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Study 33 of 38Semaglutide literaturebiorxiv-preprint · Animal study · Preclinical2026

Semaglutide Activates the Orexin/Hypocretin and Basal Forebrain Cholinergic Systems and Increases Acetylcholine Levels in the Hippocampus of Young and Aged Rats

Semaglutide activates specific neuronal systems and increases acetylcholine in the rat hippocampus, suggesting a potential mechanism for cognitive effects.

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Where it sits

this study against the rest of the semaglutide corpus
9
Preclinical · this one
23
Observational
0
Open-label
2
Randomised
4
Reviews

Summary and findings

The study investigated the effects of semaglutide on specific neuronal populations in rats, focusing on the orexin/hypocretin and basal forebrain cholinergic systems. Acute administration of semaglutide activated these systems and increased acetylcholine levels in the hippocampus. The research aimed to explore potential therapeutic mechanisms of GLP-1 agonists in neurological disorders.

How much of this paper we could read: full text read (0.80). We had a clear abstract, so the summary below closely tracks the paper. What this means →
Semaglutide acutely increases acetylcholine efflux in the ventral hippocampus of conscious and freely moving rats.Preclinical2026

Abstract

The authors’ words, as biorxiv-preprint supplied them

GLP-1 agonist drug repurposing efforts may establish new clinical niches in managing psychiatric and neurological disorders. However, a comprehensive understanding of GLP-1 neurobiology and an appreciation of specific neural mechanisms by which GLP-1 agonists might provide therapeutic effects is limited and stands as a barrier to these efforts. When considering current preclinical research evaluating GLP-1 agonist central mechanisms, a considerable knowledge gap remains regarding which specific cellular populations and systems define potential therapeutic effects in the brain. In this research, we used cFos immunohistochemistry to identify specific neuronal populations that exhibited altered cellular activity following acute administration of semaglutide to rats. We found that the orexin/hypocretin and basal forebrain cholinergic systems are activated following acute semaglutide administration in male and female young adult rats (3-5 months). Informed by the results of our histological analysis, we next employed in vivo microdialysis to test our hypothesis that semaglutide would acutely increase acetylcholine release in the rodent hippocampus. Here, we report that semaglutide acutely increases acetylcholine efflux in the ventral hippocampus of conscious and freely moving rats regardless of biological sex in both young adult and aged rats (23-26 months). Given the relevance of hippocampal cholinergic neurotransmission in learning and memory, our research mechanistically connects GLP-1 agonists with established targets in cognitive decline and dementia.

Background

The study addresses the potential repurposing of GLP-1 agonists, like semaglutide, for managing psychiatric and neurological disorders. Current understanding of GLP-1 neurobiology is limited, particularly regarding the specific neural mechanisms involved. This research aims to fill the knowledge gap by identifying neuronal populations affected by semaglutide, which could inform therapeutic strategies for cognitive decline and dementia.

Methods

The study used cFos immunohistochemistry to identify neuronal populations activated by semaglutide in rats. Acute administration was performed on male and female young adult rats (3-5 months). In vivo microdialysis was then used to measure acetylcholine release in the hippocampus of both young adult and aged rats (23-26 months).

Results

Acute administration of semaglutide activated the orexin/hypocretin and basal forebrain cholinergic systems in rats. It also increased acetylcholine efflux in the ventral hippocampus, observed in both young adult and aged rats, regardless of sex. These findings suggest a potential mechanism by which GLP-1 agonists could impact cognitive functions.

Interpretation

The study provides mechanistic insights into how semaglutide might influence cognitive processes through activation of specific neuronal systems. While the findings are statistically significant, their clinical relevance remains uncertain due to the preclinical nature of the study. The results align with existing literature on the role of hippocampal cholinergic neurotransmission in learning and memory, but further research is needed to assess clinical applicability.

Key findings

  • Orexin/hypocretin and basal forebrain cholinergic systems activated after semaglutide administration.
  • Semaglutide acutely increased acetylcholine efflux in the ventral hippocampus.
  • Effects observed in both young adult (3-5 months) and aged rats (23-26 months).
  • Findings consistent across male and female rats.

Limitations

  • Preclinical study in rats, not humans.
  • Acute administration only, no long-term effects studied.
  • Single-site study with potential for limited generalizability.

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DEffect of semaglutide on kidney outcomes in the SELECT, FLOW, and SOUL trials: a prespecified pooled analysis.The lancet. Diabetes & endocrinology · 2026DMultimodal Strategies for Obesity Management: Integration and Combination of GLP-1/GIP Therapies, Bariatric Endoscopy, and Metabolic Surgery: A Scoping Reviewbiorxiv-preprint · 2026 · Not reported in abstract.reviewBReal-World Insulin Deintensification and Discontinuation with GLP-1 Incretin Therapies Versus SGLT2 Inhibitors in Type 2 Diabetesbiorxiv-preprint · 2026 · 27.8% discontinued basal insulin with semaglutide vs 22.2% with SGLT2-i at 24 months, sHR 1.26, 95% CI 1.05–1.52, Gray P=0.013HumanBCardiovascular Outcomes of Tirzepatide vs Semaglutide in Obesity Without Type 2 Diabetes: A Matched Cohort Studybiorxiv-preprint · 2026 · HR 0.80; 95% CI 0.69–0.92 for MACE at 12 months.HumanDNeuro-Adverse Events Associated with GLP-1 Receptor Agonists: A Study Based on the FAERS Database and External Validation Using NHANES Databasebiorxiv-preprint · 2026 · ROR 3.94; 95%CI 3.42-4.54 for muscle atrophy with semaglutide.reviewDMapping Models of Tirzepatide Delivery for Obesity Management in Primary Care Settingsbiorxiv-preprint · 2026 · Not reported in abstract.review