Choline occurs in the body as a constituent of lipid molecules in cell membranes, as a source of methyl groups, and as a precursor for the neurotransmitter acetylcholine. Choline is not an essential nutrient in humans, and deficiencies are rarely seen, since it is ubiquitous in the diet. However, in recent decades, dietary choline has been a focus of interest, because of the possibility that changes in choline intake could influence neuronal acetylcholine synthesis. Acetylcholine (ACh) is a neurotransmit-ter; its synthesis in and release by brain neurons is influenced by choline availability, which in turn can be altered by dietary choline intake, either in the form of free or fat-bound choline (phosphati-dylcholine). In this context, oral choline and phos-phatidylcholine have found some application in human diseases thought to involve ACh. For example, they have been used successfully to treat movement disorders such as tardive dyskinesia, a drug-induced muscular disorder in schizophrenic patients linked to low ACh function. However, they proved to be of little value in controlling abnormal muscle movements associated with Hun-tington's disease (also linked to low ACh function). Dietary choline and phosphatidylcholine supplements have also been studied as potential memory enhancers, since CNS ACh neurons play an important role in memory. Patients with Alzheimer's disease have been most studied but, in general, the disappointing outcome has been that neither cho-line nor phosphatidylcholine has afforded much improvement in memory.

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