Alterations in gait and balance are manifest in numerous neurological disorders such as the ataxias and
Parkinson's disease, and may occur as a consequence of stroke, traumatic brain injury and chemical insults to the
brain. Although the underlying etiology of these disorders differs, disturbances in gait and balance appear to reflect
deficits in cholinergic pathways within the brain. During the past 40 years, both clinical case studies and preclinical
data have provided evidence that nicotinic cholinergic activation is beneficial for alleviating gait and balance
deficits in many disorders. Further, studies indicate that activation of neuronal nicotinic receptors leads to neuroprotective
and neurotrophic actions. And yet, despite these findings, there hsas been no concerted effort to develop
neuronal nicotinic agonists for the treatment of abnormal gait and balance. The goal of this review is to shed light
on the therapeutic benefit of the cholinergic nicotinic system for the treatment of ataxia, and discuss the challenges
and limitations associated with developing drugs to treat disorders involving deficits in gait and balance.
Keywords: Ataxias, neuronal nicotinic receptor, varenicline, nicotine, gait, balance.
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