Acetyl-L-carnitine normalizes pituitary-adrenocortical hyperactivity in pathological ageing brain

The prevalence of glucocorticoid hypersecretion and the loss of hippocampal inhibition of hypothalamus-pituitary-adrenal (HPA) axis in Alzheimer type dementia (ATD) underlie the 'glucocorticoid cascade' hypothesis for a neuroendocrine definition of aging. Therefore we measured, in mild to moderate demented patients, plasma B-endorphin and cortisol levels, which, in 41% of the subjects were both higher than 2 SD of mean control values. The treatment with Acetyl-L-Carnitine (ALC) normalized the highest values, while piracetam did not. The possibilities that this effect is due to the cholinergic activity of ALC and/or its action in preventing the loss of hippocampal glucocorticoid receptors after cold stress are suggested.