the basal forebrain, medial septal nucleus and nucleus basalis of Meynert are degenerative; these findings have led to formation of the choline hypothesis [10]. Interestingly, cholinergic agonists, particularly the stimulation of the muscarinic M1 receptor, can, at least in part, prevent LTP impairment by synthetic Aβ oligomers as well as β2-adrenergic stimulants [9]. The effects of cholinergic activation on the amelioration of cognitive function via cholinesterase inhibitors have been confirmed in clinical settings, whereas cholinesterase inhibitors do not ameliorate memory function in individuals without dementia.However, the effects of cholinesterase inhibitors are limited, and were found to disappear 10-12 months after beginning medication once cognitive function was ameliorated [11]. To utilize cholinergic activation for cognitive preservation for prolonged periods, the degenerative process of cholinergic neurons in the forebrain would need to be inhibited in the Alzheimer's brain. Several neurotrophic factors have been proposed as candidates, including brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). However, the details of the underlying mechanisms of these factors in the human brain remain unclear.Previously, we reported the importance of a cholinergic regulator gene in the medial septal nucleus (MSN) called hippocampal cholinergic neurostimulating peptide (HCNP) [12,13]. Recently, we demonstrated that cholinergic neural activation enhanced glutamatergic neuronal activity during unsaturated LTP, but not saturated LTP, using hippocampal sections from mice. Synthetic Aβ oligomers also suppressed the hippocampal glutamatergic activity in a concentrationdependent manner. Furthermore, HCNP over-expression as well as a cholinergic agonist, through the muscarinic M1 receptor, appeared *Corresponding author: Noriyuki Matsukawa, Professor and Chairman, Nagoya City University, Department of Neurology, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan, Tel: +81-52-852-3590; E-mail: norim@med.nagoya-uc.ac.jp Previous research suggests that amyloid-β (Aβ) assemblies can inhibit glutamatergic neuronal activity in the hippocampus and increase neurofibrillary tangle (NFT) formation via phosphorylation of tau protein in Alzheimer's disease (AD), forming the basis of the amyloid hypothesis [1]. However, several therapeutic interventions for reducing Aβ in patients with AD have failed to ameliorate the decline of cognitive function. Meanwhile, some patients have been reported to exhibit preserved cognitive function despite pathological changes in the brain; for example, a nun named Sister Mary maintained cognitive function within the normal range until just prior to death in spite of abundant senile plaques (SPs) and NFTs in the brain [2]. Other studies have reported that some individuals can tolerate more Alzheimer'srelated pathological changes than others, a phenomenon known as "cognitive reserve". Epidemiological studies have suggested that a range of factors, including education (intelligence quotie...