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The cortical cholinergic system contributes to the top‐down control of distraction: Evidence from patients with Parkinson's disease

Kamin Kim,M. Müller,N. Bohnen,M. Sarter,C. Lustig

Published 2019 in NeuroImage

ABSTRACT

ABSTRACT Past animal and human studies robustly report that the cholinergic system plays an essential role in both top‐down and bottom‐up attentional control, as well as other aspects of cognition (see Ballinger et al., 2016 for a recent review). However, current understanding of how two major cholinergic pathways in the human brain (the basal forebrain‐cortical pathway, and the brainstem pedunculopontine‐thalamic pathway) contribute to specific cognitive functions remains somewhat limited. To address this issue, we examine how individual variation in the integrity of striatal‐dopaminergic, thalamic‐cholinergic, and cortical‐cholinergic pathways (measured using Positron Emission Tomography in patients with Parkinson's disease) was associated with individual variation in the initial goal‐directed focus of attention, the ability to sustain attentional performance over time, and the ability to avoid distraction from a highly‐salient, but irrelevant, environmental stimulus. Compared to healthy controls, PD patients performed similarly in the precision of attention‐dependent judgments of duration, and in sustaining attention over time. However, PD patients' performance was strikingly more impaired by the distractor. More critically, regression analyses indicated that only cortical‐cholinergic integrity, not thalamic‐cholinergic or striatal‐dopaminergic integrity, made a specific contribution to the ability to resist distraction after controlling for the other variables. These results demonstrate that the basal forebrain cortical cholinergic system serves a specific role in executing top‐down control to resist external distraction.

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