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Background Cholinesterase inhibitors (e.g. galantamine) can enhance cognitive functions in healthy elderly and delay cognitive decline in patients with Alzheimer`s diseases (AD). However, not everyone benefits from this treatment (non‐responders). Current studies show clinical meaningful improvements only in one third of AD patients treated with cholinesterase inhibitors. In this context, predictors of drug response could optimize AD treatment by identifying non‐responders and protect these patients from common adverse side effects. Method Here, we investigate structural MRI of the basal forebrain cholinergic system volume (BFvol) as a potential predictor of cognitive response to a single dose of galantamine in healthy adults (n=18; 59‐75 years). Result We observed that the cognitive response to galantamine, more specifically the attention‐dependent filtering performance in a delayed match‐to‐sample working memory task, correlated with BFvol: Only participants with high BFvol showed a significant positive effect of galantamine on the ability to filter out distracting information during the working memory encoding process. Conclusion Our results indicate that BFvol could be a predictor of galantamine response in healthy elderly. Future studies need to assess whether BFvol may serve as a predictor of the galantamine response in AD patients, too.

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