Altered multimodal magnetic resonance parameters of basal nucleus of Meynert in Alzheimer’s disease

OBJECTIVES: We aimed to examine how gray matter volume (GMV), regional blood flow (rCBF), and resting‐state functional connectivity (FC) of the basal nucleus of Meynert (BNM) are altered in 40 patients with AD, relative to 30 healthy controls (HCs). METHODS: We defined the BNM on the basis of a mask histochemically reconstructed from postmortem human brains. We examined GMV with voxel‐based morphometry of high‐resolution structural images, rCBF with arterial spin labeling imaging, and whole‐brain FC with published routines. We performed partial correlations to explore how the imaging metrics related to cognitive and living status in patients with AD. Further, we employed receiver operating characteristic analysis to compute the “diagnostic” accuracy of these imaging markers. RESULTS: AD relative to HC showed lower GMV and higher rCBF of the BNM as well as lower BNM connectivity with the right insula and cerebellum. In addition, the GMVs of BNM were correlated with cognitive and daily living status in AD. Finally, these imaging markers predicted AD (vs. HC) with an accuracy (area under the curve) of 0.70 to 0.86. Combination of BNM metrics provided the best prediction accuracy. CONCLUSIONS: By combining multimode MR imaging, we demonstrated volumetric atrophy, hyperperfusion, and disconnection of the BNM in AD. These findings support cholinergic dysfunction as an etiological marker of AD and related dementia.