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Enteric Nervous System

  • The enteric nervous system (ENS) is a complex network of neurons and glia, reminiscent of the central nervous system (CNS), innervating the gut and controlling intestinal function.
  • The occurrence of enteric pathology in dementia is well recognised.
  • Gastro-intestinal dysfunction, particularly constipation (a clinical expression of enteric neurodegeneration), is a prevalent symptom in neurologic and systemic diseases associated with neurodegeneration. This dysfunction is partly related to abnormalities and cell loss in the ENS.
  • Additionally, during aging there is evidence of a loss of excitatory (cholinergic) enteric neurons and interstitial cells of Cajal whereas inhibitory neurons appear unaffected.
  • A cholinergic hypothesis of neuronal vulnerability in the CNS is thought to contribute to the cognitive decline seen in aging and neurodegenerative disease.
  • Beta amyloid (AB) peptides and it's precursors are well described in the peripheral nervous system including the ENS.
  • Recently, a transgenic AD mouse model confirmed the presence of AB in the small and large intestine during aging.
  • The ENS may provide a valuable entity to study the pathophysiology of neurodegeneration as well as present as a pathological marker during early stages of AD.


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