Because membrane polarization is maintained by energy-dependent mechanisms, impaired energy can trigger partial membrane depolarization, which abolishes the Mg2+ block and allows normal concentrations of transmitter Glu to drive abnormal currents on a chronic basis. Oxidative stressors may act through a similar mechanism, in view of evidence that free radical generation in nitric oxide pathways disrupts glycolytic metabolism, and superoxide radical formation

causes hyperactivation of NMDA receptors in cultured neurons. The proposal that oxidative stress may contribute to neurodegeneration in AD is consistent Inhibitors,research,lifescience,medical with selleck kinase inhibitor recent evidence155 that antioxidant drugs may retard the progression of cognitive deterioration in AD. Whether impaired energy or oxidative stressors are relatively Inhibitors,research,lifescience,medical more active in the aging AD brain than the aging normal

brain is not. clear at this time. Their presence, even if not, more severe than that in the normal aging Inhibitors,research,lifescience,medical brain, would augment, amyloid’s ability to sensitize neurons to Glu’s excitotoxic potential. Persistent hyperactivation of NMDA receptors would result, in either excitotoxic degeneration of the dendritic spines on which NMDA receptors are located or Inhibitors,research,lifescience,medical in degeneration of the entire NMDA receptor-bearing neuron. In either case, NMDA receptors are deleted from the brain and the NMDA receptor system is reduced to a hypofunctional status. NRHypo thus could represent, a residual deficit, condition caused by NRHyper. AD neurodegeneration: a two-stage process A major tenet of our proposal is that the NMDA receptor system becomes hypofunctional in either the normal brain or the AD brain after having first gone through an early stage of NRHyper. This hypothesis, consistent with the bulk of available data, assumes that Inhibitors,research,lifescience,medical the pattern

of massive neurodegeneration in AD tends to follow the pattern of NFT formation, and that the neurons that display NFT at the time of autopsy are injured neurons that would be destined to slowly die and leave behind neurofibrillary debris. However, this hypothesis also assumes that there is a less massive pattern Thiamine-diphosphate kinase of neuronal degeneration that corresponds to the pattern of amyloid deposition. Our hypothesis suggests that the neurodegenerative events in AD occur in two separate stages, by two separate mechanisms, and according to two separate patterns. These have been difficult to tease apart because the two stages have a significant degree of temporal overlap and the two patterns have significant spatial overlap.