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Glycolysis-enhancing α 1 -adrenergic antagonists modify cognitive symptoms related to Parkinson's disease
Journal article   Open access   Peer reviewed

Glycolysis-enhancing α 1 -adrenergic antagonists modify cognitive symptoms related to Parkinson's disease

Matthew A Weber, Kartik Sivakumar, Ervina E Tabakovic, Mayu Oya, Georgina M Aldridge, Qiang Zhang, Jacob E Simmering and Nandakumar S Narayanan
NPJ Parkinson's Disease, Vol.9(1), 32
03/02/2023
DOI: 10.1038/s41531-023-00477-1
PMCID: PMC9981768
PMID: 36864060
url
https://doi.org/10.1038/s41531-023-00477-1View
Published (Version of record) Open Access

Abstract

Terazosin is an α -adrenergic receptor antagonist that enhances glycolysis and increases cellular ATP by binding to the enzyme phosphoglycerate kinase 1 (PGK1). Recent work has shown that terazosin is protective against motor dysfunction in rodent models of Parkinson's disease (PD) and is associated with slowed motor symptom progression in PD patients. However, PD is also characterized by profound cognitive symptoms. We tested the hypothesis that terazosin protects against cognitive symptoms associated with PD. We report two main results. First, in rodents with ventral tegmental area (VTA) dopamine depletion modeling aspects of PD-related cognitive dysfunction, we found that terazosin preserved cognitive function. Second, we found that after matching for demographics, comorbidities, and disease duration, PD patients newly started on terazosin, alfuzosin, or doxazosin had a lower hazard of being diagnosed with dementia compared to tamsulosin, an α -adrenergic receptor antagonist that does not enhance glycolysis. Together, these findings suggest that in addition to slowing motor symptom progression, glycolysis-enhancing drugs protect against cognitive symptoms of PD.

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