The Locus Coeruleus-Basal Forebrain tract in Lewy body disease: autonomic dysfunction and cognition

The study investigated the relationship between autonomic dysfunction and cognitive impairment in patients with Lewy body disease by analyzing the locus coeruleus-basal forebrain tract using advanced brain imaging. The research included cross-sectional imaging analysis with deterministic tractography based on quantitative anisotropy. Results demonstrated that neurogenic orthostatic hypotension was associated with lower bilateral fourth-quarter volume (OR = 0.19) and left fourth-quarter volume (OR = 0.13) of the tract. Additionally, lower surface area and total volume on the left side were observed. Participants with impaired cognition showed lower bilateral fourth-quarter volume (OR = 0.33). These associations remained consistent even after adjusting for additional factors such as high blood pressure and disease duration. The findings suggest a mechanistic relationship between tract volume and cognitive impairment in Lewy body disease.