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Guberman GI, Theaud G, Hawes SW, Ptito A, Descoteaux M, Hodgins S. White matter microstructure, traumatic brain injury, and disruptive behavior disorders in girls and boys. Front Neurosci 2024; 18:1391407. [PMID: 39099631 PMCID: PMC11295658 DOI: 10.3389/fnins.2024.1391407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/11/2024] [Indexed: 08/06/2024] Open
Abstract
Introduction Girls and boys presenting disruptive behavior disorders (DBDs) display differences in white matter microstructure (WMM) relative to typically developing (TD) sex-matched peers. Boys with DBDs are at increased risk for traumatic brain injuries (TBIs), which are also known to impact WMM. This study aimed to disentangle associations of WMM with DBDs and TBIs. Methods The sample included 673 children with DBDs and 836 TD children, aged 9-10, from the Adolescent Brain Cognitive Development Study. Thirteen white matter bundles previously associated with DBDs were the focus of study. Analyses were undertaken separately by sex, adjusting for callous-unemotional traits (CU), attention-deficit hyperactivity disorder (ADHD), age, pubertal stage, IQ, ethnicity, and family income. Results Among children without TBIs, those with DBDs showed sex-specific differences in WMM of several tracts relative to TD. Most differences were associated with ADHD, CU, or both. Greater proportions of girls and boys with DBDs than sex-matched TD children had sustained TBIs. Among girls and boys with DBDs, those who had sustained TBIs compared to those not injured, displayed WMM alterations that were robust to adjustment for all covariates. Across most DBD/TD comparisons, axonal density scores were higher among children presenting DBDs. Discussion In conclusion, in this community sample of children, those with DBDs were more likely to have sustained TBIs that were associated with additional, sex-specific, alterations of WMM. These additional alterations further compromise the future development of children with DBDs.
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Affiliation(s)
- Guido I. Guberman
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Guillaume Theaud
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
| | - Samuel W. Hawes
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, United States
| | - Alain Ptito
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Maxime Descoteaux
- Department of Computer Science, Sherbrooke University, Sherbrooke, QC, Canada
| | - Sheilagh Hodgins
- Département de Psychiatrie et Addictologie, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, QC, Canada
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2
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Saker Z, Rizk M, Merie D, Nabha RH, Pariseau NJ, Nabha SM, Makki MI. Insight into brain sex differences of typically developed infants and brain pathologies: A systematic review. Eur J Neurosci 2024; 60:3491-3504. [PMID: 38693604 DOI: 10.1111/ejn.16364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/12/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024]
Abstract
The continually advancing landscape of neuroscientific and imaging research has broadened our comprehension of sex differences encoded in the human brain, expanding from the hypothalamus and sexual behaviour to encompass the entire brain, including its diverse lobes, structures, and functions. However, less is known about sex differences in the brains of neonates and infants, despite their relevance to various sex-linked diseases that develop early in life. In this review, we provide a synopsis of the literature evidence on sex differences in the brains of neonates and infants at the morphological, structural and network levels. We also briefly overview the present evidence on the sex bias in some brain disorders affecting infants and neonates.
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Affiliation(s)
- Zahraa Saker
- Research Department, Al-Rassoul Al-Aazam Hospital, Beirut, Lebanon
| | - Mahdi Rizk
- School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon
| | - Diana Merie
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | | | - Nicole J Pariseau
- Department of Pediatrics-Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sanaa M Nabha
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Malek I Makki
- Laboratory of Functional Neurosciences and Pathologies, University of Picardy Jules Verne, Amiens, France
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3
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Gajawelli N, Paulli A, Deoni S, Paquette N, Darakjian D, Salazar C, Dean D, O'Muircheartaigh J, Nelson MD, Wang Y, Lepore N. Surface-based morphometry of the corpus callosum in young children of ages 1-5. Hum Brain Mapp 2024; 45:e26693. [PMID: 38924235 PMCID: PMC11199824 DOI: 10.1002/hbm.26693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 02/05/2024] [Accepted: 04/05/2024] [Indexed: 06/28/2024] Open
Abstract
The corpus callosum (CC) is a large white matter fiber bundle in the brain and is involved in various cognitive, sensory, and motor processes. While implicated in various developmental and psychiatric disorders, much is yet to be uncovered about the normal development of this structure, especially in young children. Additionally, while sexual dimorphism has been reported in prior literature, observations have not necessarily been consistent. In this study, we use morphometric measures including surface tensor-based morphometry (TBM) to investigate local changes in the shape of the CC in children between the ages of 12 and 60 months, in intervals of 12 months. We also analyze sex differences in each of these age groups. We observed larger significant clusters in the earlier ages between 12 v 24 m and between 48 v 60 m and localized differences in the anterior region of the body of the CC. Sex differences were most pronounced in the 12 m group. This study adds to the growing literature of work aiming to understand the developing brain and emphasizes the utility of surface TBM as a useful tool for analyzing regional differences in neuroanatomical morphometry.
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Affiliation(s)
- Niharika Gajawelli
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Athelia Paulli
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Sean Deoni
- Department of PediatricsWarren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
- Bill & Melinda Gates FoundationSeattleWashingtonUSA
| | - Natacha Paquette
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of PsychologyCHU Sainte‐JustineMontrealQuebecCanada
| | - Danielle Darakjian
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- College of MedicineCalifornia Northstate UniversityElk GroveCaliforniaUSA
| | - Carlos Salazar
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of Biomedical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Douglas Dean
- Waisman Laboratory for Brain Imaging and BehaviorUniversity of Wisconsin MadisonMadisonWisconsinUSA
| | | | - Marvin D. Nelson
- Department of PediatricsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
| | - Yalin Wang
- Department of Computer ScienceArizona State UniversityTempeArizonaUSA
| | - Natasha Lepore
- CIBORG Lab, Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
- Department of Biomedical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of PediatricsUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of RadiologyChildren's Hospital Los AngelesLos AngelesCaliforniaUSA
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4
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Lima Santos JP, Kontos AP, Holland CL, Suss SJ, Stiffler RS, Bitzer HB, Colorito AT, Shaffer M, Skeba A, Iyengar S, Manelis A, Brent D, Shirtcliff EA, Ladouceur CD, Phillips ML, Collins MW, Versace A. The Role of Puberty and Sex on Brain Structure in Adolescents With Anxiety Following Concussion. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:285-297. [PMID: 36517369 DOI: 10.1016/j.bpsc.2022.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adolescence represents a window of vulnerability for developing psychological symptoms following concussion, especially in girls. Concussion-related lesions in emotion regulation circuits may help explain these symptoms. However, the contribution of sex and pubertal maturation remains unclear. Using the neurite density index (NDI) in emotion regulation tracts (left/right cingulum bundle [CB], forceps minor [FMIN], and left/right uncinate fasciculus), we sought to elucidate these relationships. METHODS No adolescent had a history of anxiety and/or depression. The Screen for Child Anxiety Related Emotional Disorders and Children's Depression Rating Scale were used at scan to assess anxiety and depressive symptoms in 55 concussed adolescents (41.8% girls) and 50 control adolescents with no current/history of concussion (44% girls). We evaluated if a mediation-moderation model including the NDI (mediation) and sex or pubertal status (moderation) could help explain this relationship. RESULTS Relative to control adolescents, concussed adolescents showed higher anxiety (p = .003) and lower NDI, with those at more advanced pubertal maturation showing greater abnormalities in 4 clusters: the left CB frontal (p = .002), right CB frontal (p = .011), FMIN left-sided (p = .003), and FMIN right-sided (p = .003). Across all concussed adolescents, lower NDI in the left CB frontal and FMIN left-sided clusters partially mediated the association between concussion and anxiety, with the CB being specific to female adolescents. These effects did not explain depressive symptoms. CONCLUSIONS Our findings indicate that lower NDI in the CB and FMIN may help explain anxiety following concussion and that adolescents at more advanced (vs less advanced) status of pubertal maturation may be more vulnerable to concussion-related injuries, especially in girls.
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Affiliation(s)
- João Paulo Lima Santos
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony P Kontos
- Department of Orthopaedic Surgery/UPMC Sports Concussion Program, University of Pittsburgh, Pennsylvania
| | - Cynthia L Holland
- Department of Orthopaedic Surgery/UPMC Sports Concussion Program, University of Pittsburgh, Pennsylvania
| | - Stephen J Suss
- Department of Orthopaedic Surgery/UPMC Sports Concussion Program, University of Pittsburgh, Pennsylvania
| | - Richelle S Stiffler
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hannah B Bitzer
- Department of Psychology, Florida International University, Miami, Florida
| | - Adam T Colorito
- Department of Psychology, Florida International University, Miami, Florida
| | - Madelyn Shaffer
- Department of Psychology, Florida International University, Miami, Florida
| | - Alexander Skeba
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Satish Iyengar
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anna Manelis
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David Brent
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania
| | - Elizabeth A Shirtcliff
- Center for Translational Neuroscience and Department of Psychology, University of Oregon, Eugene, Oregon
| | - Cecile D Ladouceur
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary L Phillips
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael W Collins
- Department of Orthopaedic Surgery/UPMC Sports Concussion Program, University of Pittsburgh, Pennsylvania
| | - Amelia Versace
- Department of Psychiatry, Western Psychiatric Hospital, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Radiology, Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
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KL V, Anusha SR, K Muthaiah P, BS HJ. Insights into morphometry and topography of corpus callosum among Indians. Bioinformation 2023; 19:1063-1066. [PMID: 38046518 PMCID: PMC10692978 DOI: 10.6026/973206300191063] [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: 11/01/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/05/2023] Open
Abstract
Corpus callosum is one of the major association fibre of brain performs an integral role of integration and communication of information between the two hemispheres. 50 formalin fixed cerebral hemispheres (25 right and 25 left) were used for the study. The longitudinal and vertical length of brain, longitudinal length and height of corpus callosum, distance of corpus callosum from various landmarks such as frontal and occipital pole, anterior commissure, lamina terminalis, and highest point on parietal pole and width of different parts of corpus callosum and height were measured. Results were analysed statistically. The results showed positive correlation between the longitudinal dimension of brain and all other parameters. Morphometric variation in size and its relation to nearby structures are seen in many neurological and psychiatric conditions such as Alzheimer's disease, Schizophrenia and bipolar disorders. Hence the present study can be used as reference by neurologist, neurosurgeons and psychiatrists.
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Affiliation(s)
- Varalakshmi KL
- Department of Anatomy, MVJ Medical College and Research Hospital, Hoskote, Bangalore; India
| | - SR Anusha
- Department of Anatomy, MVJ Medical College and Research Hospital, Hoskote, Bangalore; India
| | - Prajwal K Muthaiah
- Department of Anatomy, MVJ Medical College and Research Hospital, Hoskote, Bangalore; India
| | - Harshini Jain BS
- Department of Anatomy, MVJ Medical College and Research Hospital, Hoskote, Bangalore; India
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6
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Demir A, Rosas HD. Exploring interhemispheric connectivity using the directional tract density patterns of the corpus callosum. NEUROIMAGE. REPORTS 2023; 3:100174. [PMID: 37388455 PMCID: PMC10310067 DOI: 10.1016/j.ynirp.2023.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The corpus callosum (CC) is one of the most important interhemispheric white matter tracts that connects interrelated regions of the cerebral cortex. Its disruption has been investigated in previous studies and has been found to play an important role in several neurodegenerative disorders. Currently available methods to assess the interhemispheric connectivity of the CC have several limitations: i) they require the a priori identification of specific cortical regions as targets or seeds, ii) they are limited by the characterization of only small components of the structure, primarily voxels that constitute the mid-sagittal slice, and iii) they use global measures of microstructural integrity, which provide only limited characterization. In order to address some of these limitations, we developed a novel method that enables the characterization of white matter tracts covering the structure of CC, from the mid-sagittal plane to corresponding regions of cortex, using directional tract density patterns (dTDPs). We demonstrate that different regions of CC have distinctive dTDPs that reflect a unique regional topology. We conducted a pilot study using this approach to evaluate two different datasets collected from healthy subjects, and we demonstrate that this method is reliable, reproducible, and independent of diffusion acquisition parameters, suggesting its potential applicability to clinical applications.
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Affiliation(s)
- Ali Demir
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - H. Diana Rosas
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
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7
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Chen SJ, Wu BS, Ge YJ, Chen SD, Ou YN, Dong Q, Feng J, Cheng W, Yu JT. The genetic architecture of the corpus callosum and its genetic overlap with common neuropsychiatric diseases. J Affect Disord 2023; 335:418-430. [PMID: 37164063 DOI: 10.1016/j.jad.2023.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND The corpus callosum (CC) is the main structure transferring information between the cerebral hemispheres. Although previous large-scale genome-wide association study (GWAS) has illustrated the genetic architecture of white matter integrity of CC, CC volume is less stressed. METHODS Using MRI data from 33,861 individuals in UK Biobank, we conducted univariate and multivariate GWAS for CC fractional anisotropy (FA) and volume with PLINK 2.0 and MOSTest. All discovered SNPs in the multivariate framework were functionally annotated in FUMA v1.3.8. In the meanwhile, a series of gene property analyses was conducted simultaneously. In addition, we estimated genetic relationship between CC metrics and other neuropsychiatric traits and diseases. RESULTS We identified a total of 36 and 82 significant genomic loci for CC FA and volume (P < 5 × 10-8). And 53 and 27 genes were respectively mapped by four mapping strategies. For CC volume, gene-set analysis revealed pathways mainly relating to cell migration; cell-type analysis found the top enrichment in neuroglia while for CC FA in GABAergic neurons. Furthermore, we found a lot of genetic overlap and shared loci between CC FA and volume and common neuropsychiatric diseases. DISCUSSION Collectively, this study helps to better understand the genetic architecture of whole CC and CC subregions. However, the way to divide CC FA and volume in our study restricts the interpretations of our results. Future work will be needed to pay attention to the genetic structure of white matter volume, and an appropriate division of CC may help to better understand CC structure.
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Affiliation(s)
- Si-Jia Chen
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Jun Ge
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Shi-Dong Chen
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Nan Ou
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry CV4 7AL, UK
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China; Department of Computer Science, University of Warwick, Coventry CV4 7AL, UK.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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8
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Isiklar S, Ozdemir ST, Ozkaya G, Ozpar R. Three dimensional development and asymmetry of the corpus callosum in the 0-18 age group: A retrospective magnetic resonance imaging study. Clin Anat 2022; 36:581-598. [PMID: 36527384 DOI: 10.1002/ca.23996] [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: 10/19/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
Most of the corpus callosum (CC) developmental studies are concerned with its two-dimensional structure. Linear and area measurements do not directly assess the CC size but estimate the overall structure from the cross-sectional image. This study investigated age- and sex-related changes in volumetric development and asymmetry of CC from birth to 18. For this retrospective study, we selected 696 patients (329 [47.27%] females) with both 3D-T1-weighted sequence and normal radiological anatomy from patients 0-18 years of age who had brain magnetic resonance imaging (MRI) between 2012 and 2020. The genu, body, splenium, and total volume of CC were calculated using MRICloud. The measurement results of 23 age groups were analyzed with SPSS (ver.28). Total CC volume was 18740.76 ± 4314.06 mm3 between 0 and 18 years of age, and its ratio to total brain volume (TBV) was 1.70% ± 0.23%. We observed that the total CC volume has six developmental periods 0 years, 1, 2-4, 5-9, 10-16, and 17-18 years. Genu and body grew in five developmental periods, while splenium in seven. There was intermittent sexual dimorphism in the CC volume in the first 4 years of life (p < 0.05). However, sex factor was insignificant in CC ratio to TBV. Total CC was right lateralized on average 1.81% (ranging -0.59% to 4.52%). Genu was 8.70% lateralized to the right, the body was 2.99% to the left, and the splenium was 1.41% to the right. The three-dimensional development of CC agreed with the two-dimensional developmental data of CC except for some differences.
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Affiliation(s)
- Sefa Isiklar
- Medical Imaging Techniques Program, Vocational School of Health Services, Bursa Uludag University, Bursa, Turkey
| | - Senem Turan Ozdemir
- Department of Anatomy, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Güven Ozkaya
- Department of Biostatistics, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Rıfat Ozpar
- Department of Radiology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
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9
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Bonelli C, Mancuso L, Manuello J, Liloia D, Costa T, Cauda F. Sex differences in brain homotopic co-activations: a meta-analytic study. Brain Struct Funct 2022; 227:2839-2855. [PMID: 36269398 DOI: 10.1007/s00429-022-02572-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022]
Abstract
An element of great interest in functional connectivity is 'homotopic connectivity' (HC), namely the connectivity between two mirrored areas of the two hemispheres, mainly mediated by the fibers of the corpus callosum. Despite a long tradition of studying sexual dimorphism in the human brain, to our knowledge only one study has addressed the influence of sex on HC.We investigated the issue of homotopic co-activations in women and men using a coordinate-based meta-analytic method and data from the BrainMap database. A first unexpected observation was that the database was affected by a sex bias: women-only groups are investigated less often than men-only ones, and they are more often studied in certain domains such as emotion compared to men, and less in cognition. Implementing a series of sampling procedures to equalize the size and proportion of the datasets, our results indicated that females exhibit stronger interhemispheric co-activation than males, suggesting that the female brain is less lateralized and more integrated than that of males. In addition, males appear to show less intense but more extensive co-activation than females. Some local differences also appeared. In particular, it appears that primary motor and perceptual areas are more co-activated in males, in contrast to the opposite trend in the rest of the brain. This argues for a multidimensional view of sex brain differences and suggests that the issue should be approached with more complex models than previously thought.
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Affiliation(s)
- Chiara Bonelli
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Lorenzo Mancuso
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
| | - Jordi Manuello
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
- Department of Psychology, GCS-fMRI, Koelliker Hospital, University of Turin, Turin, Italy
| | - Donato Liloia
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
- Department of Psychology, GCS-fMRI, Koelliker Hospital, University of Turin, Turin, Italy
| | - Tommaso Costa
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy.
- Department of Psychology, GCS-fMRI, Koelliker Hospital, University of Turin, Turin, Italy.
| | - Franco Cauda
- FocusLab, Department of Psychology, University of Turin, Via Giuseppe Verdi 10, 10124, Turin, Italy
- Department of Psychology, GCS-fMRI, Koelliker Hospital, University of Turin, Turin, Italy
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10
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Lewis JD, Acosta H, Tuulari JJ, Fonov VS, Collins DL, Scheinin NM, Lehtola SJ, Rosberg A, Lidauer K, Ukharova E, Saunavaara J, Parkkola R, Lähdesmäki T, Karlsson L, Karlsson H. Allometry in the corpus callosum in neonates: Sexual dimorphism. Hum Brain Mapp 2022; 43:4609-4619. [PMID: 35722945 PMCID: PMC9491283 DOI: 10.1002/hbm.25977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022] Open
Abstract
The corpus callosum (CC) is the largest fiber tract in the human brain, allowing interhemispheric communication by connecting homologous areas of the two cerebral hemispheres. In adults, CC size shows a robust allometric relationship with brain size, with larger brains having larger callosa, but smaller brains having larger callosa relative to brain size. Such an allometric relationship has been shown in both males and females, with no significant difference between the sexes. But there is some evidence that there are alterations in these allometric relationships during development. However, it is currently not known whether there is sexual dimorphism in these allometric relationships from birth, or if it only develops later. We study this in neonate data. Our results indicate that there are already sex differences in these allometric relationships in neonates: male neonates show the adult‐like allometric relationship between CC size and brain size; however female neonates show a significantly more positive allometry between CC size and brain size than either male neonates or female adults. The underlying cause of this sexual dimorphism is unclear; but the existence of this sexual dimorphism in neonates suggests that sex‐differences in lateralization have prenatal origins.
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Affiliation(s)
- John D Lewis
- Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Henriette Acosta
- Department of Psychiatry and Psychotherapy, Philipps University of Marburg, Marburg, Germany.,FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Jetro J Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Turku Collegium for Science and Medicine and Technology, University of Turku, Turku, Finland.,Department of Future Technologies, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Vladimir S Fonov
- Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - D Louis Collins
- Montreal Neurological Institute and Hospital, McGill University, Quebec, Canada
| | - Noora M Scheinin
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Satu J Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Aylin Rosberg
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Kristian Lidauer
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland
| | - Elena Ukharova
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Jani Saunavaara
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Riitta Parkkola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Pediatric Neurology, University of Turku and Turku University Hospital, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Institute of Clinical Medicine, University of Turku, Turku, Finland.,Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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11
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Tsuzuki D, Taga G, Watanabe H, Homae F. Individual variability in the nonlinear development of the corpus callosum during infancy and toddlerhood: a longitudinal MRI analysis. Brain Struct Funct 2022; 227:1995-2013. [PMID: 35396953 DOI: 10.1007/s00429-022-02485-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/22/2022] [Indexed: 11/29/2022]
Abstract
The human brain spends several years bootstrapping itself through intrinsic and extrinsic modulation, thus gradually developing both spatial organization and functions. Based on previous studies on developmental patterns and inter-individual variability of the corpus callosum (CC), we hypothesized that inherent variations of CC shape among infants emerge, depending on the position within the CC, along the developmental timeline. Here we used longitudinal magnetic resonance imaging data from infancy to toddlerhood and investigated the area, thickness, and shape of the midsagittal plane of the CC by applying multilevel modeling. The shape characteristics were extracted using the Procrustes method. We found nonlinearity, region-dependency, and inter-individual variability, as well as intra-individual consistencies, in CC development. Overall, the growth rate is faster in the first year than in the second year, and the trajectory differs between infants; the direction of CC formation in individual infants was determined within six months and maintained to two years. The anterior and posterior subregions increase in area and thickness faster than other subregions. Moreover, we clarified that the growth rate of the middle part of the CC is faster in the second year than in the first year in some individuals. Since the division of regions exhibiting different tendencies coincides with previously reported divisions based on the diameter of axons that make up the region, our results suggest that subregion-dependent individual variability occurs due to the increase in the diameter of the axon caliber, myelination partly due to experience and axon elimination during the early developmental period.
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Affiliation(s)
- Daisuke Tsuzuki
- Department of Language Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, 192-0397, Japan. .,Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Gentaro Taga
- Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hama Watanabe
- Graduate School of Education, The University of Tokyo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Fumitaka Homae
- Department of Language Sciences, Tokyo Metropolitan University, Hachioji, Tokyo, 192-0397, Japan.,Research Center for Language, Brain and Genetics, Tokyo Metropolitan University, Hachioji, Tokyo, 192-0397, Japan
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12
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Zhang Y, Qin B, Wang L, Zhang K, Song C, Chen J, Cai J, Li T. Corpus Callosum Volumes in Children with Autism Spectrum Disorders: Sex-Associated Differences. J Autism Dev Disord 2022; 53:2421-2429. [PMID: 35352234 DOI: 10.1007/s10803-022-05538-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 11/27/2022]
Abstract
This study aimed to analyze the relationship between sex and corpus callosum (CC) volume in children with autism spectrum disorders (ASD) aged 2-4 years. This prospective study included 50 children with ASD and 50 typically developing (TD) children aged 2-4 years. Midsagittal slices of the CCs of the participants were divided into five subregions using FreeSurfer software. The PMCC, AMCC and TCC volumes were significantly higher in ASD participants than in TD participants, and results were significant in females with ASD rather than in males with ASD (all P < 0.05). In toddlers with ASD, the CC volumes were increased and more pronounced in females than in males. This could be due to overgrowth of axons or/and axonal pruning disorders.
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Affiliation(s)
- Yun Zhang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Chongqing Engineering Research Center for Clinical Big-Data and Drug Evaluation, Medical Data Science, Academy of Chongqing Medical University, Chongqing, 400014, China
| | - Bin Qin
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Chongqing Engineering Research Center for Clinical Big-Data and Drug Evaluation, Medical Data Science, Academy of Chongqing Medical University, Chongqing, 400014, China
| | - Longlun Wang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Ke Zhang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Cui Song
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Department of Endocrinology and Genetic Metabolic Disease, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Chen
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jinhua Cai
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
| | - Tingyu Li
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Department of Radiology, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
- Children Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing, China.
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13
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Copeland A, Silver E, Korja R, Lehtola SJ, Merisaari H, Saukko E, Sinisalo S, Saunavaara J, Lähdesmäki T, Parkkola R, Nolvi S, Karlsson L, Karlsson H, Tuulari JJ. Infant and Child MRI: A Review of Scanning Procedures. Front Neurosci 2021; 15:666020. [PMID: 34321992 PMCID: PMC8311184 DOI: 10.3389/fnins.2021.666020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a safe method to examine human brain. However, a typical MR scan is very sensitive to motion, and it requires the subject to lie still during the acquisition, which is a major challenge for pediatric scans. Consequently, in a clinical setting, sedation or general anesthesia is often used. In the research setting including healthy subjects anesthetics are not recommended for ethical reasons and potential longer-term harm. Here we review the methods used to prepare a child for an MRI scan, but also on the techniques and tools used during the scanning to enable a successful scan. Additionally, we critically evaluate how studies have reported the scanning procedure and success of scanning. We searched articles based on special subject headings from PubMed and identified 86 studies using brain MRI in healthy subjects between 0 and 6 years of age. Scan preparations expectedly depended on subject's age; infants and young children were scanned asleep after feeding and swaddling and older children were scanned awake. Comparing the efficiency of different procedures was difficult because of the heterogeneous reporting of the used methods and the success rates. Based on this review, we recommend more detailed reporting of scanning procedure to help find out which are the factors affecting the success of scanning. In the long term, this could help the research field to get high quality data, but also the clinical field to reduce the use of anesthetics. Finally, we introduce the protocol used in scanning 2 to 5-week-old infants in the FinnBrain Birth Cohort Study, and tips for calming neonates during the scans.
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Affiliation(s)
- Anni Copeland
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Eero Silver
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Satu J. Lehtola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Harri Merisaari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Ekaterina Saukko
- Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Susanne Sinisalo
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Tuire Lähdesmäki
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Pediatric Neurology, Turku University Hospital, University of Turku, Turku, Finland
| | - Riitta Parkkola
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, Turku Institute for Advanced Studies, University of Turku, Turku, Finland
| | - Linnea Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Hasse Karlsson
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
| | - Jetro J. Tuulari
- FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychiatry, Turku University Hospital, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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14
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Buyanova IS, Arsalidou M. Cerebral White Matter Myelination and Relations to Age, Gender, and Cognition: A Selective Review. Front Hum Neurosci 2021; 15:662031. [PMID: 34295229 PMCID: PMC8290169 DOI: 10.3389/fnhum.2021.662031] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022] Open
Abstract
White matter makes up about fifty percent of the human brain. Maturation of white matter accompanies biological development and undergoes the most dramatic changes during childhood and adolescence. Despite the advances in neuroimaging techniques, controversy concerning spatial, and temporal patterns of myelination, as well as the degree to which the microstructural characteristics of white matter can vary in a healthy brain as a function of age, gender and cognitive abilities still exists. In a selective review we describe methods of assessing myelination and evaluate effects of age and gender in nine major fiber tracts, highlighting their role in higher-order cognitive functions. Our findings suggests that myelination indices vary by age, fiber tract, and hemisphere. Effects of gender were also identified, although some attribute differences to methodological factors or social and learning opportunities. Findings point to further directions of research that will improve our understanding of the complex myelination-behavior relation across development that may have implications for educational and clinical practice.
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Affiliation(s)
- Irina S. Buyanova
- Neuropsy Lab, HSE University, Moscow, Russia
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Marie Arsalidou
- Neuropsy Lab, HSE University, Moscow, Russia
- Cognitive Centre, Sirius University of Science and Technology, Sochi, Russia
- Department of Psychology, York University, Toronto, ON, Canada
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15
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Campbell KSJ, Williams LJ, Bjornson BH, Weik E, Brain U, Grunau RE, Miller SP, Oberlander TF. Prenatal antidepressant exposure and sex differences in neonatal corpus callosum microstructure. Dev Psychobiol 2021; 63:e22125. [PMID: 33942888 DOI: 10.1002/dev.22125] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/09/2022]
Abstract
Prenatal exposure to selective serotonin reuptake inhibitor (SSRI) antidepressants may influence white matter (WM) development, as previous studies report widespread microstructural alterations and reduced interhemispheric connectivity in SSRI-exposed infants. In rodents, perinatal SSRIs had sex-specific disruptions in corpus callosum (CC) axon architecture and connectivity; yet it is unknown whether SSRI-related brain outcomes in humans are sex specific. In this study, the neonate CC was selected as a region-of-interest to investigate whether prenatal SSRI exposure has sex-specific effects on early WM microstructure. On postnatal day 7, diffusion tensor imaging was used to assess WM microstructure in SSRI-exposed (n = 24; 12 male) and nonexposed (n = 48; 28 male) term-born neonates. Fractional anisotropy was extracted from CC voxels and a multivariate discriminant analysis was used to identify latent patterns differing between neonates grouped by SSRI-exposure and sex. Analysis revealed localized variations in CC fractional anisotropy that significantly discriminated neonate groups and correctly predicted group membership with an 82% accuracy. Such effects were identified across three dimensions, representing sex differences in SSRI-exposed neonates (genu, splenium), SSRI-related effects independent of sex (genu-to-rostral body), and sex differences in nonexposed neonates (isthmus-splenium, posterior midbody). Our findings suggest that CC microstructure may have a sex-specific, localized, developmental sensitivity to prenatal SSRI exposure.
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Affiliation(s)
- Kayleigh S J Campbell
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada
| | | | - Bruce H Bjornson
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ella Weik
- BC Children's Hospital Research Institute, Vancouver, Canada
| | - Ursula Brain
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Ruth E Grunau
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Steven P Miller
- Department of Pediatrics, The Hospital for Sick Children and the University of Toronto, Toronto, Canada
| | - Tim F Oberlander
- BC Children's Hospital Research Institute, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada
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