A cholinergic hypothesis of the unconscious in affective disorders. 2013

Costa Vakalopoulos
Private Practice Melbourne, VIC, Australia.

The interactions between distinct pharmacological systems are proposed as a key dynamic in the formation of unconscious memories underlying rumination and mood disorder, but also reflect the plastic capacity of neural networks that can aid recovery. An inverse and reciprocal relationship is postulated between cholinergic and monoaminergic receptor subtypes. M1-type muscarinic receptor transduction facilitates encoding of unconscious, prepotent behavioral repertoires at the core of affective disorders and ADHD. Behavioral adaptation to new contingencies is mediated by the classic prototype receptor: 5-HT1A (Gi/o) and its modulation of M1-plasticity. Reversal of learning is dependent on increased phasic activation of midbrain monoaminergic nuclei and is a function of hippocampal theta. Acquired hippocampal dysfunction due to abnormal activation of the hypothalamic-pituitary-adrenal (HPA) axis predicts deficits in hippocampal-dependent memory and executive function and further impairments to cognitive inhibition. Encoding of explicit memories is mediated by Gq/11 and Gs signaling of monoamines only. A role is proposed for the phasic activation of the basal forebrain cholinergic nucleus by cortical projections from the complex consisting of the insula and claustrum. Although controversial, recent studies suggest a common ontogenetic origin of the two structures and a functional coupling. Lesions of the region result in loss of motivational behavior and familiarity based judgements. A major hypothesis of the paper is that these lost faculties result indirectly, from reduced cholinergic tone.

UI MeSH Term Description Entries

Related Publications

Costa Vakalopoulos
January 1988, Fortschritte der Neurologie-Psychiatrie,
Costa Vakalopoulos
July 1984, The New England journal of medicine,
Costa Vakalopoulos
October 1978, Psychopharmacology bulletin,
Costa Vakalopoulos
December 1976, Lancet (London, England),
Costa Vakalopoulos
January 1973, Journal of the American Psychoanalytic Association,
Costa Vakalopoulos
January 1990, Pharmacopsychiatry,
Costa Vakalopoulos
January 1975, Psychopharmacology communications,
Costa Vakalopoulos
September 1989, Trends in neurosciences,
Costa Vakalopoulos
July 1986, International clinical psychopharmacology,
Costa Vakalopoulos
December 1994, American journal of medical genetics,
Copied contents to your clipboard!