Studies have shown that a decrease in cholinesterase activity and the consequent increase in acetylcholine may lead to cholinergic hyperstimulation and increase cell proliferation in PCa, and moreover it has been shown that patients with increased preoperative BCHE levels have a higher 5-year BRRFS rate and are an independent prognostic factor for PCa after RP (31, 32). This evidence concerns the gene BCHE and posterior cortical atrophy.