New Developments in Cholinergic Imaging in Alzheimer and Lewy Body Disorders
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GEROPSYCHIATRY & COGNITIVE DISORDERS OF LATE LIFE (P NEWHOUSE, SECTION EDITOR)
New Developments in Cholinergic Imaging in Alzheimer and Lewy Body Disorders Chesney E. Craig 1,2 & Nicola J. Ray 1,2 & Martijn L. T. M. Müller 3,4 & Nicolaas I. Bohnen 3,4,5 Accepted: 30 September 2020 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract Purpose of Review This paper aims to review novel trends in cholinergic neuroimaging in Alzheimer and Lewy body parkinsonian disorders. Recent Findings The spectrum of cholinergic imaging is expanding with the availability of spatially more precise radioligands that allow assessment of previously less recognized subcortical and cortical structures with more dense cholinergic innervation. In addition, advances in MRI techniques now allow quantitative structural or functional assessment of both the cholinergic forebrain and the pedunculopontine nucleus, which may serve as non-invasive prognostic predictors. Multimodal imaging approaches, such as PET-MRI or multiligand PET, offer new insights into the dynamic and interactive roles of the cholinergic system at both local and larger-scale neural network levels. Summary Our understanding of the heterogeneous roles of the cholinergic system in age-related diseases is evolving. Multimodal imaging approaches that provide complimentary views of the cholinergic system will be necessary to shed light on the impact of cholinergic degeneration on regional and large-scale neural networks that underpin clinical symptom manifestation in neurodegeneration. Keywords Alzheimer’s disease . Cholinergic . Imaging . Lewy body dementias and Parkinson’s disease
Abbreviations AD Alzheimer disease cBF Cholinergic basal forebrain DTI Diffusion tensor imaging PD Parkinson disease
LBD Ch4 PPN VAChT
This article is part of the Topical Collection on Geropsychiatry & Cognitive Disorders of Late Life
Introduction
* Nicolaas I. Bohnen [email protected] 1
Department of Psychology, Manchester Metropolitan University, Manchester, UK
2
Health, Psychology and Communities Research Centre, Manchester Metropolitan University, Manchester, UK
3
Department of Radiology, University of Michigan, Ann Arbor, MI 48105, USA
4
Morris K. Udall Center of Excellence for Parkinson’s Disease Research, University of Michigan, Ann Arbor, MI 48105, USA
5
Veterans Administration Ann Arbor Healthcare System, Ann Arbor, MI 48105, USA
Lewy body dementias Nucleus basalis of Meynert Pedunculopontine nucleus Vesicular Acetylcholine Transporter
Degeneration of the cholinergic system has been identified as a major component of the neurodegenerative dementia process in Alzheimer’s disease (AD) and Lewy body parkinsonian disorders, including Parkinson’s disease (PD) and in particular Parkinson’s disease dementia (PDD) and Lewy body dementia (LBD); see Bohnen et al. [1] for review. The cholinergic hypothesis of dementia is evolving from a primary focus on memory and a traditional view of a more diffuse neuromodula
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