. A unique feature of ␣7 nicotinic acetylcholine receptor physiology is that, under normal physiological conditions, ␣7 receptors are constantly perfused with their natural selective agonist, choline. Studying neurons of hypothalamic tuberomammillary (TM) nucleus, we show that choline and the selective ␣7 receptor agonist 4OH-GTS-21 can regulate neuronal functions directly, via activation of the native ␣7 receptors, and indirectly, via desensitizing those receptors or transferring them into a state "primed" for desensitization. The direct action produces depolarization and thereby increases the TM neuron spontaneous firing (SF) rate. The regulation of the spontaneous firing rate is robust in a nonphysiological range of choline concentrations Ͼ200 M. However, modest effects persist at concentrations of choline that are likely to be attained perineuronally under some conditions (20 -100 M). At high physiological concentration levels, the indirect choline action reduces or even eliminates the responsiveness of ␣7 receptors and their availability to other strong cholinergic inputs. Similarly to choline, 4OH-GTS-21 increases the TM neuron spontaneous firing rate via activation of ␣7 receptors, and this regulation is robust in the range of clinically relevant concentrations of 4OH-GTS-21. We conclude that factors that regulate choline accumulation in the brain and in experimental slices such as choline uptake, hydrolysis of ACh, membrane phosphatidylcholine catabolism, and solution perfusion rate influence ␣7 nAChR neuronal and synaptic functions, especially under pathological conditions such as stroke, seizures, Alzheimer's disease, and head trauma, when the choline concentration in the CSF is expected to rise.