ReviewThe Lancet. Neurology2022
Cholinergic system changes in Parkinson's disease: emerging therapeutic approaches.
Review in The Lancet. Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 159 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
159 citing papers in PubMed, 3 syntheses or guidelines pooled it, 258 citations in OpenAlex.
- Advances in gait research related to Alzheimer's disease.Frontiers in neurology · 2025Pooled it
- Pooled it
- Adverse event profiles of adjuvant treatment with opicapone in Parkinson's disease: A systematic review and meta-analysis.Frontiers in pharmacology · 2022Pooled it
- An Acetylcholine M1 Receptor-Positive Allosteric Modulator (TAK-071) in Parkinson Disease With Cognitive Impairment: A Phase 2 Randomized Clinical Trial.JAMA neurology · 2025Trial
- Dopamine modulation of motor and implicit learning contributions to auditory temporal attention.iScience · 2026Article
- White matter lesions disrupt cholinergic pathways important for cognition in Parkinson's disease.Brain : a journal of neurology · 2026Article
- Increased Binding of [Synapse (New York, N.Y.) · 2026Article
- Dopaminergic- and Cholinergic-Related Structural MRI Patterns Across Cognitive Subtypes of Parkinson's Disease With Mild Cognitive Impairment.European journal of neurology · 2026Article
- Frequency- and Network-Specific Changes in Functional Connectivity Reflect Pathophysiological Mechanisms across Parkinson's Disease Stages.Annals of neurology · 2026Article
- Baseline Regional Cholinergic Denervation Predicts Cognitive Trajectories in Moderate Parkinson Disease.Annals of clinical and translational neurology · 2026Article
- Nigrostriatal dopaminergic vulnerability in Parkinson's disease: Neuroprotective strategies.Neural regeneration research · 2026Article
- Photopharmacological Cholinergic Modulation of Cortical Activity in Human Brain Slices.Brain sciences · 2026Article
- Falls Induced by Optogenetic Inhibition of Basal Forebrain Cholinergic Projections after Dorsomedial Striatal Dopamine Depletion in a Dual Disruption Model of Falling Vulnerability in Parkinson Disease.bioRxiv : the preprint server for biology · 2026Article
- Dopamine-related alterations in functional brain network dynamic reconfiguration in Parkinson's disease.NPJ Parkinson's disease · 2026Article
- Article
- Freezing of Gait Levodopa Response Pattern in Parkinson's Disease Provides Clues to Pathophysiology.The European journal of neuroscience · 2026Review
- Fast analysis and engineering of protein function by microbe-independent deep assembly and screening.Molecular systems biology · 2026Article
- The Pupil-Brain System at Rest: Spontaneous Pupil Fluctuations as Markers of Neuromodulatory and Network Dynamics.Psychophysiology · 2026Review
- Digital measurement of ocular microtremor in Parkinson's Disease: Analytical and clinical validation.PLOS digital health · 2026Article
- Neurotransmitter Systems Underlying Freezing of Gait (FOG) in Parkinson's Disease.The European journal of neuroscience · 2026Review
99 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
In patients with Parkinson's disease, heterogeneous cholinergic system changes can occur in different brain regions. These changes correlate with a range of clinical features, both motor and non-motor, that are refractory to dopaminergic therapy, and can be conceptualised within a systems-level framework in which nodal deficits can produce circuit dysfunctions. The topographies of cholinergic changes overlap with neural circuitries involved in sleep and cognitive, motor, visuo-auditory perceptual, and autonomic functions. Cholinergic deficits within cognition network hubs predict cognitive deficits better than do total brain cholinergic changes. Postural instability and gait difficulties are associated with cholinergic system changes in thalamic, caudate, limbic, neocortical, and cerebellar nodes. Cholinergic system deficits can involve also peripheral organs. Hypercholinergic activity of mesopontine cholinergic neurons in people with isolated rapid eye movement (REM) sleep behaviour disorder, as well as in the hippocampi of cognitively normal patients with Parkinson's disease, suggests early compensation during the prodromal and early stages of Parkinson's disease. Novel pharmacological and neurostimulation approaches could target the cholinergic system to treat motor and non-motor features of Parkinson's disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.