Distribution of Cholinergic Nerve Terminals in the Aged Human Brain Measured with [18F]FEOBV PET and its Correlation with Histological Data

Niels Okkels*, Jacob Horsager, Miguel A Labrador-Espinosa, Frederik Orm Hansen, Katrine B Andersen, Mie Kristine Just, Tatyana D Fedorova, Casper Skjærbæk, Ole L Munk, Kim Vang Hansen, Hanne Gottrup, Allan K Hansen, Michel J Grothe, Per Borghammer

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review


INTRODUCTION: [ 18F]fluoroetoxybenzovesamicol ([ 18F]FEOBV) is a positron emission topography (PET) tracer for the vesicular acetylcholine transporter (VAChT), a protein located predominantly in synaptic vesicles in cholinergic nerve terminals. We aimed to use [ 18F]FEOBV PET to study the cholinergic topography of the healthy human brain.

MATERIALS AND METHODS: [ 18F]FEOBV PET brain data volumes of healthy elderly humans were normalized to standard space and intensity-normalized to the white matter. Stereotactic atlases of regions of interest were superimposed to describe and quantify tracer distribution. The spatial distribution of [ 18F]FEOBV PET uptake was compared with histological and gene expression data.

RESULTS: Twenty participants of both sexes and a mean age of 73.9±6.0 years, age-range [64; 86], were recruited. Highest tracer binding was present in the striatum, some thalamic nuclei, and the basal forebrain. Intermediate binding was found in most nuclei of the brainstem, thalamus, and hypothalamus; the vermis and flocculonodular lobe; and the hippocampus, amygdala, insula, cingulate, olfactory cortex, and Heschl's gyrus. Lowest binding was present in most areas of the cerebral cortex, and in the cerebellar nuclei and hemispheres. The spatial distribution of tracer correlated with immunohistochemical post-mortem data, as well as with regional expression levels of SLC18A3, the VAChT coding gene.

DISCUSSION: Our in vivo findings confirm the regional cholinergic distribution in specific brain structures as described post-mortem. A positive spatial correlation between tracer distribution and regional gene expression levels further corroborates [ 18F]FEOBV PET as a validated tool for in vivo cholinergic imaging. The study represents an advancement in the continued efforts to delineate the spatial topography of the human cholinergic system in vivo.

Original languageEnglish
Article number119908
Number of pages13
Publication statusPublished - Apr 2023


  • Brain
  • Cholinergic Neurons
  • Healthy Volunteer
  • PET-CT
  • VAChT Proteins
  • mRNA


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