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Choline acetyltransferase (Ch AT) is the marker enzyme for cholinergic neurons where it catalyzes the synthesis of acetylcholine (ACh) from acetyl coenzyme A (Ac Co A) and choline (Ch): Ac Co A Ch→Ch ATACh Acetyl coenzyme A derives from the tricarboxylic acid (TCA) cycle whereas choline is transported into nerve terminals from the extracellular medium by the sodium-dependent, high-affinity carrier system that is localized in the presynaptic terminals.From: -acetyltransferase, EC in skeletal muscles is probably of neural origin, and its activity varies among skeletal muscles.

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Treatment consists of prophylactic therapy with pyridostigmine.

The decreased rate of ACh resynthesis progressively depletes the ACh content of the synaptic vesicles, and hence the amplitude of the miniature EP potential (MEPP), when neuronal impulse flow is increased ().

Some patients present with hypotonia, bulbar paralysis, and apnea at birth.

A transient Ch AT-IR population is observed in the embryonic cortex, originating at the dorsal ventricular surface and hence derived from principal neurons rather than interneuron progenitors (see below; ).

In adult mouse cortex, Kitt and colleagues (1994) suggested there was a near-complete overlap of Ch AT-IR and ACh E histochemistry, but their antibody failed to show Ch AT-IR cell bodies.