Cholinergic basal forebrain atrophy predicts amyloid burden in Alzheimer's disease

• Published in: Neurobiology of aging 2014-03, Vol.35 (3), p.482-491
• Main Authors: Teipel, Stefan, Heinsen, Helmut, Amaro, Edson, Grinberg, Lea T, Krause, Bernd, Grothe, Michel
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - metabolism; Alzheimer Disease - pathology; Amyloid beta-Peptides - metabolism; Amyloid PET; Atrophy; Cerebral Cortex - metabolism; Cholinergic Neurons - diagnostic imaging; Cholinergic Neurons - pathology; Cholinergic system; Cognitive Dysfunction - metabolism; Cognitive Dysfunction - pathology; Diagnosis; Female; Hippocampus; Hippocampus - diagnostic imaging; Hippocampus - pathology; Humans; Internal Medicine; Magnetic Resonance Imaging; Male; Neurology; Positron-Emission Tomography; Predementia Alzheimer's disease; Prosencephalon - cytology; Prosencephalon - diagnostic imaging; Prosencephalon - pathology
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2013.09.029

Abstract We compared accuracy of hippocampus and basal forebrain cholinergic system (BFCS) atrophy to predict cortical amyloid burden in 179 cognitively normal subjects (CN), 269 subjects with early stages of mild cognitive impairment (MCI), 136 subjects with late stages of MCI, and 86 subjects with Alzheimer's disease (AD) dementia retrieved from the Alzheimer's Disease Neuroimaging Initiative database. Hippocampus and BFCS volumes were determined from structural magnetic resonance imaging scans at 3 Tesla, and cortical amyloid load from AV45 (florbetapir) positron emission tomography scans. In receiver operating characteristics analyses, BFCS volume provided significantly more accurate classification into amyloid-negative and -positive categories than hippocampus volume. In contrast, hippocampus volume more accurately identified the diagnostic categories of AD, late and early MCI, and CN compared with whole and anterior BFCS volume, whereas posterior BFCS and hippocampus volumes yielded similar diagnostic accuracy. In logistic regression analysis, hippocampus and posterior BFCS volumes contributed significantly to discriminate MCI and AD from CN, but only BFCS volume predicted amyloid status. Our findings suggest that BFCS atrophy is more closely associated with cortical amyloid burden than hippocampus atrophy in predementia AD.