Berthier_2004_Neurologia_19 Suppl 2_64

The loss of neurotransmitters coupled with the degeneration of cortico-subcortical neural networks may underlie the full array of cognitive behavioural and functional deficits in dementia. Recent advances in the neurochemical and functional neuroimaging correlates of cognition and behavioural and psychological signs and symptoms of dementia have important implications for the pathophysiology and pharmacological treatment of Alzheimer's disease and other dementing illness. The aim of this article is to provide an overview of recent findings on the pharmacological treatment of dementia focusing on advances in the mechanism of action of drugs as well as the drug-related enhancement of neural plasticity in areas implicated in cognition and emotion. The beneficial effects safety and tolerability of the cholinesterase inhibitors donepezil rivastigmine and galantamine and of the uncompetitive N-methyl-D-aspartate NMDA receptor antagonist memantine in monotherapy or combined with donepezil among patients Alzheimer's disease will be also analysed. The promising role of these pharmacological agents in dementias secondary to cerebrovascular disease Parkinson's disease dementia with Lewy bodies and in other less frequent dementing illness will be outlined.