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Normality and Pathology in Cognitive Function

Neurologists must have been following the explosion of information about peptides in gut and brain with some amazement. Clinical practice has not led us to suppose that there would be such a dramatic interrelation between these two organs. However, since about 1974, it has been revealed that many of the peptides present in the gastro-intestinal tract are also present in restricted areas of the brain. To have to consider that hormones such as cholecystokinin, vaso-active intestinal polypeptide, and bombesin must be involved in the workings of the nervous system may appear a difficult concept to grasp. Likewise, the discovery that certain neurotransmitters, such as substance P, the enkephalins, and neurotensin are widely distributed in the gut as well as the brain also has seemed surprising. The very number of these gut-brain peptides is amazing; at a recent count, twenty-one such substances have been identified, and there may be many more. Many of these regulatory peptides can be found in the gut and the nervous system of lower animal forms, even in such coelenterates as Hydra. It seems likely that peptides came into use