{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:36:26Z","timestamp":1792758986618,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p>Degeneration of cortical cholinergic projections from the nucleus basalis of Meynert (NBM) is characteristic of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), whereas involvement of cholinergic projections from the pedunculopontine nucleus (PPN) to the thalamus is less clear.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We studied both cholinergic projection systems using a free water\u2010corrected diffusion tensor imaging (DTI) model in the following cases: 46 AD, 48 DLB, 35 mild cognitive impairment (MCI) with AD, 38 MCI with Lewy bodies, and 71 controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Free water in the NBM\u2010cortical pathway was increased in both dementia and MCI groups compared to controls and associated with cognition. Free water along the PPN\u2010thalamus tract was increased only in DLB and related to visual hallucinations. Results were largely replicated in an independent cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>While NBM\u2010cortical projections degenerate early in AD and DLB, the thalamic cholinergic input from the PPN appears to be more selectively affected in DLB and might associate with visual hallucinations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Free water in the NBM\u2010cortical cholinergic pathways is increased in AD and DLB.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>NBM\u2010cortical pathway integrity is related to overall cognitive performance.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Free water in the PPN\u2010thalamus cholinergic pathway is only increased in DLB, not AD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>PPN\u2010thalamus pathway integrity might be related to visual hallucinations in DLB.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.13034","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T04:14:39Z","timestamp":1678853679000},"page":"4549-4563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Free water imaging of the cholinergic system in dementia with Lewy bodies and Alzheimer's disease"],"prefix":"10.1002","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7323-4789","authenticated-orcid":false,"given":"Julia","family":"Schumacher","sequence":"first","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL   UK"},{"name":"Department of Neurology University Medical Center Rostock  Rostock Germany"},{"name":"German Center for Neurodegenerative Diseases (DZNE) Rostock\u2010Greifswald  Rostock Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Ray","sequence":"additional","affiliation":[{"name":"Health, Psychology and Communities Research Centre, Department of Psychology Manchester Metropolitan University  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calum A.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University Campus for Ageing and Vitality, Newcastle upon Tyne, Nebraska4 5PL   UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Bergamino","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute Neuroimaging Research  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Donaghy","sequence":"additional","affiliation":[{"name":"Translational and 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