127
38
.
[PubMed]
1734-1140
32.
Guntupalli
S
,
Widagdo
J
,
Anggono
V
.
Amyloid-β-induced dysregulation of AMPA receptor trafficking
.
Neural Plast
.
2016
;
2016
:
3204519
.
[PubMed]
1687-5443
33.
Irie
K
,
Murakami
K
,
Masuda
Y
,
Morimoto
A
,
Ohigashi
H
,
Ohashi
R
, et al
Structure of β-amyloid fibrils and its relevance to their neurotoxicity: implications for the pathogenesis of Alzheimer’s disease
.
J Biosci Bioeng
.
2005
May
;
99
(
5
):
437
47
.
[PubMed]
1389-1723
34.
Ishola
IO
,
Adamson
FM
,
Adeyemi
OO
.
Ameliorative effect of kolaviron, a biflavonoid complex from Garcinia kola seeds against scopolamine-induced memory impairment in rats: role of antioxidant defense system
.
Metab Brain Dis
.
2017
Feb
;
32
(
1
):
235
45
.
[PubMed]
0885-7490
35.
Kayed
R
,
Lasagna-Reeves
CA
.
Molecular mechanisms of amyloid oligomers toxicity
.
J Alzheimers Dis
.
2013
;
33
(
s1
Suppl 1
):
S67
78
.
[PubMed]
1387-2877
36.
Khalsa
DS
.
Stress, meditation, and Alzheimer’s disease prevention: where the evidence stands
.
J Alzheimers Dis
.
2015
;
48
(
1
):
1
12
.
[PubMed]
1387-2877
37.
Khanfar
MA
,
Affini
A
,
Lutsenko
K
,
Nikolic
K
,
Butini
S
,
Stark
H
.
Multiple targeting approaches on histamine H3 receptor antagonists
.
Front Neurosci
.
2016
May
;
10
:
201
.
[PubMed]
1662-4548
38.
Khateb
A
,
Fort
P
,
Pegna
A
,
Jones
BE
,
Mühlethaler
M
.
Cholinergic nucleus basalis neurons are excited by histamine in vitro
.
Neuroscience
.
1995
Nov
;
69
(
2
):
495
506
.
[PubMed]
0306-4522
39.
Koffie
RM
,
Hyman
BT
,
Spires-Jones
TL
.
Alzheimer’s disease: synapses gone cold
.
Mol Neurodegener
.
2011
Aug
;
6
(
1
):
63
.
[PubMed]
1750-1326
40.
LaFerla
FM
,
Green
KN
,
Oddo
S
.
Intracellular amyloid-β in Alzheimer’s disease
.
Nat Rev Neurosci
.
2007
Jul
;
8
(
7
):
499
509
.
[PubMed]
1471-003X
41.
Lezoualc’h
F
.
5-HT4 receptor and Alzheimer’s disease: the amyloid connection
.
Exp Neurol
.
2007
Jun
;
205
(
2
):
325
9
.
[PubMed]
0014-4886
42.
Li
K
,
Wei
Q
,
Liu
FF
,
Hu
F
,
Xie
AJ
,
Zhu
LQ
, et al
Synaptic dysfunction in Alzheimer’s disease: aβ, tau, and epigenetic alterations
.
Mol Neurobiol
.
2018
Apr
;
55
(
4
):
3021
32
.
[PubMed]
0893-7648
43.
Marcello
E
,
Epis
R
,
Saraceno
C
,
Di Luca
M
. Synaptic dysfunction in Alzheimer’s disease.
Synaptic Plasticity
.
Vienna
:
Springer
;
2012
. pp.
573
601
.
44.
Marsh
J
,
Alifragis
P
.
Synaptic dysfunction in Alzheimer’s disease: the effects of amyloid beta on synaptic vesicle dynamics as a novel target for therapeutic intervention
.
Neural Regen Res
.
2018
Apr
;
13
(
4
):
616
23
.
[PubMed]
1673-5374
45.
Maura
G
,
Marcoli
M
,
Pepicelli
O
,
Rosu
C
,
Viola
C
,
Raiteri
M
.
Serotonin inhibition of the NMDA receptor/nitric oxide/cyclic GMP pathway in human neocortex slices: involvement of 5-HT(2C) and 5-HT(1A) receptors
.
Br J Pharmacol
.
2000
Aug
;
130
(
8
):
1853
8
.
[PubMed]
0007-1188
46.
McCall
MC
.
How might yoga work? An overview of potential underlying mechanisms
.
J Yoga Phys Ther
.
2013
;
3
(
1
):
1
. 2157-7595
47.
Monti
JM
.
Serotonin control of sleep-wake behavior
.
Sleep Med Rev
.
2011
Aug
;
15
(
4
):
269
81
.
[PubMed]
1087-0792
48.
Mufson
EJ
,
Counts
SE
,
Perez
SE
,
Ginsberg
SD
.
Cholinergic system during the progression of Alzheimer’s disease: therapeutic implications
.
Expert Rev Neurother
.
2008
Nov
;
8
(
11
):
1703
18
.
[PubMed]
1473-7175
49.
Murphy
M
,
Wilson
YM
,
Vargas
E
,
Munro
KM
,
Smith
B
,
Huang
A
, et al
Reduction of p75 neurotrophin receptor ameliorates the cognitive deficits in a model of Alzheimer’s disease
.
Neurobiol Aging
.
2015
Feb
;
36
(
2
):
740
52
.
[PubMed]
0197-4580
50.
Nunes-Tavares
N
,
Santos
LE
,
Stutz
B
,
Brito-Moreira
J
,
Klein
WL
,
Ferreira
ST
, et al
Inhibition of choline acetyltransferase as a mechanism for cholinergic dysfunction induced by amyloid-β peptide oligomers
.
J Biol Chem
.
2012
Jun
;
287
(
23
):
19377
85
.
[PubMed]
0021-9258
51.
Ovsepian
SV
,
Antyborzec
I
,
O’Leary
VB
,
Zaborszky
L
,
Herms
J
,
Oliver Dolly
J
.
Neurotrophin receptor p75 mediates the uptake of the amyloid beta (Aβ) peptide, guiding it to lysosomes for degradation in basal forebrain cholinergic neurons
.
Brain Struct Funct
.
2014
Sep
;
219
(
5
):
1527
41
.
[PubMed]
1863-2653
52.
Panula
P
,
Rinne
J
,
Kuokkanen
K
,
Eriksson
KS
,
Sallmen
T
,
Kalimo
H
, et al
Neuronal histamine deficit in Alzheimer’s disease
.
Neuroscience
.
1998
Feb
;
82
(
4
):
993
7
.
[PubMed]
0306-4522
53.
Peters
I
,
Igbavboa
U
,
Schütt
T
,
Haidari
S
,
Hartig
U
,
Rosello
X
, et al
The interaction of beta-amyloid protein with cellular membranes stimulates its own production
.
Biochim Biophys Acta
.
2009
May
;
1788
(
5
):
964
72
.
[PubMed]
0006-3002
54.
Pimplikar
SW
,
Nixon
RA
,
Robakis
NK
,
Shen
J
,
Tsai
LH
.
Amyloid-independent mechanisms in Alzheimer’s disease pathogenesis
.
J Neurosci
.
2010
Nov
;
30
(
45
):
14946
54
.
[PubMed]
0270-6474
55.
Praticò
D
,
Sung
S
.
Lipid peroxidation and oxidative imbalance: early functional events in Alzheimer’s disease
.
J Alzheimers Dis
.
2004
Apr
;
6
(
2
):
171
5
.
[PubMed]
1387-2877
56.
Price
JM
,
Chi
X
,
Hellermann
G
,
Sutton
ET
.
Physiological levels of β-amyloid induce cerebral vessel dysfunction and reduce endothelial nitric oxide production
.
Neurol Res
.
2001
Jul
;
23
(
5
):
506
12
.
[PubMed]
0161-6412
57.
Reddy
PH
,
Tripathi
R
,
Troung
Q
,
Tirumala
K
,
Reddy
TP
,
Anekonda
V
, et al
Abnormal mitochondrial dynamics and synaptic degeneration as early events in Alzheimer’s disease: implications to mitochondria-targeted antioxidant therapeutics
.
Biochim Biophys Acta
.
2012
May
;
1822
(
5
):
639
49
.
[PubMed]
0006-3002
58.
Robinson
,
Meghan
,
Suk-yu
Yau
,
Lin
Sun
,
Nicole
Gabers
,
Emma
Bibault
,
Brian R.
Christie
, and
Stephanie M.
Willerth
. "
Optimizing Differentiation Protocols for Producing Dopaminergic Neurons from Human Induced Pluripotent Stem Cells for Tissue Engineering Applications: Supplementary Issue: Stem Cell Biology.
" Biomarker insights 10 (
2015
): BMI-S20064.
59.
Saatcioglu
F
.
Regulation of gene expression by yoga, meditation and related practices: a review of recent studies
.
Asian J Psychiatr
.
2013
Feb
;
6
(
1
):
74
7
.
[PubMed]
1876-2018
60.
Shankar
GM
,
Walsh
DM
.
Alzheimer’s disease: synaptic dysfunction and Abeta
.
Mol Neurodegener
.
2009
Nov
;
4
(
1
):
48
.
[PubMed]
1750-1326
61.
Simmons
DA
,
Knowles
JK
,
Belichenko
NP
,
Banerjee
G
,
Finkle
C
,
Massa
SM
, et al
A small molecule p75NTR ligand, LM11A-31, reverses cholinergic neurite dystrophy in Alzheimer’s disease mouse models with mid- to late-stage disease progression
.
PLoS One
.
2014
Aug
;
9
(
8
):
e102136
.
[PubMed]
1932-6203
62.
Sotthibundhu
A
,
Sykes
AM
,
Fox
B
,
Underwood
CK
,
Thangnipon
W
,
Coulson
EJ
.
β-amyloid(1-42) induces neuronal death through the p75 neurotrophin receptor
.
J Neurosci
.
2008
Apr
;
28
(
15
):
3941
6
.
[PubMed]
0270-6474
63.
Stephenson
D
,
Perry
D
,
Bens
C
,
Bain
LJ
,
Berry
D
,
Krams
M
, et al
Charting a path toward combination therapy for Alzheimer’s disease
.
Expert Rev Neurother
.
2015
Jan
;
15
(
1
):
107
13
.
[PubMed]
1473-7175
64.
Stine
WB
,
Jungbauer
L
,
Yu
C
,
LaDu
MJ
. Preparing synthetic Aβ in different aggregation states.
Alzheimer’s Disease and Frontotemporal Dementia
.
Totowa (NJ)
:
Humana Press
;
2010
. pp.
13
32
.
65.
Tolahunase
M
,
Sagar
R
,
Dada
R
.
Impact of yoga and meditation on cellular aging in apparently healthy individuals: a prospective, open-label single-arm exploratory study
.
Oxid Med Cell Longev
.
2017
;
•••
:
2017
.1942-0900
66.
Torrent
A
,
Moreno-Delgado
D
,
Gómez-Ramírez
J
,
Rodríguez-Agudo
D
,
Rodríguez-Caso
C
,
Sanchez-Jimenez
F
, et al
H3 autoreceptors modulate histamine synthesis through calcium/calmodulin-and cAMP-dependent protein kinase pathways
.
Mol Pharmacol
.
2004
.
[PubMed]
0026-895X
67.
Whitehouse
PJ
,
Price
DL
,
Clark
AW
,
Coyle
JT
,
DeLong
MR
.
Alzheimer disease: evidence for selective loss of cholinergic neurons in the nucleus basalis
.
Ann Neurol
.
1981
Aug
;
10
(
2
):
122
6
.
[PubMed]
0364-5134
68.
Winblad
B
,
Amouyel
P
,
Andrieu
S
,
Ballard
C
,
Brayne
C
,
Brodaty
H
, et al
Defeating Alzheimer’s disease and other dementias: a priority for European science and society
.
Lancet Neurol
.
2016
Apr
;
15
(
5
):
455
532
.
[PubMed]
1474-4422
69.
Ye
X
,
Tai
W
,
Zhang
D
.
The early events of Alzheimer’s disease pathology: from mitochondrial dysfunction to BDNF axonal transport deficits
.
Neurobiol Aging
.
2012
Jun
;
33
(
6
):
1122.e1
10
.
[PubMed]
0197-4580
70.
Zant
JC
,
Rozov
S
,
Wigren
HK
,
Panula
P
,
Porkka-Heiskanen
T
.
Histamine release in the basal forebrain mediates cortical activation through cholinergic neurons
.
J Neurosci
.
2012
Sep
;
32
(
38
):
13244
54
.
[PubMed]
0270-6474
71.
Zhang
Y
,
Li
P
,
Feng
J
,
Wu
M
.
Dysfunction of NMDA receptors in Alzheimer’s disease
.
Neurol Sci
.
2016
Jul
;
37
(
7
):
1039
47
.
[PubMed]
1590-1874
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.