Winder K, Linker RA, Seifert F, et al. - Via voxel-based lesion-symptom mapping (VLSM), researchers assessed correlations between cardiovascular autonomic dysfunction and cerebral multiple sclerosis (MS)-related lesion sites in 74 individuals with MS. The VLSM-analysis exhibited relationships between greater RR-interval low-frequency/high-frequency ratios and lesions mostly in the left insular, hippocampal, and right frontal inferior opercular region and a smaller lesion cluster in the right middle cerebellar peduncle. Elevated blood pressure-low-frequency powers were correlated with lesions mainly in the right posterior parietal white matter and again left the insular region. In conclusion, a relationship between a shift of cardiovascular sympathetic-parasympathetic balance toward heightened sympathetic modulation and lesions in the left insular region and hippocampus areas of the central autonomic network. The VLSM-analysis additionally differentiated between right inferior fronto-opercular lesions disinhibiting cardiac sympathetic activation and right posterior parietal lesions raising sympathetic blood pressure modulation.