The locus coeruleus gap: a novel marker of neurodegenerative resilience

Abstract

This study mapped whole-brain connectivity of the locus coeruleus (LC) across aging and the Alzheimer’s disease (AD) continuum and introduced a novel imaging marker called the LC gap, which quantifies deviations in LC connectivity patterns. Among several LC gap measures, left-right asymmetry was the most informative: in cognitively normal individuals at high risk for AD, a lower LC gap was associated with slower tau accumulation in the entorhinal cortex and predicted less cognitive decline. These findings suggest that the LC gap, and in particular its asymmetry component, might serve as a resilience marker against AD-related neurodegeneration.