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@ARTICLE{Schumacher:276279,
      author       = {Schumacher, Julia and Teipel, Stefan and Storch, Alexander},
      title        = {{A}ssociation of {A}lzheimer's and {L}ewy body disease
                      pathology with basal forebrain volume and cognitive
                      impairment.},
      journal      = {Alzheimer's research $\&$ therapy},
      volume       = {17},
      number       = {1},
      issn         = {1758-9193},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DZNE-2025-00258},
      pages        = {28},
      year         = {2025},
      abstract     = {Degeneration of the basal forebrain cholinergic system is a
                      hallmark feature shared by Alzheimer's disease (AD) and Lewy
                      body disease (LBD) whereas hippocampus atrophy is more
                      specifically related to AD. We aimed to investigate the
                      relationship between basal forebrain and hippocampus
                      atrophy, cognitive decline, and neuropathology in a large
                      autopsy sample.Data were obtained from the National
                      Alzheimer's Coordinating Center (NACC). Basal forebrain and
                      hippocampus volumes were extracted using an established
                      automated MRI volumetry approach. Associations of regional
                      volumes with pathological markers (Braak stage, CERAD score,
                      and McKeith criteria for LB pathology) and cognitive
                      performance were assessed using Bayesian statistical
                      methods.We included people with autopsy-confirmed pure AD (N
                      = 248), pure LBD (N = 22), and mixed AD/LBD (N = 185).
                      Posterior basal forebrain atrophy was most severe in mixed
                      AD/LB pathology compared to pure AD (Bayes factor against
                      the null hypothesis BF10 = 16.2) or pure LBD (BF10 = 4.5).
                      In contrast, hippocampal atrophy was primarily associated
                      with AD pathology, independent of LB pathology (pure AD vs.
                      pure LBD: BF10 = 166, pure AD vs. mixed AD/LBD: BF10 = 0.11,
                      pure LBD vs. mixed AD/LBD: BF10 = 350). Cognitive
                      performance was more impaired in AD pathology groups, with
                      Braak stage being the strongest predictor. Hippocampal
                      volume partially mediated this relationship between tau
                      pathology and cognitive impairment, while basal forebrain
                      volume had a limited role in mediating the relationship
                      between pathological burden and cognitive outcomes.In a
                      heterogeneous autopsy sample, AD and LB pathology both
                      contribute to cholinergic basal forebrain degeneration
                      whereas hippocampus atrophy is more specifically related to
                      AD pathology. Cognitive deficits are primarily associated
                      with tau pathology which is partly mediated by hippocampus,
                      but not basal forebrain atrophy.},
      keywords     = {Humans / Alzheimer Disease: pathology / Alzheimer Disease:
                      diagnostic imaging / Lewy Body Disease: pathology / Lewy
                      Body Disease: diagnostic imaging / Female / Male / Cognitive
                      Dysfunction: pathology / Cognitive Dysfunction: diagnostic
                      imaging / Aged / Basal Forebrain: pathology / Basal
                      Forebrain: diagnostic imaging / Aged, 80 and over / Atrophy:
                      pathology / Magnetic Resonance Imaging / Hippocampus:
                      pathology / Hippocampus: diagnostic imaging / Organ Size},
      cin          = {AG Storch / AG Teipel},
      ddc          = {610},
      cid          = {I:(DE-2719)5000014 / I:(DE-2719)1510100},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39865328},
      doi          = {10.1186/s13195-025-01678-x},
      url          = {https://pub.dzne.de/record/276279},
}