Structural MRI of the basal forebrain as predictor of cognitive response to galantamine in healthy older adults-A randomized controlled double-blinded crossover study

Alzheimers Dement (N Y). 2021 Apr 5;7(1):e12153. doi: 10.1002/trc2.12153. eCollection 2021.

Abstract

Introduction: Cholinesterase inhibitors can enhance cognitive functions in healthy elderly and delay cognitive decline in patients with Alzheimer`s disease (AD). However, not everyone benefits from this treatment (non-responders). Current studies show clinical meaningful improvements only in one third of AD patients treated with cholinesterase inhibitors.

Methods: Here we investigate structural magnetic resonance imaging of the basal forebrain cholinergic system volume (BFvol) as a potential predictor of cognitive response to a single dose of galantamine in healthy adults (n = 18; 59 to 75 years).

Results: We observed that the cognitive response to galantamine, more specifically the attention-dependent filtering performance in a delayed match-to-sample working memory task, correlated with BFvol: Only participants with high BFvol showed a significant positive effect of galantamine on the ability to filter out distracting information during the working memory encoding process.

Discussion: Future studies need to assess whether BFvol may serve as a predictor of the galantamine response in AD patients, too.

Keywords: Alzheimer's disease; basal forebrain; galantamine; magnetic resonance imaging; personalized medicine.