Home › Research › Treatments
Challenging the cholinergic system in mild cognitive impairment: a pharmacological fMRI study
Goekoop R, Rombouts SA, Jonker C, Hibbel A, Knol DL, Truyen L, Barkhof F, Scheltens P.. NeuroImage, 2004-12-01
Topic: Risk, prevention and care in population studies
Mild cognitive impairment (MCI) often represents an early form of Alzheimer disease (AD). In both MCI and AD, characteristic cholinergic changes may occur. Functional magnetic resonance imaging (fMRI) may help to examine neurochemical changes in early disease by studying signal reactivity to pharmacological challenge. In this study, MCI patients [n=28; mean age 73.6+/-7.5; mini mental state examination (MMSE) 27.0+/-1.2] were scanned during task performance in a randomized trial under three different medication regimes: at baseline [BL; no galantamine (GAL)], after a single oral dose of GAL (SD), and after prolonged exposure (steady state: SS). Memory tasks included an episodic face-encoding task and a parametric n-letter back working memory (WM) task. Alterations in brain activation patterns before and after treatment were analyzed for both tasks using multilevel statistical analysis. Significant increases in brain activation from BL were observed after prolonged exposure only. For face encoding (n=28), these involved left prefrontal areas, the anterior cingulate gyrus, left occipital areas, and left posterior hippocampus. For working memory (n=28), increased activation was found in right precuneus and right middle frontal gyrus, coinciding with increased accuracy scores after GAL treatment. In conclusion, cholinergic challenge produces alterations in brain activation patterns in elderly MCI patients that can be detected with fMRI. This should encourage further functional imaging studies to examine the status of neurotransmitter systems in disease.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Goekoop, R., Rombouts, S. A., Jonker, C., Hibbel, A., Knol, D. L., Truyen, L., et al. (2004). Challenging the cholinergic system in mild cognitive impairment: a pharmacological fMRI study. NeuroImage. https://doi.org/10.1016/j.neuroimage.2004.08.006
Vancouver
Goekoop R, Rombouts SA, Jonker C, Hibbel A, Knol DL, Truyen L, et al. Challenging the cholinergic system in mild cognitive impairment: a pharmacological fMRI study. NeuroImage. 2004. doi:10.1016/j.neuroimage.2004.08.006. PMID: 15589109.
BibTeX
@article{goekoop2004-15589109,
author = {Goekoop, R. and Rombouts, S. A. and Jonker, C. and Hibbel, A. and Knol, D. L. and Truyen, L. and Barkhof, F. and Scheltens, P.},
title = {{Challenging the cholinergic system in mild cognitive impairment: a pharmacological fMRI study}},
journal = {NeuroImage},
year = {2004},
doi = {10.1016/j.neuroimage.2004.08.006},
pmid = {15589109},
url = {https://doi.org/10.1016/j.neuroimage.2004.08.006}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Significant increases in brain activation from BL were observed after prolonged exposure only.
- In conclusion, cholinergic challenge produces alterations in brain activation patterns in elderly MCI patients that can be detected with fMRI.
Why it matters
In 28 patients with mild cognitive impairment, prolonged treatment with galantamine increased brain activation during memory tasks and improved accuracy on a working memory task. This small study shows that brain imaging can detect drug effects on brain activity, but it did not test whether this translates into slower progression to Alzheimer's disease.
New to this subject? Start with our plain-English guide: Treatments →
Study details
- Study designrandomized controlled trial
- Participants28
- Evidence strengthHigh
How this study scored 65/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (NeuroImage) |
| Journal's citation record | 4 / 4 | NeuroImage: journal h-index 523 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2004 — older than 20 years, still counted |
| Sample size | 1 / 4 | 28 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 5 / 7 | Cited 110 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.6 citations a year over 24 year(s) since 2004 |
| Impact for its field and year | 3 / 6 | Cited 5.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Philip Scheltens: h-index 181 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Vrije Universiteit Amsterdam: institution h-index 1,014 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15589109) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
3 studies in the alzhub library list this one in their references.
Related studies in Treatments
Also tagged “assessment”
840 studies in the library carry the topic tag “assessment”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 840 tagged studies.