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Verhulst MMLH, Glimmerveen AB, van Heugten CM, Helmich RCG, Hofmeijer J. MRI factors associated with cognitive functioning after acute onset brain injury: Systematic review and meta-analysis. Neuroimage Clin 2023; 38:103415. [PMID: 37119695 PMCID: PMC10165272 DOI: 10.1016/j.nicl.2023.103415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/22/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023]
Abstract
Impairments of memory, attention, and executive functioning are frequently reported after acute onset brain injury. MRI markers hold potential to contribute to identification of patients at risk for cognitive impairments and clarification of mechanisms. The aim of this systematic review was to summarize and value the evidence on MRI markers of memory, attention, and executive functioning after acute onset brain injury. We included ninety-eight studies, on six classes of MRI factors (location and severity of damage (n = 15), volume/atrophy (n = 36), signs of small vessel disease (n = 15), diffusion-weighted imaging measures (n = 36), resting-state functional MRI measures (n = 13), and arterial spin labeling measures (n = 1)). Three measures showed consistent results regarding their association with cognition. Smaller hippocampal volume was associated with worse memory in fourteen studies (pooled correlation 0.58 [95% CI: 0.46-0.68] for whole, 0.11 [95% CI: 0.04-0.19] for left, and 0.34 [95% CI: 0.17-0.49] for right hippocampus). Lower fractional anisotropy in cingulum and fornix was associated with worse memory in six and five studies (pooled correlation 0.20 [95% CI: 0.08-0.32] and 0.29 [95% CI: 0.20-0.37], respectively). Lower functional connectivity within the default-mode network was associated with worse cognition in four studies. In conclusion, hippocampal volume, fractional anisotropy in cingulum and fornix, and functional connectivity within the default-mode network showed consistent associations with cognitive performance in all types of acute onset brain injury. External validation and cut off values for predicting cognitive impairments are needed for clinical implementation.
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Affiliation(s)
- Marlous M L H Verhulst
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands.
| | - Astrid B Glimmerveen
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Limburg Brain Injury Center, Maastricht University, Maastricht, The Netherlands; Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rick C G Helmich
- Donders Institute for Brain, Cognition, and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands; Department of Neurology, Centre of Expertise for Parkinson & Movement Disorders, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jeannette Hofmeijer
- Clinical Neurophysiology, University of Twente, Enschede, The Netherlands; Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands
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Haque ZZ, Samandra R, Mansouri FA. Neural substrate and underlying mechanisms of working memory: insights from brain stimulation studies. J Neurophysiol 2021; 125:2038-2053. [PMID: 33881914 DOI: 10.1152/jn.00041.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The concept of working memory refers to a collection of cognitive abilities and processes involved in the short-term storage of task-relevant information to guide the ongoing and upcoming behavior and therefore describes an important aspect of executive control of behavior for achieving goals. Deficits in working memory and related cognitive abilities have been observed in patients with brain damage or neuropsychological disorders and therefore it is important to better understand neural substrate and underlying mechanisms of working memory. Working memory relies on neural mechanisms that enable encoding, maintenance, and manipulation of stored information as well as integrating them with ongoing and future goals. Recently, a surge in brain stimulation studies have led to development of various noninvasive techniques for localized stimulation of prefrontal and other cortical regions in humans. These brain stimulation techniques can potentially be tailored to influence neural activities in particular brain regions and modulate cognitive functions and behavior. Combined use of brain stimulation with neuroimaging and electrophysiological recording have provided a great opportunity to monitor neural activity in various brain regions and noninvasively intervene and modulate cognitive functions in cognitive tasks. These studies have shed more light on the neural substrate and underlying mechanisms of working memory in humans. Here, we review findings and insight from these brain stimulation studies about the contribution of brain regions, and particularly prefrontal cortex, to working memory.
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Affiliation(s)
- Zakia Z Haque
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Ranshikha Samandra
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Farshad Alizadeh Mansouri
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,ARC Centre for Integrative Brain Function, Monash University, Clayton, Victoria, Australia
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Watson EL, Bearden AC, Doughton JH, Needle AR. THE EFFECTS OF MULTIPLE MODALITIES OF COGNITIVE LOADING ON DYNAMIC POSTURAL CONTROL IN INDIVIDUALS WITH CHRONIC ANKLE INSTABILITY. Gait Posture 2020; 79:10-15. [PMID: 32304990 DOI: 10.1016/j.gaitpost.2020.03.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/29/2019] [Accepted: 03/30/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Evidence of neuroplasticity after joint injury has suggested that individuals with chronic ankle instability (CAI) may have degraded movement when facing cognitive demand. To date, research into these effects have been limited to static balance models, and typically only incorporate a single type of cognitive demands. RESEARCH QUESTION We aimed to determine the effects of multiple modalities of cognitive load (quantitative, verbal-memory, visuospatial) on dynamic postural control strategies in a sample of patients with CAI compared to uninjured controls. METHODS Thirty-two participants (16 CAI, 16 healthy) performed a series of 20 hops-to-stabilization while either under no cognitive load (CON), or while performing Benton's judgment of line orientation (JLO), the symbol digit modalities test (SDM), or a serial seven task (SVN). Dynamic postural stability indices and mean muscle activation from the lower leg muscles were extracted and assessed via analysis of variance. RESULTS Healthy subjects demonstrated better vertical and dynamic postural stability indices under JLO (P ≤ 0.017) and SVN (P ≤ 0.010) conditions compared to CON. Postural stability was unaffected in CAI (P > 0.050). Peroneus longus and lateral gastrocnemius activation was lowest in SVN across all subjects (P ≤ 0.033). Lateral gastrocnemius activation was greatest in SDM (P ≤ 0.033). SIGNIFICANCE These results suggest improvements in postural stability under cognitive demand in healthy individuals that did not occur in CAI, suggesting less movement optimization. Quantitative tasks appear to impede stabilizing muscle activation in the leg, while verbal-memory tasks result in a more protective landing strategy.
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Affiliation(s)
- Elizabeth L Watson
- Department of Health & Exercise Science, Appalachian State University, Boone, NC USA
| | - Anna C Bearden
- Department of Health & Exercise Science, Appalachian State University, Boone, NC USA
| | - J Horton Doughton
- Department of Health & Exercise Science, Appalachian State University, Boone, NC USA
| | - Alan R Needle
- Department of Health & Exercise Science, Appalachian State University, Boone, NC USA.
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Coenen VA, Schlaepfer TE, Reinacher PC, Mast H, Urbach H, Reisert M. Machine learning-aided personalized DTI tractographic planning for deep brain stimulation of the superolateral medial forebrain bundle using HAMLET. Acta Neurochir (Wien) 2019; 161:1559-1569. [PMID: 31144167 PMCID: PMC6616222 DOI: 10.1007/s00701-019-03947-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 04/24/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Growing interest exists for superolateral medial forebrain bundle (slMFB) deep brain stimulation (DBS) in psychiatric disorders. The surgical approach warrants tractographic rendition. Commercial stereotactic planning systems use deterministic tractography which suffers from inherent limitations, is dependent on manual interaction (ROI definition), and has to be regarded as subjective. We aimed to develop an objective but patient-specific tracking of the slMFB which at the same time allows the use of a commercial surgical planning system in the context of deep brain stimulation. METHODS The HAMLET (Hierarchical Harmonic Filters for Learning Tracts from Diffusion MRI) machine learning approach was introduced into the standardized workflow of slMFB DBS tractographic planning on the basis of patient-specific dMRI. Rendition of the slMFB with HAMLET serves as an objective comparison for the refinement of the deterministic tracking procedure. Our application focuses on the tractographic planning of DBS (N = 8) for major depression and OCD. RESULTS Previous results have shown that only fibers belonging to the ventral tegmental area to prefrontal/orbitofrontal axis should be targeted. With the proposed technique, the deterministic tracking approach, that serves as the surgical planning data, can be refined, over-sprouting fibers are eliminated, bundle thickness is reduced in the target region, and thereby probably a more accurate targeting is facilitated. The HAMLET-driven method is meant to achieve a more objective surgical fiber display of the slMFB with deterministic tractography. CONCLUSIONS The approach allows overlying the results of patient-specific planning from two different approaches (manual deterministic and machine learning HAMLET). HAMLET shows the slMFB as a volume and thus serves as an objective tracking corridor. It helps to refine results from deterministic tracking in the surgical workspace without interfering with any part of the standard software solution. We have now included this workflow in our daily clinical experimental work on slMFB DBS for psychiatric indications.
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Chai WJ, Abd Hamid AI, Abdullah JM. Working Memory From the Psychological and Neurosciences Perspectives: A Review. Front Psychol 2018; 9:401. [PMID: 29636715 PMCID: PMC5881171 DOI: 10.3389/fpsyg.2018.00401] [Citation(s) in RCA: 181] [Impact Index Per Article: 30.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/09/2018] [Indexed: 11/29/2022] Open
Abstract
Since the concept of working memory was introduced over 50 years ago, different schools of thought have offered different definitions for working memory based on the various cognitive domains that it encompasses. The general consensus regarding working memory supports the idea that working memory is extensively involved in goal-directed behaviors in which information must be retained and manipulated to ensure successful task execution. Before the emergence of other competing models, the concept of working memory was described by the multicomponent working memory model proposed by Baddeley and Hitch. In the present article, the authors provide an overview of several working memory-relevant studies in order to harmonize the findings of working memory from the neurosciences and psychological standpoints, especially after citing evidence from past studies of healthy, aging, diseased, and/or lesioned brains. In particular, the theoretical framework behind working memory, in which the related domains that are considered to play a part in different frameworks (such as memory’s capacity limit and temporary storage) are presented and discussed. From the neuroscience perspective, it has been established that working memory activates the fronto-parietal brain regions, including the prefrontal, cingulate, and parietal cortices. Recent studies have subsequently implicated the roles of subcortical regions (such as the midbrain and cerebellum) in working memory. Aging also appears to have modulatory effects on working memory; age interactions with emotion, caffeine and hormones appear to affect working memory performances at the neurobiological level. Moreover, working memory deficits are apparent in older individuals, who are susceptible to cognitive deterioration. Another younger population with working memory impairment consists of those with mental, developmental, and/or neurological disorders such as major depressive disorder and others. A less coherent and organized neural pattern has been consistently reported in these disadvantaged groups. Working memory of patients with traumatic brain injury was similarly affected and shown to have unusual neural activity (hyper- or hypoactivation) as a general observation. Decoding the underlying neural mechanisms of working memory helps support the current theoretical understandings concerning working memory, and at the same time provides insights into rehabilitation programs that target working memory impairments from neurophysiological or psychological aspects.
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Affiliation(s)
- Wen Jia Chai
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Aini Ismafairus Abd Hamid
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Center for Neuroscience Services and Research, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Jafri Malin Abdullah
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Center for Neuroscience Services and Research, Universiti Sains Malaysia, Kubang Kerian, Malaysia
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Coenen VA, Schumacher LV, Kaller C, Schlaepfer TE, Reinacher PC, Egger K, Urbach H, Reisert M. The anatomy of the human medial forebrain bundle: Ventral tegmental area connections to reward-associated subcortical and frontal lobe regions. Neuroimage Clin 2018; 18:770-783. [PMID: 29845013 PMCID: PMC5964495 DOI: 10.1016/j.nicl.2018.03.019] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/13/2018] [Accepted: 03/14/2018] [Indexed: 12/29/2022]
Abstract
Introduction Despite their importance in reward, motivation, and learning there is only sparse anatomical knowledge about the human medial forebrain bundle (MFB) and the connectivity of the ventral tegmental area (VTA). A thorough anatomical and microstructural description of the reward related PFC/OFC regions and their connection to the VTA - the superolateral branch of the MFB (slMFB) - is however mandatory to enable an interpretation of distinct therapeutic effects from different interventional treatment modalities in neuropsychiatric disorders (DBS, TMS etc.). This work aims at a normative description of the human MFB (and more detailed the slMFB) anatomy with respect to distant prefrontal connections and microstructural features. Methods and material Healthy subjects (n = 55; mean age ± SD, 40 ± 10 years; 32 females) underwent high resolution anatomical magnetic resonance imaging including diffusion tensor imaging. Connectivity of the VTA and the resulting slMFB were investigated on the group level using a global tractography approach. The Desikan/Killiany parceling (8 segments) of the prefrontal cortex was used to describe sub-segments of the MFB. A qualitative overlap with Brodmann areas was additionally described. Additionally, a pure visual analysis was performed comparing local and global tracking approaches for their ability to fully visualize the slMFB. Results The MFB could be robustly described both in the present sample as well as in additional control analyses in data from the human connectome project. Most VTA- connections reached the superior frontal gyrus, the middel frontal gyrus and the lateral orbitofrontal region corresponding to Brodmann areas 10, 9, 8, 11, and 11m. The projections to these regions comprised 97% (right) and 98% (left) of the total relative fiber counts of the slMFB. Discussion The anatomical description of the human MFB shows far reaching connectivity of VTA to reward-related subcortical and cortical prefrontal regions - but not to emotion-related regions on the medial cortical surface - realized via the superolateral branch of the MFB. Local tractography approaches appear to be inferior in showing these far-reaching projections. Since these local approaches are typically used for surgical targeting of DBS procedures, the here established detailed map might - as a normative template - guide future efforts to target deep brain stimulation of the slMFB in depression and other disorders related to dysfunction of reward and reward-associated learning.
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Affiliation(s)
- Volker Arnd Coenen
- Department of Stereotactic and Functional Neurosurgery, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany.
| | - Lena Valerie Schumacher
- Department of Neuroradiology, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany; Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Germany
| | - Christoph Kaller
- Department of Neurology, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
| | - Thomas Eduard Schlaepfer
- Department of Interventional Biological Psychiatry, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
| | - Peter Christoph Reinacher
- Department of Stereotactic and Functional Neurosurgery, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
| | - Karl Egger
- Department of Neuroradiology, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
| | - Marco Reisert
- Department of Stereotactic and Functional Neurosurgery, Medical Center, Freiburg University, Germany; Department of Medical Physics, Medical Center, Freiburg University, Germany; Medical Faculty, Freiburg University, Germany
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Owens JA, Spitz G, Ponsford JL, Dymowski AR, Ferris N, Willmott C. White matter integrity of the medial forebrain bundle and attention and working memory deficits following traumatic brain injury. Brain Behav 2017; 7:e00608. [PMID: 28239519 PMCID: PMC5318362 DOI: 10.1002/brb3.608] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 09/10/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The medial forebrain bundle (MFB) contains ascending catecholamine fibers that project to the prefrontal cortex (PFC). Damage to these fibers following traumatic brain injury (TBI) may alter extracellular catecholamine levels in the PFC and impede attention and working memory ability. This study investigated white matter microstructure of the medial MFB, specifically the supero-lateral branch (slMFB), following TBI, and its association with performance on attention and working memory tasks. METHOD Neuropsychological measures of attention and working memory were administered to 20 moderate-severe participants with TBI (posttraumatic amnesia M = 40.05 ± 37.10 days, median time since injury 10.48 months, range 3.72-87.49) and 20 healthy controls. Probabilistic tractography was used to obtain fractional anisotropy (FA) and mean diffusivity (MD) values for 17 participants with TBI and 20 healthy controls. RESULTS When compared to controls, participants with TBI were found to have significantly lower FA (p < .001) and higher MD (p < .001) slMFB values, and they were slower to complete tasks including Trail Making Task-A, Hayling, selective attention task, n-back, and Symbol Digit Modalities Test. CONCLUSION This study was the first to demonstrate microstructural white matter damage within the slMFB following TBI. However, no evidence was found for an association of alterations to this tract and performance on attentional tasks.
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Affiliation(s)
- Jacqueline A Owens
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Gershon Spitz
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Jennie L Ponsford
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Alicia R Dymowski
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
| | - Nicholas Ferris
- Monash Biomedical Imaging Monash University Melbourne Vic. Australia
| | - Catherine Willmott
- School of Psychological Sciences Monash University Melbourne Vic. Australia; Monash-Epworth Rehabilitation Research Centre Epworth Health Care Melbourne Vic. Australia; Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Vic. Australia
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