Acetylcholinesterase and cholinergic receptor activation. Under normal physiological conditions, AChE plays a dynamic role in regulating cholinergic signaling, rapidly degrading acetylcholine to terminate neurotransmission. Cholinergic motoneurons release acetylcholine to activate skeletal muscles for ambulation and fine motor control. Similarly, parasympathetic neurons stimulate smooth muscles to drive gut peristalsis, contraction of the bladder, secretion from salivary glands, slow heartbeats at the sinoatrial node. When AChE activity is suppressed, cholinergic receptor activation causes increased muscle contractions, exocrine secretions, GI disturbances, incontinence and increased parasympathetic tone leading to decreased rate and force of heartbeats. When AChE activity is high, reduction of cholinergic receptor activation, lowers force and tone in muscle and heart, and reduced exocrine secretions.