Functional MRI mapping of visual function and selective attention for performance assessment and presurgical planning using conjunctive visual search

The effects of yohimbine and hydrocortisone on selective attention to fearful faces: An fMRI study

INTRODUCTION

Selective attention to salient emotional information can enable an advantage in the face of danger. The present study aims to investigate the influence of the stress neuromodulators, norepinephrine and cortisol, on selective attention processes to fearful faces and its neuronal activation.

METHODS AND MATERIALS

We used a randomized, double-blind, placebo-controlled design. 167 healthy men between 18 and 35 years (mean [SD] age: 25.23 [4.24] years) participated in the study. Participants received either: (A) yohimbine (n= 41), (B) hydrocortisone (n = 41), (C) yohimbine and hydrocortisone (n = 42) or (D) placebo only (n= 43) and participated in a dot-probe task with fearful and neutral faces in an fMRI scanner.

RESULTS

We found an attentional bias toward fearful faces across all groups and related neuronal activation in the left cuneus. We did not find any differences between experimental treatment groups in selective attention and its neuronal activation.

DISCUSSION

Our results provide evidence that fearful faces lead to an attentional bias with related neuronal activation in the left cuneus. We did not replicate formerly reported activation in the amygdala, intraparietal sulcus, dorsal anterior cingulate cortex, and thalamus. Suitability of the dot-probe task for fMRI studies and insignificant treatment effects are discussed.

Decoding visual fatigue in a visual search task selectively manipulated via myopia-correcting lenses

Introduction

Visual fatigue resulting from sustained, high-workload visual activities can significantly impact task performance and general wellbeing. So far, however, little is known about the underlying brain networks of visual fatigue. This study aimed to identify such potential networks using a unique paradigm involving myopia-correcting lenses known to directly modulate subjectively-perceived fatigue levels.

Methods

A sample of N = 31 myopia participants [right eye-SE: -3.77D (SD: 2.46); left eye-SE: -3.75D (SD: 2.45)] performed a demanding visual search task with varying difficulty levels, both with and without the lenses, while undergoing fMRI scanning. There were a total of 20 trials, after each of which participants rated the perceived difficulty and their subjective visual fatigue level. We used representational similarity analysis to decode brain regions associated with fatigue and difficulty, analyzing their individual and joint decoding pattern.

Results and discussion

Behavioral results showed correlations between fatigue and difficulty ratings and above all a significant reduction in fatigue levels when wearing the lenses. Imaging results implicated the cuneus, lingual gyrus, middle occipital gyrus (MOG), and declive for joint fatigue and difficulty decoding. Parts of the lingual gyrus were able to selectively decode perceived difficulty. Importantly, a broader network of visual and higher-level association areas showed exclusive decodability of fatigue (culmen, middle temporal gyrus (MTG), parahippocampal gyrus, precentral gyrus, and precuneus). Our findings enhance our understanding of processing within the context of visual search, attention, and mental workload and for the first time demonstrate that it is possible to decode subjectively-perceived visual fatigue during a challenging task from imaging data. Furthermore, the study underscores the potential of myopia-correcting lenses in investigating and modulating fatigue.

ROI-based analysis of diffusion indices in healthy subjects and subjects with deficit or non-deficit syndrome schizophrenia

We analyzed DTI data involving 22 healthy subjects (HC), 15 patients with deficit syndrome schizophrenia (DSZ), and 25 patients with non-deficit syndrome schizophrenia (NDSZ). We used a 1.5-T MRI scanner to collect diffusion-weighted images and T1 images, which were employed to correct distortions and deformations within the diffusion-weighted images. For 156 regions of interest (ROI), we calculated the average fractional anisotropy (FA), mean diffusion (MD), and radial diffusion (RD). Each ROI underwent a group-wise comparison using permutation F-test, followed by post hoc pairwise comparisons with Bonferroni correction. In general, we observed lower FA in both schizophrenia groups compared to HC (i.e., HC>(DSZ=NDSZ)), while MD and RD showed the opposite pattern. Notably, specific ROIs with reduced FA in schizophrenia patients included bilateral nucleus accumbens, left fusiform area, brain stem, anterior corpus callosum, left rostral and caudal anterior cingulate, right posterior cingulate, left thalamus, left hippocampus, left inferior temporal cortex, right superior temporal cortex, left pars triangularis and right lingual gyrus. Significantly, the right cuneus exhibited lower FA in the DSZ group compared to other groups ((HC=NDSZ)>DSZ), without affecting MD and RD. These results indicate that compromised neural integrity in the cuneus may contribute to the pathophysiological distinctions between DSZ and NDSZ.

Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging-Tractography in Resective Brain Surgery: Lesion Coverage Strategies and Patient Outcomes

Diffusion tensor imaging (DTI)-tractography and functional magnetic resonance imaging (fMRI) have dynamically entered the presurgical evaluation context of brain surgery during the past decades, providing novel perspectives in surgical planning and lesion access approaches. However, their application in the presurgical setting requires significant time and effort and increased costs, thereby raising questions regarding efficiency and best use. In this work, we set out to evaluate DTI-tractography and combined fMRI/DTI-tractography during intra-operative neuronavigation in resective brain surgery using lesion-related preoperative neurological deficit (PND) outcomes as metrics. We retrospectively reviewed medical records of 252 consecutive patients admitted for brain surgery. Standard anatomical neuroimaging protocols were performed in 127 patients, 69 patients had additional DTI-tractography, and 56 had combined DTI-tractography/fMRI. fMRI procedures involved language, motor, somatic sensory, sensorimotor and visual mapping. DTI-tractography involved fiber tracking of the motor, sensory, language and visual pathways. At 1 month postoperatively, DTI-tractography patients were more likely to present either improvement or preservation of PNDs (p = 0.004 and p = 0.007, respectively). At 6 months, combined DTI-tractography/fMRI patients were more likely to experience complete PND resolution (p < 0.001). Low-grade lesion patients (N = 102) with combined DTI-tractography/fMRI were more likely to experience complete resolution of PNDs at 1 and 6 months (p = 0.001 and p < 0.001, respectively). High-grade lesion patients (N = 140) with combined DTI-tractography/fMRI were more likely to have PNDs resolved at 6 months (p = 0.005). Patients with motor symptoms (N = 80) were more likely to experience complete remission of PNDs at 6 months with DTI-tractography or combined DTI-tractography/fMRI (p = 0.008 and p = 0.004, respectively), without significant difference between the two imaging protocols (p = 1). Patients with sensory symptoms (N = 44) were more likely to experience complete PND remission at 6 months with combined DTI-tractography/fMRI (p = 0.004). The intraoperative neuroimaging modality did not have a significant effect in patients with preoperative seizures (N = 47). Lack of PND worsening was observed at 6 month follow-up in patients with combined DTI-tractography/fMRI. Our results strongly support the combined use of DTI-tractography and fMRI in patients undergoing resective brain surgery for improving their postoperative clinical profile.

Decreased intrinsic neural timescales in obsessive compulsive disorder and two distinct subtypes revealed by heterogeneity through discriminative analysis

BACKGROUND

OCD is featured as the destruction of information storage and processing. The cognition of neurobiological and clinical heterogeneity is in suspense and poorly studied.

METHODS

Ninety-nine patients and matched HCs(n = 104) were recruited and underwent resting-state functional MRI scans. We applied INT to evaluate altered local neural dynamics representing the ability of information integration. Moreover, considering OCD was a highly heterogeneous disorder, we investigated putative OCD subtypes from INT using a novel semi-supervised machine learning, named HYDRA.

RESULTS

Compared with HCs, patients with OCD showed decreased INTs in extensive brain regions, including bilateral cerebellum and precuneus, STG/MTG and PCC, hippocampus in DMN; right IFG/MFG/SFG, SPL and bilateral angular gyrus in CEN and insula, SMA in SN. Moreover, many other regions involved in visual processing also had disrupted dynamics of local neural organization, consisting of bilateral CUN, LING and fusiform gyrus and occipital lobe. HYDRA divided patients into two distinct neuroanatomical subtypes from INT. Subtype 1 showed decreased INTs in distributed networks, while subtype 2 presented increased in several common regions which were also found to be decreased in subtype 1, such as STG, IPL, postcentral gyrus and left insula, supramarginal gyrus.

CONCLUSION

This study showed distinct abnormalities from the perspective of dynamics of local neural organization in OCD. Such alteration and dimensional approach may provide a new insight into the prior traditional cognition of this disorder and to some extent do favor of more precise diagnosis and treatment response in the future.

Cerebellar functional connectivity change is associated with motor and neuropsychological function in early stage drug-naïve patients with Parkinson's disease

Introduction

Parkinson's Disease (PD) is a progressive neurodegenerative disorder affecting both motor and cognitive function. Previous neuroimaging studies have reported altered functional connectivity (FC) in distributed functional networks. However, most neuroimaging studies focused on patients at an advanced stage and with antiparkinsonian medication. This study aims to conduct a cross-sectional study on cerebellar FC changes in early-stage drug-naïve PD patients and its association with motor and cognitive function.

Methods

Twenty-nine early-stage drug-naïve PD patients and 20 healthy controls (HCs) with resting-state fMRI data and motor UPDRS and neuropsychological cognitive data were extracted from the Parkinson's Progression Markers Initiative (PPMI) archives. We used seed-based resting-state fMRI (rs-fMRI) FC analysis and the cerebellar seeds were defined based on the hierarchical parcellation of the cerebellum (AAL atlas) and its topological function mapping (motor cerebellum and non-motor cerebellum).

Results

The early stage drug-naïve PD patients had significant differences in cerebellar FC when compared with HCs. Our findings include: (1) Increased intra-cerebellar FC within motor cerebellum, (2) increase motor cerebellar FC in inferior temporal gyrus and lateral occipital gyrus within ventral visual pathway and decreased motor-cerebellar FC in cuneus and dorsal posterior precuneus within dorsal visual pathway, (3) increased non-motor cerebellar FC in attention, language, and visual cortical networks, (4) increased vermal FC in somatomotor cortical network, and (5) decreased non-motor and vermal FC within brainstem, thalamus and hippocampus. Enhanced FC within motor cerebellum is positively associated with the MDS-UPDRS motor score and enhanced non-motor FC and vermal FC is negatively associated with cognitive function test scores of SDM and SFT.

Conclusion

These findings provide support for the involvement of cerebellum at an early stage and prior to clinical presentation of non-motor features of the disease in PD patients.

Alterations of amplitude of low-frequency fluctuations and fractional amplitude of low-frequency fluctuations in end-stage renal disease on maintenance dialysis: An activation likelihood estimation meta-analysis

BACKGROUND

Cognitive impairment (CI) is a common complication of end-stage renal disease (ESRD). Many resting-state functional magnetic resonance imaging (rs-fMRI) studies have identified abnormal spontaneous low-frequency brain activity in ESRD dialysis patients. However, these studies have reported inconsistent results. So far, no meta-analyses on this topic have been published. This meta-analysis aimed to identify the more consistently vulnerable brain regions in ESRD patients at rest and to reveal its possible neuropathophysiological mechanisms.

METHODS

We systematically searched PubMed, Cochrane Library, Web of Science, Medline, and EMBASE databases up to July 20, 2022 based on the amplitude of low-frequency fluctuation (ALFF) or fractional amplitude of low-frequency fluctuation (fALFF). Brain regions with abnormal spontaneous neural activity in ESRD compared to healthy controls (HCs) from previous studies were integrated and analyzed using an activation likelihood estimation (ALE) method. Jackknife sensitivity analysis was carried out to assess the reproducibility of the results.

RESULTS

In total, 11 studies (380 patients and 351 HCs) were included in the final analysis. According to the results of the meta-analysis, compared with HCs, ESRD patients had decreased ALFF/fALFF in the right precuneus, right cuneus, and left superior temporal gyrus (STG), while no brain regions with increased brain activity were identified. Jackknife sensitivity analysis showed that our results were highly reliable.

CONCLUSION

Compared to HCs, ESRD dialysis patients exhibit significant abnormalities in spontaneous neural activity associated with CI, occurring primarily in the default mode network, visual recognition network (VRN), and executive control network (ECN). This contributes to the understanding of its pathophysiological mechanisms.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022348694].

Altered spontaneous brain activity in major depressive disorder: An activation likelihood estimation meta-analysis

BACKGROUND

Wide application of resting-state functional magnetic resonance imaging (fMRI) in psychiatric research has revealed that major depressive disorder (MDD) manifest abnormal neural activities in several brain regions involving key resting state networks. However, inconsistent results have hampered our understanding of the exact neuropathology associated with MDD. Therefore, our aim was to conduct a meta-analysis to identify the consistent vulnerable brain regions of MDD in resting state, and to reveal the potential pathogenesis of MDD.

METHODS

A systematic review analysis was conducted on studies involving brain resting-state changes in MDD using low-frequency amplitude (ALFF), fractional low-frequency amplitude (fALFF) and regional homogeneity (ReHo) analysis. The meta-analysis was based on the activation likelihood estimation method, using the software of Ginger ALE 2.3.

RESULTS

25 studies (892 MDD and 799 healthy controls) were included. Based on the meta-analysis results of ReHo, we found robust reduction of resting-state spontaneous brain activity in MDD, including the left cuneus and right middle occipital gyrus (cluster size = 216, 256 mm³, uncorrected P < 0.0001), while no increased spontaneous activation in any of the brain regions. We also found reduced ALFF in the left middle occipital gyrus (cluster size = 224 mm³, uncorrected P < 0.0001), and no increased spontaneous brain activation in any regions.

CONCLUSION

Our meta-analysis study using the activation likelihood estimation method demonstrated that MDD showed significant abnormalities in spontaneous neural activity, compared with healthy controls, mainly in areas associated with visual processing, such as the cuneus and the middle occipital gyrus. Dysfunction of these brain regions may be one of the pathogenesis of MDD.

Cortical network formation based on subthalamic beta bursts in Parkinson's disease

Recent evidence suggests that beta bursts in subthalamic nucleus (STN) play an important role in Parkinsonian pathophysiology. We studied the spatio-temporal relationship between STN beta bursts and cortical activity in 26 Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) surgery. Postoperatively, we simultaneously recorded STN local field potentials (LFP) from externalized DBS leads and cortical activity using whole-brain magnetoencephalography. Event-related magnetic fields (ERF) were averaged time-locked to STN beta bursts and subjected to source localization. Our results demonstrate that ERF exhibiting activity significantly different from baseline activity were localized within areas functionally related to associative, limbic, and motor systems as well as regions pertinent for visual and language processing. Our data suggest that STN beta bursts are involved in network formation between STN and cortex. This interaction is in line with the idea of parallel processing within the basal ganglia-cortex loop, specifically within the functional subsystems of the STN (i.e., associative, limbic, motor, and the related cortical areas). ERFs within visual and language-related cortical areas indicate involvement of beta bursts in STN-cortex networks beyond the associative, limbic, and motor loops. In sum, our results highlight the involvement of STN beta bursts in the formation of multiple STN - cortex loops in patients with PD.

Altered Brain Function in Treatment-Resistant and Non-treatment-resistant Depression Patients: A Resting-State Functional Magnetic Resonance Imaging Study

OBJECTIVE

In this study, we used amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) to observe differences in local brain functional activity and its characteristics in patients with treatment-resistant depression (TRD) and non-treatment-resistant depression (nTRD), and to explore the correlation between areas of abnormal brain functional activity and clinical symptoms.

METHOD

Thirty-seven patients with TRD, 36 patients with nTRD, and 35 healthy controls (HCs) were included in resting-state fMRI scans. ALFF and ReHo were used for image analysis and further correlation between abnormal brain regions and clinical symptoms were analyzed.

RESULTS

ANOVA revealed that the significantly different brain regions of ALFF and ReHo among the three groups were mainly concentrated in the frontal and temporal lobes. Compared with the nTRD group, the TRD group had decreased ALFF in the left/right inferior frontal triangular gyrus, left middle temporal gyrus, left cuneus and bilateral posterior lobes of the cerebellum, and increased ALFF in the left middle frontal gyrus and right superior temporal gyrus, and the TRD group had decreased ReHo in the left/right inferior frontal triangular gyrus, left middle temporal gyrus, and increased ReHo in the right superior frontal gyrus. Compared with the HC group, the TRD group had decreased ALFF/ReHo in both the right inferior frontal triangular gyrus and the left middle temporal gyrus. Pearson correlation analysis showed that both ALFF and ReHo values in these abnormal brain regions were positively correlated with HAMD-17 scores (P < 0.05).

CONCLUSION

Although the clinical symptoms were similar in the TRD and nTRD groups, abnormal neurological functional activity were present in some of the same brain regions. Compared with the nTRD group, ALFF and ReHo showed a wider range of brain area alterations and more complex neuropathological mechanisms in the TRD group, especially in the inferior frontal triangular gyrus of the frontal lobe and the middle temporal gyrus of the temporal lobe.

Subthreshold depressive symptoms relate to cuneus structure: Thickness asymmetry and sex differences

Despite the prominence of frontolimbic regions in depression research, recent studies also implicate posterior brain regions, including the cuneus. The current study examined the relationship between depressive symptoms and asymmetry in cuneal cortical thickness in healthy adults between the ages of 18 and 81 with primarily subthreshold levels of depressive symptoms. An asymmetry index was calculated for cortical thickness in the cuneus [(left - right) × 100/(left + right)], and regression analyses were conducted with total scores on the Center for Epidemiologic Studies Depression Scale predicting this asymmetry index, controlling for age and sex. Higher depressive symptoms were associated with a left > right asymmetry in cuneal cortical thickness, reflecting greater cortical thickness in the left hemisphere compared to right hemisphere. Follow-up analyses examining CES-D subscales showed significant effects for somatic symptoms of depression, but not negative affect or anhedonia. Analyses stratified by sex yielded significant effects in men but not in women. Results of this preliminary study further support the cuneus' role in depression and highlight the importance of examining symptom dimensions and sex differences in the neurobiology of depression.

Altered Dynamic Functional Connectivity of Cuneus in Schizophrenia Patients: A Resting-State fMRI Study

Objective: Schizophrenia (SZ) is a functional mental condition that has a significant impact on patients’ social lives. As a result, accurate diagnosis of SZ has attracted researchers’ interest. Based on previous research, resting-state functional magnetic resonance imaging (rsfMRI) reported neural alterations in SZ. In this study, we attempted to investigate if dynamic functional connectivity (dFC) could reveal changes in temporal interactions between SZ patients and healthy controls (HC) beyond static functional connectivity (sFC) in the cuneus, using the publicly available COBRE dataset. Methods: Sliding windows were applied to 72 SZ patients’ and 74 healthy controls’ (HC) rsfMRI data to generate temporal correlation maps and, finally, evaluate mean strength (dFC-Str), variability (dFC-SD and ALFF) in each window, and the dwelling time. The difference in functional connectivity (FC) of the cuneus between two groups was compared using a two-sample t-test. Results: Our findings demonstrated decreased mean strength connectivity between the cuneus and calcarine, the cuneus and lingual gyrus, and between the cuneus and middle temporal gyrus (TPOmid) in subjects with SZ. Moreover, no difference was detected in variability (standard deviation and the amplitude of low-frequency fluctuation), the dwelling times of all states, or static functional connectivity (sFC) between the groups. Conclusions: Our verdict suggest that dynamic functional connectivity analyses may play crucial roles in unveiling abnormal patterns that would be obscured in static functional connectivity, providing promising impetus for understanding schizophrenia disease.

Current and Future Challenges of Functional MRI and Diffusion Tractography in the Surgical Setting: From Eloquent Brain Mapping to Neural Plasticity

Decades ago, Spetzler (1986) and Sawaya (1998) provided a rough brain segmentation of the eloquent areas of the brain, aimed to help surgical decisions in cases of vascular malformations and tumors, respectively. Currently in clinical use, their criteria are in need of revision. Defining functions (eg, sensorimotor, language and visual) that should be preserved during surgery seems a straightforward task. In practice, locating the specific areas that could cause a permanent vs transient deficit is not an easy task. This is particularly true for the associative cortex and cognitive domains such as language. The old model, with Broca's and Wernicke's areas at the forefront, has been superseded by a dual-stream model of parallel language processing; named ventral and dorsal pathways. This complicated network of cortical hubs and subcortical white matter pathways needing preservation during surgery is a work in progress. Preserving not only cortical regions but most importantly preserving the connections, or white matter fiber bundles, of core regions in the brain is the new paradigm. For instance, the arcuate fascicululs and inferior fronto-occipital fasciculus are key components of the dorsal and ventral language pathways, respectively; and their damage result in permanent language deficits. Interestedly, the damage of the temporal portions of these bundles -where there is a crossroad with other multiple bundles-, appears to be more important (permanent) than the damage of the frontal portions - where plasticity and contralateral activation could help. Although intraoperative direct cortical and subcortical stimulation have contributed largely, advanced MR techniques such as functional MRI (fMRI) and diffusion tractography (DT), are at the epi-center of our current understanding. Nevertheless, these techniques posse important challenges: such as neurovascular uncoupling or venous bias on fMRI; and appropriate anatomical validation or accurate representation of crossing fibers on DT. These limitations should be well understood and taken into account in clinical practice. Unifying multidisciplinary research and clinical efforts is desirable, so these techniques could contribute more efficiently not only to locate eloquent areas but to improve outcomes and our understanding of neural plasticity. Finally, although there are constant anatomical and functional regions at the individual level, there is a known variability at the inter-individual level. This concept should strengthen the importance of a personalized approach when evaluating these regions on fMRI and DT. It should strengthen the importance of personalized treatments as well, aimed to meet tailored needs and expectations.

Brain and Behavioral Evidence for Reweighting of Vestibular Inputs with Long-Duration Spaceflight

Microgravity alters vestibular signaling. In-flight adaptation to altered vestibular afferents is reflected in post-spaceflight aftereffects, evidenced by declines in vestibularly mediated behaviors (e.g., walking/standing balance), until readaptation to Earth's 1G environment occurs. Here we examine how spaceflight affects neural processing of applied vestibular stimulation. We used fMRI to measure brain activity in response to vestibular stimulation in 15 astronauts pre- and post-spaceflight. We also measured vestibularly-mediated behaviors, including balance, mobility, and rod-and-frame test performance. Data were collected twice preflight and four times postflight. As expected, vestibular stimulation at the preflight sessions elicited activation of the parietal opercular area ("vestibular cortex") and deactivation of somatosensory and visual cortices. Pre- to postflight, we found widespread reductions in this somatosensory and visual cortical deactivation, supporting sensory compensation and reweighting with spaceflight. These pre- to postflight changes in brain activity correlated with changes in eyes closed standing balance, and greater pre- to postflight reductions in deactivation of the visual cortices associated with less postflight balance decline. The observed brain changes recovered to baseline values by 3 months postflight. Together, these findings provide evidence for sensory reweighting and adaptive cortical neuroplasticity with spaceflight. These results have implications for better understanding compensation and adaptation to vestibular functional disruption.

Prefrontal cortex activation during dual-task walking in older adults is moderated by thickness of several cortical regions

Dual tasking, a defined facet of executive control processes, is subserved, in part, by the prefrontal cortex (PFC). Previous functional near-infrared spectroscopy (fNIRS) studies revealed elevated PFC oxygenated hemoglobin (HbO₂) under Dual-Task-Walk (DTW) compared to Single-Task Walk (STW) conditions. Based on the concept of neural inefficiency (i.e., greater activation coupled with similar or worse performance), we hypothesized that decreased cortical thickness across multiple brain regions would be associated with greater HbO₂ increases from STW to DTW. Participants were 55 healthy community-dwelling older adults, whose cortical thickness was measured via MRI. HbO₂ levels in the PFC, measured via fNIRS, were assessed during active walking under STW and DTW conditions. Statistical analyses were adjusted for demographics and behavioral performance. Linear mixed-effects models revealed that the increase in HbO₂ from STW to DTW was moderated by cortical thickness in several regions. Specifically, thinner cortex in specific regions of the frontal, parietal, temporal, and occipital lobes, cingulate cortex, and insula was associated with greater increases in HbO₂ levels from single to dual-task walking. In conclusion, participants with thinner cortex in regions implicated in higher order control of walking employed greater neural resources, as measured by increased HbO₂, in the PFC during DTW, without demonstrating benefits to behavioral performance. To our knowledge, this is the first study to examine cortical thickness as a marker of neural inefficiency during active walking.

Brain structural plasticity in visual and sensorimotor areas of airline pilots: A voxel-based morphometric study

BACKGROUND AND PURPOSE

Airline pilot is a highly specialized profession that requires to response quickly and accurately in the presence of a wide variety of visual information. Although functional imaging studies have employed virtual simulation to identify brain areas that underlie various flying-related tasks, little is known about the specific patterns of structural plasticity in the airline pilot's brain.

MATERIALS AND METHODS

In this study, we examined differences of gray matter and white matter volumes between 42 airline pilots and 39 non-pilots by using voxel-based morphometry, and further assessed the association between magnitude of structural alterations and flight time in the pilots.

RESULTS

We found significantly increased white matter volume in the cuneus area in the pilot group compared to the non-pilot group (p <  0.05, FWE corrected). Using a relaxed threshold, it was also observed that the pilots had increased gray matter volume in the lingual gyrus, inferior frontal gyrus, supramarginal gyrus, cuneus, and postcentral gyrus, and increased white matter volume in the postcentral area (p <  0.001, uncorrected). Moreover, the pilots' flight time was positively correlated with gray matter volume in the postcentral gyrus and white matter volume in the cuneus area (p <  0.001, uncorrected).

CONCLUSIONS

The morphological changes in specific visual and sensorimotor areas may provide airline pilots with neural efficiency in the visuo-motor processing related to flight.

Anatomy and White Matter Connections of the Lingual Gyrus and Cuneus

BACKGROUND

The medial occipital lobe, composed of the lingual gyrus and cuneus, is necessary for both basic and higher level visual processing. It is also known to facilitate cross-modal, nonvisual functions, such as linguistic processing and verbal memory, after the loss of the visual senses. A detailed cortical model elucidating the white matter connectivity associated with this area could improve our understanding of the interacting brain networks that underlie complex human processes and postoperative outcomes related to vision and language.

METHODS

Generalized q-sampling imaging tractography, validated by gross anatomic dissection for qualitative visual agreement, was performed on 10 healthy adult controls obtained from the Human Connectome Project.

RESULTS

Major white matter connections were identified by tractography and validated by gross dissection, which connected the medial occipital lobe with itself and the adjacent cortices, especially the temporal lobe. The short- and long-range connections identified consisted mainly of U-shaped association fibers, intracuneal fibers, and inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, middle longitudinal fasciculus, and lingual-fusiform connections.

CONCLUSIONS

The medial occipital lobe is an extremely interconnected system, supporting its ability to perform coordinated basic visual processing, but also serves as a center for many long-range association fibers, supporting its importance in nonvisual functions, such as language and memory. The presented data represent clinically actionable anatomic information that can be used in multimodal navigation of white matter lesions in the medial occipital lobe to prevent neurologic deficits and improve patients' quality of life after cerebral surgery.

Altered brain network centrality in middle-aged patients with retinitis pigmentosa: A resting-state functional magnetic resonance imaging study

OBJECTIVE

The purpose of this study is to explore the underlying functional network brain activity changes of patients in middle-aged with retinitis pigmentosa (RP) and the relationships with clinical features such as depression scale and visual functioning using voxel-wise degree centrality (DC) method.

METHODS

We included 16 patients with RP (11 men, 5 women) and 16 healthy controls (HCs; 11 men, 5 women). Participants were matched in terms of age, weight, gender and handedness (age and weight between the two groups were compared using independent sample t-tests, gender and handedness were compared using chi-square test). We use the voxel-wise DC method to assess spontaneous brain activity. Receiver operating characteristic (ROC) curve analysis was performed to distinguish between RP patients and HCs. Correlation analysis was used to examine the relationships between mean DC values in various brain regions and clinical features (such as depression scale and visual functioning) in RP patients.

RESULTS

Compared with HCs, the DC values of patients with RP were reduced in the right medial frontal gyrus, bilateral cuneus, bilateral precuneus, and bilateral superior frontal gyrus, and increased in the right cerebellum posterior lobe, left inferior temporal gyrus, and right fusiform gyrus. The mean DC values in the bilateral cuneus negatively correlated with the depression scale, and those in the bilateral precuneus positively correlated with the Visual Functioning Questionnaire-25.

CONCLUSIONS

Middle-aged patients with RP exhibit abnormal brain network activity in various brain regions, and this may underlie the pathological mechanism of RP.

Cortical thickness and functional connectivity changes in Chinese chess experts

Background

Repeated practice to acquire expertise could result in the structural and functional changes in relevant brain circuits as a result of long-term potentiation, neurogenesis, glial genesis, and remodeling.

Purpose

The goal of this study is to use surface-based morphology (SBM) to study cortical thickness differences in Chinese chess experts and novices, and to use regions of cortical thickness differences as seeds to guide a resting state connectivity analysis of the same population.

Methods

A raw public dataset from Huaxi MR Research Center consisting of 29 Chinese chess experts and 29 novices was used in this study, with both T1-weighted and resting state functional MRI. Surface based morphometry was performed on the T1 images with the Freesurfur pipeline, with a vertex significance threshold of p<0.05 and a cluster false discovery rate of α < 0.05. Regions with significant differences were used in a seed-based comparison of resting state functional connectivity carried out with Statistical Parameter Mapping (SPM) and the Connectivity Toolbox (CONN). Regions of connectivity differences within groups were computed with a voxel significance threshold of p<0.05 and a cluster false discovery rate of α < 0.01.

Results

Ten regions of the cortex of Chinese chess experts were found to be thinner than chess novices, including regions involved in visual processing, attention, working and episodic memory, and mental imagery, as well as several regions in the prefrontal cortex. There were no regions where experts’ cortices were thicker than novices. Three of the thinner regions exhibited increased functional connectivity to distant brain regions in chess experts.

Conclusions

Brain regions that are structurally affected by chess training are associated with processes that would likely have a high utility in chess expertise. Using a hierarchical control model, we hypothesize that the functional changes linked with some of these structural changes are related to the professionally trained chess players’ ability to perceive and use contextual information, visuospatial perception, and outcome prediction in the domain of chess, all contributing to their exceptional performance.

Test-retest of a phoria adaptation stimulus-induced functional MRI experiment

This study was designed to identify the neural substrates activated during a phoria adaptation task using functional magnetic resonance imaging (MRI) in young adults with normal binocular vision and to test the repeatability of the fMRI measurements for this protocol. The phoria adaptation task consisted of a block protocol of 90 seconds of near visual crossed fixation followed by 90 seconds of far visual uncrossed fixation, repeated three times; the data were collected during two different experimental sessions. Results showed that the oculomotor vermis, cuneus, and primary visual cortex had the greatest functional activity within the regions of interest studied when stimulated by the phoria adaptation task. The oculomotor vermis functional activity had an intraclass correlation coefficient (ICC) of 0.3, whereas the bilateral cuneus and primary visual cortex had good ICC results of greater than 0.6. These results suggest that the sustained visual fixation task described within this study reliably activates the neural substrates of phoria adaptation. This protocol establishes a methodology that can be used in future longitudinal studies investigating therapeutic interventions that may modify phoria adaptation.

Cortical thickness and gyrification index measuring cognition in Parkinson's disease

OBJECTIVE

Cortical dynamics is driven by cortico-cortical connectivity and it characterizes cortical morphological features. These brain surface features complement volumetric changes and may offer improved understanding of disease pathophysiology. Hence, present study aims to investigate surface features; cortical thickness (CT) and gyrification index (GI) in Parkinson's disease (PD) patients of normal cognition (PD-CN), cognitively impaired patients with PD (PD-CI) in comparison with cognitively normal healthy controls (HC) to better elucidate cognition linked features in PD.

METHOD

Anatomical MRI (3DT1) was carried out in 30 HC (56.53 ± 8.42 years), 30 PD-CN (58.8 ± 6.07 years), and 30 PD-CI (60.3 ± 6.43 years) subjects. Whole brain ROI based parcellation using Desikan-Killiany (DK-40) atlas followed by regional CT and GI differentiation [with 'age' and 'total intracranial volume' (TIV) correction], multiple linear regression (with 'age', 'TIV', and 'education' correction) with clinical variables, ROC analysis, and CT-GI correlation across the groups was used for data analysis.

RESULTS

Widespread cortical thinning with regional GI reduction was evident in PD-CI with respect to other two groups (HC and PD-CN), and with absence of such alterations in PD-CN compared to HC. Frontal, parietal, and temporal CT/GI significantly correlated with cognition and presented classification abilities for cognitive state in PD. Mean regional CT and GI were found negatively correlated across groups with heterogeneous regions.

CONCLUSION

Fronto-parietal and temporal regions suffer cognition associated cortical thinning and GI reduction. CT may serve better discriminator properties and may be more consistent than GI in studying cognition in PD. Heterogeneous surface dynamics across the groups may signify neuro-developmental alterations in PD.

Functional, anatomical and diffusion tensor MRI study of radiology expertise

BACKGROUND

Repeated practice to acquire expertise could result in the structural and functional changes in relevant brain circuits as a result of long-term potentiation, neurogenesis, glial genesis, and remodeling.

PURPOSE

The goal of this study is to use task fMRI to study the brain of expert radiologists performing a diagnosis task where a series of medical images were presented during fMRI acquisition for 12s and participants were asked to choose a diagnosis. Structural and diffusion-tensor MRI were also acquired.

METHODS

Radiologists (N = 12, 11M, 38.2±10.3 years old) and non-radiologists (N = 17, 15M, 30.6±5.5 years old) were recruited with informed consent. Medical images were presented for 12 s and three multiple choices were displayed and the participants were asked to choose a diagnosis. fMRI, structural and diffusion-tensor MRI were acquired. fMRI analysis used FSL to determine differences in fMRI responses between groups. Voxel-wise analysis was performed to determine if subcortical volume, cortical thickness and fractional anisotropy differed between groups. Correction for multiple comparisons used false discovery rate.

RESULTS

Radiologists showed overall lower task-related brain activation than non-radiologists. Radiologists showed significantly lower activation in the left lateral occipital cortex, left superior parietal lobule, occipital pole, right superior frontal and precentral gyri, lingual gyrus, and the left intraparietal sulcus (p<0.05). There were no significant differences between groups in cortical thickness, subcortical volume and fractional anisotropy (p>0.05).

CONCLUSIONS

Radiologists and non-radiologists had no significant difference in structural metrics. However, in diagnosis tasks, radiologists showed markedly lower task-related brain activations overall as well as a number of high-order visual and non-visual brain regions than non-radiologists. Some brain circuits appear to be uniquely associated with differential-diagnosis paradigm expertise that are not involved in simpler object-recognition cases. Improved understanding of the brain circuitry involved in acquisition of expertise might be used to design optimal training paradigms.

The relationship between sleep efficiency and clinical symptoms is mediated by brain function in major depressive disorder

BACKGROUND

Sleep disturbance is a common and key symptom that affects most of patients with major depressive disorder (MDD). However, neural substrates underlying sleep disturbance and their clinical relevance in depression remain unclear.

METHODS

Ninety-six MDD patients underwent resting-state functional MRI. Fractional amplitude of low-frequency fluctuation (fALFF) and resting-state functional connectivity (rsFC) were used to measure brain function. Overnight polysomnography was performed to objectively measure sleep efficiency (SE), which was used to classify patients into normal sleep efficiency (NSE) and low sleep efficiency (LSE) groups. Between-group differences in fALFF and rsFC were examined using two-sample t-tests. Moreover, correlation and mediation analyses were conducted to test for potential associations between SE, brain functional changes, and clinical variables.

RESULTS

LSE group showed decreased fALFF in right cuneus, thalamus, and middle temporal gyrus compared to NSE group. MDD patients with low SE also exhibited lower rsFC of right cuneus to right lateral temporal cortex, which was associated with more severe depression and anxiety symptoms. More importantly, mediation analyses revealed that the relationships between SE and severity of depression and anxiety symptoms were significantly mediated by the altered rsFC. In addition, these low SE-related brain functional alterations were not affected by antidepressant medication and were independent of structural changes.

LIMITATIONS

The lack of healthy controls because of "first-night effect".

CONCLUSION

These findings not only may expand existing knowledge about neuropathology of sleep disturbance in depression, but also may inform real-world clinical practice by improving depression and anxiety symptoms through sleep regulation.

Brain structural abnormalities in emotional regulation and sensory processing regions associated with anxious depression

BACKGROUND

Considerable patients with major depressive disorder (MDD) comorbid with anxious symptoms, referred as anxious depression. The neural structural basis of this MDD specifier remains largely unknown.

METHODS

104 patients with anxious depression, 57 MDD patients without significant anxious symptoms, and 160 healthy controls from single research center participated in the study with age and sex well-matched. We investigated gray matter alterations in anxious and non-anxious depression, explored different brain alterations between these two patient groups, and possible relationships between brain structural parameter and clinical information in patients.

RESULTS

Gray matter volumes differed in the right inferior frontal gyrus, right orbital frontal gyrus, left postcentral gyrus, bilateral culmen and left cuneus among the three groups. Anxious depression had smaller gray matter volumes in the right inferior frontal gyrus and orbital frontal gyrus relative to both non-anxious depression and healthy controls. Patients with anxious depression presented larger gray matter volumes in the left postcentral gyrus than non-anxious depression, and larger gray matter volumes in the left cuneus than healthy controls. In addition, both patient groups showed larger gray matter volumes in bilateral culmen relative to healthy controls. Gray matter volumes in the left postcentral gyrus were positively associated with overall depression severity and anxiety factor scores in anxious depression.

CONCLUSION

Our study revealed brain structural abnormalities in emotional regulation and sensory processing regions of anxious depression, which may suggested distinct neurobiological mechanisms of this MDD specifier and could help explain different clinical manifestations in anxious depression from pure depression.

Cortical thinning in benign epilepsy with centrotemporal spikes (BECTS) with or without attention-deficit/hyperactivity (ADHD)

The aim of this study is to evaluate the abnormal cortical structures associated with newly diagnosed benign epilepsy with centrotemporal spikes (BECTS) patients and assessed the effects of comorbid attention-deficit/hyperactivity (ADHD) on these abnormalities. Newly diagnosed BECTS patients (n = 33, 23 males) and age-matched healthy controls (n = 48) were evaluated by surface and volumetric MRI. CAT12 toolbox (HYPERLINK "http://www.neuro.uni-jena.de/cat/"\t"_blank" http://www.neuro.uni-jena.de/cat/, version r1109), SPM12(HYPERLINK"http://www.fil.ion.ucl.ac.uk/spm/software/spm12/"\t"_blank"http://www.fil.ion.ucl.ac.uk/spm/software/spm12/, version 6225) and MATLAB (9.5, Mathworks, Natick, MA) were used to gather CT estimates. An additional comparison was performed between BECTS children with (n = 13) and without ADHD (n = 20). BECTS patients had significantly smaller volume in left postcentral gyrus when compared to healthy controls. BECTS patients with ADHD had significantly thinner superior-inferior frontal cortex, superior temporal cortex, left pericalcarine, lingual and fusiform cortex to healthy controls. Also BECTS without ADHD patients had thinner cortical areas when compared to healthy controls, however the significance was more relevant in the BECTS with ADHD. The left fusiform cortex of BECTS patients with ADHD patients was significantly thinner than BECTS patients without ADHD. Our results showed that BECTS affects frontal, temporal, parietal and occipital lobes by cortical thinning. Our study supports the need for better characterization of patients with BECTS so identification of different phenotypes can occur. Further studies are needed to investigate the relationship between BECTS and ADHD.

Transdiagnostic neural correlates of volitional emotion regulation in anxiety and depression

BACKGROUND

Individuals who suffer from anxiety and/or depression face difficulty in adaptively managing emotional responses, while accumulating evidence suggests impaired emotion regulation is a transdiagnostic feature of psychopathology. Effectual regulation in the context of negative stimuli is characterized by engagement of the prefrontal cortex (PFC) coupled with reduced amygdala reactivity. In anxiety disorders and major depression, PFC underengagement and atypical PFC-amygdala connectivity has been observed, although patient findings based on case-control studies have been mixed with regard to magnitude, locality, and extent of dysfunction. As anxiety disorders and major depression are heterogeneous disorders and frequently comorbid with one another, delineating relationships between reappraise-related substrates and symptoms may advance our understanding of emotion dysregulation in these populations.

METHODS

We examined PFC activation and its functional connectivity (FC) to the amygdala using functional magnetic resonance imaging in a large sample of patients (N = 174) with primary generalized anxiety disorder (n = 47), social anxiety disorder (n = 78), or major depressive disorder (n = 49) during a reappraisal-based emotion regulation task. Comorbidity was permitted and the majority of participants had a concurrent psychiatric illnesses.

RESULTS

Across participants, whole-brain results showed that (1) greater anxiety and depression symptom severity was related to less engagement of the dorsal anterior cingulate cortex (ACC) and (2) less FC between the amygdala and ventrolateral PFC. Results were driven by anxiety, while depression symptoms were not significant.

CONCLUSION

These findings demonstrate that individual differences in anxiety and depression may help explain ACC and PFC dysfunction during emotion regulation observed across anxiety and depressive disorders.

Development and evaluation of a multimodal marker of major depressive disorder

This study aimed to identify biomarkers of major depressive disorder (MDD), by relating neuroimage-derived measures to binary (MDD/control), ordinal (severe MDD/mild MDD/control), or continuous (depression severity) outcomes. To address MDD heterogeneity, factors (severity of psychic depression, motivation, anxiety, psychosis, and sleep disturbance) were also used as outcomes. A multisite, multimodal imaging (diffusion MRI [dMRI] and structural MRI [sMRI]) cohort (52 controls and 147 MDD patients) and several modeling techniques-penalized logistic regression, random forest, and support vector machine (SVM)-were used. An additional cohort (25 controls and 83 MDD patients) was used for validation. The optimally performing classifier (SVM) had a 26.0% misclassification rate (binary), 52.2 ± 1.69% accuracy (ordinal) and r = .36 correlation coefficient (p < .001, continuous). Using SVM, R² values for prediction of any MDD factors were <10%. Binary classification in the external data set resulted in 87.95% sensitivity and 32.00% specificity. Though observed classification rates are too low for clinical utility, four image-based features contributed to accuracy across all models and analyses-two dMRI-based measures (average fractional anisotropy in the right cuneus and left insula) and two sMRI-based measures (asymmetry in the volume of the pars triangularis and the cerebellum) and may serve as a priori regions for future analyses. The poor accuracy of classification and predictive results found here reflects current equivocal findings and sheds light on challenges of using these modalities for MDD biomarker identification. Further, this study suggests a paradigm (e.g., multiple classifier evaluation with external validation) for future studies to avoid nongeneralizable results.

Clinical Long-Term Follow-Up Evaluation of Functional Neuronavigation in Adult Cerebral Gliomas

OBJECTIVE

To assess the application of functional neuronavigation in surgeries of adult cerebral gliomas.

METHODS

We performed a retrospective analysis of 375 cases of adult cerebral glioma patients who underwent microsurgical treatment between 2011 and 2017 in our department. Among them, 142 patients underwent surgery using functional neuronavigation (group A), and the other 233 patients were operated on without the help of functional neuronavigation (group B). For both groups, we categorized them into several subgroups according to the lesion locations.

RESULTS

A significant difference in the gross total resection rate was observed between group A and group B (P = 0.001 for overall; P = 0.036 for EO area; and P = 0.004 for BBT area). The postoperative complication rate of group A was much lower than that of group B (P = 0.003 for overall; and P = 0.016 for BBT area). The postoperative 6-month Karnofsky Performance Scale score of all patients in group A was significantly higher than that of group B. Kaplan-Meier survival analyses showed significant increases in the median survival time of group A compared with that of group B (P < 0.001 for overall; P = 0.012 for EO area; P = 0.006 for BBT area), and the Cox proportional regression analysis estimated the hazard ratio of the functional neuronavigation to be 0.533, helping reduce the risk of death by 46.7%.

CONCLUSIONS

This study confirmed that the application of neuronavigation in adult glioma surgery can improve postoperative quality of life and lengthen the survival time of patients, especially in cases involving the brainstem and the eloquent area.

Single Session Low Frequency Left Dorsolateral Prefrontal Transcranial Magnetic Stimulation Changes Neurometabolite Relationships in Healthy Humans

Background: Dorsolateral prefrontal cortex (DLPFC) low frequency repetitive transcranial magnetic stimulation (LF-rTMS) has shown promise as a treatment and investigative tool in the medical and research communities. Researchers have made significant progress elucidating DLPFC LF-rTMS effects—primarily in individuals with psychiatric disorders. However, more efforts investigating underlying molecular changes and establishing links to functional and behavioral outcomes in healthy humans are needed.

Objective: We aimed to quantify neuromolecular changes and relate these to functional changes following a single session of DLPFC LF-rTMS in healthy participants.

Methods: Eleven participants received sham-controlled neuronavigated 1 Hz rTMS to the region most activated by a 7-letter Sternberg working memory task (SWMT) within the left DLPFC. We quantified SWMT performance, functional magnetic resonance activation and proton Magnetic resonance spectroscopy (MRS) neurometabolite measure changes before and after stimulation.

Results: A single LF-rTMS session was not sufficient to change DLPFC neurometabolite levels and these changes did not correlate with DLPFC activation changes. Real rTMS, however, significantly altered neurometabolite correlations (compared to sham rTMS), both with baseline levels and between the metabolites themselves. Additionally, real rTMS was associated with diminished reaction time (RT) performance improvements and increased activation within the motor, somatosensory and lateral occipital cortices.

Conclusion: These results show that a single session of LF-rTMS is sufficient to influence metabolite relationships and causes widespread activation in healthy humans. Investigating correlational relationships may provide insight into mechanisms underlying LF-rTMS.

Minimizing eddy currents induced in the ground plane of a large phased-array ultrasound applicator for echo-planar imaging-based MR thermometry

BACKGROUND

The study aims to investigate different ground plane segmentation designs of an ultrasound transducer to reduce gradient field induced eddy currents and the associated geometric distortion and temperature map errors in echo-planar imaging (EPI)-based MR thermometry in transcranial magnetic resonance (MR)-guided focused ultrasound (tcMRgFUS).

METHODS

Six different ground plane segmentations were considered and the efficacy of each in suppressing eddy currents was investigated in silico and in operando. For the latter case, the segmented ground planes were implemented in a transducer mockup model for validation. Robust spoiled gradient (SPGR) echo sequences and multi-shot EPI sequences were acquired. For each sequence and pattern, geometric distortions were quantified in the magnitude images and expressed in millimeters. Phase images were used for extracting the temperature maps on the basis of the temperature-dependent proton resonance frequency shift phenomenon. The means, standard deviations, and signal-to-noise ratios (SNRs) were extracted and contrasted with the geometric distortions of all patterns.

RESULTS

The geometric distortion analysis and temperature map evaluations showed that more than one pattern could be considered the best-performing transducer. In the sagittal plane, the star (d) (3.46 ± 2.33 mm) and star-ring patterns (f) (2.72 ± 2.8 mm) showed smaller geometric distortions than the currently available seven-segment sheet (c) (5.54 ± 4.21 mm) and were both comparable to the reference scenario (a) (2.77 ± 2.24 mm). Contrasting these results with the temperature maps revealed that (d) performs as well as (a) in SPGR and EPI.

CONCLUSIONS

We demonstrated that segmenting the transducer ground plane into a star pattern reduces eddy currents to a level wherein multi-plane EPI for accurate MR thermometry in tcMRgFUS is feasible.

Automated and nonbiased regional quantification of functional neuroimaging data

PURPOSE

In the quantification of functional neuroimaging data, region-of-interest (ROI) analysis can be used to assess a variety of properties of the activation signal, but taken alone these properties are susceptible to noise and may fail to accurately describe overall regional involvement. Here, the authors present and evaluate an automated method for quantification and localization of functional neuroimaging data that combines multiple properties of the activation signal to generate rank-order lists of regional activation results.

METHODS

The proposed automated quantification method, referred to as neuroimaging results decomposition (NIRD), begins by decomposing an activation map into a hierarchical list of ROIs using a digital atlas. In an intermediate step, the ROIs are rank-ordered according to extent, mean intensity, and total intensity. A final rank-order list (NIRD average rank) is created by sorting the ROIs according to the average of their ranks from the intermediate step. The authors hypothesized that NIRD average rank would have improved regional quantification accuracy compared to all other quantitative metrics, including methods based on properties of statistical clusters. To test their hypothesis, NIRD rankings were directly compared to three common cluster-based methods using simulated fMRI data both with and without realistic head motion.

RESULTS

For both the no-motion and motion datasets, an analysis of variance found that significant differences between the quantification methods existed (F = 64.8, p < 0.0001 for no motion; F = 55.2, p < 0.0001 for motion), and a post-hoc test found that NIRD average rank was the most accurate quantification method tested (p < 0.05 for both datasets). Furthermore, all variants of the NIRD method were found to be significantly more accurate than the cluster-based methods in all cases.

CONCLUSIONS

These results confirm their hypothesis and demonstrate that the proposed NIRD methodology provides improved regional quantification accuracy compared to cluster-based methods.