Abstract

The basal forebrain (BF) is among the first brain structures to degenerate in Alzheimer’s disease (AD). However, the relationship between in vivo longitudinal degeneration within the BF and its cortical targets is poorly understood. Recent evidence from transgenic models of AD shows that neuronal accumulation of amyloid-β (Aβ) can potentiate the release and spread of pathological tau fragments from neuron to neuron, causing propagation of AD pathology over functionally and anatomically connected networks. Following from this work, we examined whether BF and cortical degeneration are interdependent in older human adults expressing abnormal accumulation of Aβ, with AD progressing via a predictive cascade from BF to cortical areas receiving its projections. To do so, we employed multimodal in vivo imaging of longitudinal structural degeneration and cholinergic binding with the [18F] FEOBV PET radiotracer. We show that distinct subregions of the BF predict degeneration in cortical areas in a spatial topography that reflects the cholinergic projection system.

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