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Keleher F, Lindsey HM, Kerestes R, Amiri H, Asarnow RF, Babikian T, Bartnik-Olson B, Bigler ED, Caeyenberghs K, Esopenko C, Ewing-Cobbs L, Giza CC, Goodrich-Hunsaker NJ, Hodges CB, Hoskinson KR, Irimia A, Königs M, Max JE, Newsome MR, Olsen A, Ryan NP, Schmidt AT, Stein DJ, Suskauer SJ, Ware AL, Wheeler AL, Zielinski BA, Thompson PM, Harding IH, Tate DF, Wilde EA, Dennis EL. Multimodal Analysis of Secondary Cerebellar Alterations After Pediatric Traumatic Brain Injury. JAMA Netw Open 2023; 6:e2343410. [PMID: 37966838 PMCID: PMC10652147 DOI: 10.1001/jamanetworkopen.2023.43410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Importance Traumatic brain injury (TBI) is known to cause widespread neural disruption in the cerebrum. However, less is known about the association of TBI with cerebellar structure and how such changes may alter executive functioning. Objective To investigate alterations in subregional cerebellum volume and cerebral white matter microstructure after pediatric TBI and examine subsequent changes in executive function. Design, Setting, and Participants This retrospective cohort study combined 12 data sets (collected between 2006 and 2020) from 9 sites in the Enhancing Neuroimaging Genetics Through Meta-Analysis Consortium Pediatric TBI working group in a mega-analysis of cerebellar structure. Participants with TBI or healthy controls (some with orthopedic injury) were recruited from trauma centers, clinics, and institutional trauma registries, some of which were followed longitudinally over a period of 0.7 to 1.9 years. Healthy controls were recruited from the surrounding community. Data analysis occurred from October to December 2022. Exposure Accidental mild complicated-severe TBI (msTBI) for those in the TBI group. Some controls received a diagnosis of orthopedic injury. Main Outcomes and Measures Volume of 18 cerebellar lobules and vermal regions were estimated from 3-dimensional T1-weighted magnetic resonance imaging (MRI) scans. White matter organization in 28 regions of interest was assessed with diffusion tensor MRI. Executive function was measured by parent-reported scores from the Behavior Rating Inventory of Executive Functioning. Results A total of 598 children and adolescents (mean [SD] age, 14.05 [3.06] years; range, 5.45-19.70 years; 386 male participants [64.5%]; 212 female participants [35.5%]) were included in the study, with 314 participants in the msTBI group, and 284 participants in the non-TBI group (133 healthy individuals and 151 orthopedically injured individuals). Significantly smaller total cerebellum volume (d = -0.37; 95% CI, -0.52 to -0.22; P < .001) and subregional cerebellum volumes (eg, corpus medullare; d = -0.43; 95% CI, -0.58 to -0.28; P < .001) were observed in the msTBI group. These alterations were primarily seen in participants in the chronic phase (ie, >6 months postinjury) of injury (total cerebellar volume, d = -0.55; 95% CI, -0.75 to -0.35; P < .001). Smaller cerebellum volumes were associated with higher scores on the Behavior Rating Inventory of Executive Functioning Global Executive Composite score (β = -208.9 mm3; 95% CI, -319.0 to -98.0 mm3; P = .008) and Metacognition Index score (β = -202.5 mm3; 95% CI, -319.0 to -85.0 mm3; P = .02). In a subset of 185 participants with longitudinal data, younger msTBI participants exhibited cerebellum volume reductions (β = 0.0052 mm3; 95% CI, 0.0013 to 0.0090 mm3; P = .01), and older participants slower growth rates. Poorer white matter organization in the first months postinjury was associated with decreases in cerebellum volume over time (β=0.52 mm3; 95% CI, 0.19 to 0.84 mm3; P = .005). Conclusions and Relevance In this cohort study of pediatric msTBI, our results demonstrated robust cerebellar volume alterations associated with pediatric TBI, localized to the posterior lobe. Furthermore, longitudinal cerebellum changes were associated with baseline diffusion tensor MRI metrics, suggesting secondary cerebellar atrophy. These results provide further understanding of secondary injury mechanisms and may point to new opportunities for intervention.
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Affiliation(s)
- Finian Keleher
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
| | - Hannah M. Lindsey
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Rebecca Kerestes
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Houshang Amiri
- Institute of Neuropharmacology, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Robert F. Asarnow
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Brain Research Institute, University of California, Los Angeles
- Department of Psychology, University of California, Los Angeles
| | - Talin Babikian
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Steve Tisch BrainSPORT Program, University of California, Los Angeles
| | - Brenda Bartnik-Olson
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, California
| | - Erin D. Bigler
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- Department of Psychology, Brigham Young University, Provo, Utah
- Neuroscience Center, Brigham Young University, Provo, Utah
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Carrie Esopenko
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Linda Ewing-Cobbs
- Children’s Learning Institute, Department of Pediatrics, University of Texas Health Science Center at Houston
| | - Christopher C. Giza
- Steve Tisch BrainSPORT Program, University of California, Los Angeles
- Division of Neurology, Department of Pediatrics, Mattel Children’s Hospital University of California, Los Angeles
- Department of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles
| | - Naomi J. Goodrich-Hunsaker
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Cooper B. Hodges
- Department of Psychology, Brigham Young University, Provo, Utah
- School of Social and Behavioral Sciences, Andrews University, Berrien Springs, Michigan
| | - Kristen R. Hoskinson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles
- Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles
| | - Marsh Königs
- Emma Neuroscience Group, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Jeffrey E. Max
- Department of Psychiatry, University of California, San Diego, La Jolla
- Department of Psychiatry, Rady Children’s Hospital, San Diego, California
| | - Mary R. Newsome
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NorHEAD-Norwegian Centre for Headache Research, Trondheim, Norway
| | - Nicholas P. Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Department of Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adam T. Schmidt
- Department of Psychological Sciences, Texas Tech University, Lubbock
| | - Dan J. Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Cape Town University, Cape Town, South Africa
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, Neuroscience Institute, Cape Town University, Cape Town, South Africa
| | - Stacy J. Suskauer
- Kennedy Krieger Institute, Baltimore, Maryland
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley L. Ware
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- Department of Psychology, Georgia State University, Atlanta
| | - Anne L. Wheeler
- Neuroscience and Mental Health Program, Hospital for Sick Children, Toronto, Ontario, Canada
- Physiology Department, University of Toronto, Toronto, Ontario, Canada
| | - Brandon A. Zielinski
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- Department of Pediatrics, University of Florida, Gainesville
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City
- Department of Neurology, University of Florida, Gainesville
| | - Paul M. Thompson
- Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey
- Department of Neurology, University of Southern California, Los Angeles
- Department of Pediatrics, University of Southern California, Los Angeles
- Department of Psychiatry, University of Southern California, Los Angeles
- Department of Radiology, University of Southern California, Los Angeles
- Department of Engineering, University of Southern California, Los Angeles
- Department of Ophthalmology, University of Southern California, Los Angeles
| | - Ian H. Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - David F. Tate
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Elisabeth A. Wilde
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Emily L. Dennis
- TBI and Concussion Center, Department of Neurology, University of Utah School of Medicine, Salt Lake City
- George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, Utah
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Noriega‐Navarro R, Martínez‐Tapia RJ, González‐Rivera R, Ochoa‐Sánchez A, Abarca‐Magaña JC, Landa‐Navarro L, Rodríguez‐Mata V, Ugalde‐Muñiz P, Pérez‐Torres A, Landa A, Navarro L. The effect of thioredoxin-1 in a rat model of traumatic brain injury depending on diurnal variation. Brain Behav 2023; 13:e3031. [PMID: 37157915 PMCID: PMC10275561 DOI: 10.1002/brb3.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/17/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023] Open
Abstract
INTRODUCTION Traumatic brain injury (TBI) is a public health concern with limited treatment options because it causes a cascade of side effects that are the leading cause of hospital death. Thioredoxin is an enzyme with neuroprotective properties such as antioxidant, antiapoptotic, immune response modulator, and neurogenic, among others; it has been considered a therapeutic target for treating many disorders. METHODS The controlled cortical impact (CCI) model was used to assess the effect of recombinant human thioredoxin 1 (rhTrx1) (1 μg/2 μL, intracortical) on rats subjected to TBI at two different times of the light-dark cycle (01:00 and 13:00 h). We analyzed the food intake, body weight loss, motor coordination, pain perception, and histology in specific hippocampus (CA1, CA2, CA3, and Dental Gyrus) and striatum (caudate-putamen) areas. RESULTS Body weight loss, reduced food intake, spontaneous pain, motor impairment, and neuronal damage in specific hippocampus and striatum regions are more evident in rats subjected to TBI in the light phase than in the dark phase of the cycle and in groups that did not receive rhTrx1 or minocycline (as positive control). Three days after TBI, there is a recovery in body weight, food intake, motor impairment, and pain, which is more pronounced in the rats subjected to TBI at the dark phase of the cycle and those that received rhTrx1 or minocycline. CONCLUSIONS Knowing the time of day a TBI occurs in connection to the neuroprotective mechanisms of the immune response in diurnal variation and the usage of the Trx1 protein might have a beneficial therapeutic impact in promoting quick recovery after a TBI.
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Affiliation(s)
- Roxana Noriega‐Navarro
- Departamento de Fisiología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | | | - Rubén González‐Rivera
- Departamento de Fisiología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Alicia Ochoa‐Sánchez
- Departamento de Microbiología y Parasitología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Julio César Abarca‐Magaña
- Departamento de Fisiología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Lucía Landa‐Navarro
- Simons Initiative for the Developing Brain, Centre for Discovery Brain SciencesUniversity of EdinburghEdinburghUK
| | - Verónica Rodríguez‐Mata
- Departamento de Biología Celular y Tisular, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Perla Ugalde‐Muñiz
- Departamento de Fisiología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Armando Pérez‐Torres
- Departamento de Biología Celular y Tisular, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Abraham Landa
- Departamento de Microbiología y Parasitología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
| | - Luz Navarro
- Departamento de Fisiología, Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMéxico
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Chiang HS, Motes M, Kraut M, Vanneste S, Hart J. High-definition transcranial direct current stimulation modulates theta response during a Go-NoGo task in traumatic brain injury. Clin Neurophysiol 2022; 143:36-47. [PMID: 36108520 PMCID: PMC10545365 DOI: 10.1016/j.clinph.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 08/08/2022] [Accepted: 08/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE High Definition transcranial Direct Current Stimulation (HD-tDCS) has been shown to improve cognitive performance in individuals with chronic traumatic brain injury (TBI), although electrophysiological mechanisms remain unclear. METHODS Veterans with TBI underwent active anodal (N = 15) vs sham (N = 10) HD-tDCS targeting the pre-supplementary motor area (pre-SMA). A Go-NoGo task was conducted simultaneously with electroencephalography (EEG) at baseline and after intervention completion. RESULTS We found increased theta event-related spectral perturbation (ERSP) and inter-trial phase coherence (ITPC) during Go in the frontal midline electrodes overlying the pre-SMA after active HD-tDCS intervention, but not after sham. We also found increased theta phase coherence during Go between the frontal midline and left posterior regions after active HD-tDCS. A late increase in alpha-theta ERSP was found in the left central region after active HD-tDCS. Notably, lower baseline theta ERSP/ITPC in the frontal midline region predicted more post-intervention improvement in Go performance only in the active group. CONCLUSIONS There are local and interregional oscillatory changes in response to HD-tDCS modulation in chronic TBI. SIGNIFICANCE These findings may guide future research in utilizing EEG time-frequency metrics not only to measure interventional effects, but also in selecting candidates who may optimally respond to treatment.
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Affiliation(s)
- Hsueh-Sheng Chiang
- Department of Neurology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
| | - Michael Motes
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
| | - Michael Kraut
- Department of Radiology, The Johns Hopkins University School of Medicine, 601 N Caroline St, Baltimore, MD 21205, USA.
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA; Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland.
| | - John Hart
- Department of Neurology, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W Campbell Rd, Richardson, TX 75080, USA.
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4
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Botchway E, Kooper CC, Pouwels PJW, Bruining H, Engelen M, Oosterlaan J, Königs M. Resting-state network organisation in children with traumatic brain injury. Cortex 2022; 154:89-104. [PMID: 35763900 DOI: 10.1016/j.cortex.2022.05.014] [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: 10/21/2021] [Revised: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/03/2022]
Abstract
Children with traumatic brain injury are at risk of neurocognitive and behavioural impairment. Although there is evidence for abnormal brain activity in resting-state networks after TBI, the role of resting-state network organisation in paediatric TBI outcome remains poorly understood. This study is the first to investigate the impact of paediatric TBI on resting-state network organisation using graph theory, and its relevance for functional outcome. Participants were 8-14 years and included children with (i) mild TBI and risk factors for complicated TBI (mildRF+, n = 20), (ii) moderate/severe TBI (n = 15), and (iii) trauma control injuries (n = 27). Children underwent resting-state functional magnetic resonance imaging (fMRI), neurocognitive testing, and behavioural assessment at 2.8 years post-injury. Graph theory was applied to fMRI timeseries to evaluate the impact of TBI on global and local organisation of the resting-state network, and relevance for neurocognitive and behavioural functioning. Children with TBI showed atypical global network organisation as compared to the trauma control group, reflected by lower modularity (mildRF + TBI and moderate/severe TBI), higher smallworldness (mildRF + TBI) and lower assortativity (moderate/severe TBI ps < .04, Cohen's ds: > .6). Regarding local network organisation, the relative importance of hub regions in the network did not differ between groups. Regression analyses showed relationships between global as well as local network parameters with neurocognitive functioning (i.e., working memory, memory encoding; R2 = 23.3 - 38.5%) and behavioural functioning (i.e., externalising problems, R2 = 36.1%). Findings indicate the impact of TBI on global functional network organisation, and the relevance of both global and local network organisation for long-term neurocognitive and behavioural outcome after paediatric TBI. The results suggest potential prognostic value of resting-state network organisation for outcome after paediatric TBI.
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Affiliation(s)
- Edith Botchway
- School of Psychology, Faculty of Health at the Deakin University, Burwood, Australia
| | - Cece C Kooper
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Emma Neuroscience Group, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands.
| | - Petra J W Pouwels
- Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Boelelaan 1117, Amsterdam, the Netherlands
| | - Hilgo Bruining
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands; Emma Children's Hospital, Amsterdam UMC location Vrije Universiteit Amsterdam, N=You Centre, Amsterdam, the Netherlands
| | - Marc Engelen
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatric Neurology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Leukodystrophy Center, Amsterdam, the Netherlands
| | - Jaap Oosterlaan
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Meibergdreef 9, Amsterdam, the Netherlands
| | - Marsh Königs
- Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands; Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Meibergdreef 9, Amsterdam, the Netherlands
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Wilde EA, Wanner I, Kenney K, Gill J, Stone JR, Disner S, Schnakers C, Meyer R, Prager EM, Haas M, Jeromin A. A Framework to Advance Biomarker Development in the Diagnosis, Outcome Prediction, and Treatment of Traumatic Brain Injury. J Neurotrauma 2022; 39:436-457. [PMID: 35057637 PMCID: PMC8978568 DOI: 10.1089/neu.2021.0099] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elisabeth A. Wilde
- University of Utah, Neurology, 383 Colorow, Salt Lake City, Utah, United States, 84108
- VA Salt Lake City Health Care System, 20122, 500 Foothill Dr., Salt Lake City, Utah, United States, 84148-0002
| | - Ina Wanner
- UCLA, Semel Institute, NRB 260J, 635 Charles E. Young Drive South, Los Angeles, United States, 90095-7332, ,
| | - Kimbra Kenney
- Uniformed Services University of the Health Sciences, Neurology, Center for Neuroscience and Regenerative Medicine, 4301 Jones Bridge Road, Bethesda, Maryland, United States, 20814
| | - Jessica Gill
- National Institutes of Health, National Institute of Nursing Research, 1 cloister, Bethesda, Maryland, United States, 20892
| | - James R. Stone
- University of Virginia, Radiology and Medical Imaging, Box 801339, 480 Ray C. Hunt Dr. Rm. 185, Charlottesville, Virginia, United States, 22903, ,
| | - Seth Disner
- Minneapolis VA Health Care System, 20040, Minneapolis, Minnesota, United States
- University of Minnesota Medical School Twin Cities, 12269, 10Department of Psychiatry and Behavioral Sciences, Minneapolis, Minnesota, United States
| | - Caroline Schnakers
- Casa Colina Hospital and Centers for Healthcare, 6643, Pomona, California, United States
- Ronald Reagan UCLA Medical Center, 21767, Los Angeles, California, United States
| | - Restina Meyer
- Cohen Veterans Bioscience, 476204, New York, New York, United States
| | - Eric M Prager
- Cohen Veterans Bioscience, 476204, External Affairs, 535 8th Ave, New York, New York, United States, 10018
| | - Magali Haas
- Cohen Veterans Bioscience, 476204, 535 8th Avenue, 12th Floor, New York City, New York, United States, 10018,
| | - Andreas Jeromin
- Cohen Veterans Bioscience, 476204, Translational Sciences, Cambridge, Massachusetts, United States
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Motanis H, Khorasani LN, Giza CC, Harris NG. Peering into the Brain through the Retrosplenial Cortex to Assess Cognitive Function of the Injured Brain. Neurotrauma Rep 2021; 2:564-580. [PMID: 34901949 PMCID: PMC8655812 DOI: 10.1089/neur.2021.0044] [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] [Indexed: 11/12/2022] Open
Abstract
The retrosplenial cortex (RSC) is a posterior cortical area that has been drawing increasing interest in recent years, with a growing number of studies studying its contribution to cognitive and sensory functions. From an anatomical perspective, it has been established that the RSC is extensively and often reciprocally connected with the hippocampus, neocortex, and many midbrain regions. Functionally, the RSC is an important hub of the default-mode network. This endowment, with vast anatomical and functional connections, positions the RSC to play an important role in episodic memory, spatial and contextual learning, sensory-cognitive activities, and multi-modal sensory information processing and integration. Additionally, RSC dysfunction has been reported in cases of cognitive decline, particularly in Alzheimer's disease and stroke. We review the literature to examine whether the RSC can act as a cortical marker of persistent cognitive dysfunction after traumatic brain injury (TBI). Because the RSC is easily accessible at the brain's surface using in vivo techniques, we argue that studying RSC network activity post-TBI can shed light into the mechanisms of less-accessible brain regions, such as the hippocampus. There is a fundamental gap in the TBI field about the microscale alterations occurring post-trauma, and by studying the RSC's neuronal activity at the cellular level we will be able to design better therapeutic tools. Understanding how neuronal activity and interactions produce normal and abnormal activity in the injured brain is crucial to understanding cognitive dysfunction. By using this approach, we expect to gain valuable insights to better understand brain disorders like TBI.
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Affiliation(s)
- Helen Motanis
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Laila N. Khorasani
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Christopher C. Giza
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
| | - Neil G. Harris
- UCLA Brain Injury Research Center, Department of Neurosurgery, Geffen Medical School, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- Intellectual Development and Disabilities Research Center, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California, USA
- *Address correspondence to: Neil G. Harris, PhD, Department of Neurosurgery, University of California at Los Angeles, Wasserman Building, 300 Stein Plaza, Room 551, Los Angeles, CA 90095, USA;
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7
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Cao M, Halperin JM, Li X. Abnormal Functional Network Topology and Its Dynamics during Sustained Attention Processing Significantly Implicate Post-TBI Attention Deficits in Children. Brain Sci 2021; 11:brainsci11101348. [PMID: 34679412 PMCID: PMC8533973 DOI: 10.3390/brainsci11101348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
Traumatic brain injury (TBI) is highly prevalent in children. Attention deficits are among the most common and persistent post-TBI cognitive and behavioral sequalae that can contribute to adverse outcomes. This study investigated the topological properties of the functional brain network for sustained attention processing and their dynamics in 42 children with severe post-TBI attention deficits (TBI-A) and 47 matched healthy controls. Functional MRI data during a block-designed sustained attention task was collected for each subject, with each full task block further divided into the pre-, early, late-, and post-stimulation stages. The task-related functional brain network was constructed using the graph theoretic technique. Then, the sliding-window-based method was utilized to assess the dynamics of the topological properties in each stimulation stage. Relative to the controls, the TBI-A group had significantly reduced nodal efficiency and/or degree of left postcentral, inferior parietal, inferior temporal, and fusiform gyri and their decreased stability during the early and late-stimulation stages. The left postcentral inferior parietal network anomalies were found to be significantly associated with elevated inattentive symptoms in children with TBI-A. These results suggest that abnormal functional network characteristics and their dynamics associated with the left parietal lobe may significantly link to the onset of the severe post-TBI attention deficits in children.
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Affiliation(s)
- Meng Cao
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
| | - Jeffery M. Halperin
- Department of Psychology, Queens College, City University of New York, New York, NY 11367, USA;
| | - Xiaobo Li
- Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ 07102, USA;
- Correspondence: ; Tel.: +1-973-596-5880
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Song J, Li J, Chen L, Lu X, Zheng S, Yang Y, Cao B, Weng Y, Chen Q, Ding J, Huang R. Altered gray matter structural covariance networks at both acute and chronic stages of mild traumatic brain injury. Brain Imaging Behav 2021; 15:1840-1854. [PMID: 32880075 DOI: 10.1007/s11682-020-00378-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cognitive and emotional impairments observed in mild traumatic brain injury (mTBI) patients may reflect variances of brain connectivity within specific networks. Although previous studies found altered functional connectivity (FC) in mTBI patients, the alterations of brain structural properties remain unclear. In the present study, we analyzed structural covariance (SC) for the acute stages of mTBI (amTBI) patients, the chronic stages of mTBI (cmTBI) patients, and healthy controls. We first extracted the mean gray matter volume (GMV) of seed regions that are located in the default-mode network (DMN), executive control network (ECN), salience network (SN), sensorimotor network (SMN), and the visual network (VN). Then we determined and compared the SC for each seed region among the amTBI, the cmTBI and the healthy controls. Compared with healthy controls, the amTBI patients showed lower SC for the ECN, and the cmTBI patients showed higher SC for the both DMN and SN but lower SC for the SMN. The results revealed disrupted ECN in the amTBI patients and disrupted DMN, SN and SMN in the cmTBI patients. These alterations suggest that early disruptions in SC between bilateral insula and the bilateral prefrontal cortices may appear in amTBI and persist into cmTBI, which might be potentially related to the cognitive and emotional impairments.
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Affiliation(s)
- Jie Song
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,School of Psychology, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Jie Li
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Lixiang Chen
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,School of Psychology, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Xingqi Lu
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Senning Zheng
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,School of Psychology, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Ying Yang
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China
| | - Bolin Cao
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,School of Psychology, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Yihe Weng
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,School of Psychology, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China
| | - Qinyuan Chen
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China.,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.,Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, 510631, China
| | - Jianping Ding
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, China. .,School of Medicine, Hangzhou Normal University, Hangzhou, 310015, China.
| | - Ruiwang Huang
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, 510631, China. .,School of Psychology, South China Normal University, Guangzhou, 510631, China. .,Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, 510631, China.
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9
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Tuerk C, Dégeilh F, Catroppa C, Dooley JJ, Kean M, Anderson V, Beauchamp MH. Altered resting-state functional connectivity within the developing social brain after pediatric traumatic brain injury. Hum Brain Mapp 2019; 41:561-576. [PMID: 31617298 PMCID: PMC7267957 DOI: 10.1002/hbm.24822] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/03/2019] [Indexed: 01/31/2023] Open
Abstract
Traumatic brain injury (TBI) in childhood and adolescence can interrupt expected development, compromise the integrity of the social brain network (SBN) and impact social skills. Yet, no study has investigated functional alterations of the SBN following pediatric TBI. This study explored functional connectivity within the SBN following TBI in two independent adolescent samples. First, 14 adolescents with mild complex, moderate or severe TBI and 16 typically developing controls (TDC) underwent resting‐state functional magnetic resonance imaging 12–24 months post‐injury. Region of interest analyses were conducted to compare the groups' functional connectivity using selected SBN seeds. Then, replicative analysis was performed in an independent sample of adolescents with similar characteristics (9 TBI, 9 TDC). Results were adjusted for age, sex, socioeconomic status and total gray matter volume, and corrected for multiple comparisons. Significant between‐group differences were detected for functional connectivity in the dorsomedial prefrontal cortex and left fusiform gyrus, and between the left fusiform gyrus and left superior frontal gyrus, indicating positive functional connectivity for the TBI group (negative for TDC). The replication study revealed group differences in the same direction between the left superior frontal gyrus and right fusiform gyrus. This study indicates that pediatric TBI may alter functional connectivity of the social brain. Frontal‐fusiform connectivity has previously been shown to support affect recognition and changes in the function of this network could relate to more effortful processing and broad social impairments.
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Affiliation(s)
- Carola Tuerk
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Fanny Dégeilh
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Cathy Catroppa
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Science and Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Julian J Dooley
- Cuyahoga County Juvenile Court, Diagnostic Clinic, Cleveland, Ohio
| | - Michael Kean
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Science and Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Miriam H Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
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10
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Sta Maria NS, Sargolzaei S, Prins ML, Dennis EL, Asarnow RF, Hovda DA, Harris NG, Giza CC. Bridging the gap: Mechanisms of plasticity and repair after pediatric TBI. Exp Neurol 2019; 318:78-91. [PMID: 31055004 DOI: 10.1016/j.expneurol.2019.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 03/09/2019] [Accepted: 04/25/2019] [Indexed: 01/25/2023]
Abstract
Traumatic brain injury is the leading cause of death and disability in the United States, and may be associated with long lasting impairments into adulthood. The multitude of ongoing neurobiological processes that occur during brain maturation confer both considerable vulnerability to TBI but may also provide adaptability and potential for recovery. This review will examine and synthesize our current understanding of developmental neurobiology in the context of pediatric TBI. Delineating this biology will facilitate more targeted initial care, mechanism-based therapeutic interventions and better long-term prognostication and follow-up.
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Affiliation(s)
- Naomi S Sta Maria
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, University of Southern California, 1501 San Pablo Street, ZNI115, Los Angeles, CA 90033, United States of America.
| | - Saman Sargolzaei
- UCLA Brain Injury Research Center, Department of Neurosurgery, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562, 5th Floor, Los Angeles, CA 90095-6901, United States of America.
| | - Mayumi L Prins
- UCLA Brain Injury Research Center, Department of Neurosurgery, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562, 5th Floor, Los Angeles, CA 90095-6901, United States of America; Steve Tisch BrainSPORT Program, University of California at Los Angeles, Los Angeles, CA, United States of America.
| | - Emily L Dennis
- Brigham and Women's Hospital/Harvard University and Department of Psychology, Stanford University, 1249 Boylston Street, Boston, MA 02215, United States of America.
| | - Robert F Asarnow
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Box 951759, 760 Westwood Plaza, 48-240C Semel Institute, Los Angeles, CA 90095-1759, United States of America.
| | - David A Hovda
- UCLA Brain Injury Research Center, Department of Neurosurgery, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562, 5th Floor, Los Angeles, CA 90095-6901, United States of America; Department of Medical and Molecular Pharmacology, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562 & Semel 18-228A, Los Angeles, CA 90095-6901, United States of America.
| | - Neil G Harris
- UCLA Brain Injury Research Center, Department of Neurosurgery, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562, 5th Floor, Los Angeles, CA 90095-6901, United States of America; Intellectual Development and Disabilities Research Center, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, United States of America.
| | - Christopher C Giza
- UCLA Brain Injury Research Center, Department of Neurosurgery, University of California at Los Angeles, Box 956901, 300 Stein Plaza, Ste 562, 5th Floor, Los Angeles, CA 90095-6901, United States of America; Steve Tisch BrainSPORT Program, University of California at Los Angeles, Los Angeles, CA, United States of America; Division of Pediatric Neurology, Mattel Children's Hospital - UCLA, Los Angeles, CA, United States of America.
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11
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Parent M, Li Y, Santhakumar V, Hyder F, Sanganahalli BG, Kannurpatti SS. Alterations of Parenchymal Microstructure, Neuronal Connectivity, and Cerebrovascular Resistance at Adolescence after Mild-to-Moderate Traumatic Brain Injury in Early Development. J Neurotrauma 2019; 36:601-608. [PMID: 29855211 PMCID: PMC6354598 DOI: 10.1089/neu.2018.5741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of morbidity in children. To investigate outcome of early developmental TBI during adolescence, a rat model of fluid percussion injury was developed, where previous work reported deficits in sensorimotor behavior and cortical blood flow at adolescence.1 Based on the nonlocalized outcome, we hypothesized that multiple neurophysiological components of brain function, namely neuronal connectivity, synapse/axonal microstructural integrity, and neurovascular function, are altered and magnetic resonance imaging (MRI) methods could be used to determine regional alterations. Adolescent outcomes of developmental TBI were studied 2 months after injury, using functional MRI (fMRI) and diffusion tensor imaging (DTI). fMRI-based resting-state functional connectivity (RSFC), representing neural connectivity, was significantly altered between sham and TBI. RSFC strength decreased in the cortex, hippocampus, and thalamus, accompanied by decrease in spatial extent of their corresponding RSFC networks and interhemispheric asymmetry. Cerebrovascular reactivity to arterial CO2 changes diminished after TBI across both hemispheres, with a more pronounced decrease in the ipsilateral hippocampus, thalamus, and motor cortex. DTI measures of fractional anisotropy and apparent diffusion coefficient, reporting on axonal and microstructural integrity of the brain, indicated similar interhemispheric asymmetry, with highest change in the ipsilateral hippocampus and regions adjoining the ipsilateral thalamus, hypothalamus, and amygdala. TBI-induced corpus callosal microstructural alterations indicated measurable changes in interhemispheric structural connectivity. Hippocampus, thalamus, and select cortical regions were most consistently affected in multiple imaging markers. The multi-modal MRI results demonstrate cortical and subcortical alterations in neural connectivity, cerebrovascular resistance, and parenchymal microstructure in the adolescent brain, indicating the highly diffuse and persistent nature of the lateral fluid percussion TBI early in development.
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Affiliation(s)
- Maxime Parent
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Ying Li
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
| | - Vijayalakshmi Santhakumar
- Department of Pharmacology, Physiology and Neuroscience, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
- Department of Molecular, Cell and Systems Neuroscience, University of California at Riverside, Riverside, California
| | - Fahmeed Hyder
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
- Department of Biomedical Engineering, Yale University, New Haven, Connecticut
| | - Basavaraju G. Sanganahalli
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Sridhar S. Kannurpatti
- Department of Radiology, Rutgers Biomedical and Health Sciences–New Jersey Medical School, Newark, New Jersey
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12
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Dennis EL, Babikian T, Giza CC, Thompson PM, Asarnow RF. Neuroimaging of the Injured Pediatric Brain: Methods and New Lessons. Neuroscientist 2018; 24:652-670. [PMID: 29488436 DOI: 10.1177/1073858418759489] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Traumatic brain injury (TBI) is a significant public health problem in the United States, especially for children and adolescents. Current epidemiological data estimate over 600,000 patients younger than 20 years are treated for TBI in emergency rooms annually. While many patients experience a full recovery, for others there can be long-lasting cognitive, neurological, psychological, and behavioral disruptions. TBI in youth can disrupt ongoing brain development and create added family stress during a formative period. The neuroimaging methods used to assess brain injury improve each year, providing researchers a more detailed characterization of the injury and recovery process. In this review, we cover current imaging methods used to quantify brain disruption post-injury, including structural magnetic resonance imaging (MRI), diffusion MRI, functional MRI, resting state fMRI, and magnetic resonance spectroscopy (MRS), with brief coverage of other methods, including electroencephalography (EEG), single-photon emission computed tomography (SPECT), and positron emission tomography (PET). We include studies focusing on pediatric moderate-severe TBI from 2 months post-injury and beyond. While the morbidity of pediatric TBI is considerable, continuing advances in imaging methods have the potential to identify new treatment targets that can lead to significant improvements in outcome.
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Affiliation(s)
- Emily L Dennis
- 1 Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University Southern California, Marina del Rey, CA, USA
| | - Talin Babikian
- 2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.,3 UCLA Brain Injury Research Center, Department of Neurosurgery and Division of Pediatric Neurology, Mattel Children's Hospital, Los Angeles, CA, USA.,4 UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA
| | - Christopher C Giza
- 3 UCLA Brain Injury Research Center, Department of Neurosurgery and Division of Pediatric Neurology, Mattel Children's Hospital, Los Angeles, CA, USA.,4 UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA.,5 Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Paul M Thompson
- 1 Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of University Southern California, Marina del Rey, CA, USA.,6 Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Robert F Asarnow
- 2 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.,4 UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA.,5 Brain Research Institute, University of California, Los Angeles, CA, USA.,7 Department of Psychology, University of California, Los Angeles, CA, USA
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