Abstract
The study of ataxias with physostigmine was originally based entirely on theoretical considerations. A great deal of evidence relates abnormalities of pyruvate metabolism to ataxia (for reviews see Blass et al., 1976a; Blass et al., 1975; Kark etal., (in press). Certain inherited ataxias are associated with defects of the pyruvate dehydrogenase multi-enzyme complex and especially its pyruvate decarboxylase and lipoamide dehydrogenase components (Blass et al.1970; Blass et al., 1971; Blass et al., 1976b; Rodriguez-Budelli et al., in press; Blass et al., in press; and Kark et al., in press). Experiments on brain slices and whole animals have shown that the synthesis of acetylcholine (ACh) is decreased by each of a number of conditions that impair the oxidation of pyruvate or glucose. ACh synthesis is reduced before there is any change in energy-charge or levels of ATP or creatine phosphate (Gibson and Blass, 1976a, 1976b). The conditions that decrease ACh synthesis include mild hypoxia, hypoglycemia, and various poisons that inhibit the pyruvate dehydrogenase complex (Gibson and Blass, 1976a, 1976b;Gibson et al., 1975). It was tempting to speculate that there might be insufficient ACh in some central nervous pathway in inherited ataxias associated with defects of pyruvate oxidation, and perhaps in other ataxias as well. If so, physostigmine might lessen the severity of one or more aspects of the ataxia.
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Kark, R.A.P., Rodriguez-Budelli, M., Blass, J.P., Spence, M.A. (1979). Oral Physostigmine and Inherited Ataxias. In: Davis, K.L., Berger, P.A. (eds) Brain Acetylcholine and Neuropsychiatric Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2934-3_11
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DOI: https://doi.org/10.1007/978-1-4613-2934-3_11
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