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Nusbaum F, Hannoun S, Barile B, Suprano I, Mouchet S, Sappey-Marinier D. Personal Income Performance Correlates with Brain Structural Network Modularity but Not Intelligence Quotient. Brain Connect 2024; 14:284-293. [PMID: 38848246 DOI: 10.1089/brain.2023.0077] [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] [Indexed: 06/09/2024] Open
Abstract
Introduction: This study aims to use diffusion tensor imaging (DTI) in conjunction with brain graph techniques to define brain structural connectivity and investigate its association with personal income (PI) in individuals of various ages and intelligence quotients (IQ). Methods: MRI examinations were performed on 55 male subjects (mean age: 40.1 ± 9.4 years). Graph data and metrics were generated, and DTI images were analyzed using tract-based spatial statistics (TBSS). All subjects underwent the Wechsler Adult Intelligence Scale for a reliable estimation of the full-scale IQ (FSIQ), which includes verbal comprehension index, perceptual reasoning index, working memory index, and processing speed index. The performance score was defined as the monthly PI normalized by the age of the subject. Results: The analysis of global graph metrics showed that modularity correlated positively with performance score (p = 0.003) and negatively with FSIQ (p = 0.04) and processing speed index (p = 0.005). No significant correlations were found between IQ indices and performance scores. Regional analysis of graph metrics showed modularity differences between right and left networks in sub-cortical (p = 0.001) and frontal (p = 0.044) networks. TBSS analysis showed greater axial and mean diffusivities in the high-performance group in correlation with their modular brain organization. Conclusion: This study showed that PI performance is strongly correlated with a modular organization of brain structural connectivity, which implies short and rapid networks, providing automatic and unconscious brain processing. Additionally, the lack of correlation between performance and IQ suggests a reduced role of academic reasoning skills in performance to the advantage of high uncertainty decision-making networks.
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Affiliation(s)
- Fanny Nusbaum
- Health Systemic Process (P2S), UR 4129, Université Claude Bernard-Lyon 1, Université de Lyon, Lyon, France
| | - Salem Hannoun
- Medical Imaging Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Berardino Barile
- CREATIS, CNRS UMR 5220, INSERM U1294, Université Claude Bernard-Lyon1, INSA-Lyon, Université de Lyon, Villeurbanne, France
| | - Ilaria Suprano
- CREATIS, CNRS UMR 5220, INSERM U1294, Université Claude Bernard-Lyon1, INSA-Lyon, Université de Lyon, Villeurbanne, France
| | - Sabine Mouchet
- Service de Psychiatrie Légale - Pôle Santé Mentale des Détenus et Psychiatrie Légale, Centre Hospitalier le Vinatier, Bron, France
| | - Dominique Sappey-Marinier
- CREATIS, CNRS UMR 5220, INSERM U1294, Université Claude Bernard-Lyon1, INSA-Lyon, Université de Lyon, Villeurbanne, France
- CERMEP-Imagerie du Vivant, Université de Lyon, Bron, France
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2
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Wainberg M, Forde NJ, Mansour S, Kerrebijn I, Medland SE, Hawco C, Tripathy SJ. Genetic architecture of the structural connectome. Nat Commun 2024; 15:1962. [PMID: 38438384 PMCID: PMC10912129 DOI: 10.1038/s41467-024-46023-2] [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: 09/13/2022] [Accepted: 02/12/2024] [Indexed: 03/06/2024] Open
Abstract
Myelinated axons form long-range connections that enable rapid communication between distant brain regions, but how genetics governs the strength and organization of these connections remains unclear. We perform genome-wide association studies of 206 structural connectivity measures derived from diffusion magnetic resonance imaging tractography of 26,333 UK Biobank participants, each representing the density of myelinated connections within or between a pair of cortical networks, subcortical structures or cortical hemispheres. We identify 30 independent genome-wide significant variants after Bonferroni correction for the number of measures studied (126 variants at nominal genome-wide significance) implicating genes involved in myelination (SEMA3A), neurite elongation and guidance (NUAK1, STRN, DPYSL2, EPHA3, SEMA3A, HGF, SHTN1), neural cell proliferation and differentiation (GMNC, CELF4, HGF), neuronal migration (CCDC88C), cytoskeletal organization (CTTNBP2, MAPT, DAAM1, MYO16, PLEC), and brain metal transport (SLC39A8). These variants have four broad patterns of spatial association with structural connectivity: some have disproportionately strong associations with corticothalamic connectivity, interhemispheric connectivity, or both, while others are more spatially diffuse. Structural connectivity measures are highly polygenic, with a median of 9.1 percent of common variants estimated to have non-zero effects on each measure, and exhibited signatures of negative selection. Structural connectivity measures have significant genetic correlations with a variety of neuropsychiatric and cognitive traits, indicating that connectivity-altering variants tend to influence brain health and cognitive function. Heritability is enriched in regions with increased chromatin accessibility in adult oligodendrocytes (as well as microglia, inhibitory neurons and astrocytes) and multiple fetal cell types, suggesting that genetic control of structural connectivity is partially mediated by effects on myelination and early brain development. Our results indicate pervasive, pleiotropic, and spatially structured genetic control of white-matter structural connectivity via diverse neurodevelopmental pathways, and support the relevance of this genetic control to healthy brain function.
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Affiliation(s)
- Michael Wainberg
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
| | - Natalie J Forde
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Salim Mansour
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Isabel Kerrebijn
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Colin Hawco
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Shreejoy J Tripathy
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
- Department of Physiology, University of Toronto, Toronto, ON, Canada.
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Chen M, Wang Y, Shi Y, Feng J, Feng R, Guan X, Xu X, Zhang Y, Jin C, Wei H. Brain Age Prediction Based on Quantitative Susceptibility Mapping Using the Segmentation Transformer. IEEE J Biomed Health Inform 2024; 28:1012-1021. [PMID: 38090820 DOI: 10.1109/jbhi.2023.3341629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The process of brain aging is intricate, encompassing significant structural and functional changes, including myelination and iron deposition in the brain. Brain age could act as a quantitative marker to evaluate the degree of the individual's brain evolution. Quantitative susceptibility mapping (QSM) is sensitive to variations in magnetically responsive substances such as iron and myelin, making it a favorable tool for estimating brain age. In this study, we introduce an innovative 3D convolutional network named Segmentation-Transformer-Age-Network (STAN) to predict brain age based on QSM data. STAN employs a two-stage network architecture. The first-stage network learns to extract informative features from the QSM data through segmentation training, while the second-stage network predicts brain age by integrating the global and local features. We collected QSM images from 712 healthy participants, with 548 for training and 164 for testing. The results demonstrate that the proposed method achieved a high accuracy brain age prediction with a mean absolute error (MAE) of 4.124 years and a coefficient of determination (R2) of 0.933. Furthermore, the gaps between the predicted brain age and the chronological age of Parkinson's disease patients were significantly higher than those of healthy subjects (P<0.01). We thus believe that using QSM-based predicted brain age offers a more reliable and accurate phenotype, with the potentiality to serve as a biomarker to explore the process of advanced brain aging.
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4
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Seguin C, Sporns O, Zalesky A. Brain network communication: concepts, models and applications. Nat Rev Neurosci 2023; 24:557-574. [PMID: 37438433 DOI: 10.1038/s41583-023-00718-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/14/2023]
Abstract
Understanding communication and information processing in nervous systems is a central goal of neuroscience. Over the past two decades, advances in connectomics and network neuroscience have opened new avenues for investigating polysynaptic communication in complex brain networks. Recent work has brought into question the mainstay assumption that connectome signalling occurs exclusively via shortest paths, resulting in a sprawling constellation of alternative network communication models. This Review surveys the latest developments in models of brain network communication. We begin by drawing a conceptual link between the mathematics of graph theory and biological aspects of neural signalling such as transmission delays and metabolic cost. We organize key network communication models and measures into a taxonomy, aimed at helping researchers navigate the growing number of concepts and methods in the literature. The taxonomy highlights the pros, cons and interpretations of different conceptualizations of connectome signalling. We showcase the utility of network communication models as a flexible, interpretable and tractable framework to study brain function by reviewing prominent applications in basic, cognitive and clinical neurosciences. Finally, we provide recommendations to guide the future development, application and validation of network communication models.
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Affiliation(s)
- Caio Seguin
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia.
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
| | - Olaf Sporns
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Program in Cognitive Science, Indiana University, Bloomington, IN, USA
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, USA
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, Melbourne School of Engineering, University of Melbourne, Melbourne, Victoria, Australia
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Sarasso E, Filippi M, Agosta F. Clinical and MRI features of gait and balance disorders in neurodegenerative diseases. J Neurol 2023; 270:1798-1807. [PMID: 36577818 DOI: 10.1007/s00415-022-11544-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
Gait and balance disorders are common signs in several neurodegenerative diseases such as Parkinson's disease, atypical parkinsonism, idiopathic normal pressure hydrocephalus, cerebrovascular disease, dementing disorders and multiple sclerosis. According to each condition, patients present with different gait and balance alterations depending on the structural and functional brain changes through the disease course. In this review, we will summarize the main clinical characteristics of gait and balance disorders in the major neurodegenerative conditions, providing an overview of the significant structural and functional MRI brain alterations underlying these deficits. We also will discuss the role of neurorehabilitation strategies in promoting brain plasticity and gait/balance improvements in these patients.
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Affiliation(s)
- Elisabetta Sarasso
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
- Vita-Salute San Raffaele University, Milan, Italy.
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Comparing models of information transfer in the structural brain network and their relationship to functional connectivity: diffusion versus shortest path routing. Brain Struct Funct 2023; 228:651-662. [PMID: 36723674 PMCID: PMC9944050 DOI: 10.1007/s00429-023-02613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/16/2023] [Indexed: 02/02/2023]
Abstract
The relationship between structural and functional connectivity in the human brain is a core question in network neuroscience, and a topic of paramount importance to our ability to meaningfully describe and predict functional outcomes. Graph theory has been used to produce measures based on the structural connectivity network that are related to functional connectivity. These measures are commonly based on either the shortest path routing model or the diffusion model, which carry distinct assumptions about how information is transferred through the network. Unlike shortest path routing, which assumes the most efficient path is always known, the diffusion model makes no such assumption, and lets information diffuse in parallel based on the number of connections to other regions. Past research has also developed hybrid measures that use concepts from both models, which have better predicted functional connectivity from structural connectivity than the shortest path length alone. We examined the extent to which each of these models can account for the structure-function relationship of interest using graph theory measures that are exclusively based on each model. This analysis was performed on multiple parcellations of the Human Connectome Project using multiple approaches, which all converged on the same finding. We found that the diffusion model accounts for much more variance in functional connectivity than the shortest path routing model, suggesting that the diffusion model is better suited to describing the structure-function relationship in the human brain at the macroscale.
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Schoonheim MM, Broeders TAA, Geurts JJG. The network collapse in multiple sclerosis: An overview of novel concepts to address disease dynamics. Neuroimage Clin 2022; 35:103108. [PMID: 35917719 PMCID: PMC9421449 DOI: 10.1016/j.nicl.2022.103108] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/01/2022] [Accepted: 07/10/2022] [Indexed: 11/16/2022]
Abstract
Multiple sclerosis (MS) can be considered as a network disorder. This review discusses network concepts in order to understand progression in MS. Damage is hypothesized to lead to a “network collapse” and clinical progression. New concepts are discussed that will likely influence the field in the near future. These include brain wiring, how regions communicate and robustness to damage.
Multiple sclerosis is a neuroinflammatory and neurodegenerative disorder of the central nervous system that can be considered a network disorder. In MS, lesional pathology continuously disconnects structural pathways in the brain, forming a disconnection syndrome. Complex functional network changes then occur that are poorly understood but closely follow clinical status. Studying these structural and functional network changes has been and remains crucial to further decipher complex symptoms like cognitive impairment and physical disability. Recent insights especially implicate the importance of monitoring network hubs in MS, like the thalamus and default-mode network which seem especially hit hard. Such network insights in MS have led to the hypothesis that as the network continues to become disconnected and dysfunctional, exceeding a certain threshold of network efficiency loss leads to a “network collapse”. After this collapse, crucial network hubs become rigid and overloaded, and at the same time a faster neurodegeneration and accelerated clinical (and cognitive) progression can be seen. As network neuroscience has evolved, the MS field can now move towards a clearer classification of the network collapse itself and specific milestone events leading up to it. Such an updated network-focused conceptual framework of MS could directly impact clinical decision making as well as the design of network-tailored rehabilitation strategies. This review therefore provides an overview of recent network concepts that have enhanced our understanding of clinical progression in MS, especially focusing on cognition, as well as new concepts that will likely move the field forward in the near future.
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Affiliation(s)
- Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Tommy A A Broeders
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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8
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Zhang F, Daducci A, He Y, Schiavi S, Seguin C, Smith RE, Yeh CH, Zhao T, O'Donnell LJ. Quantitative mapping of the brain's structural connectivity using diffusion MRI tractography: A review. Neuroimage 2022; 249:118870. [PMID: 34979249 PMCID: PMC9257891 DOI: 10.1016/j.neuroimage.2021.118870] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/03/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022] Open
Abstract
Diffusion magnetic resonance imaging (dMRI) tractography is an advanced imaging technique that enables in vivo reconstruction of the brain's white matter connections at macro scale. It provides an important tool for quantitative mapping of the brain's structural connectivity using measures of connectivity or tissue microstructure. Over the last two decades, the study of brain connectivity using dMRI tractography has played a prominent role in the neuroimaging research landscape. In this paper, we provide a high-level overview of how tractography is used to enable quantitative analysis of the brain's structural connectivity in health and disease. We focus on two types of quantitative analyses of tractography, including: 1) tract-specific analysis that refers to research that is typically hypothesis-driven and studies particular anatomical fiber tracts, and 2) connectome-based analysis that refers to research that is more data-driven and generally studies the structural connectivity of the entire brain. We first provide a review of methodology involved in three main processing steps that are common across most approaches for quantitative analysis of tractography, including methods for tractography correction, segmentation and quantification. For each step, we aim to describe methodological choices, their popularity, and potential pros and cons. We then review studies that have used quantitative tractography approaches to study the brain's white matter, focusing on applications in neurodevelopment, aging, neurological disorders, mental disorders, and neurosurgery. We conclude that, while there have been considerable advancements in methodological technologies and breadth of applications, there nevertheless remains no consensus about the "best" methodology in quantitative analysis of tractography, and researchers should remain cautious when interpreting results in research and clinical applications.
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Affiliation(s)
- Fan Zhang
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
| | | | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Chinese Institute for Brain Research, Beijing, China
| | - Simona Schiavi
- Department of Computer Science, University of Verona, Verona, Italy
| | - Caio Seguin
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia; The University of Sydney, School of Biomedical Engineering, Sydney, Australia
| | - Robert E Smith
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Florey Department of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia
| | - Chun-Hung Yeh
- Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tengda Zhao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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Tozlu C, Jamison K, Nguyen T, Zinger N, Kaunzner U, Pandya S, Wang Y, Gauthier S, Kuceyeski A. Structural disconnectivity from paramagnetic rim lesions is related to disability in multiple sclerosis. Brain Behav 2021; 11:e2353. [PMID: 34498432 PMCID: PMC8553317 DOI: 10.1002/brb3.2353] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/28/2021] [Accepted: 08/19/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In people with multiple sclerosis (pwMS), lesions with a hyperintense rim (rim+) on Quantitative Susceptibility Mapping (QSM) have been shown to have greater myelin damage compared to rim- lesions, but their association with disability has not yet been investigated. Furthermore, how QSM rim+ and rim- lesions differentially impact disability through their disruptions to structural connectivity has not been explored. We test the hypothesis that structural disconnectivity due to rim+ lesions is more predictive of disability compared to structural disconnectivity due to rim- lesions. METHODS Ninety-six pwMS were included in our study. Individuals with Expanded Disability Status Scale (EDSS) <2 were considered to have lower disability (n = 59). For each gray matter region, a Change in Connectivity (ChaCo) score, that is, the percent of connecting streamlines also passing through a rim- or rim+ lesion, was computed. Adaptive Boosting was used to classify the pwMS into lower versus greater disability groups based on ChaCo scores from rim+ and rim- lesions. Classification performance was assessed using the area under ROC curve (AUC). RESULTS The model based on ChaCo from rim+ lesions outperformed the model based on ChaCo from rim- lesions (AUC = 0.67 vs 0.63, p-value < .05). The left thalamus and left cerebellum were the most important regions in classifying pwMS into disability categories. CONCLUSION rim+ lesions may be more influential on disability through their disruptions to the structural connectome than rim- lesions. This study provides a deeper understanding of how rim+ lesion location/size and resulting disruption to the structural connectome can contribute to MS-related disability.
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Affiliation(s)
- Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Thanh Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Nicole Zinger
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Ulrike Kaunzner
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Sneha Pandya
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Susan Gauthier
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA.,Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
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Tozlu C, Jamison K, Gu Z, Gauthier SA, Kuceyeski A. Estimated connectivity networks outperform observed connectivity networks when classifying people with multiple sclerosis into disability groups. Neuroimage Clin 2021; 32:102827. [PMID: 34601310 PMCID: PMC8488753 DOI: 10.1016/j.nicl.2021.102827] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS), a neurodegenerative and neuroinflammatory disease, causing lesions that disrupt the brain's anatomical and physiological connectivity networks, resulting in cognitive, visual and/or motor disabilities. Advanced imaging techniques like diffusion and functional MRI allow measurement of the brain's structural connectivity (SC) and functional connectivity (FC) networks, and can enable a better understanding of how their disruptions cause disability in people with MS (pwMS). However, advanced MRI techniques are used mainly for research purposes as they are expensive, time-consuming and require high-level expertise to acquire and process. As an alternative, the Network Modification (NeMo) Tool can be used to estimate SC and FC using lesion masks derived from pwMS and a reference set of controls' connectivity networks. OBJECTIVE Here, we test the hypothesis that estimated SC and FC (eSC and eFC) from the NeMo Tool, based only on an individual's lesion masks, can be used to classify pwMS into disability categories just as well as SC and FC extracted from advanced MRI directly in pwMS. We also aim to find the connections most important for differentiating between no disability vs evidence of disability groups. MATERIALS AND METHODS One hundred pwMS (age:45.5 ± 11.4 years, 66% female, disease duration: 12.97 ± 8.07 years) were included in this study. Expanded Disability Status Scale (EDSS) was used to assess disability, 67 pwMS had no disability (EDSS < 2). Observed SC and FC were extracted from diffusion and functional MRI directly in pwMS, respectively. The NeMo Tool was used to estimate the remaining structural connectome (eSC), by removing streamlines in a reference set of tractograms that intersected the lesion mask. The NeMo Tool's eSC was used then as input to a deep neural network to estimate the corresponding FC (eFC). Logistic regression with ridge regularization was used to classify pwMS into disability categories (no disability vs evidence of disability), based on demographics/clinical information (sex, age, race, disease duration, clinical phenotype, and spinal lesion burden) and either pairwise entries or regional summaries from one of the following matrices: SC, FC, eSC, and eFC. The area under the ROC curve (AUC) was used to assess the classification performance. Both univariate statistics and parameter coefficients from the classification models were used to identify features important to differentiating between the groups. RESULTS The regional eSC and eFC models outperformed their observed FC and SC counterparts (p-value < 0.05), while the pairwise eSC and SC performed similarly (p = 0.10). Regional eSC and eFC models had higher AUC (0.66-0.68) than the pairwise models (0.60-0.65), with regional eFC having highest classification accuracy across all models. Ridge regression coefficients for the regional eFC and regional observed FC models were significantly correlated (Pearson's r = 0.52, p-value < 10e-7). Decreased estimated SC node strength in default mode and ventral attention networks and increased eFC node strength in visual networks was associated with evidence of disability. DISCUSSION Here, for the first time, we use clinically acquired lesion masks to estimate both structural and functional connectomes in patient populations to better understand brain lesion-dysfunction mapping in pwMS. Models based on the NeMo Tool's estimates of SC and FC better classified pwMS by disability level than SC and FC observed directly in the individual using advanced MRI. This work provides a viable alternative to performing high-cost, advanced MRI in patient populations, bringing the connectome one step closer to the clinic.
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Affiliation(s)
- Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Zijin Gu
- Electrical and Computer Engineering Department, Cornell University, Ithaca 14850, USA
| | - Susan A Gauthier
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA; Department of Neurology, Weill Cornell Medicine, New York, NY, USA; Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA; Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
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11
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Bosticardo S, Schiavi S, Schaedelin S, Lu PJ, Barakovic M, Weigel M, Kappos L, Kuhle J, Daducci A, Granziera C. Microstructure-Weighted Connectomics in Multiple Sclerosis. Brain Connect 2021; 12:6-17. [PMID: 34210167 PMCID: PMC8867108 DOI: 10.1089/brain.2021.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction: Graph theory has been applied to study the pathophysiology of multiple sclerosis (MS) since it provides global and focal measures of brain network properties that are affected by MS. Typically, the connection strength and, consequently, the network properties are computed by counting the number of streamlines (NOS) connecting couples of gray matter regions. However, recent studies have shown that this method is not quantitative. Methods: We evaluated diffusion-based microstructural measures extracted from three different models to assess the network properties in a group of 66 MS patients and 64 healthy subjects. Besides, we assessed their correlation with patients' disability and with a biological measure of neuroaxonal damage. Results: Graph metrics extracted from connectomes weighted by intra-axonal microstructural components were the most sensitive to MS pathology and the most related to clinical disability. In contrast, measures of network segregation extracted from the connectomes weighted by maps describing extracellular diffusivity were the most related to serum concentration of neurofilament light chain. Network properties assessed with NOS were neither sensitive to MS pathology nor correlated with clinical and pathological measures of disease impact in MS patients. Conclusion: Using tractometry-derived graph measures in MS patients, we identified a set of metrics based on microstructural components that are highly sensitive to the disease and that provide sensitive correlates of clinical and biological deterioration in MS patients.
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Affiliation(s)
- Sara Bosticardo
- Diffusion Imaging and Connectivity Estimation (DICE) Lab, Department of Computer Science, University of Verona, Verona, Italy
| | - Simona Schiavi
- Diffusion Imaging and Connectivity Estimation (DICE) Lab, Department of Computer Science, University of Verona, Verona, Italy
| | - Sabine Schaedelin
- Neurology Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Po-Jui Lu
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Muhamed Barakovic
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Matthias Weigel
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
- Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Ludwig Kappos
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Neurology Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Alessandro Daducci
- Diffusion Imaging and Connectivity Estimation (DICE) Lab, Department of Computer Science, University of Verona, Verona, Italy
| | - Cristina Granziera
- Neurology Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland
- Address correspondence to: Cristina Granziera, Translational Imaging in Neurology (ThINk), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Gewerbestrasse 16, 4123 Allschwil, BL, Switzerland
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12
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Farooq H, Lenglet C, Nelson F. Robustness of Brain Structural Networks Is Affected in Cognitively Impaired MS Patients. Front Neurol 2020; 11:606478. [PMID: 33329369 PMCID: PMC7710804 DOI: 10.3389/fneur.2020.606478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022] Open
Abstract
The robustness of brain structural networks, estimated from diffusion MRI data, may be relevant to cognition. We investigate whether measures of network robustness, such as Ollivier-Ricci curvature, can explain cognitive impairment in multiple sclerosis (MS). We assessed whether local (i.e., cortical area) and/or global (i.e., whole brain) robustness, differs between cognitively impaired (MSCI) and non-impaired (MSNI) MS patients. Fifty patients, with Expanded Disability Status Scale mean (m): 3.2, disease duration m: 12 years, and age m: 40 years, were enrolled. Cognitive impairment scores were estimated from the Minimal Assessment of Cognitive Function in Multiple Sclerosis. Images were obtained in a 3T MRI using a diffusion protocol with a 2 min acquisition time. Brain structural networks were created using 333 cortical areas. Local and global robustness was estimated for each individual, and comparisons were performed between MSCI and MSNI patients. 31 MSCI and 10 MSNI patients were included in the analyses. Brain structural network robustness and centrality showed significant correlations with cognitive impairment. Measures of network robustness and centrality identified specific cortical areas relevant to MS-related cognitive impairment. These measures can be obtained on clinical scanners and are succinct yet accurate potential biomarkers of cognitive impairment.
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Affiliation(s)
- Hamza Farooq
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
| | - Christophe Lenglet
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Flavia Nelson
- Department of Neurology, University of Minnesota, Minneapolis, MN, United States
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13
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Neurochemical Changes in the Brain and Neuropsychiatric Symptoms in Clinically Isolated Syndrome. J Clin Med 2020; 9:jcm9123909. [PMID: 33276455 PMCID: PMC7761482 DOI: 10.3390/jcm9123909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/08/2020] [Accepted: 11/28/2020] [Indexed: 11/20/2022] Open
Abstract
To assess cognitive impairment and affective symptoms and their association with damage to normal-appearing white matter (NAWM) in patients with clinically isolated syndrome (CIS), we compared neuropsychological test scores between patients with CIS and healthy controls and examined correlations between these and proton magnetic resonance spectroscopy (1H-MRS) outcomes in patients with CIS. Forty patients with CIS and 40 healthy participants were tested with a set of neuropsychological tests, which included the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS). Single-voxel 1H-MRS was performed on frontal and parietal NAWM of patients with CIS to assess ratios of N-acetyl-aspartate (NAA) to creatine (Cr), myo-inositol (mI), and choline (Cho), as well as mI/Cr and Cho/Cr ratios. Patients with CIS had lower cognitive performance and higher scores for the BDI and anxiety subscale of HADS than healthy controls. There were significant correlations between the following neuropsychological tests and metabolic ratios in the frontal NAWM: Stroop Color-Word Test and Cho/Cr, Symbol Digit Modalities Test and mI/Cr, as well as NAA/mI, Go/no-go reaction time, and NAA/Cho, as well as NAA/mI, Californian Verbal Learning Test, and NAA/Cr. BDI scores were related to frontal NAA/mI and parietal NAA/Cr and Cho/Cr ratios, whereas HADS-depression scores were associated with frontal NAA/Cr and NAA/mI and parietal NAA/Cr and Cho/Cr ratios. HADS-anxiety correlated with parietal NAA/Cr ratio. This study suggests that neurochemical changes in the NAWM assessed with single-voxel 1H-MRS are associated with cognitive performance and affective symptoms in patients with CIS.
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14
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Patankar SP, Kim JZ, Pasqualetti F, Bassett DS. Path-dependent connectivity, not modularity, consistently predicts controllability of structural brain networks. Netw Neurosci 2020; 4:1091-1121. [PMID: 33195950 PMCID: PMC7655114 DOI: 10.1162/netn_a_00157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 07/15/2020] [Indexed: 01/03/2023] Open
Abstract
The human brain displays rich communication dynamics that are thought to be particularly well-reflected in its marked community structure. Yet, the precise relationship between community structure in structural brain networks and the communication dynamics that can emerge therefrom is not well understood. In addition to offering insight into the structure-function relationship of networked systems, such an understanding is a critical step toward the ability to manipulate the brain's large-scale dynamical activity in a targeted manner. We investigate the role of community structure in the controllability of structural brain networks. At the region level, we find that certain network measures of community structure are sometimes statistically correlated with measures of linear controllability. However, we then demonstrate that this relationship depends on the distribution of network edge weights. We highlight the complexity of the relationship between community structure and controllability by performing numerical simulations using canonical graph models with varying mesoscale architectures and edge weight distributions. Finally, we demonstrate that weighted subgraph centrality, a measure rooted in the graph spectrum, and which captures higher order graph architecture, is a stronger and more consistent predictor of controllability. Our study contributes to an understanding of how the brain's diverse mesoscale structure supports transient communication dynamics.
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Affiliation(s)
| | - Jason Z. Kim
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
| | - Fabio Pasqualetti
- Department of Mechanical Engineering, University of California, Riverside, CA USA
| | - Danielle S. Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA USA
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA USA
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA USA
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA USA
- Santa Fe Institute, Santa Fe, NM USA
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15
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Lella E, Estrada E. Communicability distance reveals hidden patterns of Alzheimer's disease. Netw Neurosci 2020; 4:1007-1029. [PMID: 33195946 PMCID: PMC7655045 DOI: 10.1162/netn_a_00143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/29/2020] [Indexed: 01/18/2023] Open
Abstract
The communicability distance between pairs of regions in human brain is used as a quantitative proxy for studying Alzheimer's disease. Using this distance, we obtain the shortest communicability path lengths between different regions of brain networks from patients with Alzheimer's disease (AD) and healthy cohorts (HC). We show that the shortest communicability path length is significantly better than the shortest topological path length in distinguishing AD patients from HC. Based on this approach, we identify 399 pairs of brain regions for which there are very significant changes in the shortest communicability path length after AD appears. We find that 42% of these regions interconnect both brain hemispheres, 28% connect regions inside the left hemisphere only, and 20% affect vermis connection with brain hemispheres. These findings clearly agree with the disconnection syndrome hypothesis of AD. Finally, we show that in 76.9% of damaged brain regions the shortest communicability path length drops in AD in relation to HC. This counterintuitive finding indicates that AD transforms the brain network into a more efficient system from the perspective of the transmission of the disease, because it drops the circulability of the disease factor around the brain regions in relation to its transmissibility to other regions.
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Affiliation(s)
- Eufemia Lella
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Bari, Italy
- Innovation Lab, Exprivia S.p.A., Molfetta, Italy
| | - Ernesto Estrada
- Institute of Applied Mathematics (IUMA), Universidad de Zaragoza, Zaragoza, Spain
- ARAID Foundation, Government of Aragón, Zaragoza, Spain
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16
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Localised Grey Matter Atrophy in Multiple Sclerosis and Clinically Isolated Syndrome-A Coordinate-Based Meta-Analysis, Meta-Analysis of Networks, and Meta-Regression of Voxel-Based Morphometry Studies. Brain Sci 2020; 10:brainsci10110798. [PMID: 33143012 PMCID: PMC7693631 DOI: 10.3390/brainsci10110798] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 01/04/2023] Open
Abstract
Background: Atrophy of grey matter (GM) is observed in the earliest stages of multiple sclerosis (MS) and is associated with cognitive decline and physical disability. Localised GM atrophy in MS can be explored and better understood using magnetic resonance imaging and voxel-based morphometry (VBM). However, results are difficult to interpret due to methodological differences between studies. Methods: Coordinate-based analysis is a way to find the reliably observable results across multiple independent VBM studies. This work uses coordinate-based meta-analysis, meta-analysis of networks, and meta-regression to summarise the evidence from voxel-based morphometry of regional GM hanges in patients with MS and clinically isolated syndrome (CIS), and whether these measured changes are relatable to clinical features. Results: Thirty-four published articles reporting forty-four independent experiments using VBM for the assessment of GM atrophy between MS or CIS patients and healthy controls were identified. Analysis identified eight clusters of consistent cross-study reporting of localised GM atrophy involving both cortical and subcortical regions. Meta-network analysis identified a network-like pattern indicating that GM loss occurs with some symmetry between hemispheres. Meta-regression analysis indicates a relationship between disease duration or age and the magnitude of reported statistical effect in some deep GM structures. Conclusions: These results suggest consistency in MRI-detectible regional GM loss across multiple MS studies, and the estimated effect sizes and symmetries can help design prospective studies to test specific hypotheses.
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17
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Fusion of ULS Group Constrained High- and Low-Order Sparse Functional Connectivity Networks for MCI Classification. Neuroinformatics 2020; 18:1-24. [PMID: 30982183 DOI: 10.1007/s12021-019-09418-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Functional connectivity networks, derived from resting-state fMRI data, have been found as effective biomarkers for identifying mild cognitive impairment (MCI) from healthy elderly. However, the traditional functional connectivity network is essentially a low-order network with the assumption that the brain activity is static over the entire scanning period, ignoring temporal variations among the correlations derived from brain region pairs. To overcome this limitation, we proposed a new type of sparse functional connectivity network to precisely describe the relationship of temporal correlations among brain regions. Specifically, instead of using the simple pairwise Pearson's correlation coefficient as connectivity, we first estimate the temporal low-order functional connectivity for each region pair based on an ULS Group constrained-UOLS regression algorithm, where a combination of ultra-least squares (ULS) criterion with a Group constrained topology structure detection algorithm is applied to detect the topology of functional connectivity networks, aided by an Ultra-Orthogonal Least Squares (UOLS) algorithm to estimate connectivity strength. Compared to the classical least squares criterion which only measures the discrepancy between the observed signals and the model prediction function, the ULS criterion takes into consideration the discrepancy between the weak derivatives of the observed signals and the model prediction function and thus avoids the overfitting problem. By using a similar approach, we then estimate the high-order functional connectivity from the low-order connectivity to characterize signal flows among the brain regions. We finally fuse the low-order and the high-order networks using two decision trees for MCI classification. Experimental results demonstrate the effectiveness of the proposed method on MCI classification.
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18
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Welton T, Constantinescu CS, Auer DP, Dineen RA. Graph Theoretic Analysis of Brain Connectomics in Multiple Sclerosis: Reliability and Relationship with Cognition. Brain Connect 2020; 10:95-104. [PMID: 32079409 PMCID: PMC7196369 DOI: 10.1089/brain.2019.0717] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Research suggests that disruption of brain networks might explain cognitive deficits in multiple sclerosis (MS). The reliability and effectiveness of graph theoretic network metrics as measures of cognitive performance were tested in 37 people with MS and 23 controls. Specifically, relationships with cognitive performance (linear regression against the paced auditory serial addition test-3 seconds [PASAT-3], symbol digit modalities test [SDMT], and attention network test) and 1-month reliability (using the intraclass correlation coefficient [ICC]) of network metrics were measured using both resting-state functional and diffusion magnetic resonance imaging data. Cognitive impairment was directly related to measures of brain network segregation and inversely related to network integration (prediction of PASAT-3 by small worldness, modularity, characteristic path length, R2 = 0.55; prediction of SDMT by small worldness, global efficiency, and characteristic path length, R2 = 0.60). Reliability of the measures for 1 month in a subset of nine participants was mostly rated as good (ICC >0.6) for both controls and MS patients in both functional and diffusion data, but was highly dependent on the chosen parcellation and graph density, with the 0.2–0.5 density range being the most reliable. This suggests that disrupted network organization predicts cognitive impairment in MS and its measurement is reliable for a 1-month period. These new findings support the hypothesis of network disruption as a major determinant of cognitive deficits in MS and the future possibility of the application of derived metrics as surrogate outcomes in trials of therapies for cognitive impairment.
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Affiliation(s)
- Thomas Welton
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,Sydney Translational Imaging Laboratory, Heart Research Institute, University of Sydney, Camperdown, Australia
| | - Cris S Constantinescu
- Clinical Neurology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Rob A Dineen
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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19
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Kim M, Jewells V. Multimodal Image Analysis for Assessing Multiple Sclerosis and Future Prospects Powered by Artificial Intelligence. Semin Ultrasound CT MR 2020; 41:309-318. [DOI: 10.1053/j.sult.2020.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Schiavi S, Petracca M, Battocchio M, El Mendili MM, Paduri S, Fleysher L, Inglese M, Daducci A. Sensory-motor network topology in multiple sclerosis: Structural connectivity analysis accounting for intrinsic density discrepancy. Hum Brain Mapp 2020; 41:2951-2963. [PMID: 32412678 PMCID: PMC7336144 DOI: 10.1002/hbm.24989] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/11/2022] Open
Abstract
Graph theory and network modelling have been previously applied to characterize motor network structural topology in multiple sclerosis (MS). However, between‐group differences disclosed by graph analysis might be primarily driven by discrepancy in density, which is likely to be reduced in pathologic conditions as a consequence of macroscopic damage and fibre loss that may result in less streamlines properly traced. In this work, we employed the convex optimization modelling for microstructure informed tractography (COMMIT) framework, which, given a tractogram, estimates the actual contribution (or weight) of each streamline in order to optimally explain the diffusion magnetic resonance imaging signal, filtering out those that are implausible or not necessary. Then, we analysed the topology of this ‘COMMIT‐weighted sensory‐motor network’ in MS accounting for network density. By comparing with standard connectivity analysis, we also tested if abnormalities in network topology are still identifiable when focusing on more ‘quantitative’ network properties. We found that topology differences identified with standard tractography in MS seem to be mainly driven by density, which, in turn, is strongly influenced by the presence of lesions. We were able to identify a significant difference in density but also in network global and local properties when accounting for density discrepancy. Therefore, we believe that COMMIT may help characterize the structural organization in pathological conditions, allowing a fair comparison of connectomes which considers discrepancies in network density. Moreover, discrepancy‐corrected network properties are clinically meaningful and may help guide prognosis assessment and treatment choice.
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Affiliation(s)
- Simona Schiavi
- Department of Computer Science, University of Verona, Verona, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy
| | - Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Mohamed M El Mendili
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Swetha Paduri
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lazar Fleysher
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy.,Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Ospedale Policlinico San Martino IRCCS, Genoa, Italy
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21
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Has Silemek AC, Fischer L, Pöttgen J, Penner IK, Engel AK, Heesen C, Gold SM, Stellmann JP. Functional and structural connectivity substrates of cognitive performance in relapsing remitting multiple sclerosis with mild disability. Neuroimage Clin 2020; 25:102177. [PMID: 32014828 PMCID: PMC6997626 DOI: 10.1016/j.nicl.2020.102177] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/06/2019] [Accepted: 01/11/2020] [Indexed: 01/10/2023]
Abstract
Multiple Sclerosis (MS) is the most common chronic inflammatory and neurodegenerative disease of the central nervous system (CNS), which can lead to severe cognitive impairment over time. Magnetic resonance imaging (MRI) is currently the best available biomarker to track MS pathophysiology in vivo and examine the link to clinical disability. However, conventional MRI metrics have limited sensitivity and specificity to detect direct associations between symptoms and their underlying CNS substrates. In this study, we aimed to investigate structural and resting state functional connectomes and subnetworks associated with neuropsychological (NP) performance using a graph theoretical approach. A comprehensive NP test battery was administered in a sample of patients with relapsing remitting MS (RRMS) and mild disability [n = 33, F/M = 20/13, age = 40.9 ± 9.7, median [Expanded Disability Status Scale] (EDSS) = 2, range =0-4] and compared to healthy controls (HC) [n = 29, F/M = 19/10, age = 41.0 ± 8.5] closely matched for age, sex, and level of education. The NP battery comprised the most relevant domains of cognitive dysfunction in MS including attention, processing speed, verbal and spatial learning and memory, and executive function. While standard MRI metrics showed good correlations with TAP Alertness test, disease duration and neurological exams, structural networks showed closer associations with 9-hole peg test and cognitive performances. Decreased graph strength was associated with two out of the 5 NP tests in the spatial learning and memory domain specified by BVMT [Sum 1-3] and BVMT [Recall], and with also SDMT which is one out of the 9 NP tests in the attention/processing speed domain, while no correlation was found between these scores and functional connectivity. Nodal strength was decreased in all subnetworks based on Yeo atlas in patients compared to HC; however, no difference was observed in nodal level of functional connectivity between the groups. The difference in structural and functional nodal connectivity between the groups was also observed in the relationship between structural and functional connectivity within the groups; the relationship between nodal degree and nodal strength was reversed in patients but positive in controls. On a nodal level, structural and functional networks (mainly the default mode network) were correlated with more than one cognitive domain rather than one specific network for each domain within patients. Interestingly, poorer cognitive performance was mostly correlated with increased functional connectivity but decreased structural connectivity in patients. Increased functional connectivity in the default mode network had both positive as well as negative associations with verbal and spatial learning and memory, possibly indicating adaptive and maladaptive mechanisms. In conclusion, our results suggest that cognitive performance, even in patients with RRMS and very mild disability, may reflect a loss of structural connectivity. In contrast, widespread increases in functional connectivity may be the result of maladaptive processes.
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Affiliation(s)
- Arzu Ceylan Has Silemek
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany.
| | - Lukas Fischer
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany
| | - Jana Pöttgen
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany; Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany
| | - Iris-Katharina Penner
- Klinik für Neurologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf 40225, Germany; COGITO Zentrum für Angewandte Neurokognition und Neuropsychologische Forschung, Düsseldorf 40225, Germany
| | - Andreas K Engel
- Institut für Neurophysiologie und Pathophysiologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany
| | - Christoph Heesen
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany; Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany
| | - Stefan M Gold
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany; Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt Universität zu Berlin, and Berlin Institute of Health (BIH), Klinik für Psychiatrie & Psychotherapie und Medizinische Klinik m.S. Psychosomatik, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, Berlin 12203, Germany
| | - Jan-Patrick Stellmann
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany; Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, Hamburg 20246, Germany; APHM, Hopital de la Timone, CEMEREM, Marseille, France; Aix Marseille Univ, CNRS, CRMBM, UMR 7339, Marseille, France
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22
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Solana E, Martinez-Heras E, Casas-Roma J, Calvet L, Lopez-Soley E, Sepulveda M, Sola-Valls N, Montejo C, Blanco Y, Pulido-Valdeolivas I, Andorra M, Saiz A, Prados F, Llufriu S. Modified connectivity of vulnerable brain nodes in multiple sclerosis, their impact on cognition and their discriminative value. Sci Rep 2019; 9:20172. [PMID: 31882922 PMCID: PMC6934774 DOI: 10.1038/s41598-019-56806-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/25/2019] [Indexed: 12/30/2022] Open
Abstract
Brain structural network modifications in multiple sclerosis (MS) seem to be clinically relevant. The discriminative ability of those changes to identify MS patients or their cognitive status remains unknown. Therefore, this study aimed to investigate connectivity changes in MS patients related to their cognitive status, and to define an automatic classification method to classify subjects as patients and healthy volunteers (HV) or as cognitively preserved (CP) and impaired (CI) patients. We analysed structural brain connectivity in 45 HV and 188 MS patients (104 CP and 84 CI). A support vector machine with k-fold cross-validation was built using the graph metrics features that best differentiate the groups (p < 0.05). Local efficiency (LE) and node strength (NS) network properties showed the largest differences: 100% and 69.7% of nodes had reduced LE and NS in CP patients compared to HV. Moreover, 55.3% and 57.9% of nodes had decreased LE and NS in CI compared to CP patients, in associative multimodal areas. The classification method achieved an accuracy of 74.8–77.2% to differentiate patients from HV, and 59.9–60.8% to discriminate CI from CP patients. Structural network integrity is widely reduced and worsens as cognitive function declines. Central network properties of vulnerable nodes can be useful to classify MS patients.
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Affiliation(s)
- Elisabeth Solana
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Eloy Martinez-Heras
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Jordi Casas-Roma
- E-health Centre, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Laura Calvet
- E-health Centre, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Elisabet Lopez-Soley
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Maria Sepulveda
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Nuria Sola-Valls
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Carmen Montejo
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Irene Pulido-Valdeolivas
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Magi Andorra
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Ferran Prados
- E-health Centre, Universitat Oberta de Catalunya, Barcelona, Spain.,Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.,NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London, UK
| | - Sara Llufriu
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain.
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Drummond C, Coutinho G, Monteiro MC, Assuncao N, Teldeschi A, de Souza AS, Oliveira N, Bramati I, Sudo FK, Vanderboght B, Brandao CO, Fonseca RP, de Oliveira-Souza R, Moll J, Mattos P, Tovar-Moll F. Narrative impairment, white matter damage and CSF biomarkers in the Alzheimer's disease spectrum. Aging (Albany NY) 2019; 11:9188-9208. [PMID: 31682234 PMCID: PMC6834410 DOI: 10.18632/aging.102391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/21/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Narrative discourse (ND) refers to one's ability to verbally reproduce a sequence of temporally and logically-linked events. Impairments in ND may occur in subjects with Amnestic Mild Cognitive Impairment (aMCI) and Alzheimer's Disease (AD), but correlates across this function, neuroimaging and cerebrospinal fluid (CSF) AD biomarkers remain understudied. OBJECTIVES We sought to measure correlates among ND, Diffusion Tensor Imaging (DTI) indexes and AD CSF biomarkers in patients within the AD spectrum. RESULTS Groups differed in narrative production (NProd) and comprehension. aMCI and AD presented poorer inference abilities than controls. AD subjects were more impaired than controls and aMCI regarding WB (p<0.01). ROIs DTI assessment distinguished the three groups. Mean Diffusivity (MD) in the uncinate, bilateral parahippocampal cingulate and left inferior occipitofrontal fasciculi negatively correlated with NProd. Changes in specific tracts correlated with T-tau/Aβ1-42 ratio in CSF. CONCLUSIONS AD and aMCI patients presented more ND impairments than controls. Those findings were associated with changes in ventral language-associated and in the inferior parahippocampal pathways. The latest were correlated with biomarkers' levels in the CSF. METHODS AD (N=14), aMCI (N=31) and Control (N=39) groups were compared for whole brain (WB) and regions of interest (ROI) DTI parameters, ND and AD CSF biomarkers.
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Affiliation(s)
- Claudia Drummond
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Department of Speech and Hearing Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriel Coutinho
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Celso Lisboa University Center, Rio de Janeiro, Brazil
| | - Marina Carneiro Monteiro
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Naima Assuncao
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alina Teldeschi
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Andrea Silveira de Souza
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Natalia Oliveira
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Ivanei Bramati
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Felipe Kenji Sudo
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Bart Vanderboght
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Rochele Paz Fonseca
- Laboratory of Clinical and Experimental Neuropsychology, Department of Psychology, Pontificial Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo de Oliveira-Souza
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Paulo Mattos
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychiatry and Forensic Medicine, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Tovar-Moll
- Department of Neuroscience, D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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24
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MR g-ratio-weighted connectome analysis in patients with multiple sclerosis. Sci Rep 2019; 9:13522. [PMID: 31534143 PMCID: PMC6751178 DOI: 10.1038/s41598-019-50025-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/05/2019] [Indexed: 12/16/2022] Open
Abstract
Multiple sclerosis (MS) is a brain network disconnection syndrome. Although the brain network topology in MS has been evaluated using diffusion MRI tractography, the mechanism underlying disconnection in the disorder remains unclear. In this study, we evaluated the brain network topology in MS using connectomes with connectivity strengths based on the ratio of the inner to outer myelinated axon diameter (i.e., g-ratio), thereby providing enhanced sensitivity to demyelination compared with the conventional measures of connectivity. We mapped g-ratio-based connectomes in 14 patients with MS and compared them with those of 14 age- and sex-matched healthy controls. For comparison, probabilistic tractography was also used to map connectomes based on the number of streamlines (NOS). We found that g-ratio- and NOS-based connectomes comprised significant connectivity reductions in patients with MS, predominantly in the motor, somatosensory, visual, and limbic regions. However, only the g-ratio-based connectome enabled detection of significant increases in nodal strength in patients with MS. Finally, we found that the g-ratio-weighted nodal strength in motor, visual, and limbic regions significantly correlated with inter-individual variation in measures of disease severity. The g-ratio-based connectome can serve as a sensitive biomarker for diagnosing and monitoring disease progression.
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25
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Graph Theoretical Framework of Brain Networks in Multiple Sclerosis: A Review of Concepts. Neuroscience 2019; 403:35-53. [DOI: 10.1016/j.neuroscience.2017.10.033] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 12/11/2022]
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Filippi M, Preziosa P, Rocca MA. Brain mapping in multiple sclerosis: Lessons learned about the human brain. Neuroimage 2019; 190:32-45. [DOI: 10.1016/j.neuroimage.2017.09.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/07/2017] [Accepted: 09/09/2017] [Indexed: 02/07/2023] Open
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Abstract
PURPOSE OF REVIEW To summarize recent findings from the application of MRI in the diagnostic work-up of patients with suspected multiple sclerosis (MS), and to review the insights into disease pathophysiology and the utility of MRI for monitoring treatment response. RECENT FINDINGS New evidence from the application of MRI in patients with clinically isolated syndromes has guided the 2017 revision of the McDonald criteria for MS diagnosis, which has simplified their clinical use while preserving accuracy. Other MRI measures (e.g., cortical lesions and central vein signs) may improve diagnostic specificity, but their assessment still needs to be standardized, and their reliability confirmed. Novel MRI techniques are providing fundamental insights into the pathological substrates of the disease and are helping to give a better understanding of its clinical manifestations. Combined clinical-MRI measures of disease activity and progression, together with the use of clinically relevant MRI measures (e.g., brain atrophy) might improve treatment monitoring, but these are still not ready for the clinical setting. SUMMARY Advances in MRI technology are improving the diagnostic work-up and monitoring of MS, even in the earliest phases of the disease, and are providing MRI measures that are more specific and sensitive to disease pathological substrates.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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28
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Pagani E, Rocca MA, De Meo E, Horsfield MA, Colombo B, Rodegher M, Comi G, Filippi M. Structural connectivity in multiple sclerosis and modeling of disconnection. Mult Scler 2019; 26:220-232. [PMID: 30625050 DOI: 10.1177/1352458518820759] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by focal white matter damage, and when the brain is modeled as a network, lesions can be treated as disconnection events. OBJECTIVE To evaluate whether modeling disconnection caused by lesions helps explain motor and cognitive impairment in MS. METHODS Pathways connecting 116 cortical regions were reconstructed with magnetic resonance imaging (MRI) tractography from diffusion tensors averaged across healthy controls (HCs); maps of pathways were applied to 227 relapse-onset MS patients and 50 HCs to derive structural connectivity. Then, the likelihood of individual connections passing through lesions was used to model disconnection. Patients were grouped according to clinical phenotype (113 relapsing-remitting multiple sclerosis (RRMS), 69 secondary progressive multiple sclerosis (SPMS), 45 benign MS), and then network metrics were compared between groups (analysis of variance (ANOVA)) and correlated with motor and cognitive scores (linear regression). RESULTS Global metrics differentiated RRMS from SPMS and benign MS patients, but not benign from SPMS patients. Nodal connectivity strength replicated global results. After disconnection, few nodes were significantly different between benign MS and RRMS patients. Correlations revealed nodes pertinent to motor and cognitive dysfunctions; these became slightly stronger after disconnection. CONCLUSION Connectivity did not change greatly after modeled disconnection, suggesting that the brain network is robust against damage caused by MS lesions.
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Affiliation(s)
- Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Ermelinda De Meo
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Bruno Colombo
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Mariaemma Rodegher
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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29
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Allali G, Blumen HM, Devanne H, Pirondini E, Delval A, Van De Ville D. Brain imaging of locomotion in neurological conditions. Neurophysiol Clin 2018; 48:337-359. [PMID: 30487063 PMCID: PMC6563601 DOI: 10.1016/j.neucli.2018.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 01/20/2023] Open
Abstract
Impaired locomotion is a frequent and major source of disability in patients with neurological conditions. Different neuroimaging methods have been used to understand the brain substrates of locomotion in various neurological diseases (mainly in Parkinson's disease) during actual walking, and while resting (using mental imagery of gait, or brain-behavior correlation analyses). These studies, using structural (i.e., MRI) or functional (i.e., functional MRI or functional near infra-red spectroscopy) brain imaging, electrophysiology (i.e., EEG), non-invasive brain stimulation (i.e., transcranial magnetic stimulation, or transcranial direct current stimulation) or molecular imaging methods (i.e., PET, or SPECT) reveal extended brain networks involving both grey and white matters in key cortical (i.e., prefrontal cortex) and subcortical (basal ganglia and cerebellum) regions associated with locomotion. However, the specific roles of the various pathophysiological mechanisms encountered in each neurological condition on the phenotype of gait disorders still remains unclear. After reviewing the results of individual brain imaging techniques across the common neurological conditions, such as Parkinson's disease, dementia, stroke, or multiple sclerosis, we will discuss how the development of new imaging techniques and computational analyses that integrate multivariate correlations in "large enough datasets" might help to understand how individual pathophysiological mechanisms express clinically as an abnormal gait. Finally, we will explore how these new analytic methods could drive our rehabilitative strategies.
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Affiliation(s)
- Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA.
| | - Helena M Blumen
- Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA; Department of Medicine, Division of Geriatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
| | - Hervé Devanne
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; EA 7369, URePSSS, Unité de Recherche Pluridisciplinaire Sport Santé Société, Université du Littoral Côte d'Opale, Calais, France
| | - Elvira Pirondini
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Arnaud Delval
- Department of Clinical Neurophysiology, Lille University Medical Center, Lille, France; Unité Inserm 1171, Faculté de Médecine, Université de Lille, Lille, France
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Lin S, Vavasour I, Kosaka B, Li DKB, Traboulsee A, MacKay A, McKeown MJ. Education, and the balance between dynamic and stationary functional connectivity jointly support executive functions in relapsing-remitting multiple sclerosis. Hum Brain Mapp 2018; 39:5039-5049. [PMID: 30240533 PMCID: PMC6866468 DOI: 10.1002/hbm.24343] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 01/20/2023] Open
Abstract
Graphical network characteristics and nonstationary functional connectivity features, both derived from resting-state functional magnetic resonance imaging (rsfMRI) data, have been associated with cognitive performance in healthy subjects. How these features jointly relate to cognition in diseased states has not been investigated. In this study, 46 relapsing-remitting multiple sclerosis subjects underwent rsfMRI scans and a focused cognitive battery. With a sliding window approach, we examined six dynamic network features that indicated how connectivity changed over time as well as six measures derived from graph theory to reflect static network characteristics. Multiset canonical correlation analysis (MCCA) was then carried out to investigate the relations between dynamic network features, stationary network characteristics, cognitive testing, demographic, disease severity, and mood. Multiple sclerosis (MS) subjects demonstrated weaker connectivity strength, decreased network density, reduced global changes, but increased changes in interhemispheric connectivity compared to controls. The MCCA model determined that executive functions and processing speed ability measured by Wechsler Adult Intelligence Scale IV (WAIS-IV) Working Memory Index, WAIS-IV Processing Speed Index, and the Verbal Fluency Test were positively correlated with education, dynamic connectivity, and static connectivity strength; while poor task switching was correlated with disease severity, psychiatric comorbidities such as depression, anxiety, and fatigue, and static network density. Taken together, our results suggest that better executive functioning in MS requires maintenance of a continued coordination between stationary and dynamic functional connectivity as well as the support of education, and dynamic functional connectivity may provide an additional cognitive biomarker of disease severity in the MS population.
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Affiliation(s)
- Sue‐Jin Lin
- Graduate Program in NeuroscienceUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Pacific Parkinson's Research CentreUniversity of British Columbia HospitalVancouverBritish ColumbiaCanada
| | - Irene Vavasour
- Department of RadiologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Brenda Kosaka
- Department of PsychiatryUniversity of British Columbia HospitalVancouverBritish ColumbiaCanada
| | - David K. B. Li
- Department of RadiologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Faculty of Medicine, NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Anthony Traboulsee
- Faculty of Medicine, NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Alex MacKay
- Department of RadiologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Physics and AstronomyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Martin J. McKeown
- Graduate Program in NeuroscienceUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Pacific Parkinson's Research CentreUniversity of British Columbia HospitalVancouverBritish ColumbiaCanada
- Faculty of Medicine, NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
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Multimodal hyper-connectivity of functional networks using functionally-weighted LASSO for MCI classification. Med Image Anal 2018; 52:80-96. [PMID: 30472348 DOI: 10.1016/j.media.2018.11.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/30/2018] [Accepted: 11/12/2018] [Indexed: 01/05/2023]
Abstract
Recent works have shown that hyper-networks derived from blood-oxygen-level-dependent (BOLD) fMRI, where an edge (called hyper-edge) can be connected to more than two nodes, are effective biomarkers for MCI classification. Although BOLD fMRI is a high temporal resolution fMRI approach to assess alterations in brain networks, it cannot pinpoint to a single correlation of neuronal activity since BOLD signals are composite. In contrast, arterial spin labeling (ASL) is a lower temporal resolution fMRI technique for measuring cerebral blood flow (CBF) that can provide quantitative, direct brain network physiology measurements. This paper proposes a novel sparse regression algorithm for inference of the integrated hyper-connectivity networks from BOLD fMRI and ASL fMRI. Specifically, a least absolution shrinkage and selection operator (LASSO) algorithm, which is constrained by the functional connectivity derived from ASL fMRI, is employed to estimate hyper-connectivity for characterizing BOLD-fMRI-based functional interaction among multiple regions. An ASL-derived functional connectivity is constructed by using an Ultra-GroupLASSO-UOLS algorithm, where the combination of ultra-least squares (ULS) criterion with a group LASSO (GroupLASSO) algorithm is applied to detect the topology of ASL-based functional connectivity networks, and then an ultra-orthogonal least squares (UOLS) algorithm is used to estimate the connectivity strength. By combining the complementary characterization conveyed by rs-fMRI and ASL fMRI, our multimodal hyper-networks demonstrated much better discriminative characteristics than either the conventional pairwise connectivity networks or the unimodal hyper-connectivity networks. Experimental results on publicly available ADNI dataset demonstrate that the proposed method outperforms the existing single modality based sparse functional connectivity inference methods.
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Brain white matter structural networks in patients with non-neuropsychiatric systemic lupus erythematosus. Brain Imaging Behav 2018; 12:142-155. [PMID: 28190161 DOI: 10.1007/s11682-017-9681-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Previous neuroimaging studies have revealed cognitive dysfunction in patients with systemic lupus erythematosus (SLE) and suggested that it may be related to disrupted brain white matter (WM) connectivity. However, no study has examined the topological properties of brain WM structural networks in SLE patients, especially in patients with non-neuropsychiatric SLE (non-NPSLE). In this study, we acquired DTI datasets from 28 non-NPSLE patients and 24 healthy controls, constructed their brain WM structural networks by using a deterministic fiber tracking approach, estimated the topological parameters of their structural networks, and compared their group differences. We reached the following results: 1) At the global level, the non-NPSLE patients showed significantly increased characteristic path length, normalized clustering coefficient and small-worldness, but significantly decreased global efficiency and local efficiency compared to the controls; 2) At the nodal level, the non-NPSLE patients had significantly decreased nodal efficiency in regions related to movement control, executive control, and working memory (bilateral precentral gyri, bilateral middle frontal gyri, bilateral inferior parietal lobes, left median cingulate gyrus and paracingulate gyrus, and right middle temporal gyrus). In addition, to pinpointing the injured WM fiber tracts in the non-NPSLE patients, we reconstructed the major brain WM pathways connecting the abnormal regions at the nodal level with the corticospinal tract (CST), superior longitudinal fasciculus-parietal terminations (SLFP), and superior longitudinal fasciculus-temporal terminations (SLFT). By analyzing the diffusion parameters along these WM fiber pathways, we detected abnormal diffusion parameters in the bilateral CST and right SLFT in the non-NPSLE patients. These results seem to indicate that injured brain WM connectivity exists in SLE patients even in the absence of neuropsychiatric symptoms.
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Solana E, Martinez-Heras E, Martinez-Lapiscina EH, Sepulveda M, Sola-Valls N, Bargalló N, Berenguer J, Blanco Y, Andorra M, Pulido-Valdeolivas I, Zubizarreta I, Saiz A, Llufriu S. Magnetic resonance markers of tissue damage related to connectivity disruption in multiple sclerosis. NEUROIMAGE-CLINICAL 2018; 20:161-168. [PMID: 30094165 PMCID: PMC6072676 DOI: 10.1016/j.nicl.2018.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/19/2018] [Accepted: 07/11/2018] [Indexed: 01/16/2023]
Abstract
Patients with multiple sclerosis (MS) display reduced structural connectivity among brain regions, but the pathogenic mechanisms underlying network disruption are still unknown. We aimed to investigate the association between the loss of diffusion-based structural connectivity, measured with graph theory metrics, and magnetic resonance (MR) markers of microstructural damage. Moreover, we evaluated the cognitive consequences of connectivity changes. We analysed the frontoparietal network in 102 MS participants and 25 healthy volunteers (HV). MR measures included radial diffusivity (RD), as marker of demyelination, and ratios of myo-inositol, N-acetylaspartate and glutamate+glutamine with creatine in white (WM) and grey matter as markers of astrogliosis, neuroaxonal integrity and glutamatergic neurotoxicity. Patients showed decreased global and local efficiency, and increased assortativity (p < 0.01) of the network, as well as increased RD and myo-inositol, and decreased N-acetylaspartate in WM compared with HV (p < 0.05). In patients, the age-adjusted OR of presenting abnormal global and local efficiency was increased for each increment of 0.01 points in RD and myo-inositol, while it was decreased for each increment of 0.01 points in N-acetylaspartate (the increase of N-acetylaspartate reduced the risk of having abnormal connectivity), all in WM. In a multiple logistic regression analysis, the OR of presenting abnormal global efficiency was 0.95 (95% confidence interval, CI: 0.91–0.99, p = 0.011) for each 0.01 increase in N-acetylaspartate, and the OR of presenting abnormal local efficiency was 1.39 (95% CI: 1.14–1.71, p = 0.001) for each 0.01 increase in RD. Patients with abnormal efficiency had worse performance in attention, working memory and processing speed (p < 0.05). In conclusion, patients with MS exhibit decreased structural network efficiency driven by diffuse microstructural impairment of the WM, probably related to demyelination, astroglial and neuroaxonal damage. The accumulation of neuroaxonal pathological burden seems to magnify the risk of global network collapse, while demyelination may contribute to the regional disorganization. These network modifications have negative consequences on cognition. The pathogenic mechanisms underlying structural network disruption in MS are unknown. The microstructural damage of the white matter contributes to network impairment. The worsening of global efficiency is associated with markers of neuroaxonal burden. Local efficiency impairment is related to MR measures of demyelination. The described network modifications contribute to cognitive dysfunction.
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Affiliation(s)
- Elisabeth Solana
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Eloy Martinez-Heras
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Maria Sepulveda
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Nuria Sola-Valls
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Nuria Bargalló
- Magnetic Resonance Image Core Facility, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Joan Berenguer
- Magnetic Resonance Image Core Facility, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Magi Andorra
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Irene Pulido-Valdeolivas
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Irati Zubizarreta
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain
| | - Sara Llufriu
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Barcelona, Spain.
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Llufriu S, Rocca MA, Pagani E, Riccitelli GC, Solana E, Colombo B, Rodegher M, Falini A, Comi G, Filippi M. Hippocampal-related memory network in multiple sclerosis: A structural connectivity analysis. Mult Scler 2018; 25:801-810. [DOI: 10.1177/1352458518771838] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: We used graph theoretical analysis to quantify structural connectivity of the hippocampal-related episodic memory network and its association with memory performance in multiple sclerosis (MS) patients. Methods: Brain diffusion and T1-weighted sequences were obtained from 71 MS patients and 50 healthy controls (HCs). A total of 30 gray matter regions (selected a priori) were used as seeds to perform probabilistic tractography and create connectivity matrices. Global, nodal, and edge graph theoretical properties were calculated. In patients, verbal and visuospatial memory was assessed. Results: MS patients showed decreased network strength, assortativity, transitivity, global efficiency, and increased average path length. Several nodes had decreased strength and communicability in patients, whereas insula and left temporo-occipital cortex increased communicability. Patients had widespread decreased streamline count (SC) and communicability of edges, although a few ones increased their connectivity. Worse memory performance was associated with reduced network efficiency, decreased right hippocampus strength, and reduced SC and communicability of edges related to medial temporal lobe, thalamus, insula, and occipital cortex. Conclusion: Impaired structural connectivity occurs in the hippocampal-related memory network, decreasing the efficiency of information transmission. Network connectivity measures correlate with episodic memory, supporting the relevance of structural integrity in preserving memory processes in MS.
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Affiliation(s)
- Sara Llufriu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Casanova, Barcelona, Spain
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Gianna C Riccitelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabeth Solana
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Casanova, Barcelona, Spain
| | - Bruno Colombo
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Mariaemma Rodegher
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giancarlo Comi
- Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy/Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Tewarie P, Steenwijk MD, Brookes MJ, Uitdehaag BMJ, Geurts JJG, Stam CJ, Schoonheim MM. Explaining the heterogeneity of functional connectivity findings in multiple sclerosis: An empirically informed modeling study. Hum Brain Mapp 2018; 39:2541-2548. [PMID: 29468785 PMCID: PMC5969233 DOI: 10.1002/hbm.24020] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/10/2018] [Accepted: 02/13/2018] [Indexed: 12/31/2022] Open
Abstract
To understand the heterogeneity of functional connectivity results reported in the literature, we analyzed the separate effects of grey and white matter damage on functional connectivity and networks in multiple sclerosis. For this, we employed a biophysical thalamo‐cortical model consisting of interconnected cortical and thalamic neuronal populations, informed and amended by empirical diffusion MRI tractography data, to simulate functional data that mimic neurophysiological signals. Grey matter degeneration was simulated by decreasing within population connections and white matter degeneration by lowering between population connections, based on lesion predilection sites in multiple sclerosis. For all simulations, functional connectivity and functional network organization are quantified by phase synchronization and network integration, respectively. Modeling results showed that both cortical and thalamic grey matter damage induced a global increase in functional connectivity, whereas white matter damage induced an initially increased connectivity followed by a global decrease. Both white and especially grey matter damage, however, induced a decrease in network integration. These empirically informed simulations show that specific topology and timing of structural damage are nontrivial aspects in explaining functional abnormalities in MS. Insufficient attention to these aspects likely explains contradictory findings in multiple sclerosis functional imaging studies so far.
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Affiliation(s)
- Prejaas Tewarie
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Martijn D Steenwijk
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.,Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Matthew J Brookes
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, United Kingdom
| | - Bernard M J Uitdehaag
- Department of Neurology, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, VUmc MS Center Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
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Mangeat G, Badji A, Ouellette R, Treaba CA, Herranz E, Granberg T, Louapre C, Stikov N, Sloane JA, Bellec P, Mainero C, Cohen-Adad J. Changes in structural network are associated with cortical demyelination in early multiple sclerosis. Hum Brain Mapp 2018; 39:2133-2146. [PMID: 29411457 DOI: 10.1002/hbm.23993] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/22/2018] [Accepted: 01/25/2018] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to investigate the interplay between structural connectivity and cortical demyelination in early multiple sclerosis. About 27 multiple sclerosis patients and 18 age-matched controls underwent two MRI scanning sessions. The first was done at 7T and involved acquiring quantitative T1 and T2 * high-resolution maps to estimate cortical myelination. The second was done on a Connectom scanner and consisted of acquiring high angular resolution diffusion-weighted images to compute white matter structural connectivity metrics: strength, clustering and local efficiency. To further investigate the interplay between structural connectivity and cortical demyelination, patients were divided into four groups according to disease-duration: 0-1 year, 1-2 years, 2-3 years, and >3 years. ANOVA and Spearman's correlations were used to highlight relations between metrics. ANOVA detected a significant effect between disease duration and both cortical myelin (p = 2 × 10-8 ) and connectivity metrics (p < 10-4 ). We observed significant cortical myelin loss in the shorter disease-duration cohorts (0-1 year, p = .0015), and an increase in connectivity in the longer disease-duration cohort (2-3 years, strength: p = .01, local efficiency: p = .002, clustering: p = .001). Moreover, significant covariations between myelin estimation and white matter connectivity metrics were observed: Spearman's Rho correlation coefficients of 0.52 (p = .0003), 0.55 (p = .0001), and 0.53 (p = .0001) for strength, local efficiency, and clustering, respectively. An association between cortical myelin loss and changes in white matter connectivity in early multiple sclerosis was detected. These changes in network organization might be the result of compensatory mechanisms in response to the ongoing cortical diffuse damage in the early stages of multiple sclerosis.
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Affiliation(s)
- Gabriel Mangeat
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.,Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA
| | - Atef Badji
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.,Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, Quebec, Canada
| | - Russell Ouellette
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Constantina A Treaba
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Elena Herranz
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Tobias Granberg
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Harvard Medical School, Boston, Massachusetts, USA
| | - Céline Louapre
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Neurology Department, hôpital de la Pitié-Salpêtrière, APHP, Institut du cerveau et de la moelle épinière (ICM), Paris, France
| | - Nikola Stikov
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.,Montreal Health Institute, Montreal, Quebec, Canada
| | - Jacob A Sloane
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Pierre Bellec
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, Quebec, Canada.,Department of computer science and operations research, Université de Montréal, Montreal, Quebec, Canada
| | - Caterina Mainero
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, MGH, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Julien Cohen-Adad
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada.,Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, Quebec, Canada
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Rimkus CM, Schoonheim MM, Steenwijk MD, Vrenken H, Eijlers AJ, Killestein J, Wattjes MP, Leite CC, Barkhof F, Tijms BM. Gray matter networks and cognitive impairment in multiple sclerosis. Mult Scler 2018; 25:382-391. [PMID: 29320933 PMCID: PMC6393954 DOI: 10.1177/1352458517751650] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Coordinated patterns of gray matter morphology can be represented as networks, and network disruptions may explain cognitive dysfunction related to multiple sclerosis (MS). OBJECTIVE To investigate whether single-subject gray matter network properties are related to impaired cognition in MS. METHODS We studied 148 MS patients (99 female) and 33 healthy controls (HC, 21 female). Seven network parameters were computed and compared within MS between cognitively normal and impaired subjects, and associated with performance on neuropsychological tests in six cognitive domains with regression models. Analyses were controlled for age, gender, whole-brain gray matter volumes, and education level. RESULTS Compared to MS subjects with normal cognition, MS subjects with cognitive impairment showed a more random network organization as indicated by lower lambda values (all p < 0.05). Worse average cognition and executive function were associated with lower lambda values. Impaired information processing speed, working memory, and attention were associated with lower clustering values. CONCLUSION Our findings indicate that MS subjects with a more randomly organized gray matter network show worse cognitive functioning, suggesting that single-subject gray matter graphs may capture neurological dysfunction due to MS.
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Affiliation(s)
- Carolina M Rimkus
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Department of Radiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Department of Neurology, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Anand Jc Eijlers
- Department of Anatomy and Neurosciences, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike P Wattjes
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Claudia C Leite
- Department of Radiology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VUmc MS Center Amsterdam, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Betty M Tijms
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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Stellmann JP, Hodecker S, Cheng B, Wanke N, Young KL, Hilgetag C, Gerloff C, Heesen C, Thomalla G, Siemonsen S. Reduced rich-club connectivity is related to disability in primary progressive MS. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2017; 4:e375. [PMID: 28804744 PMCID: PMC5532749 DOI: 10.1212/nxi.0000000000000375] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 05/17/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate whether the structural connectivity of the brain's rich-club organization is altered in patients with primary progressive MS and whether such changes to this fundamental network feature are associated with disability measures. METHODS We recruited 37 patients with primary progressive MS and 21 healthy controls for an observational cohort study. Structural connectomes were reconstructed based on diffusion-weighted imaging data using probabilistic tractography and analyzed with graph theory. RESULTS We observed the same topological organization of brain networks in patients and controls. Consistent with the originally defined rich-club regions, we identified superior frontal, precuneus, superior parietal, and insular cortex in both hemispheres as rich-club nodes. Connectivity within the rich club was significantly reduced in patients with MS (p = 0.039). The extent of reduced rich-club connectivity correlated with clinical measurements of mobility (Kendall rank correlation coefficient τ = -0.20, p = 0.047), hand function (τ = -0.26, p = 0.014), and information processing speed (τ = -0.20, p = 0.049). CONCLUSIONS In patients with primary progressive MS, the fundamental organization of the structural connectome in rich-club and peripheral nodes was preserved and did not differ from healthy controls. The proportion of rich-club connections was altered and correlated with disability measures. Thus, the rich-club organization of the brain may be a promising network phenotype for understanding the patterns and mechanisms of neurodegeneration in MS.
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Affiliation(s)
- Jan-Patrick Stellmann
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Sibylle Hodecker
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Bastian Cheng
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Nadine Wanke
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Kim Lea Young
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Claus Hilgetag
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Christian Gerloff
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Christoph Heesen
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Götz Thomalla
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
| | - Susanne Siemonsen
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS) (J.-P.S., S.H., N.W., K.L.Y., C.G., C. Heesen, S.S.), Klinik und Poliklinik für Neurologie (J.-P.S., S.H., B.C., N.W., K.L.Y., C. Heesen, G.T.), Institute of Computational Neuroscience (C. Hilgetag), and Department of Diagnostic and Interventional Neuroradiology (S.S.), University Medical Center Hamburg-Eppendorf, Germany
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Wen H, Liu Y, Rekik I, Wang S, Zhang J, Zhang Y, Peng Y, He H. Disrupted topological organization of structural networks revealed by probabilistic diffusion tractography in Tourette syndrome children. Hum Brain Mapp 2017; 38:3988-4008. [PMID: 28474385 PMCID: PMC6866946 DOI: 10.1002/hbm.23643] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/17/2017] [Accepted: 04/24/2017] [Indexed: 01/18/2023] Open
Abstract
Tourette syndrome (TS) is a childhood-onset neurobehavioral disorder. Although previous TS studies revealed structural abnormalities in distinct corticobasal ganglia circuits, the topological alterations of the whole-brain white matter (WM) structural networks remain poorly understood. Here, we used diffusion MRI probabilistic tractography and graph theoretical analysis to investigate the topological organization of WM networks in 44 drug-naive TS children and 41 age- and gender-matched healthy children. The WM networks were constructed by estimating inter-regional connectivity probability and the topological properties were characterized using graph theory. We found that both TS and control groups showed an efficient small-world organization in WM networks. However, compared to controls, TS children exhibited decreased global and local efficiency, increased shortest path length and small worldness, indicating a disrupted balance between local specialization and global integration in structural networks. Although both TS and control groups showed highly similar hub distributions, TS children exhibited significant decreased nodal efficiency, mainly distributed in the default mode, language, visual, and sensorimotor systems. Furthermore, two separate networks showing significantly decreased connectivity in TS group were identified using network-based statistical (NBS) analysis, primarily composed of the parieto-occipital cortex, precuneus, and paracentral lobule. Importantly, we combined support vector machine and multiple kernel learning frameworks to fuse multiple levels of network topological features for classification of individuals, achieving high accuracy of 86.47%. Together, our study revealed the disrupted topological organization of structural networks related to pathophysiology of TS, and the discriminative topological features for classification are potential quantitative neuroimaging biomarkers for clinical TS diagnosis. Hum Brain Mapp 38:3988-4008, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Hongwei Wen
- Research Center for Brain‐inspired Intelligence, Institute of Automation, Chinese Academy of SciencesBeijingChina
- University of Chinese Academy of SciencesBeijingChina
| | - Yue Liu
- Department of RadiologyBeijing Children's Hospital, Capital Medical UniversityBeijingChina
| | - Islem Rekik
- CVIP, Computing, School of Science and EngineeringUniversity of DundeeUK
| | - Shengpei Wang
- Research Center for Brain‐inspired Intelligence, Institute of Automation, Chinese Academy of SciencesBeijingChina
- University of Chinese Academy of SciencesBeijingChina
| | - Jishui Zhang
- Department of NeurologyBeijing Children's Hospital, Capital Medical UniversityBeijingChina
| | - Yue Zhang
- Department of RadiologyBeijing Children's Hospital, Capital Medical UniversityBeijingChina
| | - Yun Peng
- Department of RadiologyBeijing Children's Hospital, Capital Medical UniversityBeijingChina
| | - Huiguang He
- Research Center for Brain‐inspired Intelligence, Institute of Automation, Chinese Academy of SciencesBeijingChina
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of SciencesBeijingChina
- University of Chinese Academy of SciencesBeijingChina
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Sepúlveda M, Fernández-Diez B, Martínez-Lapiscina EH, Llufriu S, Sola-Valls N, Zubizarreta I, Blanco Y, Saiz A, Levy D, Glimcher P, Villoslada P. Impairment of decision-making in multiple sclerosis: A neuroeconomic approach. Mult Scler 2016; 23:1762-1771. [PMID: 27903935 DOI: 10.1177/1352458516682103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the decision-making impairment in patients with multiple sclerosis (MS) and how they relate to other cognitive domains. METHODS We performed a cross-sectional analysis in 84 patients with MS, and 21 matched healthy controls using four tasks taken from behavioral economics: (1) risk preferences, (2) choice consistency, (3) delay of gratification, and (4) rate of learning. All tasks were conducted using real-world reward outcomes (food or money) in different real-life conditions. Participants underwent cognitive examination using the Brief Repeatable Battery-Neuropsychology. RESULTS Patients showed higher risk aversion (general propensity to choose the lottery was 0.51 vs 0.64, p = 0.009), a trend to choose more immediate rewards over larger but delayed rewards ( p = 0.108), and had longer reactions times ( p = 0.033). Choice consistency and learning rates were not different between groups. Progressive patients chose slower than relapsing patients. In relation to general cognitive impairments, we found correlations between impaired decision-making and impaired verbal memory ( r = 0.29, p = 0.009), visual memory ( r = -0.37, p = 0.001), and reduced processing speed ( r = -0.32, p = 0.001). Normalized gray matter volume correlated with deliberation time ( r = -0.32, p = 0.005). CONCLUSION Patients with MS suffer significant decision-making impairments, even at the early stages of the disease, and may affect patients' quality and social life.
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Affiliation(s)
- Maria Sepúlveda
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Begoña Fernández-Diez
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elena H Martínez-Lapiscina
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Sara Llufriu
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Nuria Sola-Valls
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Irati Zubizarreta
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Dino Levy
- Coller School of Management and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Paul Glimcher
- Center for Neural Science, New York University, New York, NY, USA
| | - Pablo Villoslada
- Center of Neuroimmunology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Department of Neurology, Hospital Clinic of Barcelona, Barcelona, Spain/Department of Neurology, University of California-San Francisco (UCSF), San Francisco, CA, USA
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42
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Llufriu S, Martinez-Heras E, Solana E, Sola-Valls N, Sepulveda M, Blanco Y, Martinez-Lapiscina EH, Andorra M, Villoslada P, Prats-Galino A, Saiz A. Structural networks involved in attention and executive functions in multiple sclerosis. NEUROIMAGE-CLINICAL 2016; 13:288-296. [PMID: 28050344 PMCID: PMC5192049 DOI: 10.1016/j.nicl.2016.11.026] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 11/22/2016] [Accepted: 11/26/2016] [Indexed: 12/18/2022]
Abstract
Attention and executive deficits are disabling symptoms in multiple sclerosis (MS) that have been related to disconnection mechanisms. We aimed to investigate changes in structural connectivity in MS and their association with attention and executive performance applying an improved framework that combines high order probabilistic tractography and anatomical exclusion criteria postprocessing. We compared graph theory metrics of structural networks and fractional anisotropy (FA) of white matter (WM) connections or edges between 72 MS subjects and 38 healthy volunteers (HV) and assessed their correlation with cognition. Patients displayed decreased network transitivity, global efficiency and increased path length compared with HV (p < 0.05, corrected). Also, nodal strength was decreased in 26 of 84 gray matter regions. The distribution of nodes with stronger connections or hubs of the network was similar among groups except for the right pallidum and left insula, which became hubs in patients. MS subjects presented reduced edge FA widespread in the network, while FA was increased in 24 connections (p < 0.05, corrected). Decreased integrity of frontoparietal networks, deep gray nuclei and insula correlated with worse attention and executive performance (r between 0.38 and 0.55, p < 0.05, corrected). Contrarily, higher strength in the right transverse temporal cortex and increased FA of several connections (mainly from cingulate, frontal and occipital cortices) were associated with worse functioning (r between − 0.40 and − 0.47, p < 0.05 corrected). In conclusion, structural brain connectivity is disturbed in MS due to widespread impairment of WM connections and gray matter structures. The increased edge connectivity suggests the presence of reorganization mechanisms at the structural level. Importantly, attention and executive performance relates to frontoparietal networks, deep gray nuclei and insula. These results support the relevance of network integrity to maintain optimal cognitive skills. High order tractography and anatomical exclusion criteria improve connectivity analyses. Structural connectivity is less efficient in multiple sclerosis. Attentional and executive functions relate to integrity of strategic networks. Increased connectivity suggests structural reorganization mechanisms.
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Affiliation(s)
- Sara Llufriu
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Eloy Martinez-Heras
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Elisabeth Solana
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Nuria Sola-Valls
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Maria Sepulveda
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Yolanda Blanco
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Elena H Martinez-Lapiscina
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Magi Andorra
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Pablo Villoslada
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
| | - Alberto Prats-Galino
- Laboratory of Surgical NeuroAnatomy (LSNA), Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Barcelona, Spain
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43
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Kocevar G, Stamile C, Hannoun S, Cotton F, Vukusic S, Durand-Dubief F, Sappey-Marinier D. Graph Theory-Based Brain Connectivity for Automatic Classification of Multiple Sclerosis Clinical Courses. Front Neurosci 2016; 10:478. [PMID: 27826224 PMCID: PMC5078266 DOI: 10.3389/fnins.2016.00478] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 10/06/2016] [Indexed: 11/13/2022] Open
Abstract
Purpose: In this work, we introduce a method to classify Multiple Sclerosis (MS) patients into four clinical profiles using structural connectivity information. For the first time, we try to solve this question in a fully automated way using a computer-based method. The main goal is to show how the combination of graph-derived metrics with machine learning techniques constitutes a powerful tool for a better characterization and classification of MS clinical profiles. Materials and Methods: Sixty-four MS patients [12 Clinical Isolated Syndrome (CIS), 24 Relapsing Remitting (RR), 24 Secondary Progressive (SP), and 17 Primary Progressive (PP)] along with 26 healthy controls (HC) underwent MR examination. T1 and diffusion tensor imaging (DTI) were used to obtain structural connectivity matrices for each subject. Global graph metrics, such as density and modularity, were estimated and compared between subjects' groups. These metrics were further used to classify patients using tuned Support Vector Machine (SVM) combined with Radial Basic Function (RBF) kernel. Results: When comparing MS patients to HC subjects, a greater assortativity, transitivity, and characteristic path length as well as a lower global efficiency were found. Using all graph metrics, the best F-Measures (91.8, 91.8, 75.6, and 70.6%) were obtained for binary (HC-CIS, CIS-RR, RR-PP) and multi-class (CIS-RR-SP) classification tasks, respectively. When using only one graph metric, the best F-Measures (83.6, 88.9, and 70.7%) were achieved for modularity with previous binary classification tasks. Conclusion: Based on a simple DTI acquisition associated with structural brain connectivity analysis, this automatic method allowed an accurate classification of different MS patients' clinical profiles.
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Affiliation(s)
- Gabriel Kocevar
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
| | - Claudio Stamile
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
| | - Salem Hannoun
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
- Faculty of Medicine, Abu-Haidar Neuroscience Institute, American University of BeirutBeirut, Lebanon
| | - François Cotton
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
- Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de LyonLyon, France
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de LyonLyon, France
| | - Françoise Durand-Dubief
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de LyonLyon, France
| | - Dominique Sappey-Marinier
- CREATIS Centre National de la Recherche Scientifique UMR5220 and Institut National de la Santé et de la Recherche Médicale U1206, INSA-Lyon, Université de Lyon, Université Claude Bernard-Lyon 1Lyon, France
- CERMEP—Imagerie du Vivant, Université de LyonLyon, France
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44
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Shu N, Duan Y, Xia M, Schoonheim MM, Huang J, Ren Z, Sun Z, Ye J, Dong H, Shi FD, Barkhof F, Li K, Liu Y. Disrupted topological organization of structural and functional brain connectomes in clinically isolated syndrome and multiple sclerosis. Sci Rep 2016; 6:29383. [PMID: 27403924 PMCID: PMC4941534 DOI: 10.1038/srep29383] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 06/17/2016] [Indexed: 12/30/2022] Open
Abstract
The brain connectome of multiple sclerosis (MS) has been investigated by several previous studies; however, it is still unknown how the network changes in clinically isolated syndrome (CIS), the earliest stage of MS, and how network alterations on a functional level relate to the structural level in MS disease. Here, we investigated the topological alterations of both the structural and functional connectomes in 41 CIS and 32 MS patients, compared to 35 healthy controls, by combining diffusion tensor imaging and resting-state functional MRI with graph analysis approaches. We found that the structural connectome showed a deviation from the optimal pattern as early as the CIS stage, while the functional connectome only showed local changes in MS patients, not in CIS. When comparing two patient groups, the changes appear more severe in MS. Importantly, the disruptions of structural and functional connectomes in patients occurred in the same direction and locally correlated in sensorimotor component. Finally, the extent of structural network changes was correlated with several clinical variables in MS patients. Together, the results suggested early disruption of the structural brain connectome in CIS patients and provided a new perspective for investigating the relationship of the structural and functional alterations in MS.
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Affiliation(s)
- Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, P. R. China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, P. R. China
| | - Yunyun Duan
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Mingrui Xia
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, P. R. China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, P. R. China
| | - Menno M Schoonheim
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam 1007 MB, The Netherlands.,Department of Anatomy and Neuroscience, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Jing Huang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Zhuoqiong Ren
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Zheng Sun
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Jing Ye
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Huiqing Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Fu-Dong Shi
- Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, P. R. China
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China
| | - Yaou Liu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, P. R. China.,Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam 1007 MB, The Netherlands.,Department of Neurology and Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, P. R. China
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45
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Rimkus CDM, Steenwijk MD, Barkhof F. Causes, effects and connectivity changes in MS-related cognitive decline. Dement Neuropsychol 2016; 10:2-11. [PMID: 29213424 PMCID: PMC5674907 DOI: 10.1590/s1980-57642016dn10100002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cognitive decline is a frequent but undervalued aspect of multiple sclerosis (MS). Currently, it remains unclear what the strongest determinants of cognitive dysfunction are, with grey matter damage most directly related to cognitive impairment. Multi-parametric studies seem to indicate that individual factors of MS-pathology are highly interdependent causes of grey matter atrophy and permanent brain damage. They are associated with intermediate functional effects (e.g. in functional MRI) representing a balance between disconnection and (mal) adaptive connectivity changes. Therefore, a more comprehensive MRI approach is warranted, aiming to link structural changes with functional brain organization. To better understand the disconnection syndromes and cognitive decline in MS, this paper reviews the associations between MRI metrics and cognitive performance, by discussing the interactions between multiple facets of MS pathology as determinants of brain damage and how they affect network efficiency.
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Affiliation(s)
- Carolina de Medeiros Rimkus
- Department of Radiology, Laboratory of Medical Investigation (LIM-44), Faculty of Medicine of the University of São Paulo, São Paulo SP, Brazil and Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Radiology, Laboratory of Medical Investigation (LIM-44), Faculty of Medicine of the University of São Paulo, São Paulo SP, Brazil and Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Radiology, Laboratory of Medical Investigation (LIM-44), Faculty of Medicine of the University of São Paulo, São Paulo SP, Brazil and Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands and Department of Physics and Medical technology, Neuroscience campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology, Laboratory of Medical Investigation (LIM-44), Faculty of Medicine of the University of São Paulo, São Paulo SP, Brazil and Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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46
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Abstract
Due to its sensitivity to the different multiple sclerosis (MS)-related abnormalities, magnetic resonance imaging (MRI) has become an established tool to diagnose MS and to monitor its evolution. MRI has been included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, and ad hoc criteria have been proposed and are regularly updated. In patients with definite MS, the ability of conventional MRI techniques to explain patients' clinical status and progression of disability is still suboptimal. Several advanced MRI-based technologies have been applied to estimate overall MS burden in the different phases of the disease. Their use has allowed the heterogeneity of MS pathology in focal lesions, normal-appearing white matter and gray matter to be graded in vivo. Recently, additional features of MS pathology, including macrophage infiltration and abnormal iron deposition, have become quantifiable. All of this, combined with functional imaging techniques, is improving our understanding of the mechanisms associated with MS evolution. In the near future, the use of ultrahigh-field systems is likely to provide additional insight into disease pathophysiology. However, the utility of advanced MRI techniques in clinical trial monitoring and in assessing individual patients' response to treatment still needs to be assessed.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Wu L, Zhang Y, Zhou F, Gao L, He L, Zeng X, Gong H. Altered intra- and interregional synchronization in relapsing-remitting multiple sclerosis: a resting-state fMRI study. Neuropsychiatr Dis Treat 2016; 12:853-62. [PMID: 27143886 PMCID: PMC4841392 DOI: 10.2147/ndt.s98962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Neuroimaging studies of relapsing-remitting multiple sclerosis (RRMS) have found structural disconnection and large-scale neural network dysfunction. However, few studies have explored the local brain activity of RRMS patients in the resting state. PATIENTS AND METHODS In this study, regional homogeneity (ReHo) and resting-state functional connectivity (FC) were used to investigate intra- and interregional synchronized activity in 22 patients with RRMS and 22 matched healthy controls (HCs). RESULTS Compared with HCs, patients with RRMS showed significantly decreased ReHo in the left insula and right caudate. Through further seed-based FC analysis, we found decreased FC between the left insula and left precentral gyrus in patients with RRMS compared with HCs, as well as increased FC between the right caudate and right dorsolateral prefrontal cortex. Pearson's correlation analysis showed that a decreased ReHo value in the left insula was associated with an increased total white matter lesion loads (TWMLL) score (r=-0.594, P=0.004) or a worsened paced auditory serial addition test score (r=0.536, P=0.010). No other significant correlations were observed between the FC value (left insula - left precentral gyrus) and clinical scores (P=0.246-0.982). The ReHo value of the right caudate was negatively correlated with disease duration (r=-0.526, P=0.012) and with the TWMLL score (r=-0.596, P=0.003). Moreover, a positive correlation was observed between the FC value (right caudate - right dorsolateral prefrontal cortex) and the TWMLL score (r=0.523, P=0.012) or the modified fatigue impact scale-5 score (r=0.608, P=0.003). CONCLUSION Together, these findings suggest that the insula with regional dysfunction involves disconnection with sensorimotor regions, and demyelinating lesion-related intra- and interregional dysfunction in the caudate is associated with the impact of fatigue on cognitive control functions. Abnormal synchronization of intra- and interregional activity in the insula and caudate may play important roles in the pathology of RRMS.
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Affiliation(s)
- Lin Wu
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China; Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Yue Zhang
- Department of Radiology, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Fuqing Zhou
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China; Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Lei Gao
- Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Laichang He
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China; Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China; Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
| | - Honghan Gong
- Department of Radiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, People's Republic of China; Jiangxi Province Medical Imaging Research Institute, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi Province, People's Republic of China
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48
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Pardini M, Yaldizli Ö, Sethi V, Muhlert N, Liu Z, Samson RS, Altmann DR, Ron MA, Wheeler-Kingshott CAM, Miller DH, Chard DT. Motor network efficiency and disability in multiple sclerosis. Neurology 2015; 85:1115-22. [PMID: 26320199 DOI: 10.1212/wnl.0000000000001970] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/24/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To develop a composite MRI-based measure of motor network integrity, and determine if it explains disability better than conventional MRI measures in patients with multiple sclerosis (MS). METHODS Tract density imaging and constrained spherical deconvolution tractography were used to identify motor network connections in 22 controls. Fractional anisotropy (FA), magnetization transfer ratio (MTR), and normalized volume were computed in each tract in 71 people with relapse onset MS. Principal component analysis was used to distill the FA, MTR, and tract volume data into a single metric for each tract, which in turn was used to compute a composite measure of motor network efficiency (composite NE) using graph theory. Associations were investigated between the Expanded Disability Status Scale (EDSS) and the following MRI measures: composite motor NE, NE calculated using FA alone, FA averaged in the combined motor network tracts, brain T2 lesion volume, brain parenchymal fraction, normal-appearing white matter MTR, and cervical cord cross-sectional area. RESULTS In univariable analysis, composite motor NE explained 58% of the variation in EDSS in the whole MS group, more than twice that of the other MRI measures investigated. In a multivariable regression model, only composite NE and disease duration were independently associated with EDSS. CONCLUSIONS A composite MRI measure of motor NE was able to predict disability substantially better than conventional non-network-based MRI measures.
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Affiliation(s)
- Matteo Pardini
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK.
| | - Özgür Yaldizli
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Varun Sethi
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Nils Muhlert
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Zheng Liu
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Rebecca S Samson
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Daniel R Altmann
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Maria A Ron
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Claudia A M Wheeler-Kingshott
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - David H Miller
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
| | - Declan T Chard
- From the NMR Research Unit (M.P., Ö.Y., V.S., N.M., Z.L., R.S.S., D.R.A., M.A.R., C.A.M.W.-K., D.H.M., D.T.C.), Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, Queen Square, London, UK; the Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (M.P.), University of Genoa, Italy; the Department of Neurology (Ö.Y.), University Hospital Basel, Switzerland; the Department of Psychology (N.M.), Cardiff University, UK; the Department of Neurology (Z.L.), Xuanwu Hospital of Capital Medical University, Beijing, China; the Medical Statistics Department (D.R.A.), London School of Hygiene and Tropical Medicine, UK; and the National Institute for Health Research (NIHR) (D.T.C.), University College London Hospitals (UCLH) Biomedical Research Centre, UK
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Suo X, Lei D, Li K, Chen F, Li F, Li L, Huang X, Lui S, Li L, Kemp GJ, Gong Q. Disrupted brain network topology in pediatric posttraumatic stress disorder: A resting-state fMRI study. Hum Brain Mapp 2015; 36:3677-86. [PMID: 26096541 DOI: 10.1002/hbm.22871] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 03/26/2015] [Accepted: 05/27/2015] [Indexed: 02/05/2023] Open
Abstract
Children exposed to natural disasters are vulnerable to the development of posttraumatic stress disorder (PTSD). Recent studies of other neuropsychiatric disorders have used graph-based theoretical analysis to investigate the topological properties of the functional brain connectome. However, little is known about this connectome in pediatric PTSD. Twenty-eight pediatric PTSD patients and 26 trauma-exposed non-PTSD patients were recruited from 4,200 screened subjects after the 2008 Sichuan earthquake to undergo a resting-state functional magnetic resonance imaging scan. Functional connectivity between 90 brain regions from the automated anatomical labeling atlas was established using partial correlation coefficients, and the whole-brain functional connectome was constructed by applying a threshold to the resultant 90 * 90 partial correlation matrix. Graph theory analysis was then used to examine the group-specific topological properties of the two functional connectomes. Both the PTSD and non-PTSD control groups exhibited "small-world" brain network topology. However, the functional connectome of the PTSD group showed a significant increase in the clustering coefficient and a normalized characteristic path length and local efficiency, suggesting a shift toward regular networks. Furthermore, the PTSD connectomes showed both enhanced nodal centralities, mainly in the default mode- and salience-related regions, and reduced nodal centralities, mainly in the central-executive network regions. The clustering coefficient and nodal efficiency of the left superior frontal gyrus were positively correlated with the Clinician-Administered PTSD Scale. These disrupted topological properties of the functional connectome help to clarify the pathogenesis of pediatric PTSD and could be potential biomarkers of brain abnormalities.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Kaiming Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Fuqin Chen
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, Sichuan, China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingjiang Li
- Mental Health Institute, the Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Graham J Kemp
- Department of Musculoskeletal Biology and MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Faculty of Health and Life Sciences, Magnetic Resonance and Image Analysis Research Centre (MARIARC) and Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Department of Psychology School of Public Administration, Sichuan University, Chengdu, Sichuan, China.,Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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50
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Appraisal of brain connectivity in radiologically isolated syndrome by modeling imaging measures. J Neurosci 2015; 35:550-8. [PMID: 25589750 DOI: 10.1523/jneurosci.2557-14.2015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We hypothesized that appraisal of brain connectivity may shed light on the substrate of the radiologically isolated syndrome (RIS), a term applied to asymptomatic subjects with brain MRI abnormalities highly suggestive of multiple sclerosis. We thus used a multimodal MRI approach on the human brain by modeling measures of microstructural integrity of white matter (WM) tracts with those of functional connectivity (FC) at the level of resting state networks in RIS subjects, demographically matched normal controls (NC), and relapsing-remitting (RR) MS patients, also matched with RIS for brain macrostructural damage (i.e., lesions and atrophy). Compared with NC, in both RIS subjects and MS patients altered integrity of WM tracts was present. However, RIS subjects showed, at a less conservative threshold, lower diffusivities than RRMS patients in distinct cerebral associative, commissural, projection, and cerebellar WM tracts, suggesting a relatively better anatomical connectivity. FC was similar in NC and RIS subjects, even in the presence of important risk factors for MS (spinal cord lesions, oligoclonal bands, and dissemination in time on MRI) and increased in RRMS patients in two clinically relevant networks subserving "processing" (sensorimotor) and "control" (working memory) functions. In RIS, the lack of functional reorganization in key brain networks may represent a model of "functional reserve," which may become upregulated, with an adaptive or maladaptive role, only at a later stage in case of occurrence of clinical deficit.
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