Abstract
In this issue of Biological Psychiatry, Grothe et al. ( 1 Grothe M. Heinsen H. Teipel S.J. Atrophy of the cholinergic basal forebrain over the adult age range and in early stages of Alzheimer's disease. Biol Psychiatry. 2012; 71: 805-813 Abstract Full Text Full Text PDF Scopus (177) Google Scholar ) report that the atrophy of basal forebrain cholinergic nuclei associated with aging, mild cognitive impairment (MCI), and Alzheimer's disease (AD) can be visualized in vivo with innovative imaging methods. There are plenty of reasons why such investigations deserve to be pursued. It was the discovery of the cholinergic lesion in the 1970s that shifted the focus of research in AD from descriptive morphology to systems neuroscience. It is now well known that the cerebral cortex receives a massive cholinergic innervation, that this innervation arises from the nucleus basalis of Meynert (Ch4), that it is highly vulnerable to progressive degeneration in AD, and that the discovery of this vulnerability has introduced the first rational and effective treatment for AD. However, it is equally common knowledge that the cholinergic lesion of AD does not arise in isolation, that its exact contribution to the cognitive impairment remains elusive, and that cholinergic therapies cannot reverse or slow disease progression ( 2 Mesulam M.-M. The cholinergic lesion of Alzheimer's disease: pivotal factor or side show?. Learning Memory. 2004; 11: 43-49 Google Scholar ). Atrophy of the Cholinergic Basal Forebrain Over the Adult Age Range and in Early Stages of Alzheimer's DiseaseBiological PsychiatryVol. 71Issue 9PreviewThe basal forebrain cholinergic system (BFCS) is known to undergo moderate neurodegenerative changes during normal aging as well as severe atrophy in Alzheimer's disease (AD). However, there is a controversy regarding how the cholinergic lesion in AD relates to early and incipient stages of the disease. In vivo imaging studies on the structural integrity of the BFCS in normal and pathologic aging are rare. Full-Text PDF
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