Diffusion tensor imaging of normal white matter maturation from late childhood to young adulthood: Voxel-wise evaluation of mean diffusivity, fractional anisotropy, radial and axial diffusivities, and correlation with reading development

Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils

There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.

Atypical White Matter Connectivity in Dyslexic Readers of a Fairly Transparent Orthography

Atypical structural properties of the brain's white matter bundles have been associated with failing reading acquisition in developmental dyslexia. Because these white matter properties may show dynamic changes with age and orthographic depth, we examined fractional anisotropy (FA) along 16 white matter tracts in 8- to 11-year-old dyslexic (DR) and typically reading (TR) children learning to read in a fairly transparent orthography (Dutch). Our results showed higher FA values in the bilateral anterior thalamic radiations of DRs and FA values of the left thalamic radiation scaled with behavioral reading-related scores. Furthermore, DRs tended to have atypical FA values in the bilateral arcuate fasciculi. Children's age additionally predicted FA values along the tracts. Together, our findings suggest differential contributions of cortical and thalamo-cortical pathways to the developing reading network in dyslexic and typical readers, possibly indicating prolonged letter-by-letter reading or increased attentional and/or working memory demands in dyslexic children during reading.

Radial diffusivity as an imaging biomarker for early diagnosis of non-demented amyotrophic lateral sclerosis

OBJECTIVES

To explore the sensitivity of potential DTI-based biomarkers in detecting microstructural changes for whole-brain white matter in early stage amyotrophic lateral sclerosis (ALS), analyze the relationship between the DTI indices and disease status, and further clarify potential brain regions for disease monitoring and clinical assessment.

METHODS

Thirty-three non-demented ALS patients and 32 age- and gender-matched subjects participated in this study. DTI data were acquired via 3.0T MRI scanner. Maps of diffusion-related indices including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were obtained. Tract-based spatial statistics (TBSS) were used to investigate whole-brain white matter changes of each index. Correlation analyses between both brain-wide and volume-of-interest (VOI)-wide white matter alterations and clinical factors including ALSFRS-R scores, disease duration, and progression rate were performed.

RESULTS

Compared to healthy subjects, ALS patients showed significantly increased RD, MD and reduced FA, mainly along the corticospinal tract (CST) and the body of corpus callosum (CC). Increases in RD were broader than decreases in FA, in CST of both hemispheres. Meanwhile, involvement of several extra-motor regions was also revealed by RD. Significant positive correlation between ALSFRS-R scores and FA, negative correlation between ALSFRS-R and RD were found in left CST.

CONCLUSIONS

RD may be the most sensitive biomarker for the detection of early demyelination of white matter. Both RD and FA may serve as objective biomarkers for disease severity assessment. CST may be the most affected brain region in non-demented ALS.

KEY POINTS

• Changes in RD were broader than those in FA in bilateral CST. • Involvement of extra-motor regions was uncovered by RD. • FA and RD in CST were related to ALSFRS-R scores.

Comprehensive Investigation of White Matter Tracts in Professional Chess Players and Relation to Expertise: Region of Interest and DMRI Connectometry

Purpose: Expertise is the product of training. Few studies have used functional connectivity or conventional diffusometric methods to identify neural underpinnings of chess expertise. Diffusometric variables of white matter might reflect these adaptive changes, along with changes in structural connectivity, which is a sensitive measure of microstructural changes.

Method: Diffusometric variables of 29 professional chess players and 29 age-sex matched controls were extracted for white matter regions based on John Hopkin's Mori white matter atlas and partially correlated against professional training time and level of chess proficiency. Diffusion MRI connectometry was implemented to identify changes in structural connectivity in professional players compared to novices.

Result: Compared to novices, higher planar anisotropy (CP) was observed in inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF) and cingulate gyrus, in professional chess players, which correlated with higher RPM score in this group. Higher fractional anisotropy (FA) was observed in ILF, uncinate fasciculus (UF) and hippocampus and correlated with better scores in Raven's progressive matrices (RPM) score and longer duration of chess training in professional players. Consistently, radial diffusivity in bilateral IFOF, bilateral ILF and bilateral SLF was inversely correlated with level of training in professional players. DMRI connectometry analysis identified increased connectivity in bilateral UF, bilateral IFOF, bilateral cingulum, and corpus callosum in chess player's compared to controls.

Conclusion: Structural connectivity of major associational subcortical white matter fibers are increased in professional chess players. FA and CP of ILF, SLF and UF directly correlates with duration of professional training and RPM score, in professional chess players.

Differences in brain morphology and working memory capacity across childhood

Working memory (WM) skills are closely associated with learning progress in key areas such as reading and mathematics across childhood. As yet, however, little is known about how the brain systems underpinning WM develop over this critical developmental period. The current study investigated whether and how structural brain correlates of components of the working memory system change over development. Verbal and visuospatial short-term and working memory were assessed in 153 children between 5.58 and 15.92 years, and latent components of the working memory system were derived. Fractional anisotropy and cortical thickness maps were derived from T1-weighted and diffusion-weighted MRI and processed using eigenanatomy decomposition. There was a greater involvement of the corpus callosum and posterior temporal white matter in younger children for performance associated with the executive part of the working memory system. For older children, this was more closely linked with the thickness of the occipitotemporal cortex. These findings suggest that increasing specialization leads to shifts in the contribution of neural substrates over childhood, moving from an early dependence on a distributed system supported by long-range connections to later reliance on specialized local circuitry. Our findings demonstrate that despite the component factor structure being stable across childhood, the underlying brain systems supporting working memory change. Taking the age of the child into account, and not just their overall score, is likely to be critical for understanding the nature of the limitations on their working memory capacity.

White matter alterations in the internal capsule and psychomotor impairment in melancholic depression

Emerging evidence suggests that structural brain abnormalities may play a role in the pathophysiology of melancholic depression. We set out to test whether diffusion-derived estimates of white matter structure were disrupted in melancholia in regions underpinning psychomotor function. We hypothesized that those with melancholia (and evidencing impaired psychomotor function) would show disrupted white matter organization in internal capsule subdivisions. Diffusion magnetic resonance imaging (dMRI) data were acquired from 22 melancholic depressed, 23 non-melancholic depressed, and 29 healthy control participants. Voxel-wise fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) values were derived for anterior, posterior, and retrolenticular limbs of the internal capsule and compared between groups. Neuropsychological (reaction time) and psychomotor functioning were assessed and correlated against FA. Fractional anisotropy was distinctly increased, whilst RD was decreased, in the right anterior internal capsule in those with melancholia, compared to controls. The right anterior limb of the internal capsule correlated with clinical ratings of psychomotor disturbance, and reduced psychomotor speed was associated with increased FA values in the right retrolenticular limb in those with melancholia. Our findings highlight a distinct disturbance in the local white matter arrangement in specific regions of the internal capsule in melancholia, which in turn is associated with psychomotor dysfunction. This study clarifies the contribution of structural brain integrity to the phenomenology of melancholia, and may assist future efforts seeking to integrate neurobiological markers into depression subtyping.

Alterations in white matter pathways underlying phonological and morphological processing in Chinese developmental dyslexia

Chinese is a logographic language that is different from alphabetic languages in visual and semantic complexity. Thus far, it is still unclear whether Chinese children with dyslexia show similar disruption of white matter pathways as in alphabetic languages. The present study focused on the alteration of white matter pathways in Chinese children with dyslexia. Using diffusion tensor imaging tractography, the bilateral arcuate fasciculus (AF-anterior, AF-posterior and AF-direct segments), inferior fronto-occipital fasciculus (IFOF) and inferior longitudinal fasciculus (ILF) were delineated in each individual’s native space. Compared with age-matched controls, Chinese children with dyslexia showed reduced fractional anisotropy in the left AF-direct and the left ILF. Further regression analyses revealed a functional dissociation between the left AF-direct and the left ILF. The AF-direct tract integrity was associated with phonological processing skill, an ability important for reading in all writing systems, while the ILF integrity was associated with morphological processing skill, an ability more strongly recruited for Chinese reading. In conclusion, the double disruption locus in Chinese children with dyslexia, and the functional dissociation between dorsal and ventral pathways reflect both universal and specific properties of reading in Chinese.

Hippocampal Subfields Volume Reduction in High Schoolers with Previous Verbal Abuse Experiences

Objective

Reduced hippocampal volume and alterations in white matter tracts have been frequently reported in adults having the history of emotional maltreatment. We investigated whether these structural change occur in adolescents with previous verbal abuse (VA) experiences.

Methods

Hippocampal subfield volume and white matter structural connectivity measures were assessed in 31 first year male high school students with various degrees of exposure to parental and peer VA.

Results

The high VA group showed significant volume reduction in the left cornu ammonis (CA) 1 and left subiculum compared to the low VA group (p＜0.05). Volumes of left hippocampal subfields CA1 and subiculum were negatively correlated with previous VA experiences (p＜0.05). Increased mean diffusivity (MD) of the splenium of the corpus callosum was related to high VA score across all subjects (p＜0.05). There was an inverse relationship between volume of the CA1 and subiculum and MD of the splenium (p＜0.05).

Conclusion

Exposure to parental and peer VA may affect development of the left hippocampal subfields and the splenium of corpus callosum. These structural alterations can be discernible during adolescence.

Brain structural connectivity during adrenarche: Associations between hormone levels and white matter microstructure

Levels of the adrenal hormones dehydroepiandrosterone (DHEA), its sulfate (DHEAS), and testosterone, have all been linked to behavior and mental health during adrenarche, and preclinical studies suggest that these hormones influence brain development. However, little is known about how variation in these hormones is associated with white matter structure during this period of life. The current study aimed to examine associations between DHEA, DHEAS, and testosterone, and white matter microstructure during adrenarche. To avoid the confounding effect of age on hormone levels, we tested these associations in 87 children within a narrow age range (mean age 9.56 years, SD=0.34) but varying in hormone levels. All children provided saliva samples directly after waking and completed a diffusion-weighted MRI scan. Higher levels of DHEA were associated with higher mean diffusivity (MD) in a widespread cluster of white matter tracts, which was partially explained by higher radial diffusivity (RD) and partially by higher axial diffusivity (AD). In addition, there was an interaction between DHEA and testosterone, with higher levels of testosterone being associated with higher fractional anisotropy (FA) and lower MD and RD when DHEA levels were relatively high, but with lower FA and higher MD and RD when DHEA levels were low. These findings suggest that relatively early exposure to DHEA, as well as an imbalance between the adrenal hormones, may be associated with alterations in white matter microstructure. These findings highlight the potential relevance of adrenarcheal hormones for structural brain development.

Brain white matter structure and language ability in preschool-aged children

Brain alterations are associated with reading and language difficulties in older children, but little research has investigated relationships between early language skills and brain white matter structure during the preschool period. We studied 68 children aged 3.0-5.6 years who underwent diffusion tensor imaging and participated in assessments of Phonological Processing and Speeded Naming. Tract-based spatial statistics and tractography revealed relationships between Phonological Processing and diffusion parameters in bilateral ventral white matter pathways and the corpus callosum. Phonological Processing was positively correlated with fractional anisotropy and negatively correlated with mean diffusivity. The relationships observed in left ventral pathways are consistent with studies in older children, and demonstrate that structural markers for language performance are apparent as young as 3 years of age. Our findings in right hemisphere areas that are not as commonly found in adult studies suggest that young children rely on a widespread network for language processing that becomes more specialized with age.

Diffusion MRI of white matter microstructure development in childhood and adolescence: Methods, challenges and progress

Diffusion magnetic resonance imaging (dMRI) continues to grow in popularity as a useful neuroimaging method to study brain development, and longitudinal studies that track the same individuals over time are emerging. Over the last decade, seminal work using dMRI has provided new insights into the development of brain white matter (WM) microstructure, connections and networks throughout childhood and adolescence. This review provides an introduction to dMRI, both diffusion tensor imaging (DTI) and other dMRI models, as well as common acquisition and analysis approaches. We highlight the difficulties associated with ascribing these imaging measurements and their changes over time to specific underlying cellular and molecular events. We also discuss selected methodological challenges that are of particular relevance for studies of development, including critical choices related to image acquisition, image analysis, quality control assessment, and the within-subject and longitudinal reliability of dMRI measurements. Next, we review the exciting progress in the characterization and understanding of brain development that has resulted from dMRI studies in childhood and adolescence, including brief overviews and discussions of studies focusing on sex and individual differences. Finally, we outline future directions that will be beneficial to the field.

Fornix microalterations associated with early trauma in panic disorder

BACKGROUND

It is well accepted that panic disorder (PD) is associated with early trauma, and that the limbic systems are one of the main structures involved in PD pathophysiology. However, previous studies have not addressed the relationship between early trauma and major limbic white-matter (WM) structures in PD.

METHODS

Participants enrolled in the study consisted of 53 right-handed patients with PD and 21 healthy controls (HC). The Early Trauma Inventory Self Report-Short Form (ETISR-SF), Anxiety Sensitivity Inventory-Revised (ASI-R), and the Albany Panic and Phobia Questionnaire (APPQ) were applied in the study. Tract-based spatial statistics were used for diffusion tensor magnetic resonance imaging analysis.

RESULTS

Among the patients with PD, the fractional anisotropy (FA) values of the fornix body in major limbic WM regions showed significant negative correlation with the ETISR-SF total score, while the scores of mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in the same region of fornix had significant positive correlation with those scores (p<0.05; FWE corrected). Further significant correlation was observed between these four scores and the measures of symptom severity in PD, such as that in ASI-R and APPQ in the same region.

LIMITATIONS

Recall bias is possible in evaluating early trauma in the participants.

CONCLUSIONS

The current study suggests a significant association of early trauma with the fornix body possibly through axons and myelin disruptions within major limbic structures in PD. A multi-centered large sample will be needed to confirm these findings.

Microstructural Changes of the Human Brain from Early to Mid-Adulthood

Despite numerous studies on the microstructural changes of the human brain throughout life, we have indeed little direct knowledge about the changes from early to mid-adulthood. The aim of this study was to investigate the microstructural changes of the human brain from early to mid-adulthood. We performed two sets of analyses based on the diffusion tensor imaging (DTI) data of 111 adults aged 18–55 years. Specifically, we first correlated age with skeletonized fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) at global and regional level, and then estimated individuals’ ages based on each DTI metric using elastic net, a kind of multivariate pattern analysis (MVPA) method that aims at selecting the model that achieves the best trade-off between goodness of fit and model complexity. We observed statistically significant negative age-vs-FA correlations and relatively less changes of MD. The negative age-vs-FA correlations were associated with negative age-vs-AD and positive age-vs-RD correlations. Regional negative age-vs-FA correlations were observed in the bilateral genu of the corpus callosum (CCg), the corticospinal tract (CST), the fornix and several other tracts, and these negative correlations may indicate the earlier changes of the fibers with aging. In brain age estimation, the chronological-vs-estimated-age correlations based on FA, MD, AD and RD were R = 0.62, 0.44, 0.63 and 0.69 (P = 0.002, 0.008, 0.002 and 0.002 based on 500 permutations), respectively, and these results indicate that even the microstructural changes from early to mid-adulthood alone are sufficiently specific to decode individuals’ ages. Overall, the current results not only demonstrated statistically significant FA decreases from early to mid-adulthood and clarified the driving factors of the FA decreases (RD increases and AD decreases, in contrast to increases of both measures in late-adulthood), but highlighted the necessity of considering age effects in related studies.

Detailing neuroanatomical development in late childhood and early adolescence using NODDI

Diffusion tensor imaging (DTI) studies have provided much evidence of white and subcortical gray matter changes during late childhood and early adolescence that suggest increasing myelination, axon density, and/or fiber coherence. Neurite orientation dispersion and density imaging (NODDI) can be used to further characterize development in white and subcortical grey matter regions in the brain by improving specificity of the MRI signal compared to conventional DTI. We used measures from NODDI and DTI to examine white and subcortical gray matter development in a group of 27 healthy participants aged 8–13 years. Neurite density index (NDI) was strongly correlated with age in nearly all regions, and was more strongly associated with age than fractional anisotropy (FA). No significant correlations were observed between orientation dispersion index (ODI) and age. This suggests that white matter and subcortical gray matter changes during late childhood and adolescence are dominated by changes in neurite density (i.e., axon density and myelination), rather than increasing coherence of axons. Within brain regions, FA was correlated with both ODI and NDI while mean diffusivity was only related to neurite density, providing further information about the structural variation across individuals. Data-driven clustering of the NODDI parameters showed that microstructural profiles varied along layers of white matter, but that that much of the white and subcortical gray matter matured in a similar manner. Clustering highlighted isolated brain regions with decreasing NDI values that were not apparent in region-of-interest analysis. Overall, these results help to more specifically understand patterns of white and gray matter development during late childhood and early adolescence.

Neuroanatomy of developmental dyslexia: Pitfalls and promise

Investigations into the neuroanatomical bases of developmental dyslexia have now spanned more than 40 years, starting with the post-mortem examination of a few individual brains in the 60s and 70s, and exploding in the 90s with the widespread use of MRI. The time is now ripe to reappraise the considerable amount of data gathered with MRI using different types of sequences (T1, diffusion, spectroscopy) and analysed using different methods (manual, voxel-based or surface-based morphometry, fractional anisotropy and tractography, multivariate analyses…). While selective reviews of mostly small-scale studies seem to provide a coherent view of the brain disruptions that are typical of dyslexia, involving left perisylvian and occipito-temporal regions, we argue that this view may be deceptive and that meta-analyses and large-scale studies rather highlight many inconsistencies and limitations. We discuss problems inherent to small sample size as well as methodological difficulties that still undermine the discovery of reliable neuroanatomical bases of dyslexia, and we outline some recommendations to further improve this research area.

Different relationship of magnocellular-dorsal function and reading-related skills between Chinese developing and skilled readers

Previous studies have indicated that the relationship between magnocellular-dorsal (M-D) function and reading-related skills may vary with reading development in readers of alphabetic languages. Since this relationship could be affected by the orthographic depth of writing systems, the present study explored the relationship between M-D function and reading-related skills in Chinese, a writing system with a deeper orthography than alphabetic languages. Thirty-seven primary school students and fifty-one undergraduate students participated. Orthographic and phonological awareness tests were adopted as reading-related skill measurements. A steady-pedestal paradigm was used to assess the low-spatial-frequency contrast thresholds of M-D function. Results showed that M-D function was only correlated with orthographic awareness for adults, revealing an enhancement with reading development; while being related to phonological awareness only for children revealing a developmental decrement. It suggested that the mechanism responsible for the relationship between M-D activity and reading-related skills was affected by the characteristics of literacy development in Chinese.

Brain structure and verbal function across adulthood while controlling for cerebrovascular risks

The development and decline of brain structure and function throughout adulthood is a complex issue, with cognitive aging trajectories influenced by a host of factors including cerebrovascular risk. Neuroimaging studies of age-related cognitive decline typically reveal a linear decrease in gray matter (GM) volume/density in frontal regions across adulthood. However, white matter (WM) tracts mature later than GM, particularly in regions necessary for executive functions and memory. Therefore, it was predicted that a middle-aged group (MC: 35-45 years) would perform best on a verbal working memory task and reveal greater regional WM integrity, compared with both young (YC: 18-25 years) and elder groups (EC: 60+ years). Diffusion tensor imaging (DTI) and magnetoencephalography (MEG) were obtained from 80 healthy participants. Objective measures of cerebrovascular risk and cognition were also obtained. As predicted, MC revealed best verbal working memory accuracy overall indicating some maturation of brain function between YC and MC. However, contrary to the prediction fractional anisotropy values (FA), a measure of WM integrity, were not greater in MC (i.e., there were no significant differences in FA between YC and MC but both groups showed greater FA than EC). An overall multivariate model for MEG ROIs showed greater peak amplitudes for MC and YC, compared with EC. Subclinical cerebrovascular risk factors (systolic blood pressure and blood glucose) were negatively associated with FA in frontal callosal, limbic, and thalamic radiation regions which correlated with executive dysfunction and slower processing speed, suggesting their contribution to age-related cognitive decline. Hum Brain Mapp 38:3472-3490, 2017. © 2017 Wiley Periodicals, Inc.

Maternal hypothyroxinaemia in early pregnancy and problem behavior in 5-year-old offspring

INTRODUCTION

There is evidence, though not consistent, that offspring born to mothers with subtle decreases in thyroid function early in their pregnancies may be at risk of cognitive impairments and attention problems. However, other types of problem behavior have not been addressed thus far. We tested whether maternal thyroid function in early pregnancy is associated with several types of problem behavior in offspring at age 5-6 years.

METHODS

This was a longitudinal study that included the data of 2000 mother-child pairs from the Amsterdam Born Children and their Development study. At a median gestational age of 12.9 (interquartile range: 11.9-14.1) weeks, maternal blood was sampled for assessment of free T4 and TSH. Overall problem behavior, hyperactivity/inattention, conduct problems, emotional problems, peer relationship problems and prosocial behavior were measured at age 5-6 years using the Strengths and Difficulties Questionnaire, which was filled out by both parents and teachers.

RESULTS

Maternal hypothyroxinaemia <5th percentile was associated with a 1.70 (95% confidence interval (CI): 1.01-2.86) increased odds of teacher-reported hyperactivity/inattention after adjustment for confounders. By increasing the cut-off level to <10th percentile, the odds ratio became 1.47 (95% CI: 0.99-2.20). There were no associations between maternal thyroid function parameters and hyperactivity/inattention as reported by parents, nor with teacher or parent reports of other types of problem behavior.

CONCLUSIONS

Our results partially confirm previous observations, showing that early disruptions in the maternal thyroid hormone supply may be associated with ADHD symptoms in offspring. Our study adds that there is no evidence for an effect on other types of problem behavior.

Combined Diffusion Tensor and Magnetic Resonance Spectroscopic Imaging Methodology for Automated Regional Brain Analysis: Application in a Normal Pediatric Population

During human brain development, anatomic regions mature at different rates. Quantitative anatomy-specific analysis of longitudinal diffusion tensor imaging (DTI) and magnetic resonance spectroscopic imaging (MRSI) data may improve our ability to quantify and categorize these maturational changes. Computational tools designed to quickly fuse and analyze imaging information from multiple, technically different datasets would facilitate research on changes during normal brain maturation and for comparison to disease states. In the current study, we developed a complete battery of computational tools to execute such data analyses that include data preprocessing, tract-based statistical analysis from DTI data, automated brain anatomy parsing from T1-weighted MR images, assignment of metabolite information from MRSI data, and co-alignment of these multimodality data streams for reporting of region-specific indices. We present statistical analyses of regional DTI and MRSI data in a cohort of normal pediatric subjects (n = 72; age range: 5-18 years; mean 12.7 ± 3.3 years) to establish normative data and evaluate maturational trends. Several regions showed significant maturational changes for several DTI parameters and MRSI ratios, but the percent change over the age range tended to be small. In the subcortical region (combined basal ganglia [BG], thalami [TH], and corpus callosum [CC]), the largest combined percent change was a 10% increase in fractional anisotropy (FA) primarily due to increases in the BG (12.7%) and TH (9%). The largest significant percent increase in N-acetylaspartate (NAA)/creatine (Cr) ratio was seen in the brain stem (BS) (18.8%) followed by the subcortical regions in the BG (11.9%), CC (8.9%), and TH (6.0%). We found consistent, significant (p < 0.01), but weakly positive correlations (r = 0.228-0.329) between NAA/Cr ratios and mean FA in the BS, BG, and CC regions. Age- and region-specific normative MR diffusion and spectroscopic metabolite ranges show brain maturation changes and are requisite for detecting abnormalities in an injured or diseased population.

Age-related changes of white matter association tracts in normal children throughout adulthood: a diffusion tensor tractography study

PURPOSE

The aim of this study is to study the age, gender and lateral asymmetry-related white matter changes of long association tracts throughout late childhood and adolescence into adulthood using diffusion tensor tractography (DTT).

METHODS

DTT was performed in 44 healthy subjects aged 7-45 years. Fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), Trace, density and volume were calculated for long association tracts, namely the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), uncinate fasciculus, superior longitudinal fasciculus (SLF) and its arcuate fibres. FA and diffusivity indices were correlated as function of age using Pearson correlation test. Comparison between males and females, and comparison between both hemispheres among all participants were also performed. A p value less than .01 was considered significant.

RESULTS

The majority of the examined tracts (SLF and IFOF of both hemispheres, and the arcuate fasciculus, uncinate fasciculus, and ILF of the left hemisphere) followed a common pattern of metric changes with age. This pattern was characterized by significant FA increase accompanied by reduction in RD, Trace without significant AD changes. The right arcuate fasciculus showed similar pattern but without significant FA changes. The right uncinate and right ILF fasciculus demonstrated significant reduction in RD, Trace and AD, with and without significant FA increase, respectively. Left hemispheric dominance regarding the FA and diffusivity indices was demonstrated in uncinate fasciculus with no significant gender-related differences.

CONCLUSION

Significant microstructural tract-specific maturation processes continue throughout late childhood into adulthood. These processes may represent stages in a cascade of age-related maturation in white matter microstructure.

Posterior-Anterior Brain Maturation Reflected in Perceptual, Motor and Cognitive Performance

Based on several postmortem morphometric and in vivo imaging studies it has been postulated that brain maturation roughly follows a caudal to rostral direction. In this study, we linked this maturational pattern to psychological function employing a series of well-established behavioral tasks. We addressed three distinct functions and brain regions with a perceptual (contour integration, CI), motor (finger tapping, FT), and executive control (Navon global–local) task. Our purpose was to investigate basic visual integration functions relying on primary visual cortex (V1) in CI; motor coordination function related to primary motor cortex (M1) in FT, and the executive control component, switching, related to the dorsolateral prefrontal region of the brain in the Navon task. 122 volunteer subjects were recruited to participate in this study between the ages of 10 and 20 (females n = 63, males n = 59). Employing conventional statistical methods, we found that 10 and 12 year olds are performing significantly weaker than 20 year olds in all three tasks. In the CI and Navon global–local tasks, even 14 years old perform poorer than adults. We have also investigated the developmental trajectories by fitting sigmoid curves on our data streams. The analysis of the developmental trajectories of the three tasks showed a posterior to anterior pattern in the emergence of the developmental functions with the earliest development in the visual CI task (V1), followed by motor development in the FT task (M1), and cognitive development as measured in the Navon global–local task (DLPC) being the slowest. Gender difference was also present in FT task showing an earlier maturation for girls in the motor domain.

Hemispheric Differences in White Matter Microstructure between Two Profiles of Children with High Intelligence Quotient vs. Controls: A Tract-Based Spatial Statistics Study

Objectives: The main goal of this study was to investigate and compare the neural substrate of two children's profiles of high intelligence quotient (HIQ). Methods: Two groups of HIQ children were included with either a homogeneous (Hom-HIQ: n = 20) or a heterogeneous IQ profile (Het-HIQ: n = 24) as defined by a significant difference between verbal comprehension index and perceptual reasoning index. Diffusion tensor imaging was used to assess white matter (WM) microstructure while tract-based spatial statistics (TBSS) analysis was performed to detect and localize WM regional differences in fractional anisotropy (FA), mean diffusivity, axial (AD), and radial diffusivities. Quantitative measurements were performed on 48 regions and 21 fiber-bundles of WM. Results: Hom-HIQ children presented higher FA than Het-HIQ children in widespread WM regions including central structures, and associative intra-hemispheric WM fasciculi. AD was also greater in numerous WM regions of Total-HIQ, Hom-HIQ, and Het-HIQ groups when compared to the Control group. Hom-HIQ and Het-HIQ groups also differed by their hemispheric lateralization in AD differences compared to Controls. Het-HIQ and Hom-HIQ groups showed a lateralization ratio (left/right) of 1.38 and 0.78, respectively. Conclusions: These findings suggest that both inter- and intra-hemispheric WM integrity are enhanced in HIQ children and that neural substrate differs between Hom-HIQ and Het-HIQ. The left hemispheric lateralization of Het-HIQ children is concordant with their higher verbal index while the relative right hemispheric lateralization of Hom-HIQ children is concordant with their global brain processing and adaptation capacities as evidenced by their homogeneous IQ.

Correlation between white matter damage and gray matter lesions in multiple sclerosis patients

We observed the characteristics of white matter fibers and gray matter in multiple sclerosis patients, to identify changes in diffusion tensor imaging fractional anisotropy values following white matter fiber injury. We analyzed the correlation between fractional anisotropy values and changes in whole-brain gray matter volume. The participants included 20 patients with relapsing-remitting multiple sclerosis and 20 healthy volunteers as controls. All subjects underwent head magnetic resonance imaging and diffusion tensor imaging. Our results revealed that fractional anisotropy values decreased and gray matter volumes were reduced in the genu and splenium of corpus callosum, left anterior thalamic radiation, hippocampus, uncinate fasciculus, right corticospinal tract, bilateral cingulate gyri, and inferior longitudinal fasciculus in multiple sclerosis patients. Gray matter volumes were significantly different between the two groups in the right frontal lobe (superior frontal, middle frontal, precentral, and orbital gyri), right parietal lobe (postcentral and inferior parietal gyri), right temporal lobe (caudate nucleus), right occipital lobe (middle occipital gyrus), right insula, right parahippocampal gyrus, and left cingulate gyrus. The voxel sizes of atrophic gray matter positively correlated with fractional anisotropy values in white matter association fibers in the patient group. These findings suggest that white matter fiber bundles are extensively injured in multiple sclerosis patients. The main areas of gray matter atrophy in multiple sclerosis are the frontal lobe, parietal lobe, caudate nucleus, parahippocampal gyrus, and cingulate gyrus. Gray matter atrophy is strongly associated with white matter injury in multiple sclerosis patients, particularly with injury to association fibers.

White matter properties differ in 6-year old Readers and Pre-readers

Reading, an essential life skill in modern society, is typically learned during childhood. Adults who can read show white matter differences compared to adults who never learned to read. Studies have not established whether children who can read show similar white matter differences compared to children who cannot read. We compared 6-year old children who could decode written English words and pseudowords (n = 31; Readers) and 6-year old children who could not decode pseudowords and had a standard score <100 on a task for reading single words (n = 11; Pre-readers). We employed diffusion MRI and tractography to extract fractional anisotropy (FA) along the trajectory of six bilateral intra-hemispheric tracts and two posterior subdivisions of the corpus callosum. Readers demonstrated significantly increased FA within the left anterior segment of the superior longitudinal fasciculus (aSLF-L) and the right uncinate fasciculus (UF-R) compared to Pre-readers. FA in the aSLF-L was significantly correlated with phonological awareness; FA in the UF-R was significantly correlated with language. Correlations in the UF-R but not the aSLF-L remained significant after controlling for reading ability, revealing that UF-R group differences were related to both children's language and reading abilities. Taken together, these findings demonstrate new evidence showing that individual differences in white matter structure relate to whether children have begun to read.

Multimodal MRI reveals structural connectivity differences in 22q11 deletion syndrome related to impaired spatial working memory

INTRODUCTION

Impaired spatial working memory is a core cognitive deficit observed in people with 22q11 Deletion syndrome (22q11DS) and has been suggested as a candidate endophenotype for schizophrenia. However, to date, the neuroanatomical mechanisms describing its structural and functional underpinnings in 22q11DS remain unclear. We quantitatively investigate the cognitive processes and associated neuroanatomy of spatial working memory in people with 22q11DS compared to matched controls. We examine whether there are significant between-group differences in spatial working memory using task related fMRI, Voxel based morphometry and white matter fiber tractography.

MATERIALS AND METHODS

Multimodal magnetic resonance imaging employing functional, diffusion and volumetric techniques were used to quantitatively assess the cognitive and neuroanatomical features of spatial working memory processes in 22q11DS. Twenty-six participants with genetically confirmed 22q11DS aged between 9 and 52 years and 26 controls aged between 8 and 46 years, matched for age, gender, and handedness were recruited.

RESULTS

People with 22q11DS have significant differences in spatial working memory functioning accompanied by a gray matter volume reduction in the right precuneus. Gray matter volume was significantly correlated with task performance scores in these areas. Tractography revealed extensive differences along fibers between task-related cortical activations with pronounced differences localized to interhemispheric commissural fibers within the parietal section of the corpus callosum.

CONCLUSIONS

Abnormal spatial working memory in 22q11DS is associated with aberrant functional activity in conjunction with gray and white matter structural abnormalities. These anomalies in discrete brain regions may increase susceptibility to the development of psychiatric disorders such as schizophrenia. Hum Brain Mapp 37:4689-4705, 2016. © 2016 Wiley Periodicals, Inc.

Cortical hyper-excitability in healthy children: evidence from habituation and recovery cycle phenomena of somatosensory evoked potentials

AIM

To compare neurophysiological parameters of central nervous system excitability in healthy children/adolescents with those of healthy adults.

METHOD

Two experimental protocols were used in 19 healthy children/adolescents (10 males and 9 females, mean age 9y 11mo [SD 2y 9mo], range 5-15y) and 19 healthy adults (8 males and 11 females, mean age 36y 6mo [SD 7y 9mo], range 27-51y). First, we administered repetitive trains of innocuous electrical stimulation of the median nerve and analysed habituation (progressive attenuation) of the cervical and cortical responses. Second, we administered several blocks of two closely timed electrical innocuous stimuli of the median nerve (with interstimulus intervals set at 5, 10, and 20ms in each block) and analysed the recovery index (the percentage of the response to the second stimulus with respect to that to the first).

RESULTS

Clear-cut neurophysiological signs of cortical hyper-excitability were found in children/adolescents but not in adults. In contrast with the adults, the children/adolescents did not attenuate cortical responses to repetitive stimulation, and presented with extremely shortened recovery cycle. At baseline, both groups presented with comparable cortical responses.

INTERPRETATION

Healthy children/adolescents present cortical hyper-excitability compared with healthy adults. These findings agree with previous findings that show an overall imbalance of excitatory and inhibitory neuronal and neurochemical mechanisms in favour of excitatory ones, in the healthy developing cerebral cortex.

Diffusion tensor imaging in children with tuberous sclerosis complex: tract-based spatial statistics assessment of brain microstructural changes

BACKGROUND

There is evidence of microstructural changes in normal-appearing white matter of patients with tuberous sclerosis complex.

OBJECTIVE

To evaluate major white matter tracts in children with tuberous sclerosis complex using tract-based spatial statistics diffusion tensor imaging (DTI) analysis.

MATERIALS AND METHODS

Eight children (mean age ± standard deviation: 8.5 ± 5.5 years) with an established diagnosis of tuberous sclerosis complex and 8 age-matched controls were studied. The imaging protocol consisted of T1-weighted high-resolution 3-D spoiled gradient-echo sequence and a spin-echo, echo-planar diffusion-weighted sequence. Differences in the diffusion indices were evaluated using tract-based spatial statistics.

RESULTS

Tract-based spatial statistics showed increased axial diffusivity in the children with tuberous sclerosis complex in the superior and anterior corona radiata, the superior longitudinal fascicle, the inferior fronto-occipital fascicle, the uncinate fascicle and the anterior thalamic radiation. No significant differences were observed in fractional anisotropy, mean diffusivity and radial diffusivity between patients and control subjects. No difference was found in the diffusion indices between the baseline and follow-up examination in the patient group.

CONCLUSION

Patients with tuberous sclerosis complex have increased axial diffusivity in major white matter tracts, probably related to reduced axonal integrity.

Altered Gray Matter Volume and White Matter Integrity in College Students with Mobile Phone Dependence

Mobile phone dependence (MPD) is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI). Gray matter volume (GMV) and white matter (WM) integrity [four indices: fractional anisotropy (FA); mean diffusivity (MD); axial diffusivity (AD); and radial diffusivity (RD)] were calculated via voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis, respectively. Sixty-eight college students (42 female) were enrolled and separated into two groups [MPD group, N = 34; control group (CG), N = 34] based on Mobile Phone Addiction Index (MPAI) scale score. Trait impulsivity was also measured using the Barratt Impulsiveness Scale (BIS-11). In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG), right inferior frontal gyrus (iFG), and bilateral thalamus (Thal). In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of WM integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH). Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with mobile phone overuse, and may help to better understand the neural mechanisms of MPD in relation to other behavioral and substance addiction disorders.

Impact of reading habit on white matter structure: Cross-sectional and longitudinal analyses

Psychological studies showed the quantity of reading habit affects the development of their reading skills, various language skills, and knowledge. However, despite a vast amount of literature, the effects of reading habit on the development of white matter (WM) structures critical to language and reading processes have never been investigated. In this study, we used the fractional anisotropy (FA) measure of diffusion tensor imaging to measure WM microstructural properties and examined cross-sectional and longitudinal correlations between reading habit and FA of the WM bundles in a large sample of normal children. In both cross-sectional and longitudinal analyses, we found that greater strength of reading habit positively affected FA in the left arcuate fasciculus (AF), in the left inferior fronto-occipital fasciculus (IFOF), and in the left posterior corona radiata (PCR). Consistent with previous studies, we also confirmed the significance or a tendency for positive correlation between the strength of reading habit and the Verbal Comprehension score in cross-sectional and longitudinal analyses. These cross-sectional and longitudinal findings indicate that a healthy reading habit may be directly or indirectly associated with the advanced development of WM critical to reading and language processes. Future intervention studies are needed to determine the causal effects of reading habits on WM in normal children.

Harmonizing DTI measurements across scanners to examine the development of white matter microstructure in 803 adolescents of the NCANDA study

Neurodevelopment continues through adolescence, with notable maturation of white matter tracts comprising regional fiber systems progressing at different rates. To identify factors that could contribute to regional differences in white matter microstructure development, large samples of youth spanning adolescence to young adulthood are essential to parse these factors. Recruitment of adequate samples generally relies on multi-site consortia but comes with the challenge of merging data acquired on different platforms. In the current study, diffusion tensor imaging (DTI) data were acquired on GE and Siemens systems through the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a multi-site study designed to track the trajectories of regional brain development during a time of high risk for initiating alcohol consumption. This cross-sectional analysis reports baseline Tract-Based Spatial Statistic (TBSS) of regional fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (L1), and radial diffusivity (LT) from the five consortium sites on 671 adolescents who met no/low alcohol or drug consumption criteria and 132 adolescents with a history of exceeding consumption criteria. Harmonization of DTI metrics across manufacturers entailed the use of human-phantom data, acquired multiple times on each of three non-NCANDA participants at each site's MR system, to determine a manufacturer-specific correction factor. Application of the correction factor derived from human phantom data measured on MR systems from different manufacturers reduced the standard deviation of the DTI metrics for FA by almost a half, enabling harmonization of data that would have otherwise carried systematic error. Permutation testing supported the hypothesis of higher FA and lower diffusivity measures in older adolescents and indicated that, overall, the FA, MD, and L1 of the boys were higher than those of the girls, suggesting continued microstructural development notable in the boys. The contribution of demographic and clinical differences to DTI metrics was assessed with General Additive Models (GAM) testing for age, sex, and ethnicity differences in regional skeleton mean values. The results supported the primary study hypothesis that FA skeleton mean values in the no/low-drinking group were highest at different ages. When differences in intracranial volume were covaried, FA skeleton mean reached a maximum at younger ages in girls than boys and varied in magnitude with ethnicity. Our results, however, did not support the hypothesis that youth who exceeded exposure criteria would have lower FA or higher diffusivity measures than the no/low-drinking group; detecting the effects of excessive alcohol consumption during adolescence on DTI metrics may require longitudinal study.

Sexual Dimorphism in White Matter Developmental Trajectories Using Tract-Based Spatial Statistics

Increasing evidence is emerging for sexual dimorphism in the trajectory of white matter development in children assessed using volumetric magnetic resonance imaging (MRI) and more recently diffusion MRI. Recent studies using diffusion MRI have examined cohorts with a wide age range (typically between 5 and 30 years) showing focal regions of differential diffusivity and fractional anisotropy (FA) and have implicated puberty as a possible contributory factor. To further investigate possible dimorphic trajectories in a young cohort, presumably closer to the expected onset of puberty, we used tract-based spatial statistics to investigate diffusion metrics. The cohort consisted of 23 males and 30 females between the ages of 8 and 16 years. Differences in diffusion metrics were corrected for age, total brain volume, and full scale IQ. In contrast to previous studies showing focal differences between males and females, widespread sexually dimorphic trajectories in structural white matter development were observed. These differences were characterized by more advanced development in females compared to males indicated by lower mean diffusivity, radial and axial diffusivity, and higher FA in females. This difference appeared to be larger at lower ages (8-9 years) with diffusion measures from males and females tending to converge between 10 and 14 years of age. Males showed a steeper slope for age-diffusion metric correlations compared to females, who either did not correlate with age or correlated in fewer regions. Further studies are now warranted to determine the role of hormones on the observed differences, particularly in 8-9-year-old children.

Real-time measurement and correction of both B0 changes and subject motion in diffusion tensor imaging using a double volumetric navigated (DvNav) sequence

Diffusion tensor imaging (DTI) requires a set of diffusion weighted measurements in order to acquire enough information to characterize local structure. The MRI scanner automatically performs a shimming process by acquiring a field map before the start of a DTI scan. Changes in B0, which can occur throughout the DTI acquisition due to several factors (including heating of the iron shim coils or subject motion), cause significant signal distortions that result in warped diffusion tensor (DT) parameter estimates. In this work we introduce a novel technique to simultaneously measure, report and correct in real time subject motion and changes in B0 field homogeneity, both in and through the imaging plane. This is achieved using double volumetric navigators (DvNav), i.e. a pair of 3D EPI acquisitions, interleaved with the DTI pulse sequence. Changes in the B0 field are evaluated in terms of zero-order (frequency) and first-order (linear gradients) shim. The ability of the DvNav to accurately estimate the shim parameters was first validated in a water phantom. Two healthy subjects were scanned both in the presence and absence of motion using standard, motion corrected (single navigator, vNav), and DvNav DTI sequences. The difference in performance between the proposed 3D EPI field maps and the standard 3D gradient echo field maps of the MRI scanner was also evaluated in a phantom and two healthy subjects. The DvNav sequence was shown to accurately measure and correct changes in B0 following manual adjustments of the scanner's central frequency and the linear shim gradients. Compared to other methods, the DvNav produced DTI results that showed greater spatial overlap with anatomical references, particularly in scans with subject motion. This is largely due to the ability of the DvNav system to correct shim changes and subject motion between each volume acquisition, thus reducing shear distortion.

Adverse childhood experiences influence white matter microstructure in patients with schizophrenia

Integrity of brain white matter (WM) tracts in adulthood could be detrimentally affected by exposure to adverse childhood experiences (ACE). Changes of diffusion tensor imaging (DTI) measures suggesting WM disruption have been reported in patients with schizophrenia together with a history of childhood maltreatment. We therefore hypothesized that ACE could be associated with altered DTI measures of WM integrity in patients with schizophrenia. We tested this hypothesis in 83 schizophrenia patients using whole brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial, and mean diffusivity (MD), and fractional anisotropy (FA). We observed an inverse correlation between severity of ACE and DTI measures of FA, and a positive correlation with MD in several WM tracts including corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus. Lower FA and higher MD are indexes of a reduction in fibre coherence and integrity. The association of ACE to reduced FA and increased MD in key WM tracts contributing to the functional integrity of the brain suggests that ACE might contribute to the pathophysiology of schizophrenia through a detrimental action on structural connectivity in critical cortico-limbic networks.

Motor pathway degeneration in young ataxia telangiectasia patients: A diffusion tractography study

BACKGROUND

Our understanding of the effect of ataxia-telangiectasia mutated gene mutations on brain structure and function is limited. In this study, white matter motor pathway integrity was investigated in ataxia telangiectasia patients using diffusion MRI and probabilistic tractography.

METHODS

Diffusion MRI were obtained from 12 patients (age range: 7-22 years, mean: 12 years) and 12 typically developing age matched participants (age range 8-23 years, mean: 13 years). White matter fiber tracking and whole tract statistical analyses were used to assess quantitative fractional anisotropy and mean diffusivity differences along the cortico-ponto-cerebellar, cerebellar-thalamo-cortical, somatosensory and lateral corticospinal tract length in patients using a linear mixed effects model. White matter tract streamline number and apparent fiber density in patient and control tracts were also assessed.

RESULTS

Reduced fractional anisotropy along all analyzed patient tracts were observed (p < 0.001). Mean diffusivity was significantly elevated in anterior tract locations but was reduced within cerebellar peduncle regions of all patient tracts (p < 0.001). Reduced tract streamline number and tract volume in the left and right corticospinal and somatosensory tracts were observed in patients (p < 0.006). In addition, reduced apparent fiber density in the left and right corticospinal and right somatosensory tracts (p < 0.006) occurred in patients.

CONCLUSIONS

Whole tract analysis of the corticomotor, corticospinal and somatosensory pathways in ataxia telangiectasia showed significant white matter degeneration along the entire length of motor circuits, highlighting that ataxia-telangiectasia gene mutation impacts the cerebellum and multiple other motor circuits in young patients.

White Matter Changes of Neurite Density and Fiber Orientation Dispersion during Human Brain Maturation

Diffusion tensor imaging (DTI) studies of human brain development have consistently shown widespread, but nonlinear increases in white matter anisotropy through childhood, adolescence, and into adulthood. However, despite its sensitivity to changes in tissue microstructure, DTI lacks the specificity to disentangle distinct microstructural features of white and gray matter. Neurite orientation dispersion and density imaging (NODDI) is a recently proposed multi-compartment biophysical model of brain microstructure that can estimate non-collinear properties of white matter, such as neurite orientation dispersion index (ODI) and neurite density index (NDI). In this study, we apply NODDI to 66 healthy controls aged 7-63 years to investigate changes of ODI and NDI with brain maturation, with comparison to standard DTI metrics. Using both region-of-interest and voxel-wise analyses, we find that NDI exhibits striking increases over the studied age range following a logarithmic growth pattern, while ODI rises following an exponential growth pattern. This novel finding is consistent with well-established age-related changes of FA over the lifespan that show growth during childhood and adolescence, plateau during early adulthood, and accelerating decay after the fourth decade of life. Our results suggest that the rise of FA during the first two decades of life is dominated by increasing NDI, while the fall in FA after the fourth decade is driven by the exponential rise of ODI that overcomes the slower increases of NDI. Using partial least squares regression, we further demonstrate that NODDI better predicts chronological age than DTI. Finally, we show excellent test-retest reliability of NODDI metrics, with coefficients of variation below 5% in all measured regions of interest. Our results support the conclusion that NODDI reveals biologically specific characteristics of brain development that are more closely linked to the microstructural features of white matter than are the empirical metrics provided by DTI.

White matter integrity and cognitive performance in school-age children: A population-based neuroimaging study

Child and adolescent brain development are typically accompanied by marked improvements in a wide range of cognitive abilities. However, limited information is available surrounding the role of white matter in shaping cognitive abilities in children. The current study examined associations between white matter microstructure and cognitive performance in a large sample (n=778) of 6- to 10-year-old children. Results show white matter microstructure is related to non-verbal intelligence and to visuospatial ability, independent of age. Specificity was demonstrated, as white matter associations with visuospatial ability were independent of general intellectual ability. Associations between white matter integrity and cognition were similar in boys and girls. In summary, results demonstrate white matter structure-function associations are present in children, independent of age and broader cognitive abilities. The presence of such associations in the general population is informative for studies examining child psychopathology.

Thalamo-cortical connectivity: what can diffusion tractography tell us about reading difficulties in children?

Reading is an essential skill in modern society, but many people have deficits in the decoding and word recognition aspects of reading, a difficulty often referred to as dyslexia. The primary focus of neuroimaging studies to date in dyslexia has been on cortical regions; however, subcortical regions may also be important for explaining this disability. Here, we used diffusion tensor imaging to examine the association between thalamo-cortical connectivity and children's reading ability in 20 children with typically developed reading ability (age range 8-17/10-17 years old from two imaging centers) and 19 children with developmental dyslexia (DYS) (age range 9-17/9-16 years old). To measure thalamo-cortical connections, the structural images were segmented into cortical and subcortical anatomical regions that were used as target and seed regions in the probabilistic tractography analysis. Abnormal thalamic connectivity was found in the dyslexic group in the sensorimotor and lateral prefrontal cortices. These results suggest that the thalamus may play a key role in reading behavior by mediating the functions of task-specific cortical regions; such findings lay the foundation for future studies to investigate further neurobiological anomalies in the development of thalamo-cortical connectivity in DYS.

Developmental white matter microstructure in autism phenotype and corresponding endophenotype during adolescence

During adolescence, white matter microstructure undergoes an important stage of development. It is hypothesized that the alterations of brain connectivity that have a key role in autism spectrum conditions (ASCs) may interact with the development of white matter microstructure. This interaction may be present beyond the phenotype of autism in siblings of individuals with ASC, who are 10 to 20 times more likely to develop certain forms of ASC. We use diffusion tensor imaging to examine how white matter microstructure measurements correlate with age in typically developing individuals, and how this correlation differs in n=43 adolescents with ASC and their n=38 siblings. Correlations observed in n=40 typically developing individuals match developmental changes noted in previous longitudinal studies. In comparison, individuals with ASC display weaker negative correlation between age and mean diffusivity in a broad area centred in the right superior longitudinal fasciculus. These differences may be caused either by increased heterogeneity in ASC or by temporal alterations in the group's developmental pattern. Siblings of individuals with ASC also show diminished negative correlation between age and one component of mean diffusivity-second diffusion eigenvalue-in the right superior longitudinal fasciculus. As the observed differences match for location and correlation directionality in our comparison of typically developing individuals to those with ASC and their siblings, we propose that these alterations constitute a part of the endophenotype of autism.

Normal-appearing cerebral white matter in healthy adults: mean change over 2 years and individual differences in change

Diffusion tensor imaging studies show age-related differences in cerebral white matter (WM). However, few have studied WM changes over time, and none evaluated individual differences in change across a wide age range. Here, we examined 2-year WM change in 96 healthy adults (baseline age, 19-78 years), individual differences in change, and the influence of vascular and metabolic risk thereon. Fractional anisotropy (FA), axial diffusivity, and radial diffusivity (RD) represented microstructural properties of normal-appearing WM within 13 regions. Cross-sectional analyses revealed age-related differences in all WM indices across the regions. In contrast, latent change score analyses showed longitudinal declines in axial diffusivity in association and projection fibers and increases in anterior commissural fibers. FA and RD evidenced a less consistent pattern of change. Metabolic risk mediated the effects of age on FA and RD change in corpus callosum body and dorsal cingulum. These findings underscore the importance of longitudinal studies in evaluating individual differences in change and the role of metabolic factors in shaping trajectories of brain aging.

Abnormal white matter integrity and impairment of cognitive abilities in adolescent inhalant abusers

Inhalant abuse represents a major health problem especially among adolescents and young adults. However, less is known about white matter (WM) microstructure in adolescent inhalant abusers. In the present study, we used diffusion tensor imaging (DTI) to study WM changes in adolescent inhalant abusers compared with healthy controls. We also tested whether there was any relationship between WM integrity and neuropsychological measures in adolescent inhalant abusers. The study included 19 adolescent inhalant abusers and 19 healthy control subjects. Whole brain analysis of WM microstructure was performed using tract-based spatial statistics (TBSS) to detect abnormal WM regions between groups. Wisconsin card sorting test (WCST) and Stroop test were used to measure neuropsychological performance. We found that adolescent inhalant abuser group had significantly higher axial diffusivity (AD) values in left parietal, occipital and temporal WM than in healthy control group. Inhalant abuser and control groups did not differ significantly on fractional anisotropy (FA) and radial diffusivity (RD) values. Adolescent inhalant abusers showed worse performance when compared with control group in WCST and Stroop test. There was no significant correlation of AD values in significant clusters with neuropsychological test performances within the two groups. We only found discrete impairments in neuropsychological test performance and WM integrity in adolescent inhalant abusers compared with healthy control subjects and we were not able to demonstrate a direct correlation between WM alterations and neurocognitive performance. Future work is required to longitudinally evaluate brain abnormalities through methods assessing brain structure, function and connectivity.

Sex-specific association between infant diet and white matter integrity in 8-y-old children

BACKGROUND

The American Academy of Pediatrics recommends breastfeeding, which is well known to promote cognitive and behavioral development. The evidence for why this occurs is not well understood.

METHODS

Fifty-six 7.5- to 8.5-y-old healthy children were breastfed (BF; n = 22, 10 males) or formula-fed (FF; n = 34, 16 males) as infants. All children were administered: the Reynolds Intellectual Assessment Scale (RIAS); the Clinical Evaluation of Language Fundamentals (CELF-4) tests; and magnetic resonance imaging of the brain. Diffusion tensor imaging (DTI) measured fractional anisotropy (FA) values were correlated with RIAS and CELF-4 scores.

RESULTS

DTI tract-based spatial statistics (TBSS) analyses showed multiple white matter regions in the left hemisphere with significantly higher FA (P < 0.05, corrected) values in BF than FF males, but no significant group differences in females. Males who were exclusively BF for at least 1 y appeared to have the greatest differences in FA. Mean FA values positively correlated with composite scores of RIAS (P = 0.03) and CELF-4 (P = 0.02).

CONCLUSION

Breastfeeding during infancy was associated with better white matter development at 8 y of age in boys. A similar association was not observed in girls.

Application of advanced neuroimaging modalities in pediatric traumatic brain injury

Neuroimaging is commonly used for the assessment of children with traumatic brain injury and has greatly advanced how children are acutely evaluated. More recently, emphasis has focused on how advanced magnetic resonance imaging methods can detect subtler injuries that could relate to the structural underpinnings of the neuropsychological and behavioral alterations that frequently occur. We examine several methods used for the assessment of pediatric brain injury. Susceptibility-weighted imaging is a sensitive 3-dimensional high-resolution technique in detecting hemorrhagic lesions associated with diffuse axonal injury. Magnetic resonance spectroscopy acquires metabolite information, which serves as a proxy for neuronal (and glial, lipid, etc) structural integrity and provides sensitive assessment of neurochemical alterations. Diffusion-weighted imaging is useful for the early detection of ischemic and shearing injury. Diffusion tensor imaging allows better structural evaluation of white matter tracts. These methods are more sensitive than conventional imaging in demonstrating subtle injury that underlies a child's clinical symptoms. There also is an increasing desire to develop computational methods to fuse imaging data to provide a more integrated analysis of the extent to which components of the neurovascular unit are affected. The future of traumatic brain injury neuroimaging research is promising and will lead to novel approaches to predict and improve outcomes.

Recent findings on the role of white matter pathology in bipolar disorder

Patients with bipolar disorder (BD) experience difficulties in information processing and in the cognitive control of emotions. Mood-congruent biases, which parallel illness episodes, find a neural correlate in abnormal reactivity to stimuli in specific brain regions, and in disrupted functional connectivity among brain areas pertaining to corticolimbic circuitries. It is suggested that a reduced integrity of white matter tracts could underpin dysfunctions in networks implicated in the generation and control of affect. Recent studies using diffusion tensor imaging techniques found that (1) independent of drug treatment, patients with BD show widespread signs of disrupted white matter microstructure, suggesting significant demyelination/dysmyelination without axonal loss, and (2) effective long-term treatment with lithium is associated with increased axial connectivity, proportional to the duration of treatment. These findings suggest that changes of white matter microstructure in specific brain networks could parallel disrupted neural connectivity during illness episodes in BD and that these changes might play a major role in the mechanistic explanation of the biological underpinnings of BD psychopathology.

The effects of puberty on white matter development in boys

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White matter microstructural differences occurred between early and late puberty.

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White matter regions showed reduced mean diffusivity from early to late puberty.

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Regression models showed that pubertal effects could not simply be ascribed to age.

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Mean diffusivity decreases were associated with increasing salivary testosterone levels.

Neuroimaging studies demonstrate considerable changes in white matter volume and microstructure during adolescence. Most studies have focused on age-related effects, whilst puberty-related changes are not well understood. Using diffusion tensor imaging and tract-based spatial statistics, we investigated the effects of pubertal status on white matter mean diffusivity (MD) and fractional anisotropy (FA) in 61 males aged 12.7–16.0 years. Participants were grouped into early-mid puberty (≤Tanner Stage 3 in pubic hair and gonadal development; n = 22) and late-post puberty (≥Tanner Stage 4 in pubic hair or gonadal development; n = 39). Salivary levels of pubertal hormones (testosterone, DHEA and oestradiol) were also measured. Pubertal stage was significantly related to MD in diverse white matter regions. No relationship was observed between pubertal status and FA. Regression modelling of MD in the significant regions demonstrated that an interaction model incorporating puberty, age and puberty × age best explained our findings. In addition, testosterone was correlated with MD in these pubertally significant regions. No relationship was observed between oestradiol or DHEA and MD. In conclusion, pubertal status was significantly related to MD, but not FA, and this relationship cannot be explained by changes in chronological age alone.