Effect of task difficulty on cerebral blood flow during perceptual matching of faces

Functional Connectivity within and beyond the Face Network Is Related to Reduced Discrimination of Degraded Faces in Young and Older Adults

Degrading face stimuli reduces face discrimination in both young and older adults, but the brain correlates of this decline in performance are not fully understood. We used functional magnetic resonance imaging to examine the effects of degraded face stimuli on face and nonface brain networks and tested whether these changes would predict the linear declines seen in performance. We found decreased activity in the face network (FN) and a decrease in the similarity of functional connectivity (FC) in the FN across conditions as degradation increased but no effect of age. FC in whole-brain networks also changed with increasing degradation, including increasing FC between the visual network and cognitive control networks. Older adults showed reduced modulation of this whole-brain FC pattern. The strongest predictors of within-participant decline in accuracy were changes in whole-brain network FC and FC similarity of the FN. There was no influence of age on these brain-behavior relations. These results suggest that a systems-level approach beyond the FN is required to understand the brain correlates of performance decline when faces are obscured with noise. In addition, the association between brain and behavior changes was maintained into older age, despite the dampened FC response to face degradation seen in older adults.

Training Humans to Categorize Monkey Calls: Auditory Feature- and Category-Selective Neural Tuning Changes

Grouping auditory stimuli into common categories is essential for a variety of auditory tasks, including speech recognition. We trained human participants to categorize auditory stimuli from a large novel set of morphed monkey vocalizations. Using fMRI-rapid adaptation (fMRI-RA) and multi-voxel pattern analysis (MVPA) techniques, we gained evidence that categorization training results in two distinct sets of changes: sharpened tuning to monkey call features (without explicit category representation) in left auditory cortex and category selectivity for different types of calls in lateral prefrontal cortex. In addition, the sharpness of neural selectivity in left auditory cortex, as estimated with both fMRI-RA and MVPA, predicted the steepness of the categorical boundary, whereas categorical judgment correlated with release from adaptation in the left inferior frontal gyrus. These results support the theory that auditory category learning follows a two-stage model analogous to the visual domain, suggesting general principles of perceptual category learning in the human brain.

An fMRI-adaptation study of phonological and orthographic selectivity to written words in adults with poor reading skills

Typical readers rely on two brain pathways for word processing in the left hemisphere: temporo-parietal cortex (TPC) and inferior frontal cortex (IFC), thought to subserve phonological decoding, and occipito-temporal cortex (OTC), including the "visual word form area" (VWFA), thought to subserve orthographic processing. How these regions are affected in developmental dyslexia has been a topic of intense research. We employed fMRI rapid adaptation (fMRI-RA) in adults with low reading skills to examine in independently-defined functional regions of interest (ROIs) phonological selectivity to written words in left TPC and IFC, and to orthographic selectivity to written words in OTC. Consistent with the phonological deficit hypothesis of dyslexia, we found responsivity but not selectivity to phonology, as accessed by written words, in the posterior superior temporal gyrus (pSTG) of the TPC. On the other hand, we found orthographic selectivity in the VWFA of the OTC. We also found selectivity to orthographic and not phonological processing in the IFG, a finding previously reported for typical readers. Together our results demonstrate that in adults with poor reading skills, selectivity to phonology is compromised in pSTG, while selectivity to orthography in the VWFA remains unaffected at this level of processing.

Orthographic and phonological selectivity across the reading system in deaf skilled readers

People who are born deaf often have difficulty learning to read. Recently, several studies have examined the neural substrates involved in reading in deaf people and found a left lateralized reading system similar to hearing people involving temporo-parietal, inferior frontal, and ventral occipito-temporal cortices. Previous studies in typical hearing readers show that within this reading network there are separate regions that specialize in processing orthography and phonology. We used fMRI rapid adaptation in deaf adults who were skilled readers to examine neural selectivity in three functional ROIs in the left hemisphere: temporoparietal cortex (TPC), inferior frontal gyrus (IFG), and the visual word form area (VWFA). Results show that in deaf skilled readers, the left VWFA showed selectivity for orthography similar to what has been reported for hearing readers, the TPC showed less sensitivity to phonology than previously reported for hearing readers using the same paradigm, and the IFG showed selectivity to orthography, but not phonology (similar to what has been reported previously for hearing readers). These results provide evidence that while skilled deaf readers demonstrate coarsely tuned phonological representations in the TPC, they develop finely tuned representations for the orthography of written words in the VWFA and IFG. This result suggests that phonological tuning in the TPC may have little impact on the neural network associated with skilled reading for deaf adults.

Revolution of Alzheimer Precision Neurology. Passageway of Systems Biology and Neurophysiology

The Precision Neurology development process implements systems theory with system biology and neurophysiology in a parallel, bidirectional research path: a combined hypothesis-driven investigation of systems dysfunction within distinct molecular, cellular, and large-scale neural network systems in both animal models as well as through tests for the usefulness of these candidate dynamic systems biomarkers in different diseases and subgroups at different stages of pathophysiological progression. This translational research path is paralleled by an "omics"-based, hypothesis-free, exploratory research pathway, which will collect multimodal data from progressing asymptomatic, preclinical, and clinical neurodegenerative disease (ND) populations, within the wide continuous biological and clinical spectrum of ND, applying high-throughput and high-content technologies combined with powerful computational and statistical modeling tools, aimed at identifying novel dysfunctional systems and predictive marker signatures associated with ND. The goals are to identify common biological denominators or differentiating classifiers across the continuum of ND during detectable stages of pathophysiological progression, characterize systems-based intermediate endophenotypes, validate multi-modal novel diagnostic systems biomarkers, and advance clinical intervention trial designs by utilizing systems-based intermediate endophenotypes and candidate surrogate markers. Achieving these goals is key to the ultimate development of early and effective individualized treatment of ND, such as Alzheimer's disease. The Alzheimer Precision Medicine Initiative (APMI) and cohort program (APMI-CP), as well as the Paris based core of the Sorbonne University Clinical Research Group "Alzheimer Precision Medicine" (GRC-APM) were recently launched to facilitate the passageway from conventional clinical diagnostic and drug development toward breakthrough innovation based on the investigation of the comprehensive biological nature of aging individuals. The APMI movement is gaining momentum to systematically apply both systems neurophysiology and systems biology in exploratory translational neuroscience research on ND.

Disrupted Working Memory Circuitry in Adolescent Psychosis

Individuals with schizophrenia (SZ) consistently show deficits in spatial working memory (WM) and associated atypical patterns of neural activity within key WM regions, including the dorsolateral prefrontal cortex (dlPFC) and parietal cortices. However, little research has focused on adolescent psychosis (AP) and potential age-associated disruptions of WM circuitry that may occur in youth with this severe form of illness. Here we utilized each subject's individual spatial WM capacity to investigate task-based neural dysfunction in 17 patients with AP (16.58 ± 2.60 years old) as compared to 17 typically developing, demographically comparable adolescents (18.07 ± 3.26 years old). AP patients showed lower behavioral performance at higher WM loads and lower overall WM capacity compared to healthy controls. Whole-brain activation analyses revealed greater bilateral precentral and right postcentral activity in controls relative to AP patients, when controlling for individual WM capacity. Seed-based psychophysiological interaction (PPI) analyses revealed significantly greater co-activation between the left dlPFC and left frontal pole in controls relative to AP patients. Significant group-by-age interactions were observed in both whole-brain and PPI analyses, with AP patients showing atypically greater neural activity and stronger coupling between WM task activated brain regions as a function of increasing age. Additionally, AP patients demonstrated positive relationships between right dlPFC neural activity and task performance, but unlike healthy controls, failed to show associations between neural activity and out-of-scanner neurocognitive performance. Collectively, these findings are consistent with atypical WM-related functioning and disrupted developmental processes in youth with AP.

Estimates of functional cerebral hemispheric differences in monolingual and bilingual people who stutter: Dual-task paradigm

The inter-relationship of stuttering and bilingualism to functional cerebral hemispheric processing was examined on a dual-task paradigm. Eighty native German (L1) speakers, half of whom were sequential bilinguals (L2 = English), were recruited. The participants (mean age = 38.9 years) were organised into four different groups according to speech status and language ability: 20 bilinguals who stutter (BWS), 20 monolinguals who stutter (MWS), 20 bilinguals who do not stutter (BWNS), and 20 monolinguals who do not stutter (MWNS). All participants completed a dual-task paradigm involving simultaneous speaking and finger tapping. No performance differences between BWS and BWNS were found. In contrast, MWS showed greater dual-task interference compared to BWS and MWNS, as well as greater right- than left-hand disruption. A prevailing finding was that bilingualism seems to offset deficits in executive functioning associated with stuttering. Cognitive reserve may have been reflected in the present study, resulting in a bilingual advantage.

Mindfulness Meditation Training and Executive Control Network Resting State Functional Connectivity: A Randomized Controlled Trial

OBJECTIVE

Mindfulness meditation training has been previously shown to enhance behavioral measures of executive control (e.g., attention, working memory, cognitive control), but the neural mechanisms underlying these improvements are largely unknown. Here, we test whether mindfulness training interventions foster executive control by strengthening functional connections between dorsolateral prefrontal cortex (dlPFC)-a hub of the executive control network-and frontoparietal regions that coordinate executive function.

METHODS

Thirty-five adults with elevated levels of psychological distress participated in a 3-day randomized controlled trial of intensive mindfulness meditation or relaxation training. Participants completed a resting state functional magnetic resonance imaging scan before and after the intervention. We tested whether mindfulness meditation training increased resting state functional connectivity (rsFC) between dlPFC and frontoparietal control network regions.

RESULTS

Left dlPFC showed increased connectivity to the right inferior frontal gyrus (T = 3.74), right middle frontal gyrus (MFG) (T = 3.98), right supplementary eye field (T = 4.29), right parietal cortex (T = 4.44), and left middle temporal gyrus (T = 3.97, all p < .05) after mindfulness training relative to the relaxation control. Right dlPFC showed increased connectivity to right MFG (T = 4.97, p < .05).

CONCLUSIONS

We report that mindfulness training increases rsFC between dlPFC and dorsal network (superior parietal lobule, supplementary eye field, MFG) and ventral network (right IFG, middle temporal/angular gyrus) regions. These findings extend previous work showing increased functional connectivity among brain regions associated with executive function during active meditation by identifying specific neural circuits in which rsFC is enhanced by a mindfulness intervention in individuals with high levels of psychological distress.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov,NCT01628809.

Evidence for rapid localist plasticity in the ventral visual stream: The example of words

Our recent work has shown that the Visual Word Form Area (VWFA) in left occipitotemporal cortex contains an orthographic lexicon based on neuronal representations highly selective for individual written real words (RW) and that learning novel words selectively increases neural specificity in the VWFA. But, how quickly does this change in neural tuning occur and how much training is required for new words to be codified in the VWFA? Here we present evidence that plasticity in the VWFA from broad to tight tuning can be obtained in a short time span, with no explicit training, and with comparatively few exposures, further strengthening the case for a highly plastic visual lexicon in the VWFA and for localist representations in the visual processing hierarchy.

Changes in the modulation of brain activity during context encoding vs. context retrieval across the adult lifespan

Age-related deficits in context memory may arise from neural changes underlying both encoding and retrieval of context information. Although age-related functional changes in the brain regions supporting context memory begin at midlife, little is known about the functional changes with age that support context memory encoding and retrieval across the adult lifespan. We investigated how age-related functional changes support context memory across the adult lifespan by assessing linear changes with age during successful context encoding and retrieval. Using functional magnetic resonance imaging (fMRI), we compared young, middle-aged and older adults during both encoding and retrieval of spatial and temporal details of faces. Multivariate behavioral partial least squares (B-PLS) analysis of fMRI data identified a pattern of whole-brain activity that correlated with a linear age term and a pattern of whole-brain activity that was associated with an age-by-memory phase (encoding vs. retrieval) interaction. Further investigation of this latter effect identified three main findings: 1) reduced phase-related modulation in bilateral fusiform gyrus, left superior/anterior frontal gyrus and right inferior frontal gyrus that started at midlife and continued to older age, 2) reduced phase-related modulation in bilateral inferior parietal lobule that occurred only in older age, and 3) changes in phase-related modulation in older but not younger adults in left middle frontal gyrus and bilateral parahippocampal gyrus that was indicative of age-related over-recruitment. We conclude that age-related reductions in context memory arise in midlife and are related to changes in perceptual recollection and changes in fronto-parietal retrieval monitoring.

Uncovering phonological and orthographic selectivity across the reading network using fMRI-RA

Reading has been shown to rely on a dorsal brain circuit involving the temporoparietal cortex (TPC) for grapheme-to-phoneme conversion of novel words (Pugh et al., 2001), and a ventral stream involving left occipitotemporal cortex (OTC) (in particular in the so-called "visual word form area", VWFA) for visual identification of familiar words. In addition, portions of the inferior frontal cortex (IFC) have been posited to be an output of the dorsal reading pathway involved in phonology. While this dorsal versus ventral dichotomy for phonological and orthographic processing of words is widely accepted, it is not known if these brain areas are actually strictly sensitive to orthographic or phonological information. Using an fMRI rapid adaptation technique we probed the selectivity of the TPC, OTC, and IFC to orthographic and phonological features during single word reading. We found in two independent experiments using different task conditions in adult normal readers, that the TPC is exclusively sensitive to phonology and the VWFA in the OTC is exclusively sensitive to orthography. The dorsal IFC (BA 44), however, showed orthographic but not phonological selectivity. These results support the theory that reading involves a specific phonological-based temporoparietal region and a specific orthographic-based ventral occipitotemporal region. The dorsal IFC, however, was not sensitive to phonological processing, suggesting a more complex role for this region.

Neuroimaging studies of the striatum in cognition Part I: healthy individuals

The striatum has traditionally mainly been associated with playing a key role in the modulation of motor functions. Indeed, lesion studies in animals and studies of some neurological conditions in humans have brought further evidence to this idea. However, better methods of investigation have raised concerns about this notion, and it was proposed that the striatum could also be involved in different types of functions including cognitive ones. Although the notion was originally a matter of debate, it is now well-accepted that the caudate nucleus contributes to cognition, while the putamen could be involved in motor functions, and to some extent in cognitive functions as well. With the arrival of modern neuroimaging techniques in the early 1990, knowledge supporting the cognitive aspect of the striatum has greatly increased, and a substantial number of scientific papers were published studying the role of the striatum in healthy individuals. For the first time, it was possible to assess the contribution of specific areas of the brain during the execution of a cognitive task. Neuroanatomical studies have described functional loops involving the striatum and the prefrontal cortex suggesting a specific interaction between these two structures. This review examines the data up to date and provides strong evidence for a specific contribution of the fronto-striatal regions in different cognitive processes, such as set-shifting, self-initiated responses, rule learning, action-contingency, and planning. Finally, a new two-level functional model involving the prefrontal cortex and the dorsal striatum is proposed suggesting an essential role of the dorsal striatum in selecting between competing potential responses or actions, and in resolving a high level of ambiguity.

Adding words to the brain's visual dictionary: novel word learning selectively sharpens orthographic representations in the VWFA

The nature of orthographic representations in the human brain is still subject of much debate. Recent reports have claimed that the visual word form area (VWFA) in left occipitotemporal cortex contains an orthographic lexicon based on neuronal representations highly selective for individual written real words (RWs). This theory predicts that learning novel words should selectively increase neural specificity for these words in the VWFA. We trained subjects to recognize novel pseudowords (PWs) and used fMRI rapid adaptation to compare neural selectivity with RWs, untrained PWs (UTPWs), and trained PWs (TPWs). Before training, PWs elicited broadly tuned responses, whereas responses to RWs indicated tight tuning. After training, TPW responses resembled those of RWs, whereas UTPWs continued to show broad tuning. This change in selectivity was specific to the VWFA. Therefore, word learning appears to selectively increase neuronal specificity for the new words in the VWFA, thereby adding these words to the brain's visual dictionary.

Decreased activity with increased background network efficiency in amnestic MCI during a visuospatial working memory task

Recent studies have demonstrated the working memory impairment in patients with amnestic mild cognitive impairment (aMCI). However, the neurophysiological basis of the working memory deficit in aMCI is poorly understood. The aim of this study was to explore the abnormal activity during encoding and recognition procedures, as well as the reorganization of the background network maintaining the working memory state in aMCI. Using event-related fMRI during a visuospatial working memory task with three recognition difficulty levels, the task-related activations and network efficiency of the background network in 17 aMCI patients and 19 matched controls were investigated. Compared with cognitively healthy controls, patients with aMCI showed significantly decreased activity in the frontal and visual cortices during the encoding phase, while during the recognition phase, decreased activity was detected in the frontal, parietal, and visual regions. In addition, increased local efficiency was also observed in the background network of patients with aMCI. The results suggest patients with aMCI showed impaired encoding and recognition functions during the visuospatial working memory task, and may pay more effort to maintain the cognitive state. This study extends our understanding of the impaired working memory function in aMCI and provides a new perspective to investigate the compensatory mechanism in aMCI.

Fast learning of simple perceptual discriminations reduces brain activation in working memory and in high-level auditory regions

Introducing simple stimulus regularities facilitates learning of both simple and complex tasks. This facilitation may reflect an implicit change in the strategies used to solve the task when successful predictions regarding incoming stimuli can be formed. We studied the modifications in brain activity associated with fast perceptual learning based on regularity detection. We administered a two-tone frequency discrimination task and measured brain activation (fMRI) under two conditions: with and without a repeated reference tone. Although participants could not explicitly tell the difference between these two conditions, the introduced regularity affected both performance and the pattern of brain activation. The "No-Reference" condition induced a larger activation in frontoparietal areas known to be part of the working memory network. However, only the condition with a reference showed fast learning, which was accompanied by a reduction of activity in two regions: the left intraparietal area, involved in stimulus retention, and the posterior superior-temporal area, involved in representing auditory regularities. We propose that this joint reduction reflects a reduction in the need for online storage of the compared tones. We further suggest that this change reflects an implicit strategic shift "backwards" from reliance mainly on working memory networks in the "No-Reference" condition to increased reliance on detected regularities stored in high-level auditory networks.

Long-term musical training may improve different forms of visual attention ability

Many studies have suggested that structural and functional cerebral neuroplastic processes result from long-term musical training, which in turn may produce cognitive differences between musicians and non-musicians. We aimed to investigate whether intensive, long-term musical practice is associated with improvements in three different forms of visual attention ability: selective, divided and sustained attention. Musicians from symphony orchestras (n=38) and non-musicians (n=38), who were comparable in age, gender and education, were submitted to three neuropsychological tests, measuring reaction time and accuracy. Musicians showed better performance relative to non-musicians on four variables of the three visual attention tests, and such an advantage could not solely be explained by better sensorimotor integration. Moreover, in the group of musicians, significant correlations were observed between the age at the commencement of musical studies and reaction time in all visual attention tests. The results suggest that musicians present augmented ability in different forms of visual attention, thus illustrating the possible cognitive benefits of long-term musical training.

A quantitative link between face discrimination deficits and neuronal selectivity for faces in autism

Individuals with Autism Spectrum Disorder (ASD) appear to show a general face discrimination deficit across a range of tasks including social–emotional judgments as well as identification and discrimination. However, functional magnetic resonance imaging (fMRI) studies probing the neural bases of these behavioral differences have produced conflicting results: while some studies have reported reduced or no activity to faces in ASD in the Fusiform Face Area (FFA), a key region in human face processing, others have suggested more typical activation levels, possibly reflecting limitations of conventional fMRI techniques to characterize neuron-level processing. Here, we test the hypotheses that face discrimination abilities are highly heterogeneous in ASD and are mediated by FFA neurons, with differences in face discrimination abilities being quantitatively linked to variations in the estimated selectivity of face neurons in the FFA. Behavioral results revealed a wide distribution of face discrimination performance in ASD, ranging from typical performance to chance level performance. Despite this heterogeneity in perceptual abilities, individual face discrimination performance was well predicted by neural selectivity to faces in the FFA, estimated via both a novel analysis of local voxel-wise correlations, and the more commonly used fMRI rapid adaptation technique. Thus, face processing in ASD appears to rely on the FFA as in typical individuals, differing quantitatively but not qualitatively. These results for the first time mechanistically link variations in the ASD phenotype to specific differences in the typical face processing circuit, identifying promising targets for interventions.

Age-related changes in the neural correlates of degraded and nondegraded face processing

In order to explore the neural correlates of age-related changes in visual perception of faces, positron emission tomographic scans were obtained on young and old adults while they were engaged in tasks of nondegraded and degraded face matching. Old adults were less accurate than were young adults across all face matching conditions, although the age difference was greatly reduced when degraded performance was adjusted for nondegraded performance. The interaction of age and degree of degradation on performance measures was not significant. Brain activity patterns during nondegraded face matching were similar in the two groups with some differences in parietal and prestriate cortices (greater activity in young adults) and in prefrontal cortex, thalamus, and hippocampus (greater activity in old adults). Increases in activity related to increasing degradation of the faces were seen mainly in prefrontal cortices in both age groups. Despite this similarity in the brain response to face degradation, there were striking differences between groups in the correlations between brain activity and degraded task performance. Different regions of extrastriate cortex were positively correlated with behavioural measures in the two groups (fusiform gyrus in the young adults and posterior occipital regions in old adults). In addition two areas where older adults showed greater activity during nondegraded face matching, thalamus and hippocampus, also showed positive correlations with behaviour during the degraded tasks in this group, but not in the young group. Thus, although the elderly are not more vulnerable to the effects of increasing face degradation, the brain systems involved in carrying out these visual discriminations in young and old adults are not the same. These results are consistent with the idea of functional plasticity in face processing over the life span.

Electrophysiological evidence for adult age-related sparing and decrements in emotion perception and attention

The present study examined adult age differences in processing emotional faces using a psychological refractory period paradigm. We used both behavioral and event-related potential (P1 component) measures. Task 1 was tone discrimination (fuzzy vs. pure tones) and Task 2 was emotional facial discrimination (“happy” vs. “angry” faces). The stimulus onset asynchrony (SOA) between the two tasks was 100, 300, and 900 ms. Earlier research observed larger age deficits in emotional facial discrimination for negative (angry) than for positive (happy) faces (Baena et al., 2010). Thus, we predicted that older adults would show decreased attentional efficiency in carrying out dual-task processing on the P1 (a component linked to amygdalar modulation of visual perception; Rotshtein et al., 2010). Both younger and older groups showed significantly higher P1 amplitudes at 100- and 300-ms SOAs than at the 900-ms SOA, and this suggests that both age groups could process Task 2 faces without central attention. Also, younger adults showed significantly higher P1 activations for angry than for happy faces, but older adults showed no difference. These results are consistent with the idea that younger adults exhibited amygdalar modulation of visual perception, but that older adults did not.

Task difficulty modulates young-old differences in network expression

The extent of task-related fMRI activation can vary as a function of task difficulty. Also the efficiency or capacity of the brain networks underlying task performance can change with aging. We asked whether the expression of a network underlying task performance would differ as a function of task demand in old and young individuals. 26 younger and 23 older healthy adults performed a delayed item recognition task that used the response signal method to parametrically manipulate the extrinsic difficulty of the task by imposing five different deadlines for recognition response. Both age groups showed a speed-accuracy trade-off, but the younger group achieved greater discriminability at the longer deadlines. We identified a spatial pattern of fMRI activation during the probe phase whose expression increased as the response deadline shortened and the task became more difficult. This pattern was expressed to a greater degree by the old group at the long deadlines, when the task was easiest. By contrast, this pattern was expressed to a greater degree by the younger group at the short deadlines, when the task was hardest. This suggests reduced efficiency and capacity of this network in older subjects. These findings suggest that neuroimaging studies comparing task-related activation across groups with different cognitive abilities must be interpreted in light of the relative difficulty of the task for each group.

Functional connectivity during recognition memory in individuals genetically at risk for Alzheimer's disease

The medial temporal lobes (MTL) and frontal cortex have been shown to subserve memory processes. Neurodegenerative diseases, such as Alzheimer's disease (AD), disrupt the neuronal networks that underlie memory processing. The ε4 allele of the apolipoprotein E gene is a genetic risk factor for AD and is associated with decrements in memory and in olfactory function. The present study utilized EQS, a structural equation modeling software program, to examine differences in the neuronal networks between non-demented ε4 carriers and ε4 noncarriers during a cross-modal olfactory recognition memory paradigm. Prior to fMRI scanning, participants were presented with 16 odors. During two scans, participants discriminated between names of odors presented before scanning (targets) or not presented (foils). The results indicate significant connections between bilateral frontal lobes and MTL for ε4 carriers when they misidentified a foil as a target. When ε4 noncarriers correctly identified a target, there were greater associations between the amygdala, MTL, and right frontal lobe; these associations also modeled the brain's response when ε4 noncarriers misidentified a foil as a target. During memory retrieval, affective cues may facilitate retrieval in ε4 noncarriers relative to ε4 carriers. Last, no model was found that best represented the functional network used by ε4 carriers when they correctly identified a target, which may reflect variability of neuronal recruitment within this population.

Abnormalities of object visual processing in body dysmorphic disorder

BACKGROUND

Individuals with body dysmorphic disorder (BDD) may have perceptual distortions for their appearance. Previous studies suggest imbalances in detailed relative to configural/holistic visual processing when viewing faces. No study has investigated the neural correlates of processing non-symptom-related stimuli. The objective of this study was to determine whether individuals with BDD have abnormal patterns of brain activation when viewing non-face/non-body object stimuli.

METHOD

Fourteen medication-free participants with DSM-IV BDD and 14 healthy controls participated. We performed functional magnetic resonance imaging (fMRI) while participants matched photographs of houses that were unaltered, contained only high spatial frequency (HSF, high detail) information or only low spatial frequency (LSF, low detail) information. The primary outcome was group differences in blood oxygen level-dependent (BOLD) signal changes.

RESULTS

The BDD group showed lower activity in the parahippocampal gyrus, lingual gyrus and precuneus for LSF images. There were greater activations in medial prefrontal regions for HSF images, although no significant differences when compared to a low-level baseline. Greater symptom severity was associated with lower activity in the dorsal occipital cortex and ventrolateral prefrontal cortex for normal spatial frequency (NSF) and HSF images.

CONCLUSIONS

Individuals with BDD have abnormal brain activation patterns when viewing objects. Hypoactivity in visual association areas for configural and holistic (low detail) elements and abnormal allocation of prefrontal systems for details are consistent with a model of imbalances in global versus local processing. This may occur not only for appearance but also for general stimuli unrelated to their symptoms.

Cholinergic modulation of cognition: insights from human pharmacological functional neuroimaging

Evidence from lesion and cortical-slice studies implicate the neocortical cholinergic system in the modulation of sensory, attentional and memory processing. In this review we consider findings from sixty-three healthy human cholinergic functional neuroimaging studies that probe interactions of cholinergic drugs with brain activation profiles, and relate these to contemporary neurobiological models. Consistent patterns that emerge are: (1) the direction of cholinergic modulation of sensory cortex activations depends upon top-down influences; (2) cholinergic hyperstimulation reduces top-down selective modulation of sensory cortices; (3) cholinergic hyperstimulation interacts with task-specific frontoparietal activations according to one of several patterns, including: suppression of parietal-mediated reorienting; decreasing ‘effort’-associated activations in prefrontal regions; and deactivation of a ‘resting-state network’ in medial cortex, with reciprocal recruitment of dorsolateral frontoparietal regions during performance-challenging conditions; (4) encoding-related activations in both neocortical and hippocampal regions are disrupted by cholinergic blockade, or enhanced with cholinergic stimulation, while the opposite profile is observed during retrieval; (5) many examples exist of an ‘inverted-U shaped’ pattern of cholinergic influences by which the direction of functional neural activation (and performance) depends upon both task (e.g. relative difficulty) and subject (e.g. age) factors. Overall, human cholinergic functional neuroimaging studies both corroborate and extend physiological accounts of cholinergic function arising from other experimental contexts, while providing mechanistic insights into cholinergic-acting drugs and their potential clinical applications.

Development of a novel FMRI compatible visual perception prototype battery to test older people with and without dementia

BACKGROUND

Visuoperceptual deficits in dementia are common and can reduce quality of life. Testing of visuoperceptual function is often confounded by impairments in other cognitive domains and motor dysfunction. We aimed to develop, pilot, and test a novel visuocognitive prototype test battery which addressed these issues, suitable for both clinical and functional imaging use.

METHODS

We recruited 23 participants (14 with dementia, 6 of whom had extrapyramidal motor features, and 9 age-matched controls). The novel Newcastle visual perception prototype battery (NEVIP-B-Prototype) included angle, color, face, motion and form perception tasks, and an adapted response system. It allows for individualized task difficulties. Participants were tested outside and inside the 3T functional magnetic resonance imaging (fMRI) scanner. Functional magnetic resonance imaging data were analyzed using SPM8.

RESULTS

All participants successfully completed the task inside and outside the scanner. Functional magnetic resonance imaging analysis showed activation regions corresponding well to the regional specializations of the visual association cortex. In both groups, there was significant activity in the ventral occipital-temporal region in the face and color tasks, whereas the motion task activated the V5 region. In the control group, the angle task activated the occipitoparietal cortex. Patients and controls showed similar levels of activation, except on the angle task for which occipitoparietal activation was lower in patients than controls.

CONCLUSION

Distinct visuoperceptual functions can be tested in patients with dementia and extrapyramidal motor features when tests use individualized thresholds, adapted tasks, and specialized response systems.

Selective and divided visual attention: age-related changes in regional cerebral blood flow measured by H2(15)O PET

Regional cerebral blood flow (rCBF) was measured using H2(15)O and positron emission tomography (PET) to test the hypothesis that age-related changes in the pattern of rCBF activation would be greater under divided attention conditions than under selective attention conditions. Subjects were 24 right-handed men: 12 young adults (age 21-28 years), and 12 older adults (age 60-77 years). Measurement of rCBF was obtained during performance of three visual search task conditions, each of which involved viewing a series of nine-letter displays and making a two-choice button press response to each display. Analyses of subjects' mean reaction time and error rate confirmed that older adults' search performance was disproportionately impaired when it was necessary to divide attention among the display positions. The rCBF data indicated that attending selectively to a target letter in a known (central) location was not associated with cortical activation for either age group. The requirement to divide attention among the display positions led to rCBF activation in occipitotemporal, occipitoparietal, and prefrontal cortical regions. In the divided-attention condition, rCBF activation in the occipitotemporal pathway was relatively greater for young adults; activation in prefrontal regions was relatively greater for older adults. These differences in rCBF activation were related to search reaction time and suggest that, when attention was divided, young adults' performance relied primarily on letter identification processes, whereas older adults required the recruitment of additional forms of task control.

Alzheimer disease: functional abnormalities in the dorsal visual pathway

PURPOSE

To evaluate whether patients with Alzheimer disease (AD) have altered activation compared with age-matched healthy control (HC) subjects during a task that typically recruits the dorsal visual pathway.

MATERIALS AND METHODS

The study was performed in accordance with the Declaration of Helsinki, with institutional ethics committee approval, and all subjects provided written informed consent. Two tasks were performed to investigate neural function: face matching and location matching. Twelve patients with mild AD and 14 age-matched HC subjects were included. Brain activation was measured by using functional magnetic resonance imaging. Group statistical analyses were based on a mixed-effects model corrected for multiple comparisons.

RESULTS

Task performance was not statistically different between the two groups, and within groups there were no differences in task performance. In the HC group, the visual perception tasks selectively activated the visual pathways. Conversely in the AD group, there was no selective activation during performance of these same tasks. Along the dorsal visual pathway, the AD group recruited additional regions, primarily in the parietal and frontal lobes, for the location-matching task. There were no differences in activation between groups during the face-matching task.

CONCLUSION

The increased activation in the AD group may represent a compensatory mechanism for decreased processing effectiveness in early visual areas of patients with AD. The findings support the idea that the dorsal visual pathway is more susceptible to putative AD-related neuropathologic changes than is the ventral visual pathway.

Executive control function, brain activation and white matter hyperintensities in older adults

CONTEXT

Older adults responding to executive control function (ECF) tasks show greater brain activation on functional MRI (fMRI). It is not clear whether greater fMRI activation indicates a strategy to compensate for underlying brain structural abnormalities while maintaining higher performance.

OBJECTIVE

To identify the patterns of fMRI activation in relationship with ECF performance and with brain structural abnormalities.

DESIGN

Cross-sectional analysis.

MAIN VARIABLES OF INTEREST

fMRI activation, accuracy while performing an ECF task (Digit Symbol Substitution Test), and volume of white matter hyperintensities and of total brain atrophy.

SETTING

Cohort of community-dwelling older adults.

PARTICIPANTS

Data were obtained on 25 older adults (20 women, 81 years mean age).

OUTCOME MEASURE

Accuracy (number of correct response/total number of responses) while performing the Digit Symbol Substitution Test.

RESULTS

Greater accuracy was significantly associated with greater peak fMRI activation, from ECF regions, including left middle frontal gyrus and right posterior parietal cortex. Greater WMH was associated with lower activation within accuracy-related regions. The interaction of accuracy by white matter hyperintensity volume was significant within the left posterior parietal region. Specifically, the correlation of white matter hyperintensity volume with fMRI activation varied as a function of accuracy and it was positive for greater accuracy. Associations with brain atrophy were not significant.

CONCLUSIONS

Recruitment of additional areas and overall greater brain activation in older adults is associated with higher performance. Posterior parietal activation may be particularly important to maintain higher accuracy in the presence of underlying brain connectivity structural abnormalities.

Resting-state BOLD networks versus task-associated functional MRI for distinguishing Alzheimer's disease risk groups

To assess the ability of resting-state functional magnetic resonance imaging to distinguish known risk factors for AD, we evaluated 17 cognitively normal individuals with a family history of AD and at least one copy of the apolipoprotein e4 allele compared to 12 individuals who were not carriers of the APOE4 gene and did not have a family history of AD. Blood oxygen level dependent fMRI was performed evaluating encoding-associated signal and resting-state default mode network signal differences between the two risk groups. Neurocognitive testing revealed that the high risk group performed worse on category fluency testing, but the groups were equivalent on all other cognitive measures. During encoding of novel face-name pairs, there were no regions of encoding-associated BOLD activations that were different in the high risk group. Encoding-associated deactivations were greater in magnitude in the low risk group in the medial and right lateral parietal cortex, similar to findings in AD studies. The resting-state DMN analysis demonstrated nine regions in the prefrontal, orbital frontal, temporal and parietal lobes that distinguished the two risk groups. Resting-state DMN analysis could distinguish risk groups with an effect size of 3.35, compared to an effect size of 1.39 using encoding-associated fMRI techniques. Imaging of the resting state avoids performance related variability seen in activation fMRI, is less complicated to acquire and standardize, does not require radio-isotopes, and may be more effective at identifying functional pathology associated with AD risk compared to non-resting fMRI techniques.

Evidence for highly selective neuronal tuning to whole words in the "visual word form area"

Theories of reading have posited the existence of a neural representation coding for whole real words (i.e., an orthographic lexicon), but experimental support for such a representation has proved elusive. Using fMRI rapid adaptation techniques, we provide evidence that the human left ventral occipitotemporal cortex (specifically the "visual word form area," VWFA) contains a representation based on neurons highly selective for individual real words, in contrast to current theories that posit a sublexical representation in the VWFA.

Regional brain volumes and symptom severity in body dysmorphic disorder

Body dysmorphic disorder (BDD) is a severe psychiatric condition in which individuals are preoccupied with perceived defects in their appearance. Little is known of the pathophysiology or neurobiology of BDD. Recent evidence from a functional MRI study examining visual processing of faces demonstrated abnormal activation patterns in regions including left-sided inferior frontal gyrus (IFG) and amygdala. To investigate morphometric abnormalities, we compared brain volumes from high-resolution T1 magnetic resonance images of 12 unmedicated subjects with BDD to images of 12 matched controls using voxel-based morphometry (VBM). In addition, we compared volumes in specific regions of interest including the IFG, amygdala, caudate, and total grey and white matter and examined correlations with symptom severity. VBM revealed no statistically significant volumetric differences, nor were there significant differences in any of the regions of interest. However, there were significant positive correlations between scores on the BDD version of the Yale-Brown Obsessive-Compulsive Disorder Scale (BDD-YBOCS) and volumes of the left IFG (r=0.69) and the right amygdala (r=0.54). These findings of correlations between BDD symptom severity and volumes of the left IFG and the right amygdala. These are in concordance with the involvement of these regions in pathological face processing, which may contribute to the primary symptomatology.

Cholinergic modulation of visual working memory during aging: a parametric PET study

Age-related differences in the regional recruitment of prefrontal cortex (PFC) during cognitive tasks suggests that aging is associated with functional reorganization. Cholinergic enhancement with physostigmine reduces activity in the PFC regions selectively recruited during working memory (WM) and increases activity in visual processing areas, suggesting that augmenting cholinergic function reduces task effort by improving the visual representation of WM stimuli. Here, we investigated how cholinergic enhancement influenced PFC and visual cortical activity in young and older subjects as WM difficulty was altered. Regional cerebral blood flow (rCBF) was measured using H(2)(15)O-PET in 10 young and 10 older volunteers during a parametrically varied face WM task, following an i.v. infusion of saline and physostigmine. Reaction time decreased during physostigmine relative to placebo in both groups. Prefrontal brain regions selectively recruited in each age group that responded differentially to task demands during placebo, had no significant activity during physostigmine. Medial visual processing areas showed task-selective increases in activity during drug in both groups, while lateral regions showed decreased activity in young and increased activity in older participants at longer task delays. These results are consistent with our previous findings, showing that the modulatory role of the cholinergic system persists during aging, and that the effects of cholinergic enhancement are functionally specific rather than anatomically specific. Moreover, the use of the parametric design allowed us to uncover group specific effects in lateral visual processing areas where increasing cholinergic function produced opposite effects on neural activity in the two age groups.

Cholinergic enhancement eliminates modulation of neural activity by task difficulty in the prefrontal cortex during working memory

Previously, we demonstrated that enhancing cholinergic activity during a working memory (WM) task improves performance and reduces blood flow in the right anterior middle/superior frontal cortex, an area known to be important for WM. The purpose of this study was to evaluate the interaction between WM task demands and cholinergic enhancement on neural responses in the prefrontal cortex. Regional cerebral blood flow (rCBF) was measured using H(2)(15)O and positron emission tomography, as 10 young healthy volunteers performed a parametrically varied match-to-sample WM for faces task. For each item, a picture of a face was presented, followed by a delay (1, 6, 11, or 16 sec), then by the presentation of two faces. Subjects were instructed to identify which face they previously had seen. For control items, nonsense pictures were presented in the same spatial and temporal manner. All conditions were performed during an intravenous infusion of saline and physostigmine (1 mg/hr). Subjects were blind to the substance being infused. Reaction time increased significantly with WM delay, and physostigmine decreased reaction time across delay conditions. Significant task-related rCBF increases during saline infusion were seen in superior frontal, middle frontal, and inferior frontal regions, and the response magnitudes in the regions increased systematically with task difficulty. In all of these prefrontal regions, physostigmine administration significantly reduced rCBF during task, particularly at longer task delays, so that no correlation between task delay and rCBF was observed. In the ventral visual cortex, physostigmine increased rCBF at longer task delays in medial regions, and decreased rCBF over delay conditions in lateral cortical areas. These results indicate that, during cholinergic potentiation, brain activity in prefrontal regions is not modulated by increases in WM task demands, and lends further support to the hypothesis that cholinergic modulation enhances visual processing, making the task easier to perform, and thus, compensate for the need to recruit prefrontal cortical regions as task demands increase.

A tale of two recognition systems: implications of the fusiform face area and the visual word form area for lateralized object recognition models

Two areas of current intense interest in the neuroimaging literature are that of the visual word form area (VWFA) and of the fusiform face area (FFA) and their roles in word and face perception, respectively. These two areas are of particular relevance to laterality research because visual word identification and face identification have long been shown to be especially lateralized to the left hemisphere and the right hemisphere, respectively. This review therefore seeks to evaluate their significance for the broader understanding of lateralization of object recognition. A multi-level model of lateralized object recognition is proposed based on a combination of behavioral and neuroimaging findings. Rather than seek to characterize hemispheric asymmetries according to a single principle (e.g., serial-parallel), it is suggested that current observations can be understood in terms of three asymmetric levels of processing, using the framework of the Janus model of hemispheric function. It is suggested that the left hemisphere represents features using an abstract-category code whereas the RH utilizes a specific-exemplar code. The relationships between these features are also coded asymmetrically, with the LH relying on associative co-occurrence values and the RH relying on spatial metrics. Finally, the LH controlled selection system focuses on isolating features and the RH focuses on conjoining features. It is suggested that each hemisphere utilizes efficient (apparently parallel) processing when stimuli are congruent with its preferred processing style and inefficient (apparently serial) processing when they are not, resulting in the typical left-lateralization for orthographic analysis and right-lateralization for face analysis.

Categorization training results in shape- and category-selective human neural plasticity

Object category learning is a fundamental ability, requiring the combination of "bottom-up" stimulus-driven with "top-down" task-specific information. It therefore may be a fruitful domain for study of the general neural mechanisms underlying cortical plasticity. A simple model predicts that category learning involves the formation of a task-independent shape-selective representation that provides input to circuits learning the categorization task, with the computationally appealing prediction of facilitated learning of additional, novel tasks over the same stimuli. Using fMRI rapid-adaptation techniques, we find that categorization training (on morphed "cars") induced a significant release from adaptation for small shape changes in lateral occipital cortex irrespective of category membership, compatible with the sharpening of a representation coding for physical appearance. In contrast, an area in lateral prefrontal cortex, selectively activated during categorization, showed sensitivity posttraining to explicit changes in category membership. Further supporting the model, categorization training also improved discrimination performance on the trained stimuli.

Neural correlates of processing facial identity based on features versus their spacing

Adults' expertise in recognizing facial identity involves encoding subtle differences among faces in the shape of individual facial features (featural processing) and in the spacing among features (a type of configural processing called sensitivity to second-order relations). We used fMRI to investigate the neural mechanisms that differentiate these two types of processing. Participants made same/different judgments about pairs of faces that differed only in the shape of the eyes and mouth, with minimal differences in spacing (featural blocks), or pairs of faces that had identical features but differed in the positions of those features (spacing blocks). From a localizer scan with faces, objects, and houses, we identified regions with comparatively more activity for faces, including the fusiform face area (FFA) in the right fusiform gyrus, other extrastriate regions, and prefrontal cortices. Contrasts between the featural and spacing conditions revealed distributed patterns of activity differentiating the two conditions. A region of the right fusiform gyrus (near but not overlapping the localized FFA) showed greater activity during the spacing task, along with multiple areas of right frontal cortex, whereas left prefrontal activity increased for featural processing. These patterns of activity were not related to differences in performance between the two tasks. The results indicate that the processing of facial features is distinct from the processing of second-order relations in faces, and that these functions are mediated by separate and lateralized networks involving the right fusiform gyrus, although the FFA as defined from a localizer scan is not differentially involved.

Random number generation as an index of controlled processing

Random number generation (RNG) is a functionally complex process that is highly controlled and therefore dependent on Baddeley's central executive. This study addresses this issue by investigating whether key predictions from this framework are compatible with empirical data. In Experiment 1, the effect of increasing task demands by increasing the rate of the paced generation was comprehensively examined. As expected, faster rates affected performance negatively because central resources were increasingly depleted. Next, the effects of participants' exposure were manipulated in Experiment 2 by providing increasing amounts of practice on the task. There was no improvement over 10 practice trials, suggesting that the high level of strategic control required by the task was constant and not amenable to any automatization gain with repeated exposure. Together, the results demonstrate that RNG performance is a highly controlled and demanding process sensitive to additional demands on central resources (Experiment 1) and is unaffected by repeated performance or practice (Experiment 2). These features render the easily administered RNG task an ideal and robust index of executive function that is highly suitable for repeated clinical use.

Attentional shifting and the role of the dorsal pathway in visual word recognition

A substantial amount of evidence has been collected to propose an exclusive role for the dorsal visual pathway in the control of guided visual search mechanisms, specifically in the preattentive direction of spatial selection [Vidyasagar, T. R. (1999). A neuronal model of attentional spotlight: Parietal guiding the temporal. Brain Research and Reviews, 30, 66-76; Vidyasagar, T. R. (2001). From attentional gating in macaque primary visual cortex to dyslexia in humans. Progress in Brain Research, 134, 297-312]. Moreover, it has been suggested recently that the dorsal visual pathway is specifically involved in the spatial selection and sequencing required for orthographic processing in visual word recognition. In this experiment we manipulate the demands for spatial processing in a word recognition, lexical decision task by presenting target words in a normal spatial configuration, or where the constituent letters of each word are spatially shifted relative to each other. Accurate word recognition in the Shifted-words condition should demand higher spatial encoding requirements, thereby making greater demands on the dorsal visual stream. Magnetoencephalographic (MEG) neuroimaging revealed a high frequency (35-40Hz) right posterior parietal activation consistent with dorsal stream involvement occurring between 100 and 300ms post-stimulus onset, and then again at 200-400ms. Moreover, this signal was stronger in the shifted word condition, compared to the normal word condition. This result provides neurophysiological evidence that the dorsal visual stream may play an important role in visual word recognition and reading. These results further provide a plausible link between early stage theories of reading, and the magnocellular-deficit theory of dyslexia, which characterises many types of reading difficulty.

Evaluation of a shape-based model of human face discrimination using FMRI and behavioral techniques

Understanding the neural mechanisms underlying object recognition is one of the fundamental challenges of visual neuroscience. While neurophysiology experiments have provided evidence for a "simple-to-complex" processing model based on a hierarchy of increasingly complex image features, behavioral and fMRI studies of face processing have been interpreted as incompatible with this account. We present a neurophysiologically plausible, feature-based model that quantitatively accounts for face discrimination characteristics, including face inversion and "configural" effects. The model predicts that face discrimination is based on a sparse representation of units selective for face shapes, without the need to postulate additional, "face-specific" mechanisms. We derive and test predictions that quantitatively link model FFA face neuron tuning, neural adaptation measured in an fMRI rapid adaptation paradigm, and face discrimination performance. The experimental data are in excellent agreement with the model prediction that discrimination performance should asymptote as faces become dissimilar enough to activate different neuronal populations.

Imaging studies and APOE genotype in persons at risk for Alzheimer's disease

Many studies have investigated APOE-related differences in cerebral structure, blood flow, metabolism, and activation in an attempt to detect early brain changes in subjects at risk for Alzheimer's disease (AD). Structural magnetic resonance imaging studies have produced conflicting results, with some failing to detect APOE-related differences and others suggesting that epsilon4 carriers have more pronounced atrophy, particularly at medial temporal structures. All functional imaging studies done during rest in middle-aged and elderly subjects have found decreased cerebral metabolism for epsilon4 carriers (mostly in areas that usually are affected by AD), and some have reported faster cerebral metabolic reductions over time. Areas with decreased resting cerebral perfusion and metabolism, in addition to other areas with increased perfusion, have been reported in young epsilon4 carriers. Imaging studies done during the performance of various cognitive tasks in middle-aged and elderly subjects, and a single study in young subjects, have produced mixed results with regionally nonspecific increased, decreased, or nondifferential APOE-related activations depending on the cognitive task used. APOE-related findings in imaging studies of nondemented subjects may be the result of incipient AD pathologic changes or of genetic heterogeneity in brain structure and function.

Task difficulty in a simultaneous face matching task modulates activity in face fusiform area

The level of difficulty of a task can alter the neural network that activates for performance of the task. Previous studies have shown increased activation with task difficulty in the frontal lobes while the effects in the extrastriate visual areas have been unclear. We hypothesized that the face fusiform area (FFA), an area specialized for face processing, would increase activation as task difficulty increased in a face matching task. The difficulty level was increased by degrading the quality of the images. The degradation levels were 10%, 20%, 40% and 60%. Based on the correct response rate, the data were divided into a baseline level (composed of non-degraded and 10% degraded images) and a difficult level (composed of the 20%, 40% and 60% degraded images). Brain activation was measured using functional magnetic resonance imaging. The baseline face matching task activated a wide network of regions that included bilaterally the occipital, temporal and parietal lobes and the right frontal lobe. A novel behavioral finding was that task difficulty did not linearly increase with image degradation. The novel brain imaging finding was that the FFA is modulated by task difficulty and performance in the task was linearly correlated to activation in FFA. In addition, we found that activation in the dorsolateral prefrontal cortex (DLPFC) had increased activation as task difficulty increased. When adding the response time as a covariate, the differences in the DLPFC did not remain statistically significant. Increased task difficulty also led to a decrease in activation of visual areas in the extrastriate cortex. Task difficulty increased activation in the FFA to enhance the face processing and suppressed activation in visual extrastriate areas that processed low level properties of the stimuli. Task difficulty led to enhanced response in the FFA and suppressed response in other visual areas.

Functional activation imaging in aging and dementia

With life expectancy increasing continuously, the effects of neurodegeneration on brain function are a topic of ever increasing importance. Thus there is a need for tools and models that probe both the functional consequences of neurodegenerative processes and compensatory mechanisms that might occur. As neurodegenerative burden and compensatory mechanisms may change over time, these tools will ideally be applied multiple times over the lifespan. Specifically, in order to elucidate whether brain-activation patterns in Alzheimer's disease (AD) and in healthy aging follow general rules in the context of degeneration and compensation, it is necessary to compare functional brain-activation patterns during different states of neurodegeneration. This article integrates the findings of functional activation studies at different stages of neurodegeneration: in healthy aging, in subjects at high risk of developing dementia, in subjects with mild cognitive impairment (MCI), and in patients suffering from AD. We review existing theoretical models that aim to explain the underlying mechanisms of functional activation changes in aging and dementia, and we propose an integrative account, which allows for different neural response patterns depending on the amount of neuronal damage and the recruitment of compensatory pathways.

Brain networks associated with cognitive reserve in healthy young and old adults

In order to understand the brain networks that mediate cognitive reserve, we explored the relationship between subjects' network expression during the performance of a memory test and an index of cognitive reserve. Using H2(15)O positron emission tomography, we imaged 17 healthy older subjects and 20 young adults while they performed a serial recognition memory task for nonsense shapes under two conditions: low demand, with a unique shape presented in each study trial; and titrated demand, with a study list size adjusted so that each subject recognized shapes at 75% accuracy. A factor score that summarized years of education, and scores on the NART and the WAIS-R Vocabulary subtest was used as an index of cognitive reserve. The scaled subprofile model was used to identify a set of functionally connected regions (or topography) that changed in expression across the two task conditions and was differentially expressed by the young and elderly subjects. The regions most active in this topography consisted of right hippocampus, posterior insula, thalamus, and right and left operculum; we found concomitant deactivation in right lingual gyrus, inferior parietal lobe and association cortex, left posterior cingulate, and right and left calcarine cortex. Young subjects with higher cognitive reserve showed increased expression of the topography across the two task conditions. Because this topography, which is responsive to increased task demands, was differentially expressed as a function of reserve level, it may represent a neural manifestation of innate or acquired reserve. In contrast, older subjects with higher cognitive reserve showed decreased expression of the topography across tasks. This suggests some functional reorganization of the network used by the young subjects. Thus, for the old subjects this topography may represent an altered, compensatory network that is used to maintain function in the face of age-related physiological changes.

CIRCADIAN PREFERENCE AND COGNITIVE FUNCTIONING AMONG REHABILITATION INPATIENTS

The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpatients with cognitive (n=28) and noncognitive (n=28) impairments. Each individual was tested twice: morning (preferred time) and evening (nonpreferred time); sessions and test batteries were counterbalanced to control for practice effects. Standard measures assessed attention, language, memory, visuospatial, and executive functions. Persons with cognitive impairment showed disproportionate vulnerability to the effects of circadian preference and time of testing, performing more poorly at nonpreferred than preferred times. Substantial effects (eta2 .12 to .48) were found on tests of executive functioning and tasks incorporating similar higher-order demands (e/g/. complex figure copy). Results are supported by tympanic temperature changes during a vigilance task, and index of cerebral blood flow in response to cognitive challenge. Cognitive reserve theory is suggested as an explanation for the differential effects. These findings may have implications for inpatient therapeutic interventions and discharge planning.

Altered PET functional brain responses in cognitively intact elderly persons at risk for Alzheimer disease (carriers of the epsilon4 allele)

OBJECTIVE

Few previous studies have investigated the association between APOE genotype and brain activation during performance of cognitive tasks in healthy middle-aged and elderly subjects, and the results have been mixed. The authors investigated APOE-mediated differential brain activation in a group of healthy elderly subjects.

METHODS

Using H215O positron emission tomography (PET), they imaged 32 healthy subjects (26 non-epsilon4 carriers and 6 epsilon4 carriers) performing a serial shape-recognition memory task under two conditions: Simple Demand (SD), in which one shape was presented in each study trial, and Titrated Demand (TD), in which study list length was adjusted so that each subject recognized words at approximately 75% accuracy. Multiple-regression analyses were performed, with the "activation" difference (TD-SD PET counts) as the dependent variable and the APOE genotype (presence versus absence of the epsilon4 allele) as the independent variable.

RESULTS

Compared with non-carriers, epsilon4 carriers exhibited significantly decreased TD-SD activation differences in the left superior temporal, right superior frontal, left postcental, left precuneus, and posterior cingulate gyrus because epsilon4 carriers (versus non-carriers) showed increased activation during the SD and decreased activation during the TD condition.

CONCLUSION

Patterns of brain activation during a nonverbal memory task differed as a function of APOE genotype and, therefore, of genetic risk for Alzheimer disease (AD). Differences in activation were not a reflection of task difficulty, but indicate memory-related altered cognitive processing. Brain regions with decreased activation in the epsilon4 subjects may result from subclinical incipient AD pathology and/or APOE-related neurophysiologic heterogeneity.