It is unlikely that choline acetyltransferase in brain is saturated with either of its substrates, so that choline (and possibly acetyl-CoA) availability determines the rate of acetylcholine synthesis. Under conditions of rapid neuronal firing acetylcholine release by brain neurons can be directly altered by dietary intake of choline. Based on this observation, choline has been used as a possible memory-
improvement drug. In some patients with Alzheimer's disease, choline or phosphatidylcholine has beneficial effects, but this effect is variable. Both verbal and visual memory may be impaired in other patients who require long-term intravenous feeding and this may be improved with choline supplementation.
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