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Tiwari AK, Adhikari A, Mishra LC, Srivastava A. Current Status of Our Understanding for Brain Integrated Functions and its Energetics. Neurochem Res 2022; 47:2499-2512. [PMID: 35689788 DOI: 10.1007/s11064-022-03633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
Human/animal brain is a unique organ with substantially high metabolism but it contains no energy reserve that is the reason it requires continuous supply of O2 and energy fluxes through CBF. The main source of energy remains glucose as the other biomolecules do not able to cross the blood-brain barrier. The speed of glucose metabolism is heterogeneous throughout the brain. One of the major flux consumption is Neuron-astrocyte cycling of glutamate and glutamine in glutamatergic neurons (approximately 80% of glucose metabolism in brain). The quantification of cellular glucose and other related substrate in resting, activated state can be analyzed through [18 F]FDG -positron-emission tomography (studying CMRglc) and [13 C/31P -MRS: for neuroenergetics & neurotransmitter cycling &31P-MRS: for energy induction & redox state). Merging basic in vitro studies with these techniques will help to develop new treatment paradigms for human brain diseased conditions.
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Affiliation(s)
- Anjani Kumar Tiwari
- Department of Chemistry, Babasaheb Bhimrao Ambedkar University (A Central University), 226025, Lucknow, Uttar Pradesh, India.
| | - Anupriya Adhikari
- Department of Chemistry, Babasaheb Bhimrao Ambedkar University (A Central University), 226025, Lucknow, Uttar Pradesh, India
| | - Lokesh Chandra Mishra
- Department of Zoology, Hansraj College, University of Delhi, North Campus, 110007, Delhi, India
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Basedow LA, Kuitunen-Paul S, Wiedmann MF, Ehrlich S, Roessner V, Golub Y. Verbal learning impairment in adolescents with methamphetamine use disorder: a cross-sectional study. BMC Psychiatry 2021; 21:166. [PMID: 33765981 PMCID: PMC7993453 DOI: 10.1186/s12888-021-03169-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/15/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Methamphetamine (MA) use has been shown to be associated with deficits in impulsivity, verbal learning, and working memory. Additionally, methamphetamine use disorder (MUD) is related to various brain changes, especially in adolescent users who might be more vulnerable to detrimental effects on brain development. However, little is known about the relationship between adolescent MA use and cognitive impairment. This cross-sectional study aims to explore how the presence of a MUD in adolescents is related to impairments of verbal memory, inhibition, and alertness. METHODS N = 18 psychiatric outpatients with MUD were matched in terms of depressivity, age, and gender to n = 18 adolescents with other substance use disorders (SUDs), as well as n = 18 controls without SUDs. We compared these three groups on the Verbal Learning and Memory Task (VLMT), and the alertness and go/noGo subtests of the Test of Attentional Performance (TAP). Additionally, Spearman's rank order correlation coefficients were calculated to investigate whether cognitive functioning was directly associated with frequency of past year MA use. RESULTS The three groups differed significantly in their verbal learning performance (H (2) = 11.7, p = .003, ηp2 = .19), but not in short-term memory, inhibition, cued recall, or alertness. Post hoc tests revealed significant differences in verbal learning between the MA using group and the control group without a SUD (U = 56.5, p = .001, ηp2 = .31). Frequency of past year MA use correlated negatively with short-term memory (ρ = -.25, p < .01) and verbal learning (ρ = -.41, p < .01). No other cognitive variables correlated significantly with MA use frequency. Significant p-values were considered significant after Bonferroni correction. CONCLUSIONS Adolescent MUD outpatients with regular MA use show specific impairment in verbal learning performance, but not in other basal cognitive functions when compared to adolescents without a MUD. Verbal learning and short-term memory performance is negatively associated with the frequency of MA use. Future research should apply longitudinal designs to investigate long-term effects of methamphetamine and reversibility of these effects on cognitive functioning.
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Affiliation(s)
- Lukas Andreas Basedow
- TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany.
| | - Sören Kuitunen-Paul
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Melina Felicitas Wiedmann
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Stefan Ehrlich
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany ,grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Dresden, Germany
| | - Veit Roessner
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
| | - Yulia Golub
- grid.4488.00000 0001 2111 7257TU Dresden, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Dresden, Germany
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Malucelli A, Skoch A, Ostry S, Tomek A, Urbanova B, Martinkovic L, Buksakowska I, Mohapl M, Netuka D, Hort J, Sroubek J, Vrana J, Moravec T, Bartos R, Sames M, Hajek M, Horinek D. Magnetic resonance markers of bilateral neuronal metabolic dysfunction in patients with unilateral internal carotid artery occlusion. MAGMA (NEW YORK, N.Y.) 2021; 34:141-151. [PMID: 32594274 DOI: 10.1007/s10334-020-00864-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate cerebral hemodynamic, metabolic and anatomic changes occurring in patients with unilateral occlusion of the internal carotid artery (ICA). MATERIALS AND METHODS Twenty-two patients with unilateral occlusion of ICA and twenty age and sex matched healthy subjects were included in the study. Single voxel proton magnetic resonance spectroscopy (1H-MRS) of the centrum semiovale, semi-automated hippocampal volumetry in T1-weighted scans and transcranial Doppler examination (TCD) with calculation of Breath Holding Index (BHI) were performed in both groups. Metabolic, anatomic, and hemodynamic features were compared between the two groups. RESULTS The N-acetylaspartate (NAA)/choline (Cho) ratio was significantly lower in both hemispheres of enrolled patients compared to controls (p = 0.005 for the side with occlusion, p = 0.04 for the side without occlusion). The hippocampus volume was significantly reduced bilaterally in patients compared to healthy subjects (p = 0.049). A statistically significant difference in BHI values was observed between the side with occlusion and without occlusion (p = 0.037) of the patients, as well as between BHI values of the side with occlusion and healthy volunteers (p = 0.014). DISCUSSION Patients with unilateral ICA occlusion have reduced NAA/Cho ratio in the white matter of both hemispheres and have bilateral atrophy of hippocampus. The alteration of hemodynamics alone cannot explain these changes.
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Affiliation(s)
- Alberto Malucelli
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic.
| | - Antonin Skoch
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Svapotluk Ostry
- Department of Neurology, Ceske Budejovice Hospital, Ceske Budejovice, Czech Republic
| | - Ales Tomek
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Barbora Urbanova
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Lukas Martinkovic
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Irena Buksakowska
- Department of Radiology, University Hospital Motol, Prague, Czech Republic
| | - Milan Mohapl
- Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic
| | - David Netuka
- Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic
| | - Jakub Hort
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Jan Sroubek
- Department of Neurosurgery, Hospital Na Homolce, Prague, Czech Republic
| | - Jiri Vrana
- Department of Radiology, Central Military Hospital, Prague, Czech Republic
| | - Tomas Moravec
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Robert Bartos
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic
| | - Martin Sames
- Department of Neurosurgery, Masaryk Hospital, J.E. Purkyne University, Usti nad Labem, Czech Republic
| | - Milan Hajek
- MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Daniel Horinek
- Department of Neurology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
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Zacharopoulos G, Kadosh Cohen R. Predicting Working Memory Capacity Based on Glutamatergic Concentration and its Modulation of Functional Connectivity. Neuroscience 2020; 457:12-19. [PMID: 33212221 DOI: 10.1016/j.neuroscience.2020.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
Working memory (WM) capacity, the amount of information one can hold online in mind, has a central role in cognition. Previous electrophysiological and imaging studies revealed the pivotal role of persistent activity within parietal and frontal regions as the neural foundations underpinning WM capacity. The best candidate molecules determining persistent activity are the brain's major excitatory and inhibitory neurotransmitters, glutamate and gamma-aminobutyric acid (GABA), respectively. However, our knowledge of these neurophysiological determinants in forming WM capacity is still poor. Using magnetic resonance spectroscopy (MRS), we examined the contribution of glutamate and GABA within the left intraparietal sulcus (IPS) and the left inferior/middle frontal gyrus (FG) in tracking WM capacity. A positive association was found between glutamate within the left IPS and WM capacity. By utilising resting-state functional MRI, we identified a negative association between parieto-cingulate connectivity and WM capacity. Individual variation in parieto-cingulate connectivity was explained by glutamatergic concentration in the IPS. Moreover, we found that parieto-cingulate connectivity mediated the relationship between interparietal sulcus glutamate and WM capacity. This set of findings reveals a novel mechanistic insight by which glutamatergic concentration within the IPS shapes WM capacity via parieto-cingulate connectivity.
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Affiliation(s)
- George Zacharopoulos
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, UK.
| | - Roi Kadosh Cohen
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, UK
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Levin O, Weerasekera A, King BR, Heise KF, Sima DM, Chalavi S, Maes C, Peeters R, Sunaert S, Cuypers K, Van Huffel S, Mantini D, Himmelreich U, Swinnen SP. Sensorimotor cortex neurometabolite levels as correlate of motor performance in normal aging: evidence from a 1H-MRS study. Neuroimage 2019; 202:116050. [PMID: 31349070 DOI: 10.1016/j.neuroimage.2019.116050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/17/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022] Open
Abstract
Aging is associated with gradual alterations in the neurochemical characteristics of the brain, which can be assessed in-vivo with proton-magnetic resonance spectroscopy (1H-MRS). However, the impact of these age-related neurochemical changes on functional motor behavior is still poorly understood. Here, we address this knowledge gap and specifically focus on the neurochemical integrity of the left sensorimotor cortex (SM1) and the occipital lobe (OCC), as both regions are main nodes of the visuomotor network underlying bimanual control. 1H-MRS data and performance on a set of bimanual tasks were collected from a lifespan (20-75 years) sample of 86 healthy adults. Results indicated that aging was accompanied by decreased levels of N-acetylaspartate (NAA), glutamate-glutamine (Glx), creatine + phosphocreatine (Cr) and myo-inositol (mI) in both regions, and decreased Choline (Cho) in the OCC region. Lower NAA and Glx levels in the SM1 and lower NAA levels in the OCC were related to poorer performance on a visuomotor bimanual coordination task, suggesting that NAA could serve as a potential biomarker for the integrity of the motor system supporting bimanual control. In addition, lower NAA, Glx, and mI levels in the SM1 were found to be correlates of poorer dexterous performance on a bimanual dexterity task. These findings highlight the role for 1H-MRS to study neurochemical correlates of motor performance across the adult lifespan.
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Affiliation(s)
- Oron Levin
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium.
| | - Akila Weerasekera
- Biomedical MRI Unit, Department of Imaging & Pathology, Group Biomedical Sciences, KU Leuven, Belgium
| | - Bradley R King
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium
| | - Kirstin F Heise
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium
| | | | - Sima Chalavi
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium
| | - Celine Maes
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium
| | - Ronald Peeters
- Department of Radiology, University Hospitals Leuven, UZ Gasthuisberg, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospitals Leuven, UZ Gasthuisberg, Belgium
| | - Koen Cuypers
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium; REVAL Research Institute, Hasselt University, Agoralaan, Building A, B-3590, Diepenbeek, Belgium
| | - Sabine Van Huffel
- Department of Electrical Engineering (ESAT), STADIUS Centre for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Belgium
| | - Dante Mantini
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium; Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
| | - Uwe Himmelreich
- Biomedical MRI Unit, Department of Imaging & Pathology, Group Biomedical Sciences, KU Leuven, Belgium
| | - Stephan P Swinnen
- Movement Control & Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Belgium; KU Leuven, Leuven Brain Institute (LBI), Leuven, Belgium
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Cichocka M, Bereś A. From fetus to older age: A review of brain metabolic changes across the lifespan. Ageing Res Rev 2018; 46:60-73. [PMID: 29864489 DOI: 10.1016/j.arr.2018.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/26/2018] [Accepted: 05/31/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The knowledge of metabolic changes across the lifespan is poorly understood. Thus we systematically reviewed the available literature to determine the changes in brain biochemical composition from fetus to older age and tried to explain them in the context of neural, cognitive, and behavioural changes. METHODS The search identified 1262 articles regarding proton magnetic resonance spectroscopy (1H MRS) examinations through December 2017. The following data was extracted: age range of the subjects, number of subjects studied, brain regions studied, MRS sequence used, echo time, MR system, method of statistical analysis, metabolites analyzed, significant differences in metabolites concentrations with age as well as the way of presentation of the results. RESULTS 82 studies that described brain metabolite changes with age were identified. Reports on metabolic changes related to healthy aging were analyzed and discussed among six basic age groups: fetuses, infants, children, adolescents, adults, and the elderly as well as between groups and during the whole lifetime. DISCUSSION The results presented in the reviewed papers provide evidence that normal aging is associated with a number of metabolic changes characteristic for every period of life. Therefore, it can be concluded that the age matching is essential for comparative studies of disease states using 1H MRS.
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Coplan JD, Webler R, Gopinath S, Abdallah CG, Mathew SJ. Neurobiology of the dorsolateral prefrontal cortex in GAD: Aberrant neurometabolic correlation to hippocampus and relationship to anxiety sensitivity and IQ. J Affect Disord 2018; 229:1-13. [PMID: 29288871 DOI: 10.1016/j.jad.2017.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/27/2017] [Accepted: 12/01/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The neurometabolism underlying the cognitive and affective symptoms associated with generalized anxiety disorder (GAD) remain poorly understood. After we have linked worry to intelligence in patients with GAD, we hypothesized that aberrant neurometabolic correlations between hippocampus and neocortical regions may underlie a shared substrate in GAD patients for both anxiety sensitivity and intelligence. METHODS GAD patients (n = 16; F = 11) and healthy volunteers (n = 16; F = 10) were assessed using 1H-MRSI. Co-axial planes I [hippocampus (HIPP)] and co-axial plane III [dorsolateral prefrontal cortex (DLPFC), central gyrus (CG)] were examined. Using general linear models, we examined resting metabolite concentrations using HIPP as a hub to CG and DLPFC. Neocortical ROIs were related to Anxiety Sensitivity Index (ASI) and Full Scale IQ (FSIQ) in GAD patients versus controls. RESULTS Right hippocampal Cho/Cr directly predicted left DLPFC Cho/Cr in GAD (r = 0.75), an effect distinguishable (p = 0.0004) from controls. Left HIPP Cho/Cr positively predicted left CG Cho/Cr in GAD, an effect distinguishable from controls. In patients, both left and right DLPFC Cho/Cr positively predicted ASI but only left DLPFC Cho/Cr inversely predicted IQ. By contrast, IQ in controls correlated directly with left CG Cho/Cr. LIMITATIONS Small sample size precluded us from investigating how gender and FSIQ subscales related to neurochemical correlations in the ROIs examined. CONCLUSIONS Aberrant resting state neurochemical correlation between left DLPFC and right HIPP may contribute to GAD symptomatology. Unlike controls, in GAD, IQ and worry may share a common yet inverse neurometabolic substrate in left DLPFC.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Ryan Webler
- Yale Depression Research Program, New Haven, CT, USA
| | - Srinath Gopinath
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Clinical Neuroscience Division, National Center for PTSD, West Haven, CT, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. Debakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Margari L, De Giacomo A, Craig F, Palumbi R, Peschechera A, Margari M, Picardi F, Caldarola M, Maghenzani MA, Dicuonzo F. Frontal lobe metabolic alterations in autism spectrum disorder: a 1H-magnetic resonance spectroscopy study. Neuropsychiatr Dis Treat 2018; 14:1871-1876. [PMID: 30050301 PMCID: PMC6055909 DOI: 10.2147/ndt.s165375] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Recently, neuroimaging studies were performed using 1H-magnetic resonance spectroscopy (1H-MRS), revealing a quantitative alteration of neurochemicals (such as neurotransmitters and metabolites) in several brain regions of patients with autism spectrum disorder (ASD). The involvement of the frontal lobe in the neurobiology of ASD has long been documented in the literature. Therefore, the aim of this study was to analyze the alterations of N-acetylaspartate/creatine (NAA/Cr) and choline/Cr (Cho/Cr) ratios in the frontal lobe subcortical white matter (WM) in ASD patients, in order to reveal any alteration of metabolites that might be the expression of specific clinical features of the disorder. PATIENTS AND METHODS An 1H-MRS study of the frontal lobe subcortical WM was performed in 75 children with ASD and in 50 age-matched controls to evaluate the functional activity of this brain region. RESULTS NAA/Cr and Cho/Cr ratios were significantly altered in ASD, compared to control subjects. Moreover, in the ASD group, NAA/Cr was significantly lower in patients with a cognitive impairment. CONCLUSION Results from this study confirm the existence of brain metabolites' alterations in frontal lobe WM in children with ASD, supporting the relevance of this brain region in the clinical expressions of this disorder, including its role in the cognitive impairment. Further 1H-MRS investigations will allow to comprehensively explain the relationship between metabolic alteration in a specific brain region and specific clinical features of ASD.
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Affiliation(s)
- Lucia Margari
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy,
| | - Andrea De Giacomo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy,
| | - Francesco Craig
- Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Developmental Neurology and Neurorehabilitation, Brindisi, Italy
| | - Roberto Palumbi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy,
| | - Antonia Peschechera
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy,
| | - Mariella Margari
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy,
| | - Francesca Picardi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Neuroradiology Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Marina Caldarola
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Neuroradiology Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | - Marilena Anna Maghenzani
- Emergency Department, Anesthesia and Intensive Care Unit, University of Bari Aldo Moro, Azienda Ospedaliero-Universitaria Policlinico di Bari, Bari, Italy
| | - Franca Dicuonzo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Neuroradiology Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy
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Nikolaidis A, Baniqued PL, Kranz MB, Scavuzzo CJ, Barbey AK, Kramer AF, Larsen RJ. Multivariate Associations of Fluid Intelligence and NAA. Cereb Cortex 2017; 27:2607-2616. [PMID: 27005991 DOI: 10.1093/cercor/bhw070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Understanding the neural and metabolic correlates of fluid intelligence not only aids scientists in characterizing cognitive processes involved in intelligence, but it also offers insight into intervention methods to improve fluid intelligence. Here we use magnetic resonance spectroscopic imaging (MRSI) to measure N-acetyl aspartate (NAA), a biochemical marker of neural energy production and efficiency. We use principal components analysis (PCA) to examine how the distribution of NAA in the frontal and parietal lobes relates to fluid intelligence. We find that a left lateralized frontal-parietal component predicts fluid intelligence, and it does so independently of brain size, another significant predictor of fluid intelligence. These results suggest that the left motor regions play a key role in the visualization and planning necessary for spatial cognition and reasoning, and we discuss these findings in the context of the Parieto-Frontal Integration Theory of intelligence.
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Affiliation(s)
- Aki Nikolaidis
- Beckman Institute for Advanced Science and Technology.,Neuroscience Program and
| | - Pauline L Baniqued
- Beckman Institute for Advanced Science and Technology.,Psychology Department, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Michael B Kranz
- Beckman Institute for Advanced Science and Technology.,Psychology Department, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Claire J Scavuzzo
- Neuroscience Program and.,Psychology Department, University of Alberta, Edmonton, Alberta, Canada
| | - Aron K Barbey
- Beckman Institute for Advanced Science and Technology
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology.,Neuroscience Program and.,Psychology Department, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ryan J Larsen
- Beckman Institute for Advanced Science and Technology
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Libero LE, Reid MA, White DM, Salibi N, Lahti AC, Kana RK. Biochemistry of the cingulate cortex in autism: An MR spectroscopy study. Autism Res 2015; 9:643-57. [PMID: 26526126 DOI: 10.1002/aur.1562] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/18/2015] [Indexed: 12/12/2022]
Abstract
Neuroimaging studies have uncovered structural and functional alterations in the cingulate cortex in individuals with autism spectrum disorders (ASD). Such abnormalities may underlie neurochemical imbalance. In order to characterize the neurochemical profile, the current study examined the concentration of brain metabolites in dorsal ACC (dACC) and posterior cingulate cortex (PCC) in high-functioning adults with ASD. Twenty high-functioning adults with ASD and 20 age-and-IQ-matched typically developing (TD) peers participated in this Proton magnetic resonance spectroscopy (1H-MRS) study. LCModel was used in analyzing the spectra to measure the levels of N-Acetyl aspartate (NAA), choline (Cho), creatine (Cr), and glutamate/glutamine (Glx) in dACC and PCC. Groups were compared using means for the ratio of each metabolite to their respective Cr levels as well as on absolute internal-water-referenced measures of each metabolite. There was a significant increase in Cho in PCC for ASD adults, with a marginal increase in dACC. A reduction in NAA/Cr in dACC was found in ASD participants, compared to their TD peers. No significant differences in Glx/Cr or Cho/Cr were found in dACC. There were no statistically significant group differences in the absolute concentration of NAA, Cr, Glx, or NAA/Cr, Cho/Cr, and Glx/Cr in the PCC. Differences in the metabolic properties of dACC compared to PCC were also found. Results of this study provide evidence for possible cellular and metabolic differences in the dACC and PCC in adults with ASD. This may suggest neuronal dysfunction in these regions and may contribute to the neuropathology of ASD. Autism Res 2016, 9: 643-657. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Lauren E Libero
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - David M White
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nouha Salibi
- MR R&D, Siemens Healthcare, Malvern, Pennsylvania
| | - Adrienne C Lahti
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
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Timoshanko A, Desmond P, Camfield D, Downey L, Stough C. A magnetic resonance spectroscopy (1H MRS) investigation into brain metabolite correlates of ability emotional intelligence. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2014.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Contributions of magnetic resonance spectroscopy to understanding development: potential applications in the study of adolescent alcohol use and abuse. Dev Psychopathol 2014; 26:405-23. [PMID: 24621605 DOI: 10.1017/s0954579414000030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A growing body of research has documented structural and functional brain development during adolescence, yet little is known about neurochemical changes that occur during this important developmental period. Magnetic resonance spectroscopy (MRS) is a well-developed technology that permits the in vivo quantification of multiple brain neurochemicals relevant to neuronal health and functioning. However, MRS technology has been underused in exploring normative developmental changes during adolescence and the onset of alcohol and drug use and abuse during this developmental period. This review begins with a brief overview of normative cognitive and neurobiological development during adolescence, followed by an introduction to MRS principles. The subsequent sections provide a comprehensive review of the existing MRS studies of development and cognitive functioning in healthy children and adolescents. The final sections of this article address the potential application of MRS in identifying neurochemical predictors and consequences of alcohol use and abuse in adolescence. MRS studies of adolescent populations hold promise for advancing our understanding of neurobiological risk factors for psychopathology by identifying the biochemical signatures associated with healthy brain development, as well as neurobiological and cognitive correlates of alcohol and substance use and abuse.
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Patel T, Blyth JC, Griffiths G, Kelly D, Talcott JB. Moderate relationships between NAA and cognitive ability in healthy adults: implications for cognitive spectroscopy. Front Hum Neurosci 2014; 8:39. [PMID: 24592224 PMCID: PMC3924143 DOI: 10.3389/fnhum.2014.00039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 01/19/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Proton Magnetic Resonance Spectroscopy ((1)H-MRS) is a non-invasive imaging technique that enables quantification of neurochemistry in vivo and thereby facilitates investigation of the biochemical underpinnings of human cognitive variability. Studies in the field of cognitive spectroscopy have commonly focused on relationships between measures of N-acetyl aspartate (NAA), a surrogate marker of neuronal health and function, and broad measures of cognitive performance, such as IQ. METHODOLOGY/PRINCIPAL FINDINGS In this study, we used (1)H-MRS to interrogate single-voxels in occipitoparietal and frontal cortex, in parallel with assessments of psychometric intelligence, in a sample of 40 healthy adult participants. We found correlations between NAA and IQ that were within the range reported in previous studies. However, the magnitude of these effects was significantly modulated by the stringency of data screening and the extent to which outlying values contributed to statistical analyses. CONCLUSIONS/SIGNIFICANCE (1)H-MRS offers a sensitive tool for assessing neurochemistry non-invasively, yet the relationships between brain metabolites and broad aspects of human behavior such as IQ are subtle. We highlight the need to develop an increasingly rigorous analytical and interpretive framework for collecting and reporting data obtained from cognitive spectroscopy studies of this kind.
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Affiliation(s)
- Tulpesh Patel
- Aston Brain Centre, School of Life and Health Sciences, Aston University Birmingham, UK
| | | | - Gareth Griffiths
- European Bioenergy Research Institute, Aston University Birmingham, UK
| | | | - Joel B Talcott
- Aston Brain Centre, School of Life and Health Sciences, Aston University Birmingham, UK
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Grošić V, Folnegović Grošić P, Kalember P, Bajs Janović M, Radoš M, Mihanović M, Henigsberg N. The effect of atypical antipsychotics on brain N-acetylaspartate levels in antipsychotic-naïve first-episode patients with schizophrenia: a preliminary study. Neuropsychiatr Dis Treat 2014; 10:1243-53. [PMID: 25045268 PMCID: PMC4094629 DOI: 10.2147/ndt.s61415] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To investigate the correlates of a clinical therapeutic response by using the parameters measured by proton magnetic resonance spectroscopy after the administration of atypical antipsychotics. PATIENTS AND METHODS Twenty-five antipsychotic-naïve first-episode patients with schizophrenia were monitored for 12 months. The patients were evaluated using (1)H magnetic resonance spectroscopy in the dorsolateral prefrontal cortex and Positive and Negative Syndrome Scale, Clinical Global Impression Scale of Severity, Tower of London - Drexel University, Letter-Number Span Test, Trail Making Test A, and Personal and Social Performance Scale. They were administered atypical antipsychotics, starting with quetiapine. In the absence of a therapeutic response, another antipsychotic was introduced. RESULTS After 12 study months, the N-acetylaspartate/creatine (NAA/Cr) level did not significantly change at the whole-group level. Additional analysis revealed a significant rise in the NAA/Cr level in the study group that stayed on the same antipsychotic throughout the study course (P=0.008) and a significant drop in NAA/Cr in the study group that switched antipsychotics (P=0.005). On the whole-group level, no significant correlations between NAA/Cr values and other scores were found at either baseline or after 12 study months. CONCLUSION One-year treatment with atypical antipsychotics administered to antipsychotic-naïve patients didn't result in a significant rise in the NAA/Cr ratio. However, a significant rise was witnessed in the study group in which a satisfactory therapeutic response had been achieved with a single antipsychotic administration.
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Affiliation(s)
- Vladimir Grošić
- Psychiatric Hospital Sveti Ivan, University of Zagreb, Zagreb, Croatia
| | | | - Petra Kalember
- Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Department of Neuropharmacology and Behavioral Pharmacology, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia
| | - Maja Bajs Janović
- University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - Marko Radoš
- Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Department of Neuropharmacology and Behavioral Pharmacology, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia
| | - Mate Mihanović
- Psychiatric Hospital Sveti Ivan, University of Zagreb, Zagreb, Croatia
| | - Neven Henigsberg
- Polyclinic Neuron, Croatian Institute for Brain Research, University of Zagreb, Zagreb, Croatia ; Vrapče University Hospital, University of Zagreb, Zagreb, Croatia
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Coplan JD, Hodulik S, Mathew SJ, Mao X, Hof PR, Gorman JM, Shungu DC. The Relationship between Intelligence and Anxiety: An Association with Subcortical White Matter Metabolism. FRONTIERS IN EVOLUTIONARY NEUROSCIENCE 2012; 3:8. [PMID: 22347183 PMCID: PMC3269637 DOI: 10.3389/fnevo.2011.00008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 11/30/2011] [Indexed: 11/13/2022]
Abstract
We have demonstrated in a previous study that a high degree of worry in patients with generalized anxiety disorder (GAD) correlates positively with intelligence and that a low degree of worry in healthy subjects correlates positively with intelligence. We have also shown that both worry and intelligence exhibit an inverse correlation with certain metabolites in the subcortical white matter. Here we re-examine the relationships among generalized anxiety, worry, intelligence, and subcortical white matter metabolism in an extended sample. Results from the original study were combined with results from a second study to create a sample comprised of 26 patients with GAD and 18 healthy volunteers. Subjects were evaluated using the Penn State Worry Questionnaire, the Wechsler Brief intelligence quotient (IQ) assessment, and proton magnetic resonance spectroscopic imaging (1H-MRSI) to measure subcortical white matter metabolism of choline and related compounds (CHO). Patients with GAD exhibited higher IQ’s and lower metabolite concentrations of CHO in the subcortical white matter in comparison to healthy volunteers. When data from GAD patients and healthy controls were combined, relatively low CHO predicted both relatively higher IQ and worry scores. Relatively high anxiety in patients with GAD predicted high IQ whereas relatively low anxiety in controls also predicted high IQ. That is, the relationship between anxiety and intelligence was positive in GAD patients but inverse in healthy volunteers. The collective data suggest that both worry and intelligence are characterized by depletion of metabolic substrate in the subcortical white matter and that intelligence may have co-evolved with worry in humans.
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Affiliation(s)
- Jeremy D Coplan
- Division of Neuropsychopharmacology, Department of Psychiatry, State University of New York Downstate Medical Center Brooklyn, NY, USA
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Ryman SG, Gasparovic C, Bedrick EJ, Flores RA, Marshall AN, Jung RE. Brain biochemistry and personality: a magnetic resonance spectroscopy study. PLoS One 2011; 6:e26758. [PMID: 22073190 PMCID: PMC3207834 DOI: 10.1371/journal.pone.0026758] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 10/04/2011] [Indexed: 11/18/2022] Open
Abstract
To investigate the biochemical correlates of normal personality we utilized proton magnetic resonance spectroscopy ((1)H-MRS). Our sample consisted of 60 subjects ranging in age from 18 to 32 (27 females). Personality was assessed with the NEO Five-Factor Inventory (NEO-FFI). We measured brain biochemistry within the precuneus, the cingulate cortex, and underlying white matter. We hypothesized that brain biochemistry within these regions would predict individual differences across major domains of personality functioning. Biochemical models were fit for all personality domains including Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. Our findings involved differing concentrations of Choline (Cho), Creatine (Cre), and N-acetylaspartate (NAA) in regions both within (i.e., posterior cingulate cortex) and white matter underlying (i.e., precuneus) the Default Mode Network (DMN). These results add to an emerging literature regarding personality neuroscience, and implicate biochemical integrity within the default mode network as constraining major personality domains within normal human subjects.
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Affiliation(s)
- Sephira G. Ryman
- The Mind Research Network (MRN), University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Chuck Gasparovic
- The Mind Research Network (MRN), University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Edward J. Bedrick
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Ranee A. Flores
- The Mind Research Network (MRN), University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Alison N. Marshall
- The Mind Research Network (MRN), University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
- Department of Neurosurgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
| | - Rex E. Jung
- The Mind Research Network (MRN), University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
- Department of Neurosurgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States of America
- * E-mail:
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Mandel SA, Morelli M, Halperin I, Korczyn AD. Biomarkers for prediction and targeted prevention of Alzheimer's and Parkinson's diseases: evaluation of drug clinical efficacy. EPMA J 2010. [PMID: 23199065 PMCID: PMC3405324 DOI: 10.1007/s13167-010-0036-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Neurodegenerative diseases like Parkinson’s disease (PD) and Alzheimer’s disease (AD) are considered disorders of multifactorial origin, inevitably progressive and having a long preclinical period. Therefore, the availability of biological markers or biomarkers (BMs) for early disease diagnosis will impact the management of AD and PD in several dimensions; it will 1) help to capture high-risk individuals before symptoms develop, a stage where prevention efforts might be expected to have their greatest impact; 2) provide a measure of disease progression that can be evaluated objectively, while clinical measures are much less accurate; 3) help to discriminate between true AD or PD and other causes of a similar clinical syndrome; 4) delineate pathophysiological processes responsible for the disease; 5) determine the clinical efficacy of novel, disease-modifying (neuroprotective) strategies. In the long run the availability of reliable BMs will significantly advance the research and therapeutics of AD and PD.
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Affiliation(s)
- Silvia A. Mandel
- Eve Topf Center for Neurodegenerative Diseases Research and Department of Molecular Pharmacology, Faculty of Medicine, Technion, Haifa, Israel
| | - Micaela Morelli
- Department of Toxicology and Centre of Excellence for Neurobiology of Dependence, University of Cagliari, Cagliari, Italy
| | - Ilan Halperin
- The Israeli Psycological Association, Beersheba, Israel
| | - Amos D. Korczyn
- Tel-Aviv University Medical School Sieratzki Chair of Neurology, Ramat-Aviv, Israel
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Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes. Hypertens Res 2009; 33:67-75. [PMID: 19876064 DOI: 10.1038/hr.2009.176] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hypertension is associated with cognitive decline in elderly persons. We studied asymptomatic hypertensive subjects using brain magnetic resonance (MR) spectroscopy to evaluate metabolite impairments before the appearance of symptoms in patients with different treatment outcomes. In all, 14 healthy controls and 37 asymptomatic hypertensive patients (17 controlled and 20 resistant) underwent brain structural MR and MR spectroscopy of the posterior paralimbic (PPL) area and left frontal white matter. Ischemic burden (IB), global cortical atrophy and microbleeds were analyzed with visual scales. Metabolite ratios involving N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho) and myoinositol (mI) were computed. Ultrasound measurements, including intima-media thickness, plaques and hemodynamic ratios, were obtained. Intergroup differences in IB, atrophy and metabolite ratios, and the atrophy and IB relationship were assessed with parametric and nonparametric statistical tests. In addition, the impacts of demographic, analytic and clinical factors, ischemia and atrophy, and ultrasound measurements on metabolite ratios were assessed. The significance level was set at P<or=0.05. Higher atrophy scores presented with higher total or frontal IB (P<0.05). However, there was no intergroup difference in atrophy and IB. PPL mI/Cr was increased in resistant hypertension (P<0.021), whereas frontal NAA/Cr (P<0.007) showed opposite trends between controlled (increased ratios) and resistant (decreased ratios) hypertension. Unlike PPL mI/Cr, frontal NAA/Cr showed significant correlations with the lipid profile and ultrasound measurements. PPL mI/Cr increases in resistant hypertension, and frontal NAA/Cr diverges between controlled and resistant hypertension before physical and neuropsychological symptoms appear.
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Kim HJ, Kim JE, Cho G, Song IC, Bae S, Hong SJ, Yoon SJ, Lyoo IK, Kim TS. Associations between anterior cingulate cortex glutamate and gamma-aminobutyric acid concentrations and the harm avoidance temperament. Neurosci Lett 2009; 464:103-7. [PMID: 19660524 DOI: 10.1016/j.neulet.2009.07.087] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 07/25/2009] [Accepted: 07/31/2009] [Indexed: 12/29/2022]
Abstract
Converging lines of evidence have suggested that the personality traits might have neurobiological underpinnings. The anterior cingulate cortex (ACC) has been implicated to play an important role in the human fear and anxiety. Functional and structural characteristics of ACC have been suggested to be associated with the harm avoidance (HA) temperament, one of the important temperament dimensions. Therefore, we aimed to investigate correlations between neurometabolite concentrations in ACC, specifically glutamate and gamma-aminobutyric acid (GABA), which are major excitatory and inhibitory neurotransmitters, respectively, and HA scores. Neurometabolite concentrations were measured using high resolution single voxel proton magnetic resonance spectroscopy ((1)H-MRS), and the HA temperament was evaluated using the Temperament and Character Inventory (TCI). Correlations between HA scores from 37 participants (21 men/16 women, age of 30.3+/-7.0) and glutamate and GABA concentrations in the mid-ACC region were evaluated. HA scores correlated negatively with glutamate concentrations in ACC (partial correlation, R=-0.54, df=33, P=0.001) and positively with GABA concentrations in ACC (partial correlation, R=0.48, df=30, P=0.005). These findings suggest that glutamate and GABA concentrations in ACC are closely related to levels of the HA temperament in healthy subjects.
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Affiliation(s)
- Hengjun J Kim
- Interdisciplinary Program in Brain Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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20
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Ozturk A, Degaonkar M, Matson MA, Wells CT, Mahone EM, Horská A. Proton MR spectroscopy correlates of frontal lobe function in healthy children. AJNR Am J Neuroradiol 2009; 30:1308-14. [PMID: 19357380 DOI: 10.3174/ajnr.a1576] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Neuroimaging methods have been used to improve our understanding of the topographic organization of the brain. In our study, proton (1)H-MR spectroscopic imaging was used to evaluate frontal lobe function. The goal was to determine the relationship between neuropsychological measures of frontal lobe function and levels of a surrogate neuronal marker, N-acetylaspartate (NAA), in typically developing healthy children and adolescents. MATERIALS AND METHODS Fifty-one healthy children (25 girls; 6.2-18.3 years of age; mean age, 12.3 +/- 3.6 years) were examined. All children completed a neuropsychological assessment including measures of attention, executive function, memory, language, and visual and motor skills. (1)H-MR spectroscopic imaging was performed by using a multisection spin-echo sequence at 1.5T. General linear model analysis of covariance was used to examine the relationship between the neuropsychological test scores and NAA/creatine (Cr) ratios, controlling for age and sex. RESULTS A positive relationship between frontal lobe white matter NAA/Cr ratio and performance on 2 neuropsychological tests associated with frontal lobe function was detected. The Purdue Pegboard right-hand scores were higher with increasing NAA/Cr in the left frontal white matter (P = .047), and Stanford-Binet-IV "Bead Memory" scores improved with increasing NAA/Cr ratio in the right frontal white matter (P = .032). CONCLUSIONS An association between frontal white matter NAA/Cr ratios and 1) measures of manual speed and dexterity, and 2) visual working memory was detected. Our data may provide a quantitative basis for assessment of frontal lobe impairments in disease states.
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Affiliation(s)
- A Ozturk
- Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD 21205, USA
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Haga KK, Khor YP, Farrall A, Wardlaw JM. A systematic review of brain metabolite changes, measured with 1H magnetic resonance spectroscopy, in healthy aging. Neurobiol Aging 2009; 30:353-63. [PMID: 17719145 DOI: 10.1016/j.neurobiolaging.2007.07.005] [Citation(s) in RCA: 130] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 06/19/2007] [Accepted: 07/05/2007] [Indexed: 11/21/2022]
Abstract
BACKGROUND (1)H MR spectroscopy (MRS) can identify metabolite abnormalities in age-related, neurological diseases. However, there is little information on how metabolites change with healthy aging. METHODS We systematically reviewed the literature on MRS, from 1980 to 2006, for studies where healthy young subjects (<60 years) were compared to healthy older subjects (>60 years). We extracted metabolite data reported as "no change", "increase" or "decrease" for each metabolite by brain region and, where data were available, meta-analysed mean metabolite concentrations (mM) for young versus old subjects. RESULTS Eighteen studies met the inclusion criteria (total n=703 subjects, 284 >60 years old). Most data came from the frontal region, and reported "no change" in older subjects; however, a meta-analysis revealed a decrease in frontal NAA (p=0.05) and increases in parietal choline (p=0.003) and creatine (p<0.001). DISCUSSION These data suggest that NAA may decrease and choline and creatine increase with age. Therefore, more data are needed from older subjects to characterise age effects better and ratios in older subjects should be interpreted with caution.
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Affiliation(s)
- Kristin K Haga
- Division of Clinical Neurosciences, School of Molecular and Clinical Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK.
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Jung RE, Gasparovic C, Chavez RS, Caprihan A, Barrow R, Yeo RA. Imaging intelligence with proton magnetic resonance spectroscopy. INTELLIGENCE 2009; 37:192-198. [PMID: 19936275 DOI: 10.1016/j.intell.2008.10.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Proton magnetic resonance spectroscopy ((1)H-MRS) is a technique for the assay of brain neurochemistry in vivo. N-acetylaspartate (NAA), the most prominent metabolite visible within the (1)H-MRS spectrum, is found primarily within neurons. The current study was designed to further elucidate NAA-cognition relationships, particularly whether such relationships are moderated by sex, or tissue type (gray or white matter). We administered standard measures of intelligence to 63 young, healthy subjects and obtained spectroscopic imaging data within a slab of tissue superior to the lateral ventricles. We found that lower NAA within right anterior gray matter predicted better performance VIQ (F=6.83, p=.011, r(2)=.10), while higher NAA within the right posterior gray matter region predicted better PIQ (F=8.175, p=.006, r(2)=.12). These findings add to the small but growing body of literature linking brain biochemistry to intelligence in normal healthy subjects using (1)H-MRSI.
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Affiliation(s)
- Rex E Jung
- The Mental Illness and Neuroscience Discovery (MIND) Research Network, Albuquerque, New Mexico, USA
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Iosifescu DV, Moore CM, Deckersbach T, Tilley CA, Ostacher MJ, Sachs GS, Nierenberg AA. Galantamine-ER for cognitive dysfunction in bipolar disorder and correlation with hippocampal neuronal viability: a proof-of-concept study. CNS Neurosci Ther 2009; 15:309-19. [PMID: 19889129 PMCID: PMC6493997 DOI: 10.1111/j.1755-5949.2009.00090.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many subjects with bipolar disorder experience significant cognitive dysfunction, even when euthymic, but few studies assess biological correlates of or treatment strategies for cognitive dysfunction. METHOD Nineteen subjects with bipolar disorder in remission, who reported subjective cognitive deficits, were treated with open-label galantamine-ER 8-24 mg/day for 4 months. Ten healthy volunteers matched for age and gender were also assessed. Mood and subjective cognitive questionnaires were administered monthly. At the beginning and the end of the trial all subjects were administered neuropsychological tests, including tests of attention (Conners CPT) and episodic memory (CVLT). Bipolar subjects underwent proton magnetic resonance spectroscopy (1H-MRS) measurements before and after treatment, healthy volunteers completed baseline 1H-MRS. We acquired 1H-MRS data at 4.0 T from voxels centered on the left and right hippocampus to measure hippocampal N-acetyl aspartate (NAA, a measure of neuronal viability) and choline containing compounds (Cho, a marker of lipid metabolism and membrane turn-over). RESULTS Compared to healthy volunteers, bipolar subjects had higher baseline subjective cognitive deficits and lower scores on objective tests of attention (Conner's CPT) and verbal episodic memory (CVLT). After treatment, bipolar subjects experienced significant improvement of subjective cognitive scores and on objective tests of attention (Conner's CPT) and verbal episodic memory (CVLT). In the left hippocampus NAA increased and choline (Cho) decreased in bipolar subjects during treatment. CONCLUSION Bipolar subjects had cognitive dysfunction; treatment with Galantamine-ER was associated with improved cognition and with increases in neuronal viability and normalization of lipid membrane metabolism in the left hippocampus. This study was registered on ClinicalTrials.gov (NCT00181636).
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Affiliation(s)
- Dan V Iosifescu
- The Bipolar Clinic and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Impact of the brain-derived neurotrophic factor Val66Met polymorphism on levels of hippocampal N-acetyl-aspartate assessed by magnetic resonance spectroscopic imaging at 3 Tesla. Biol Psychiatry 2008; 64:856-62. [PMID: 18707679 PMCID: PMC2586327 DOI: 10.1016/j.biopsych.2008.07.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Revised: 06/19/2008] [Accepted: 07/07/2008] [Indexed: 02/08/2023]
Abstract
BACKGROUND This study was conducted to corroborate prior evidence of an effect of the brain-derived neurotrophic factor (BDNF) valine (val) to methionine (met) amino acid substitution at codon 66 (val66met) polymorphism on measures of N-acetyl-aspartate (NAA) containing compounds in healthy subjects. METHODS The NAA to creatine (Cre) ratio (NAA/Cre), NAA to choline (Cho) ratio (NAA/Cho), and Cho to Cre ratio (Cho/Cre) were measured in the left and right hippocampi, left and right dorsolateral prefrontal cortices, occipital lobe, anterior cingulate, and white matter of the centrum semiovale of 69 carefully screened healthy volunteers utilizing proton magnetic resonance spectroscopic imaging (MRSI) at 3 Tesla (T). RESULTS Val/met subjects exhibited significantly reduced levels of left hippocampal NAA/Cre and NAA/Cho compared with val/val subjects. This effect was independent of age, IQ, number of voxels, hippocampal volume, or gray matter content in the voxels of interest. Analysis of other brain regions showed no effect of BDNF genotype on NAA measures. CONCLUSIONS We confirmed the association between the met-BDNF variant and reduced levels of hippocampal NAA found with a similar technique at 1.5T. The consonance of our results with prior findings adds to the evidence that the BDNF val/met genotype affects hippocampal biology with implications for a variety of neuropsychiatric disorders.
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Bustillo JR, Rowland LM, Jung R, Brooks WM, Qualls C, Hammond R, Hart B, Lauriello J. Proton magnetic resonance spectroscopy during initial treatment with antipsychotic medication in schizophrenia. Neuropsychopharmacology 2008; 33:2456-66. [PMID: 18094668 DOI: 10.1038/sj.npp.1301631] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Reduced brain N-acetyl-aspartate (NAA) has been repeatedly found in chronic schizophrenia and suggests neuronal loss or dysfunction. However, the potential confounding effect of antipsychotic drugs on NAA has not been resolved. We studied 32 minimally treated schizophrenia patients and 21 healthy subjects with single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) of the frontal and occipital lobes, caudate nucleus, and cerebellum. Concentrations of NAA, Choline, and Cre were determined and corrected for the proportion of cerebrospinal fluid (CSF) in the voxel. Patients were treated in a randomized-controlled double-blind manner with either haloperidol or quetiapine. (1)H-MRS was repeated every 6 months for up to 2 years. There was a group main effect for baseline NAA with lower global NAA in schizophrenia subjects before treatment compared to healthy controls. Global NAA was directly related to measures of global cognitive performance in the whole subject sample. Following treatment with haloperidol or quetiapine, there were no changes in NAA in any of the regions studied. Early in the illness, schizophrenia patients already demonstrate subtle reductions in NAA. Treatment with typical or atypical antipsychotic medications for several months does not result in NAA changes.
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Affiliation(s)
- Juan R Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM 87131-0001, USA.
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Abstract
Alzheimer's disease (AD) is a horribly debilitating disease that will increase in prevalence as the populations of the USA and Europe continue to age. It is expected that the USA alone will see some 16 million cases by 2050. At present, there is no cure for the disease and early diagnosis is all but impossible. The onset of disease is not manifested clinically and little is known regarding the cause of nonfamiliar AD. There is a need for biomarkers associated with AD to aid the diagnosis of this disease and to detect progression. Especially needed are biomarkers to monitor the effect of new drugs and therapeutic strategies as they are developed. A biomarker may be a genetic trait, a biochemical change, such as a protein, peptide or metabolite, or a change in a structural or functional feature detected using imaging technology. This review aims to cover the important field of biomarker research in association with AD.
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Affiliation(s)
- Malcolm Ward
- Proteome Sciences plc, South Wing Laboratory (PO 045), Institute of Psychiatry, London, SE5 8AF, UK.
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Jung RE, Haier RJ. The Parieto-Frontal Integration Theory (P-FIT) of intelligence: converging neuroimaging evidence. Behav Brain Sci 2007; 30:135-54; discussion 154-87. [PMID: 17655784 DOI: 10.1017/s0140525x07001185] [Citation(s) in RCA: 850] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Is there a biology of intelligence which is characteristic of the normal human nervous system?" Here we review 37 modern neuroimaging studies in an attempt to address this question posed by Halstead (1947) as he and other icons of the last century endeavored to understand how brain and behavior are linked through the expression of intelligence and reason. Reviewing studies from functional (i.e., functional magnetic resonance imaging, positron emission tomography) and structural (i.e., magnetic resonance spectroscopy, diffusion tensor imaging, voxel-based morphometry) neuroimaging paradigms, we report a striking consensus suggesting that variations in a distributed network predict individual differences found on intelligence and reasoning tasks. We describe this network as the Parieto-Frontal Integration Theory (P-FIT). The P-FIT model includes, by Brodmann areas (BAs): the dorsolateral prefrontal cortex (BAs 6, 9, 10, 45, 46, 47), the inferior (BAs 39, 40) and superior (BA 7) parietal lobule, the anterior cingulate (BA 32), and regions within the temporal (BAs 21, 37) and occipital (BAs 18, 19) lobes. White matter regions (i.e., arcuate fasciculus) are also implicated. The P-FIT is examined in light of findings from human lesion studies, including missile wounds, frontal lobotomy/leukotomy, temporal lobectomy, and lesions resulting in damage to the language network (e.g., aphasia), as well as findings from imaging research identifying brain regions under significant genetic control. Overall, we conclude that modern neuroimaging techniques are beginning to articulate a biology of intelligence. We propose that the P-FIT provides a parsimonious account for many of the empirical observations, to date, which relate individual differences in intelligence test scores to variations in brain structure and function. Moreover, the model provides a framework for testing new hypotheses in future experimental designs.
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Affiliation(s)
- Rex E Jung
- Departments of Neurology and Psychology, University of New Mexico, Albuquerque, NM 87106, USA.
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del Mar Matarín M, Pueyo R, Poca MA, Falcón C, Mataró M, Bargalló N, Sahuquillo J, Junqué C. Post-surgical changes in brain metabolism detected by magnetic resonance spectroscopy in normal pressure hydrocephalus: results of a pilot study. J Neurol Neurosurg Psychiatry 2007; 78:760-3. [PMID: 17299021 PMCID: PMC2117662 DOI: 10.1136/jnnp.2006.088450] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adult normal pressure hydrocephalus (NPH) is one of the few potentially treatable causes of dementia. Some morphological and functional abnormalities attributed to hydrocephalus improve following treatment. OBJECTIVES We focused on analysis of changes in cerebral metabolites using proton magnetic resonance spectroscopy (1H-MRS) after NPH treatment, and its clinical and cognitive correlation. METHODS 1H-MRS, neuropsychological and clinical status examinations were performed before and 6 months after shunting in 12 adults with idiopathic NPH. We obtained N-acetyl-aspartate (NAA), choline (Cho), myoinositol (MI) and creatine (Cr) values. RESULTS After surgery, NAA/Cr was significantly increased. Moreover, NAA/Cr values were related to cognitive deterioration. CONCLUSION MRS could be a marker of neuronal dysfunction in NPH.
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Charlton RA, McIntyre DJO, Howe FA, Morris RG, Markus HS. The relationship between white matter brain metabolites and cognition in normal aging: the GENIE study. Brain Res 2007; 1164:108-16. [PMID: 17632090 DOI: 10.1016/j.brainres.2007.06.027] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Revised: 05/30/2007] [Accepted: 06/14/2007] [Indexed: 11/25/2022]
Abstract
Magnetic resonance spectroscopy (MRS) has demonstrated age-related changes in brain metabolites that may underlie micro-structural brain changes, but few studies have examined their relationship with cognitive decline. We performed a cross-sectional study of brain metabolism and cognitive function in 82 healthy adults (aged 50-90) participating in the GENIE (St GEorge's Neuropsychology and Imaging in the Elderly) study. Absolute metabolite concentrations were measured by proton chemical shift imaging within voxels placed in the centrum semiovale white matter. Cognitive abilities assessed were executive function, working memory, information processing speed, long-term memory and fluid intelligence. Correlations showed that all cognitive domains declined with age. Total creatine (tCr) concentration increased with age (r=0.495, p<0.001). Regression analyses were performed for each cognitive variable, including estimated intelligence and the metabolites, with age then added as a final step. A significant relationship was observed between tCr and executive function, long-term memory, and fluid intelligence, although these relationships did not remain significant after age was added as a final step in the regression. The regression analysis also demonstrated a significant relationship between N-acetylaspartate (NAA) and executive function. As there was no age-related decline in NAA, this argues against axonal loss with age; however the relationship between NAA and executive function independent of age and estimated intelligence is consistent with white matter axonal integrity having an important role in executive function in normal individuals.
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Affiliation(s)
- R A Charlton
- Centre for Clinical Neuroscience, St. George's University of London, Cranmer Terrace London, SW17 0RE, UK.
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Ross AJ, Sachdev PS, Wen W, Brodaty H, Joscelyne A, Lorentz LM. Prediction of cognitive decline after stroke using proton magnetic resonance spectroscopy. J Neurol Sci 2006; 251:62-9. [PMID: 17092517 DOI: 10.1016/j.jns.2006.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 07/06/2006] [Accepted: 08/30/2006] [Indexed: 10/23/2022]
Abstract
Structural MRI measures have been used to predict cognitive decline in elderly subjects, but few studies have used proton magnetic resonance spectroscopy ((1)H-MRS) for this purpose, particularly after stroke. We studied the potential of (1)H-MRS to predict cognitive decline in patients with stroke or TIA and healthy ageing controls over 12 months and 3 years. Structural MRI and single-voxel (1)H-MRS in the frontal white matter and the occipito-parietal gray matter were performed at the index assessment (3-6 months post-stroke) in 49 stroke/TIA patients and 60 controls. Neuropsychological testing was performed at the index assessment and repeated at 12 months in 30 stroke/TIA patients and 49 controls, and at 3 years in 25 patients and 48 controls. In stroke/TIA patients, frontal NAA/Cr predicted cognitive decline over 12 months and 3 years, and in elderly control subjects frontal NAA predicted cognitive decline over 12 months only. In stroke/TIA patients, the (1)H-MRS measures were better predictors of cognitive decline than structural measures. (1)H-MRS may be useful in assessing early cognitive impairment after stroke/TIA and in normal ageing.
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Affiliation(s)
- Amy J Ross
- Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Barker Street, Randwick, NSW, Australia
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Takahashi T, Murata T, Narita K, Hamada T, Kosaka H, Omori M, Takahashi K, Kimura H, Yoshida H, Wada Y. Multifractal analysis of deep white matter microstructural changes on MRI in relation to early-stage atherosclerosis. Neuroimage 2006; 32:1158-66. [PMID: 16815037 DOI: 10.1016/j.neuroimage.2006.04.218] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2005] [Revised: 04/18/2006] [Accepted: 04/28/2006] [Indexed: 10/24/2022] Open
Abstract
Multifractal analysis based on generalized concepts of fractals has been applied to evaluate biological tissues composed of complex structures. This type of analysis can provide a precise quantitative description of a broad range of heterogeneous phenomena. Previously, we applied multifractal analysis to describe heterogeneity in white matter signal fluctuation on T2-weighted MR images as a new method of texture analysis and established Deltaalpha as the most suitable index for evaluating white matter structural complexity (Takahashi et al. J. Neurol. Sci., 2004; 225: 33-37). Considerable evidence suggests that pathophysiological processes occurring in deep white matter regions may be partly responsible for cognitive deterioration and dementia in elderly subjects. We carried out a multifractal analysis in a group of 36 healthy elderly subjects who showed no evidence of atherosclerotic risk factors to examine the microstructural changes of the deep white matter on T2-weighted MR images. We also performed conventional texture analysis, i.e., determined the standard deviation of signal intensity divided by mean signal intensity (SD/MSI) for comparison with multifractal analysis. Next, we examined the association between the findings of these two types of texture analysis and the ultrasonographically measured intima-media thickness (IMT) of the carotid arteries, a reliable indicator of early carotid atherosclerosis. The severity of carotid IMT was positively associated with Deltaalpha in the deep white matter region. In addition, this association remained significant after excluding 12 subjects with visually detectable deep white matter hyperintensities on MR images. However, there was no significant association between the severity of carotid IMT and SD/MSI. These results indicate the potential usefulness of applying multifractal analysis to conventional MR images as a new approach to detect the microstructural changes of apparently normal white matter during the early stages of atherosclerosis.
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Affiliation(s)
- Tetsuya Takahashi
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka-cho, Yoshida-gun, Fukui 910-1193, Japan
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Coplan JD, Mathew SJ, Mao X, Smith ELP, Hof PR, Coplan PM, Rosenblum LA, Gorman JM, Shungu DC. Decreased choline and creatine concentrations in centrum semiovale in patients with generalized anxiety disorder: relationship to IQ and early trauma. Psychiatry Res 2006; 147:27-39. [PMID: 16797939 DOI: 10.1016/j.pscychresns.2005.12.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2005] [Revised: 12/12/2005] [Accepted: 12/29/2005] [Indexed: 11/27/2022]
Abstract
We have demonstrated, using proton magnetic resonance spectroscopy imaging ((1)H-MRSI), elevations of N-acetyl-aspartate/creatine (NAA/CR) in right dorsolateral prefrontal cortex (DLPFC) in patients with generalized anxiety disorder (GAD) in comparison to healthy volunteers. A recent study indicates that the volume of prefrontal cortical white matter may be disproportionately increased in man in comparison to other primate species, with evolutionary implications. We therefore re-analyzed the identical scans with a specific focus on the centrum semiovale (CSO) as a representative region of interest of cerebral white matter. The central hypothesis was, in accordance with our gray matter findings, that patients with GAD, in comparison to healthy controls, would exhibit either an increase in NAA in CSO, or alternatively demonstrate reductions in concentrations of choline (CHO)-containing compounds and/or creatine+phosphocreatine (CR). MRSI scans that were obtained from an earlier [Mathew, S.J., Mao, X., Coplan, J.D., Smith, E.L., Sackeim, H.A., Gorman, J.M., Shungu, D.C., 2004. Dorsolateral prefrontal cortical pathology in generalized anxiety disorder: a proton magnetic resonance spectroscopic imaging study. American Journal of Psychiatry 161, 1119-1121] sample of 15 patients with GAD [6 with early trauma (ET)] and 15 healthy age- and sex-matched volunteers were analyzed further for CSO metabolite alterations. Self-reported worry was scored using the Penn State Worry Questionnaire (PSWQ) and intelligence was assessed using the Wechsler Abbreviated Scale of Intelligence (WASI). Serial multislice/multivoxel MRSI scans had been performed on a 1.5-T MRI. Using absolute quantification methods for metabolite concentrations, we examined NAA, CHO and CR. GAD patients without ET exhibited bilaterally decreased concentrations of CHO and CR in CSO in comparison to healthy volunteers, whereas GAD patients with ET were indistinguishable from controls. In patients with GAD, high IQ was paired with greater worry, whereas in healthy volunteers, high IQ was associated with less worry. In all subjects, IQ inversely predicted left and right CSO CHO concentrations, independent of age, sex, group assignment and PSWQ scores. The CSO may therefore represent a neural substrate that exhibits reductions in CHO and CR metabolite concentrations that are inversely associated with GAD symptomatology and, in the case of CHO, with intelligence. These conclusions are deemed preliminary due to small sample size, with further study of cerebral WM in anxiety disorders suggested.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry, Division of Neuropsychopharmacology, State University of New York, Downstate Medical Center, Brooklyn, 11023, USA.
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Ross AJ, Sachdev PS, Wen W, Brodaty H. Longitudinal changes during aging using proton magnetic resonance spectroscopy. J Gerontol A Biol Sci Med Sci 2006; 61:291-8. [PMID: 16567380 DOI: 10.1093/gerona/61.3.291] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE We aimed to examine the longitudinal change in proton magnetic resonance spectroscopy ((1)H-MRS) visible metabolites (N-acetyl aspartate [NAA], creatine [Cr], choline [Cho], and myo-Inositol [mI]) in brains of elderly individuals over 3 years and relate them to cognitive function. METHODS Neurologically and psychiatrically normal volunteers (n = 40) were examined at baseline and 3 years later with (1)H-MRS in two voxels (frontal white matter n = 29, and occipitoparietal gray matter n = 36) and with detailed neuropsychological assessments. Longitudinal analyses were performed with age, educational level, sex, and white matter hyperintensities (WMH) in voxels as covariates. RESULTS Frontal mI was significantly increased over time in male participants, but all other metabolites were stable over time. Neuropsychological performance was not significantly changed over 3 years, and there was no relationship between change in metabolite levels and change in neuropsychological function. CONCLUSIONS MRS-visible metabolites are stable in elderly persons over 3 years, with the exception of mI which shows an increase. Increasing mI may be a marker of aging or a preclinical neurodegenerative process. MRS changes do not correlate with change in neurocognitive function during aging.
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Affiliation(s)
- Amy J Ross
- School of Psychiatry, University of New South Wales, Sydney, Australia
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Schmithorst VJ, Wilke M, Dardzinski BJ, Holland SK. Cognitive functions correlate with white matter architecture in a normal pediatric population: a diffusion tensor MRI study. Hum Brain Mapp 2005; 26:139-47. [PMID: 15858815 PMCID: PMC1859842 DOI: 10.1002/hbm.20149] [Citation(s) in RCA: 282] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A possible relationship between cognitive abilities and white matter structure as assessed by magnetic resonance diffusion tensor imaging (DTI) was investigated in the pediatric population. DTI was performed on 47 normal children ages 5-18. Using a voxelwise analysis technique, the fractional anisotropy (FA) and mean diffusivity (MD) were tested for significant correlations with Wechsler full-scale IQ scores, with subject age and gender used as covariates. Regions displaying significant positive correlations of IQ scores with FA were found bilaterally in white matter association areas, including frontal and occipito-parietal areas. No regions were found exhibiting correlations of IQ with MD except for one frontal area significantly overlapping a region containing a significant correlation with FA. The positive direction of the correlation with FA is the same as that found previously with age, and indicates a positive relationship between fiber organization and/or density with cognitive function. The results are consistent with the hypothesis that regionally specific increased fiber organization is a mechanism responsible for the normal development of white matter tracts.
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Affiliation(s)
- Vincent J Schmithorst
- Imaging Research Center, Cincinnati Children's Hospital Medical Center, OH 45229, USA.
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35
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Ross AJ, Sachdev PS, Wen W, Valenzuela MJ, Brodaty H. Cognitive correlates of 1H MRS measures in the healthy elderly brain. Brain Res Bull 2005; 66:9-16. [PMID: 15925139 DOI: 10.1016/j.brainresbull.2005.01.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2004] [Revised: 11/05/2004] [Accepted: 01/13/2005] [Indexed: 11/16/2022]
Abstract
Ageing is associated with cognitive decline, with some studies indicating that this decline can be mostly accounted for by slowing of information processing speed. Whilst it is likely that this is associated with age-related changes in fronto-subcortical neuronal circuits, such changes are not visible on routine neuroimaging. We examined the integrity of this brain region using proton magnetic resonance spectroscopy (1H MRS) and hypothesised that functional changes measured by 1H MRS would be associated with cognitive performance. Fifty-nine healthy elderly subjects (age 58-85 years) underwent single-voxel 1H MRS in frontal white matter and occipito-parietal gray matter, and a comprehensive neuropsychological battery. The results showed a significant correlation between frontal white matter NAA/H2O and a composite measure of neuropsychological performance representing speed of information processing, attentional function and visual memory, controlling for age and sex. This research highlights the importance of the relationship between regional brain changes and cognitive function in the ageing brain, and suggests that MRS may be a sensitive marker of subclinical change in cognition.
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Affiliation(s)
- Amy J Ross
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
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36
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Jung RE, Haier RJ, Yeo RA, Rowland LM, Petropoulos H, Levine AS, Sibbitt WL, Brooks WM. Sex differences in N-acetylaspartate correlates of general intelligence: an 1H-MRS study of normal human brain. Neuroimage 2005; 26:965-72. [PMID: 15955507 DOI: 10.1016/j.neuroimage.2005.02.039] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2004] [Revised: 02/08/2005] [Accepted: 02/25/2005] [Indexed: 10/25/2022] Open
Abstract
Researchers have long attempted to determine brain correlates of intelligence using available neuroimaging technology including CT, MRI, PET, and fMRI. Although structural and functional imaging techniques are well suited to assess gross cortical regions associated with intelligence, the integrity and functioning of underlying white matter networks critical to coordinated cortical integration remain comparatively understudied. A relatively recent neuroimaging advance is magnetic resonance spectroscopy (MRS) which allows for interrogation of biochemical substrates of brain structure and function in vivo. In this study, we examined twenty-seven normal control subjects (17 male, 10 female) to determine whether N-acetylaspartate (NAA), a metabolite found primarily within neurons, is related to intelligence as assessed by the Wechsler Adult Intelligence Scale-III. Of the three white matter regions studied (i.e., left frontal, right frontal, left occipito-parietal), we found that a model including only left occipito-parietal white matter predicted intellectual performance [F(1,25) = 8.65, P = .007; r2 = .26], providing regional specificity to our previous findings of NAA-IQ relationships. Moreover, we found that a complex combination of left frontal and left occipito-parietal NAA strongly predicted performance in women, but not men [F(2,7) = 21.84, P < .001; adjusted r2 = .82]. Our results highlight a biochemical substrate of normal intellectual performance, mediated by sex, within white matter association fibers linking posterior to frontal brain regions.
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Affiliation(s)
- Rex E Jung
- Department of Neurology, University of New Mexico, Albuquerque, NM 87151, USA.
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37
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Haier RJ, Jung RE, Yeo RA, Head K, Alkire MT. The neuroanatomy of general intelligence: sex matters. Neuroimage 2005; 25:320-7. [PMID: 15734366 DOI: 10.1016/j.neuroimage.2004.11.019] [Citation(s) in RCA: 193] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 11/04/2004] [Accepted: 11/09/2004] [Indexed: 10/25/2022] Open
Abstract
We examined the relationship between structural brain variation and general intelligence using voxel-based morphometric analysis of MRI data in men and women with equivalent IQ scores. Compared to men, women show more white matter and fewer gray matter areas related to intelligence. In men IQ/gray matter correlations are strongest in frontal and parietal lobes (BA 8, 9, 39, 40), whereas the strongest correlations in women are in the frontal lobe (BA10) along with Broca's area. Men and women apparently achieve similar IQ results with different brain regions, suggesting that there is no singular underlying neuroanatomical structure to general intelligence and that different types of brain designs may manifest equivalent intellectual performance.
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Affiliation(s)
- Richard J Haier
- Department of Pediatrics, University of California, Med. Sci. I, B140, Irvine, CA 92697-5000, USA.
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Takahashi T, Murata T, Omori M, Kosaka H, Takahashi K, Yonekura Y, Wada Y. Quantitative evaluation of age-related white matter microstructural changes on MRI by multifractal analysis. J Neurol Sci 2005; 225:33-7. [PMID: 15465083 DOI: 10.1016/j.jns.2004.06.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2003] [Revised: 06/15/2004] [Accepted: 06/18/2004] [Indexed: 11/23/2022]
Abstract
Multifractal analysis has been applied to evaluate biological tissues, which are composed of complex structures. We carried out multifractal analyses in a group of healthy young and elderly subjects to examine age-related white matter microstructural changes on T2-weighted MR images without any visible abnormal intensity, and to correlate such changes with age-related cognitive decline. Comparison between the two age groups showed that Deltaalpha (established as the most suitable index of heterogeneity in our previous report) in the frontal region was significantly higher in the elderly group, but no significant group difference was found in Deltaalpha in the parieto-occipital region. The Trail-Making Test score (a measure of executive dysfunction) was significantly higher in the elderly group. In the elderly group, the Trail-Making Test score was positively correlated with Deltaalpha in the frontal region, but not in the parieto-occipital region. These results suggest that microstructural changes in the white matter preferentially occur in the frontal region with normal aging, and these changes are associated with executive cognitive decline reflective of frontal-subcortical dysfunction.
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Affiliation(s)
- Tetsuya Takahashi
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
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Abstract
The advent of MRI has made a remarkable progress in the understanding of age-related brain changes providing a noninvasive tool to study in vivo the normally aging individuals at multiple time points. However, conventional MRI techniques are unable to detect and quantify age-related microstructural changes that have been documented at the post-mortem examination of brain tissues. More sophisticated, quantitative MR techniques such as magnetization transfer imaging, diffusion tensor imaging, and proton MR spectroscopy have been shown to be sensitive to microstructural and metabolic changes that occur in gray and white matter over the course of life span. This review highlights some of these innovative, quantitative MR techniques that are particularly relevant for the study of occult age-related brain tissue changes. Characterization of the in vivo patterns of molecular and cellular changes that occur in the normal aging brain is of crucial importance to understand the pathophysiology of normal cognitive decline and to interpret observed changes in neurodegenerative diseases.
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Affiliation(s)
- Matilde Inglese
- Department of Radiology, New York University School of Medicine, New York, NY 10016, USA.
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Abstract
Recent advances in understanding the molecular biology of Alzheimer's disease (AD) offer the promise of useful therapeutic intervention in the foreseeable future. Hence, improved methods for early diagnosis and noninvasive surrogates of disease severity in AD have become more imperative. Various quantitative magnetic resonance (MR) techniques that measure the anatomic, biochemical, microstructural, functional, and blood-flow changes are being evaluated as possible surrogate measures of disease progression. Cross-sectional and longitudinal studies indicate that MR-based volume measurements are potential surrogates of disease progression in AD, starting from the preclinical stages. The validity of MR-based volumetry as a surrogate marker for therapeutic efficacy in AD remains to be tested in a positive disease-modifying drug trial. Recent development of amyloid imaging tracers for positron emission tomography has been a major breakthrough in the field of imaging markers for AD. Efforts to image plaques are also underway in MR imaging. As with indirect MR measures, these approaches of directly imaging the pathological substrate will need to undergo a validation process with longitudinal studies to prove their usefulness as surrogate markers in AD.
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Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Abstract
The neurophysiological basis of cognition is relatively unexplained, with most studies reporting weak relationships between cognition and measures of brain function, such as event-related potentials, brain size and cerebral blood flow. Magnetic resonance spectroscopy (MRS) is an in vivo method used to detect neurochemicals within the brain that are relevant to certain brain processes. The most widely used methods are 1H-MRS and 31P-MRS, which detect compounds that contain hydrogen and phosphorus, respectively. Recent studies have shown that the absolute concentrations or ratios of these neurochemicals, in particular N-acetyl aspartate (NAA), which is associated with neuronal viability, correlate with performance on neuropsychological tests or other measures of cognitive function in normal subjects. Many studies in adults and children have shown a relationship between neurometabolite values and cognitive status or extent of cognitive dysfunction in various neurological and neuropsychiatric disorders. We review these studies and conclude that MRS has potential applications for the study of cognitive processes in health and disease and may be used clinically for differential diagnosis, the early detection of pathology and the examination of longitudinal change.
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Affiliation(s)
- Amy J Ross
- School of Psychiatry, University of New South Wales, Kensington, New South Wales 2033, Australia.
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Giménez M, Junqué C, Narberhaus A, Caldú X, Segarra D, Vendrell P, Bargalló N, Mercader JM. Medial temporal MR spectroscopy is related to memory performance in normal adolescent subjects. Neuroreport 2004; 15:703-7. [PMID: 15094480 DOI: 10.1097/00001756-200403220-00026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In addition to the study of pathological conditions, magnetic resonance spectroscopy can provide useful information about brain-behavior relationships in normal subjects. Recently, there have been reports of correlations between N-acetylaspartate (NAA) values and cognitive functions in normal adults. We tested the possible specific relationship between the NAA/choline (Cho) ratio in the medial temporal lobe and memory performance in normal adolescents. The medial temporal NAA/Cho ratio was unrelated to age, gender and general intelligence but presented a clear correlation with several memory measures. In the regression analysis two memory variables (RAVLT learning and a face-name recognition task) explained 55.6% of NAA/Cho variance. We conclude that NAA values in the medial temporal lobe are related to memory abilities but not to global intelligence in normal adolescent subjects.
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Affiliation(s)
- Mónica Giménez
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain
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Gunning-Dixon FM, Raz N. Neuroanatomical correlates of selected executive functions in middle-aged and older adults: a prospective MRI study. Neuropsychologia 2004; 41:1929-41. [PMID: 14572526 DOI: 10.1016/s0028-3932(03)00129-5] [Citation(s) in RCA: 330] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neuroanatomical substrates of age-related differences in working memory and perseverative behavior were examined in a sample of healthy adults (50-81 years old). The participants, who were screened for history of neurological, psychiatric, and medical conditions known to be linked to poor cognitive performance, underwent magnetic resonance imaging (MRI) and were administered tests of working memory and perseveration. Regional brain volumes and the volume of white matter hyperintensities (WMH) were measured on magnetic resonance images. The analyses indicate that the volume of the prefrontal cortex (PFC) and the volume of white matter hyperintensities in the prefrontal region are independently associated with age-related increases in perseverative errors on the Wisconsin Card Sorting Test (WCST). When participants taking antihypertensive medication were excluded from the analysis, both the volume of the prefrontal cortex and the frontal white matter hyperintensities (FWMH) still predicted increases in perseveration. Neither reduced volume of the prefrontal cortex nor the FWMH volume was linked to age-associated declines in working memory. The volumes of the fusiform gyrus (FG) and the temporal white matter hyperintensities (TWMH) were unrelated to cognitive performance.
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Affiliation(s)
- Faith M Gunning-Dixon
- Department of Psychology, Kaufman Building, Hillside Division of Long Island Jewish Medical Center, 75-59 263rd St, Glen Oaks, NY 11040, USA.
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Jacobson AM, Samson JA, Weinger K, Ryan CM. Diabetes, the brain, and behavior: is there a biological mechanism underlying the association between diabetes and depression? INTERNATIONAL REVIEW OF NEUROBIOLOGY 2003; 51:455-79. [PMID: 12420367 DOI: 10.1016/s0074-7742(02)51013-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In summary, our review of the literature suggests that diabetes, especially type 1 diabetes, may place patients at risk for a depressive disorder through a biological mechanism linking the metabolic changes of diabetes to changes in brain structure and function. Further studies are warranted examining these relationships in order to better understand the impact of diabetes on brain functioning and structure as well as one potential manifestation of such changes--affective disorder. Moreover, such studies could play a useful role in better understanding mechanisms that commonly underlie the development of depression in individuals without diabetes but with other medical problems or conditions.
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Affiliation(s)
- Alan M Jacobson
- Harvard Medical School, Joslin Diabetes Center, Boston, Massachusetts 02215, USA
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Rutgers DR, van Osch MJP, Kappelle LJ, Mali WPTM, van der Grond J. Cerebral hemodynamics and metabolism in patients with symptomatic occlusion of the internal carotid artery. Stroke 2003; 34:648-52. [PMID: 12624286 DOI: 10.1161/01.str.0000058158.41581.41] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The goals of this study were to investigate (1) whether the concentrations of choline, creatine, and N-acetyl aspartate (NAA) in cerebral white matter are changed in patients with symptomatic occlusion of the internal carotid artery (ICA) and (2) whether possible changes in metabolite concentration are related to regional cerebral perfusion or cerebral vasoreactivity. METHODS In 19 patients (mean+/-SD age, 60+/-9 years), white matter metabolite concentrations were measured with proton MR spectroscopic imaging on average 4+/-2 months after symptoms occurred. In selected voxels, corresponding cerebral blood flow and volume, mean transit time, and time-to-bolus peak were determined with dynamic susceptibility contrast MRI. Cerebral CO2 reactivity was determined with transcranial Doppler sonography. RESULTS No significant changes in choline and creatine concentrations were observed. NAA concentration was significantly reduced in the hemisphere on the side of the symptomatic ICA (9.1+/-1.7 mmol/L) compared with the contralateral hemisphere (10.5+/-1.7 mmol/L, P<0.005) and control subjects (10.5+/-0.9 mmol/L, P<0.01). Although no significant interhemispheric difference in NAA concentration was found in patients who presented with retinal ischemia, patients with cerebral ischemia had a significantly lower NAA concentration in the symptomatic hemisphere (9.0+/-1.7 mmol/L) compared with the asymptomatic hemisphere (10.4+/-1.6 mmol/L, P<0.05). In all patients, NAA concentration was not significantly correlated with quantitative cerebral perfusion parameters or CO2 reactivity. CONCLUSIONS Patients with symptomatic ICA occlusion may show chronic neuronal damage in cerebral white matter as evidenced by reduced NAA concentration. This seems to be related to previous symptomatology rather than to the cerebral hemodynamic status in a chronic stage.
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Affiliation(s)
- D R Rutgers
- Department of Radiology, E01.132, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
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Abstract
Magnetic resonance spectroscopy (MRS) provides a useful method for studying a number of psychotropic medications and metabolites in human brain in vivo. New insights regarding the pharmacokinetic and pharmacodynamic properties of psychotropic medications in the target organ (i.e., brain) have been obtained using lithium-7 MRS and fluorine-19 MRS. Both proton and phosphorus-31 MRS have significantly enhanced our knowledge of the pathophysiology of a number of psychiatric disorders by providing estimates of brain concentrations of several important cerebral metabolites. Efforts are also being made to link MRS measures of cerebral metabolism with neurophysiologic and neurocognitive processes. Ongoing improvement and refinement in MRS techniques, including the installation of scanners with increased magnetic field strength and better methods of data processing, will improve both spatial and temporal resolution. In addition, efforts to develop multisite research studies may result in greater standardization of MRS procedures and methods for interpretation of results. In this review, the current status of MRS applications in psychiatric research is reviewed, and new frontiers and possible future developments are discussed.
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Affiliation(s)
- In Kyoon Lyoo
- McLean Hospital Brain Imaging Center, Belmont, Massachusetts 02478, USA
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Abstract
OBJECTIVE This paper briefly describes neuroimaging using magnetic resonance spectroscopy (MRS) and provides a systematic review of its application to psychiatric disorders. METHOD A literature review (Index Medicus/Medline) was carried out, as well as a review of other relevant papers and data known to the authors. RESULTS Magnetic resonance spectroscopy is a complex and sophisticated neuroimaging technique that allows reliable and reproducible quantification of brain neurochemistry provided its limitations are respected. In some branches of medicine it is already used clinically, for instance, to diagnose tumours and in psychiatry its applications are gradually extending beyond research. Neurochemical changes have been found in a variety of brain regions in dementia, schizophrenia and affective disorders and promising discoveries have also been made in anxiety disorders. CONCLUSION Magnetic resonance spectroscopy is a non-invasive investigative technique that has provided useful insights into the biochemical basis of many neuropsychiatric disorders. It allows direct measurement, in vivo, of medication levels within the brain and has made it possible to track the neurochemical changes that occur as a consequence of disease and ageing or in response to treatment. It is an extremely useful advance in neuroimaging technology and one that will undoubtedly have many clinical uses in the near future.
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Affiliation(s)
- Gin S Malhi
- Mood Disorders Unit, The Villa, Prince of Wales Hospital, Randwick NSW 2031, Sydney, Australia.
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Abstract
OBJECTIVE This paper examines the current literature pertaining to brain ageing. The objective of this review is to provide an overview of the effects of ageing on brain structure and function and to examine possible mediators of these changes. METHODS A MEDLINE search was conducted for each area of interest. A selective review was undertaken of relevant articles. RESULTS Although fundamental changes in fluid intellectual abilities occur with age, global cognitive decline is not a hallmark of the ageing process. Decline in fluid intellectual ability is paralleled by regionally specific age related changes apparent from both structural and functional neuroimaging studies. The histopathological mediators of these changes do not appear to be reduction in neuronal number, which, with the exception of selected hippocampal regions, remain relatively stable across age. At the molecular level, several mechanisms of age related change have been postulated. Such theoretical models await refinement and may eventually provide a basis for therapy designed to reduce effects of the ageing process. The role of possible protective factors such as 'brain reserve', neuroprotective agents and hormonal factors in modifying individual vulnerability to the ageing process has been the focus of a limited number of studies. CONCLUSION Our understanding of the functional and structural changes associated with both healthy and pathological ageing is rapidly gaining in sophistication and complexity. An awareness of the fundamental biological substrates underpinning the ageing process will allow improved insights into vulnerability to neuropsychiatric disease associated with advancing age.
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Affiliation(s)
- J N Trollor
- School of Psychiatry, University of New South Wales and Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia.
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