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Atrophy of the cholinergic basal forebrain in dementia with Lewy bodies and Alzheimer’s disease dementia

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Abstract

Similar to Alzheimer’s disease (AD), dementia with Lewy bodies (DLB) is characterized by a profound degeneration of cortically-projecting cholinergic neurons of the basal forebrain (BF) and associated depletion of cortical cholinergic activity. We aimed to investigate subregional atrophy of the BF in DLB in vivo and compare it to the pattern of BF atrophy in AD. Structural MRI scans of 11 patients with DLB, 11 patients with Alzheimer’s disease, and 22 healthy controls were analysed using a recently developed technique for automated BF morphometry based on high-dimensional image warping and cytoarchitectonic maps of BF cholinergic nuclei. For comparison, hippocampus volume was assessed within the same morphometric framework using recently published consensus criteria for the definition of hippocampus outlines on MRI. The DLB group demonstrated pronounced and subregion-specific atrophy of the BF which was comparable to BF atrophy in AD: volume of the nucleus basalis Meynert was significantly reduced by 20–25 %, whereas rostral BF nuclei were only marginally affected. By contrast, hippocampus volume was markedly less affected in DLB compared to AD. Global cognition as determined by MMSE score was associated with BF volume in AD, but not in DLB, whereas visuoperceptual function as determined by the trail making test was associated with BF volume in DLB, but not in AD. DLB may be characterized by a more selective degeneration of the cholinergic BF compared to AD, which may be related to the differential cognitive profiles in both conditions.

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Acknowledgments

The study was supported by the Department ‘Aging of the individual and the Society’ of the University of Rostock.

Conflicts of interest

The authors declare that they have no conflict of interest.

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All participants gave written informed consent in agreement with the local ethics committee; the study was conducted according to the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. German Center for Neurodegenerative Diseases (DZNE), Gehlsheimer Str. 20, 18147, Rostock, Germany

    Michel J. Grothe, Christina Schuster, Florian Bauer, Johannes Prudlo & Stefan J. Teipel

  2. Department of Psychiatry, Laboratory of Morphological Brain Research, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany

    Helmut Heinsen

  3. Department of Neurology, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Johannes Prudlo

  4. Department of Psychosomatic Medicine, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Stefan J. Teipel

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  1. Michel J. Grothe
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  3. Florian Bauer
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  4. Helmut Heinsen
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Correspondence to Michel J. Grothe.

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C. Schuster and M. J. Grothe contributed equally to the manuscript

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Grothe, M.J., Schuster, C., Bauer, F. et al. Atrophy of the cholinergic basal forebrain in dementia with Lewy bodies and Alzheimer’s disease dementia. J Neurol 261, 1939–1948 (2014). https://doi.org/10.1007/s00415-014-7439-z

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  • DOI: https://doi.org/10.1007/s00415-014-7439-z

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