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Acetylcholine in mind: a neurotransmitter correlate of consciousness?
Perry E, Walker M, Grace J, Perry R.. Trends in neurosciences, 1999-06-01
Topic: Brain proteins, microglia and lab models
The cholinergic system is one of the most important modulatory neurotransmitter systems in the brain and controls activities that depend on selective attention, which are an essential component of conscious awareness. Psychopharmacological and pathological evidence supports the concept of a 'cholinergic component' of conscious awareness. Drugs that antagonize muscarinic receptors induce hallucinations and reduce the level of consciousness, while the nicotinic receptor is implicated as being involved in the mechanism of action of general (inhalational) anaesthetics. In degenerative diseases of the brain, alterations in consciousness are associated with regional deficits in the cholinergic system. In Alzheimer's disease (AD), there is a loss of explicit (more than implicit) memory and hypoactivity of cholinergic projections to the hippocampus and cortex, while the visual hallucinations experienced by subjects with Dementia with Lewy bodies (DLB) are associated with reductions in neocortical ACh-related activity. In Parkinson's disease, the additional loss of pedunculopontine cholinergic neurones, which control REM (rapid eye movement) sleep or dreaming, is likely to contribute to REM abnormalities, which also occur in DLB. Widespread basal-forebrain and rostral brainstem cholinergic pathways, which include converging projections to the thalamus, appear to be located strategically for generating and integrating conscious awareness. Alleviation of a range of cognitive and non-cognitive symptoms by drugs that modulate the cholinergic system, which are being developed for the treatment of AD and related disorders, could be caused by changes in consciousness.
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APA 7th
Perry, E., Walker, M., Grace, J., & Perry, R. (1999). Acetylcholine in mind: a neurotransmitter correlate of consciousness? Trends in neurosciences. https://doi.org/10.1016/s0166-2236(98)01361-7
Vancouver
Perry E, Walker M, Grace J, Perry R. Acetylcholine in mind: a neurotransmitter correlate of consciousness? Trends in neurosciences. 1999. doi:10.1016/s0166-2236(98)01361-7. PMID: 10354606.
BibTeX
@article{perry1999-10354606,
author = {Perry, E. and Walker, M. and Grace, J. and Perry, R.},
title = {{Acetylcholine in mind: a neurotransmitter correlate of consciousness?}},
journal = {Trends in neurosciences},
year = {1999},
doi = {10.1016/s0166-2236(98)01361-7},
pmid = {10354606},
url = {https://doi.org/10.1016/s0166-2236(98)01361-7}
}
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Key findings
- In degenerative diseases of the brain, alterations in consciousness are associated with regional deficits in the cholinergic system.
- In Alzheimer's disease (AD), there is a loss of explicit (more than implicit) memory and hypoactivity of cholinergic projections to the hippocampus and cortex, while the visual hallucinations experienced by subjects with Dementia with Lewy bodies (DLB) are associated with reductions in neocortical ACh-related activity.
Why it matters
This review discusses the cholinergic system and notes that Alzheimer's disease involves loss of explicit memory and reduced cholinergic activity in the hippocampus and cortex. It describes a disease feature and does not report a tested treatment, cure, or prevention.
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Study details
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Trends in neurosciences) |
| Journal's citation record | 3 / 4 | Trends in Neurosciences: journal h-index 439 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1999 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 767 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 26.4 citations a year over 29 year(s) since 1999 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 2 / 4 | Cited 37 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Robert H. Perry: h-index 13 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Newcastle upon Tyne Hospitals NHS Foundation Trust: institution h-index 364 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 10354606) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 42 / 100 | — |
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