Many medications of different indications have a relevant anticholinergic activity. The anticholinergic burden of medication has been shown to have significant effects on the cognition and the risk for cognitive impairment and dementia particularly in older patients. So far, most of the studies used data from geriatric patients and the effect of the anticholinergic burden on brain structures is still unexplored. Our study aimed to analyze possible associations of hippocampus and cholinergic basal forebrain volumes as vulnerable brain structures for the development of dementia and the anticholinergic burden in a population-based cohort of non-demented participants spanning the adult age range from 21 to 80 years. We analyzed associations between medication-related anticholinergic burden and structural MRI volumes from participants (n = 3087, 52.2% female) of the population-based “Study of Health in Pomerania” (SHIP). Anticholinergic burden was obtained from the current medication plan using the Anticholinergic Burden Scale (ACB). All analyses were adjusted for age, sex, education, and total intracranial volume. We found statistically significant associations between the ACB and the left and right hippocampus volume but not for the basal forebrain cholinergic system. Complementary voxel-based analysis across all participants revealed FWE-corrected (p = < 0.05) clusters in the temporo-parietal regions reaching into frontal areas, showing reduced volumes with higher ACB scores. We identified an association between anticholinergic burden of medication on hippocampal volume suggesting a potential inverse effect of such medication. This association highlights the importance of a careful prescription of medication with anticholinergic activity at any adult age.

许多不同适应症的药物具有相关的抗胆碱能活性。药物的抗胆碱能负担已被证明对认知和认知障碍和痴呆的风险有显着影响，尤其是在老年患者中。到目前为止，大多数研究使用来自老年患者的数据，抗胆碱能负担对大脑结构的影响仍未探索。我们的研究旨在分析海马体和胆碱能基底前脑体积作为痴呆症发展的脆弱脑结构和抗胆碱能负担的可能关联，在一个基于人群的非痴呆参与者队列中，跨越 21 至 80 岁的成年年龄范围。我们分析了药物相关的抗胆碱能负担与参与者的结构 MRI 体积之间的关联。n  = 3087, 52.2% 女性) 基于人口的“波美拉尼亚健康研究” (SHIP)。使用抗胆碱能负担量表 (ACB) 从当前的用药计划中获得抗胆碱能负担。所有分析均针对年龄、性别、教育程度和颅内总体积进行了调整。我们发现 ACB 与左右海马体积之间存在统计学显着关联，但与基底前脑胆碱能系统无关。所有参与者的基于补充体素的分析显示 FWE 校正（p = < 0.05) 颞顶叶区域的簇延伸到额叶区域，显示体积减小，ACB 得分较高。我们确定了药物的抗胆碱能负担与海马体积之间的关联，表明这种药物的潜在反作用。这种关联强调了在任何成年年龄仔细处方具有抗胆碱能活性的药物的重要性。