Structural MRI of the basal forebrain as predictor of cognitive response to galantamine in healthy older adults—A randomized controlled double‐blinded crossover study

INTRODUCTION: Cholinesterase inhibitors can enhance cognitive functions in healthy elderly and delay cognitive decline in patients with Alzheimer`s disease (AD). However, not everyone benefits from this treatment (non‐responders). Current studies show clinical meaningful improvements only in one third of AD patients treated with cholinesterase inhibitors. METHODS: Here we investigate structural magnetic resonance imaging of the basal forebrain cholinergic system volume (BF(vol)) as a potential predictor of cognitive response to a single dose of galantamine in healthy adults (n = 18; 59 to 75 years). RESULTS: We observed that the cognitive response to galantamine, more specifically the attention‐dependent filtering performance in a delayed match‐to‐sample working memory task, correlated with BF(vol): Only participants with high BF(vol) showed a significant positive effect of galantamine on the ability to filter out distracting information during the working memory encoding process. DISCUSSION: Future studies need to assess whether BF(vol) may serve as a predictor of the galantamine response in AD patients, too.