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Chen G, Wang W, Wu H, Zhao X, Kang X, Ren J, Zhang J, Sun Y, He J, Sun S, Zhong Z, Shang D, Fan M, Cheng J, Zhang D, Su C, Lin J. Disrupted topological properties of structural brain networks present a glutamatergic neuropathophysiology in people with narcolepsy. Sleep 2024; 47:zsae002. [PMID: 38173348 DOI: 10.1093/sleep/zsae002] [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: 07/26/2023] [Revised: 11/18/2023] [Indexed: 01/05/2024] Open
Abstract
STUDY OBJECTIVES Growing evidences have documented various abnormalities of the white matter bundles in people with narcolepsy. We sought to evaluate topological properties of brain structural networks, and their association with symptoms and neuropathophysiological features in people with narcolepsy. METHODS Diffusion tensor imaging was conducted for people with narcolepsy (n = 30) and matched healthy controls as well as symptoms assessment. Structural connectivity for each participant was generated to analyze global and regional topological properties and their correlations with narcoleptic features. Further human brain transcriptome was extracted and spatially registered for connectivity vulnerability. Genetic functional enrichment analysis was performed and further clarified using in vivo emission computed tomography data. RESULTS A wide and dramatic decrease in structural connectivities was observed in people with narcolepsy, with descending network degree and global efficiency. These metrics were not only correlated with sleep latency and awakening features, but also reflected alterations of sleep macrostructure in people with narcolepsy. Network-based statistics identified a small hyperenhanced subnetwork of cingulate gyrus that was closely related to rapid eye movement sleep behavior disorder (RBD) in narcolepsy. Further imaging genetics analysis suggested glutamatergic signatures were responsible for the preferential vulnerability of connectivity alterations in people with narcolepsy, while additional PET/SPECT data verified that structural alteration was significantly correlated with metabotropic glutamate receptor 5 (mGlutR5) and N-methyl-D-aspartate receptor (NMDA). CONCLUSIONS People with narcolepsy endured a remarkable decrease in the structural architecture, which was not only closely related to narcolepsy symptoms but also glutamatergic signatures.
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Affiliation(s)
- Guoyan Chen
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Wen Wang
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Haoyang Wu
- Basic Medicine School, Air Force Medical University, Xi'an, China
| | - Xianchao Zhao
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Xiaopeng Kang
- School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Jiafeng Ren
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jun Zhang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yingzhi Sun
- Department of Radiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiaxiu He
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shihui Sun
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Zhao Zhong
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Danqing Shang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Mengmeng Fan
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jinxiang Cheng
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Dan Zhang
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Changjun Su
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Jiaji Lin
- Department of Neurology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
- Department of Radiology, Chinese PLA General Hospital/Medical School of Chinese PLA, Beijing, China
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Shi X, Shen G, Zhao Z, Yu J, Chen M, Cai H, Gao J, Zhao L, Yao Z, Hu B. Decreased structural pathways mediating functional connectivity in obstructive sleep apnea. Sleep Med 2024; 116:96-104. [PMID: 38437782 DOI: 10.1016/j.sleep.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a common sleep breathing disorder that is often accompanied by changes in structural connectivity (SC) and functional connectivity (FC). However, the current understanding of the interaction between SC and FC in OSA is still limited. METHODS The aim of this study is to integrate complementary neuroimaging modalities into a unified framework using multi-layer network analysis methods and to reveal their complex interrelationships. We introduce a new graph metric called SC-FC bandwidth, which measures the throughput of SC mediating FC in a multi-layer network. The bandwidth differences between two groups are evaluated using the network-based statistics (NBS) method. Additionally, we traced and analyzed the SC pathways corresponding to the abnormal bandwidth. RESULTS In both the healthy control and patients with OSA, the majority offunctionally synchronized nodes were connected via SC paths of length 2. With the NBS method, we observed significantly lower bandwidth between the right Posterior cingulate gyrus and right Cuneus, bilateral Middle frontal gyrus, bilateral Gyrus rectus in OSA patients. By tracing the high-proportion SC pathways, it was found that OSA patients typically exhibit a decrease in direct SC-FC, SC-FC triangles, and SC-FC quads intra- and inter-networks. CONCLUSION Complex interrelationship changes have been observed between the SC and FC in patients with OSA, which might leads to abnormal information transmission and communication in the brain network.
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Affiliation(s)
- Xuerong Shi
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China
| | - Guo Shen
- School of Clinical Medicine, Ningxia Medical University, Yinchuan, 750000, China
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China
| | - Jiandong Yu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China
| | - Miao Chen
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China
| | - Hongmin Cai
- School of Computer Science and Engineering, South China University of Technology, Guangzhou, 510000, China
| | - Jing Gao
- Department of Function, The Second Hospital of Yinchuan, Yinchuan, 750000, China
| | - Lianping Zhao
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, 730000, China.
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China.
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, 730000, China; School of Medical Technology, Beijing Institute of Technology, Beijing, 100081, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, 200031, China; Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Chinese Academy of Sciences, Lanzhou, 730000, China.
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Wenhong C, Xiaoying M, Lingli S, Binyun T, Yining W, Mingming Z, Yian L, Lixia Q, Wenyu H, Fengjin P. Assessing resting-state brain functional connectivity in adolescents and young adults with narcolepsy using functional near-infrared spectroscopy. Front Hum Neurosci 2024; 18:1373043. [PMID: 38606200 PMCID: PMC11007108 DOI: 10.3389/fnhum.2024.1373043] [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: 01/19/2024] [Accepted: 03/13/2024] [Indexed: 04/13/2024] Open
Abstract
This study aimed to elucidate the alterations in the prefrontal cortex's functional connectivity and network topology in narcolepsy patients using functional near-infrared spectroscopy (fNIRS). Twelve narcolepsy-diagnosed patients from Guangxi Zhuang Autonomous Region's People's Hospital Sleep Medicine Department and 11 matched healthy controls underwent resting fNIRS scans. Functional connectivity and graph theory analyses were employed to assess the prefrontal cortex network's properties and their correlation with clinical features. Results indicated increased functional connectivity in these adolescent and young adult patients with narcolepsy, with significant variations in metrics like average degree centrality and node efficiency, particularly in the left middle frontal gyrus. These alterations showed correlations with clinical symptoms, including depression and sleep efficiency. However, the significance of these findings was reduced post False Discovery Rate adjustment, suggesting a larger sample size is needed for validation. In conclusion, the study offers initial observations that alterations in the prefrontal cortex's functional connectivity may potentially act as a neurobiological indicator of narcolepsy, warranting further investigation with a larger cohort to substantiate these findings and understand the underlying mechanisms.
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Affiliation(s)
- Chen Wenhong
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Mo Xiaoying
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Shi Lingli
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Tang Binyun
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Wen Yining
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Zhao Mingming
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Lu Yian
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Qin Lixia
- Guangxi Clinical Reserch Center for Sleep Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Hu Wenyu
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Pan Fengjin
- Department of Sleep Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
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Oshri A, Howard CJ, Zhang L, Reck A, Cui Z, Liu S, Duprey E, Evans AI, Azarmehr R, Geier CF. Strengthening through adversity: The hormesis model in developmental psychopathology. Dev Psychopathol 2024:1-17. [PMID: 38532735 DOI: 10.1017/s0954579424000427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Employing a developmental psychopathology framework, we tested the utility of the hormesis model in examining the strengthening of children and youth through limited levels of adversity in relation to internalizing and externalizing outcomes within a brain-by-development context. METHODS Analyzing data from the Adolescent Brain and Cognitive Development study (N = 11,878), we formed latent factors of threat, deprivation, and unpredictability. We examined linear and nonlinear associations between adversity dimensions and youth psychopathology symptoms and how change of resting-state functional connectivity (rsFC) in the default mode network (DMN) from Time 1 to Time 5 moderates these associations. RESULTS A cubic association was found between threat and youth internalizing problems; low-to-moderate family conflict levels reduced these problems. Deprivation also displayed a cubic relation with youth externalizing problems, with moderate deprivation levels associated with fewer problems. Unpredictability linearly increased both problem types. Change in DMN rsFC significantly moderated the cubic link between threat levels and internalizing problems, with declining DMN rsFC levels from Time 1 to Time 5 facilitating hormesis. Hormetic effects peaked earlier, emphasizing the importance of sensitive periods and developmental timing of outcomes related to earlier experiences. CONCLUSIONS Strengthening through limited environmental adversity is crucial for developing human resilience. Understanding this process requires considering both linear and nonlinear adversity-psychopathology associations. Testing individual differences by brain and developmental context will inform preventive intervention programming.
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Affiliation(s)
- Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Cullin J Howard
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Ava Reck
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Zehua Cui
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Sihong Liu
- Graduate School of Education, Stanford University, Palo Alto, CA, USA
| | - Erinn Duprey
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Avary I Evans
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Rabeeh Azarmehr
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Charles F Geier
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Lin S, Wu P, Duan S, Du Q, Guo S, Chen Z, Wu N, Chen X, Xie T, Han Y, Zhao H. Altered functional brain networks in coronary heart disease: independent component analysis and graph theoretical analysis. Brain Struct Funct 2024; 229:133-142. [PMID: 37943310 DOI: 10.1007/s00429-023-02724-w] [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: 06/28/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
Coronary heart disease (CHD) confers a high risk of cognitive and mental impairments in patients. This study aimed to explore the association of CHD with functional connectivity and topological properties of brain networks. A total of 27 patients with CHD and 44 healthy controls (HCs) participated in this study and underwent a resting-state functional magnetic resonance imaging (rs-fMRI) scan. Intra- and internetwork functional connectivity alterations were explored using independent component analysis in CHD patients. Furthermore, graph theoretical analysis was adopted to assess abnormalities in small-world properties and network efficiency metrics of brain networks. Compared to HCs, CHD patients exhibited increased functional connectivity between the posterior default mode network and posterior visual network, as well as decreased functional connectivity between the left frontoparietal network and auditory network. In terms of graph theoretical analysis, small-world network topology was identified in both CHD patients and HCs. Furthermore, the nodal local efficiency of the left putamen was significantly decreased in CHD patients compared to HCs. This study revealed alterations in brain functional connectivity and topological properties in CHD patients, shedding light on the potential neurological mechanism underlying cognitive and mental impairments in these patients and suggesting unexplored connections between CHD and higher order cognitive processing.
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Affiliation(s)
- Simin Lin
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Puyeh Wu
- GE Healthcare, Beijing, 102600, China
| | - Shaoyin Duan
- Department of Radiology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361001, Fujian, China
| | - Qianni Du
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Shujia Guo
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China
| | - Zhishang Chen
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Naiming Wu
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Xiaoyan Chen
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Ting Xie
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China
| | - Yi Han
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China.
- Department of Ophthalmology, The First Affiliated Hospital, Postdoctoral Mobile Station of Basic Medical Sciences, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
| | - Hengyu Zhao
- Department of Radiology, Xiamen Cardiovascular Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361006, Fujian, China.
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Nada A. Functional Brain Connectivity and Neuropsychological Profiles in Narcolepsy Type 1. Acad Radiol 2024; 31:82-83. [PMID: 37973517 DOI: 10.1016/j.acra.2023.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Ayman Nada
- University of Missouri - Columbia, Department of Radiology, Columbia, Missouri 65212, USA.
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Tan Z, Zeng Q, Hu X, Di D, Chen L, Lin Z, Cheng G. Altered dynamic functional network connectivity in drug-naïve Parkinson's disease patients with excessive daytime sleepiness. Front Aging Neurosci 2023; 15:1282962. [PMID: 38125809 PMCID: PMC10731041 DOI: 10.3389/fnagi.2023.1282962] [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: 08/25/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background Excessive daytime sleepiness (EDS) is a frequent nonmotor symptoms of Parkinson's disease (PD), which seriously affects the quality of life of PD patients and exacerbates other nonmotor symptoms. Previous studies have used static analyses of these resting-state functional magnetic resonance imaging (rs-fMRI) data were measured under the assumption that the intrinsic fluctuations during MRI scans are stationary. However, dynamic functional network connectivity (dFNC) analysis captures time-varying connectivity over short time scales and may reveal complex functional tissues in the brain. Purpose To identify dynamic functional connectivity characteristics in PD-EDS patients in order to explain the underlying neuropathological mechanisms. Methods Based on rs-fMRI data from 16 PD patients with EDS and 41 PD patients without EDS, we applied the sliding window approach, k-means clustering and independent component analysis to estimate the inherent dynamic connectivity states associated with EDS in PD patients and investigated the differences between groups. Furthermore, to assess the correlations between the altered temporal properties and the Epworth sleepiness scale (ESS) scores. Results We found four distinct functional connectivity states in PD patients. The patients in the PD-EDS group showed increased fractional time and mean dwell time in state IV, which was characterized by strong connectivity in the sensorimotor (SMN) and visual (VIS) networks, and reduced fractional time in state I, which was characterized by strong positive connectivity intranetwork of the default mode network (DMN) and VIS, while negative connectivity internetwork between the DMN and VIS. Moreover, the ESS scores were positively correlated with fraction time in state IV. Conclusion Our results indicated that the strong connectivity within and between the SMN and VIS was characteristic of EDS in PD patients, which may be a potential marker of pathophysiological features related to EDS in PD patients.
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Affiliation(s)
- Zhiyi Tan
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Qiaoling Zeng
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Xuehan Hu
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Duoduo Di
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lele Chen
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Zhijian Lin
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Guanxun Cheng
- Department of Medical Imaging, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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Zhang L, Cui Z, Huffman LG, Oshri A. Sleep mediates the effect of stressful environments on youth development of impulsivity: The moderating role of within default mode network resting-state functional connectivity. Sleep Health 2023; 9:503-511. [PMID: 37270396 PMCID: PMC10524131 DOI: 10.1016/j.sleh.2023.03.005] [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: 09/19/2022] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Youth raised in stressful environments are at increased risk for developing impulsive traits, which are a robust precursor of problem behaviors. Sleep may mediate the link between stress and problem behaviors as it is both sensitive to stress and essential for neurocognitive development underlying behavioral control during adolescence. The default mode network (DMN) is a brain network implicated in stress regulation and sleep. Yet, it is poorly understood how individual differences in resting-state DMN moderate the effect of stressful environments on impulsivity via sleep problems. METHODS Three waves of data spanning 2 years were obtained from the Adolescent Brain and Cognitive Development Study, a national longitudinal sample of 11,878 children (Mage at baseline = 10.1; 47.8% female). Structural equation modeling was used to test (a) the mediating role of sleep at T3 in the link between stressful environments at baseline and impulsivity at T5 and (b) the moderation of this indirect association by baseline levels of within-DMN resting-state functional connectivity. RESULTS Sleep problems, shorter sleep duration, and longer sleep latency significantly mediated the link between stressful environments and youth impulsivity. Youth with elevated within-DMN resting-state functional connectivity showed intensified associations between stressful environments and impulsivity via shorter sleep duration. CONCLUSION Our findings suggest that sleep health can be a target for preventive intervention and thereby mitigate the link between stressful environments and increased levels of youth impulsivity.
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Affiliation(s)
- Linhao Zhang
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States.
| | - Zehua Cui
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States
| | - Landry Goodgame Huffman
- Youth Development Institute, University of Georgia, Athens, Georgia, United States; Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, Georgia, United States
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, Georgia, United States; Youth Development Institute, University of Georgia, Athens, Georgia, United States; Integrated Life Sciences, Behavioral and Cognitive Neuroscience, University of Georgia, Athens, Georgia, United States
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Baker AE, Tashjian SM, Goldenberg D, Galván A. Sleep variability over a 2-week period is associated with restfulness and intrinsic limbic network connectivity in adolescents. Sleep 2023; 46:zsac248. [PMID: 36223429 PMCID: PMC9905777 DOI: 10.1093/sleep/zsac248] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/20/2022] [Indexed: 11/05/2022] Open
Abstract
STUDY OBJECTIVES Sleep duration and intraindividual variability in sleep duration undergo substantial changes in adolescence and impact brain and behavioral functioning. Although experimental work has linked acute sleep deprivation to heightened limbic responding and reduced regulatory control, there is limited understanding of how variability in sleep patterns might interact with sleep duration to influence adolescent functioning. This is important for optimal balancing of length and consistency of sleep. Here, we investigated how objective indices of sleep duration and variability relate to stress, restfulness, and intrinsic limbic network functioning in adolescents. METHODS A sample of 101 adolescents ages 14-18 reported their stressors, after which they wore wrist actigraph watches to monitor their sleep and rated their restfulness every morning over a 2-week period. They also completed a resting-state fMRI scan. RESULTS Adolescents reporting more stress experienced shorter sleep duration and greater sleep variability over the 2-week period. Longer nightly sleep duration was linked to feeling more rested the next morning, but this effect was reduced in adolescents with high cumulative sleep variability. Sleep variability showed both linear and quadratic effects on limbic connectivity: adolescents with high sleep variability exhibited more connectivity within the limbic network and less connectivity between the limbic and frontoparietal networks than their peers, effects which became stronger once variability exceeded an hour. CONCLUSIONS Results suggest that cumulative sleep variability is related to stress and limbic network connectivity and shows interactive effects with sleep duration, highlighting the importance of balancing length and consistency of sleep for optimal functioning in adolescence.
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Affiliation(s)
- Amanda E Baker
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Sarah M Tashjian
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Diane Goldenberg
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, 502 Portola Plaza, Los Angeles, CA 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA
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Bacon EJ, Jin C, He D, Hu S, Wang L, Li H, Qi S. Functional and effective connectivity analysis of drug-resistant epilepsy: a resting-state fMRI analysis. Front Neurosci 2023; 17:1163111. [PMID: 37152592 PMCID: PMC10157077 DOI: 10.3389/fnins.2023.1163111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Objective Epilepsy is considered as a neural network disorder. Seizure activity in epilepsy may disturb brain networks and damage brain functions. We propose using resting-state functional magnetic resonance imaging (rs-fMRI) data to characterize connectivity patterns in drug-resistant epilepsy. Methods This study enrolled 47 participants, including 28 with drug-resistant epilepsy and 19 healthy controls. Functional and effective connectivity was employed to assess drug-resistant epilepsy patients within resting state networks. The resting state functional connectivity (FC) analysis was performed to assess connectivity between each patient and healthy controls within the default mode network (DMN) and the dorsal attention network (DAN). In addition, dynamic causal modeling was used to compute effective connectivity (EC). Finally, a statistical analysis was performed to evaluate our findings. Results The FC analysis revealed significant connectivity changes in patients giving 64.3% (18/28) and 78.6% (22/28) for DMN and DAN, respectively. Statistical analysis of FC was significant between the medial prefrontal cortex, posterior cingulate cortex, and bilateral inferior parietal cortex for DMN. For DAN, it was significant between the left and the right intraparietal sulcus and the frontal eye field. For the DMN, the patient group showed significant EC connectivity in the right inferior parietal cortex and the medial prefrontal cortex for the DMN. There was also bilateral connectivity between the medial prefrontal cortex and the posterior cingulate cortex, as well as between the left and right inferior parietal cortex. For DAN, patients showed significant connectivity in the right frontal eye field and the right intraparietal sulcus. Bilateral connectivity was also found between the left frontal eye field and the left intraparietal sulcus, as well as between the right frontal eye field and the right intraparietal sulcus. The statistical analysis of the EC revealed a significant result in the medial prefrontal cortex and the right intraparietal cortex for the DMN. The DAN was found significant in the left frontal eye field, as well as the left and right intraparietal sulcus. Conclusion Our results provide preliminary evidence to support that the combination of functional and effective connectivity analysis of rs-fMRI can aid in diagnosing epilepsy in the DMN and DAN networks.
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Affiliation(s)
- Eric Jacob Bacon
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Chaoyang Jin
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Dianning He
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
| | - Shuaishuai Hu
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lanbo Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Han Li
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Han Li,
| | - Shouliang Qi
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang, China
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
- Shouliang Qi,
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Ni K, Liu Y, Zhu X, Tan H, Zeng Y, Guo Q, Xiao L, Yu B. Changed Cerebral White Matter Structural Network Topological Characters and Its Correlation with Cognitive Behavioral Abnormalities in Narcolepsy Type 1. Nat Sci Sleep 2022; 14:165-173. [PMID: 35140538 PMCID: PMC8818963 DOI: 10.2147/nss.s336967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/19/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE In the current study we investigated topological abnormalities of the cerebral white matter networks in narcolepsy type 1 (NT1) patients and its relationship with their cognitive abnormalities using diffusion tensor imaging (DTI) technology. METHODS DTI and the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) were applied to 30 NT1 patients and 30 age-matched healthy controls. DTI studies were also carried using the 3T MRI system. Next, DTI data was used to establish a cerebral white matter network for all subjects and graph theory was applied to analyze the topological characteristics of the white matter structural network. Topographical parameters (such as local efficiency (Eloc), global efficiency (Eglob) and small-world (σ)) between NT1 patients and controls were then compared. The correlation between MoCA-BJ scores and topological parameters was also analyzed. RESULTS MoCA-BJ scores in NT1 patients were lower than those in the healthy controls. Compared with healthy controls, the global efficiency of the white matter network and attributes of the small world network were significantly reduced in NT1 patients. Finally, the global efficiency of the white matter structural network was related to the MoCA-BJ score of NT1 patients. CONCLUSION The abnormal topological characteristics of the white matter structural network in NT1 patients may be associated with their cognitive impairment.
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Affiliation(s)
- Kunlin Ni
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yishu Liu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xiaoyu Zhu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Huiwen Tan
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Yin Zeng
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Li Xiao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.,Sleep Medicine Center, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Bing Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
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Brooks SJ, Katz ES, Stamoulis C. Shorter Duration and Lower Quality Sleep Have Widespread Detrimental Effects on Developing Functional Brain Networks in Early Adolescence. Cereb Cortex Commun 2021; 3:tgab062. [PMID: 35047823 PMCID: PMC8759437 DOI: 10.1093/texcom/tgab062] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 08/26/2021] [Accepted: 10/15/2021] [Indexed: 11/12/2022] Open
Abstract
Sleep is critical for cognitive health, especially during complex developmental periods such as adolescence. However, its effects on maturating brain networks that support cognitive function are only partially understood. We investigated the impact of shorter duration and reduced quality sleep, common stressors during development, on functional network properties in early adolescence-a period of significant neural maturation, using resting-state functional magnetic resonance imaging from 5566 children (median age = 120.0 months; 52.1% females) in the Adolescent Brain Cognitive Development cohort. Decreased sleep duration, increased sleep latency, frequent waking up at night, and sleep-disordered breathing symptoms were associated with lower topological efficiency, flexibility, and robustness of visual, sensorimotor, attention, fronto-parietal control, default-mode and/or limbic networks, and with aberrant changes in the thalamus, basal ganglia, hippocampus, and cerebellum (P < 0.05). These widespread effects, many of which were body mass index-independent, suggest that unhealthy sleep in early adolescence may impair neural information processing and integration across incompletely developed networks, potentially leading to deficits in their cognitive correlates, including attention, reward, emotion processing and regulation, memory, and executive control. Shorter sleep duration, frequent snoring, difficulty waking up, and daytime sleepiness had additional detrimental network effects in nonwhite participants, indicating racial disparities in the influence of sleep metrics.
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Son DY, Kwon HB, Lee DS, Jin HW, Jeong JH, Kim J, Choi SH, Yoon H, Lee MH, Lee YJ, Park KS. Changes in physiological network connectivity of body system in narcolepsy during REM sleep. Comput Biol Med 2021; 136:104762. [PMID: 34399195 DOI: 10.1016/j.compbiomed.2021.104762] [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: 05/06/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Narcolepsy is marked by pathologic symptoms including excessive daytime drowsiness and lethargy, even with sufficient nocturnal sleep. There are two types of narcolepsy: type 1 (with cataplexy) and type 2 (without cataplexy). Unlike type 1, for which hypocretin is a biomarker, type 2 narcolepsy has no adequate biomarker to identify the causality of narcoleptic phenomenon. Therefore, we aimed to establish new biomarkers for narcolepsy using the body's systemic networks. METHOD Thirty participants (15 with type 2 narcolepsy, 15 healthy controls) were included. We used the time delay stability (TDS) method to examine temporal information and determine relationships among multiple signals. We quantified and analyzed the network connectivity of nine biosignals (brainwaves, cardiac and respiratory information, muscle and eye movements) during nocturnal sleep. In particular, we focused on the differences in network connectivity between groups according to sleep stages and investigated whether the differences could be potential biomarkers to classify both groups by using a support vector machine. RESULT In rapid eye movement sleep, the narcolepsy group displayed more connections than the control group (narcolepsy connections: 24.47 ± 2.87, control connections: 21.34 ± 3.49; p = 0.022). The differences were observed in movement and cardiac activity. The performance of the classifier based on connectivity differences was a 0.93 for sensitivity, specificity and accuracy, respectively. CONCLUSION Network connectivity with the TDS method may be used as a biomarker to identify differences in the systemic networks of patients with narcolepsy type 2 and healthy controls.
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Affiliation(s)
- Dong Yeon Son
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Integrated Major in Innovative Medical Science, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Hyun Bin Kwon
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea
| | - Dong Seok Lee
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea
| | - Hyung Won Jin
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, 03080, South Korea
| | - Jong Hyeok Jeong
- Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, 03080, South Korea; Integrated Major in Innovative Medical Science, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Jeehoon Kim
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, 03080, South Korea
| | - Sang Ho Choi
- School of Computer and Information Engineering, Kwangwoon University, Seoul, 01897, South Korea
| | - Heenam Yoon
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Seoul, 03016, South Korea
| | - Mi Hyun Lee
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Kwang Suk Park
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, 03080, South Korea; Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, 03080, South Korea.
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Fulong X, Karen S, Xiaosong D, Zhaolong C, Jun Z, Fang H. Morphological and Age-Related Changes in the Narcolepsy Brain. Cereb Cortex 2021; 31:5460-5469. [PMID: 34165139 DOI: 10.1093/cercor/bhab171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 11/12/2022] Open
Abstract
Morphological changes in the cortex of narcolepsy patients were investigated by surface-based morphometry analysis in this study. Fifty-one type 1 narcolepsy patients and 60 demographically group-matched healthy controls provided resting-state functional and high-resolution 3T anatomical magnetic resonance imaging scans. Vertex-level cortical thickness (CT), gyrification, and voxel-wise functional connectivity were calculated. Adolescent narcolepsy patients showed decreased CT in bilateral frontal cortex and left precuneus. Adolescent narcolepsy demonstrated increased gyrification in left occipital lobe, left precuneus, and right fusiform but decreased gyrification in left postcentral gyrus, whereas adult narcolepsy exhibited increased gyrification in left temporal lobe and right frontal cortex. Furthermore, sleepiness severity was associated with altered CT and gyrification. Increased gyrification was associated with reduced long-range functional connectivity. In adolescent patients, those with more severe sleepiness showed increased right postcentral gyrification. Decreased frontal and occipital gyrification was found in cases with hallucination. In adult patients, a wide range of regions showed reduced gyrification in those with adolescence-onset compared adult-onset narcolepsy patients. Particularly the frontal lobes showed altered brain morphology, being a thinner cortex and more gyri. The impact of narcolepsy on age-related brain morphological changes may remain from adolescence to young adulthood, and it was especially exacerbated in adolescence.
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Affiliation(s)
- Xiao Fulong
- Department of General Internal Medicine, Peking University People's Hospital, Beijing 100044, People's Republic of China
| | - Spruyt Karen
- Lyon Neuroscience Research Center, INSERM, U1028-CNRS UMR 5292, School of Medicine, University Claude Bernard, Lyon, France
| | - Dong Xiaosong
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, People's Republic of China
| | - Cao Zhaolong
- Department of General Internal Medicine, Peking University People's Hospital, Beijing 100044, People's Republic of China
| | - Zhang Jun
- Department of Neurology, Peking University People's Hospital, Beijing 100044, People's Republic of China
| | - Han Fang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, People's Republic of China
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15
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Zhu X, Ni K, Tan H, Liu Y, Zeng Y, Yu B, Guo Q, Xiao L. Abnormal Brain Network Topology During Non-rapid Eye Movement Sleep and Its Correlation With Cognitive Behavioral Abnormalities in Narcolepsy Type 1. Front Neurol 2021; 11:617827. [PMID: 33505350 PMCID: PMC7829333 DOI: 10.3389/fneur.2020.617827] [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: 10/15/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Simultaneous electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) were applied to investigate the abnormalities in the topological characteristics of functional brain networks during non-rapid eye movement(NREM)sleep. And we investigated its relationship with cognitive abnormalities in patients with narcolepsy type 1 (NT1) disorder in the current study. Methods: The Beijing version of the Montreal Cognitive Assessment (MoCA-BJ) and EEG-fMRI were applied in 25 patients with NT1 and 25 age-matched healthy controls. All subjects participated in a nocturnal video polysomnography(PSG)study, and total sleep time (TST), percentage of TST (%TST) for each sleep stage and arousal index were calculated. The Epworth Sleepiness Score (ESS) was used to measure the degree of daytime sleepiness. The EEG-fMRI study was performed simultaneously using a 3T MRI system and a 32-channel MRI-compatible EEG system during sleep. Visual scoring of EEG data was used for sleep staging. Cognitive function was assessed for all subjects using the MoCA-BJ. The fMRI data were applied to establish a whole-brain functional connectivity network for all subjects, and the topological characteristics of the whole-brain functional network were analyzed using a graph-theoretic approach. The topological parameters were compared between groups. Lastly, the correlation between topological parameters and the assessment scale using Montreal Cognition was analyzed. Results: The MoCA-BJ scores were lower in patients with NT1 than in normal controls. Whole-brain global efficiency during stage N2 sleep in patients with NT1 displayed significantly lower small-world properties than in normal controls. Whole-brain functional network global efficiency in patients with NT1 was significantly correlated with MoCA-BJ scores. Conclusion: The global efficiency of the functional brain network during stage N2 sleep in patients with NT1 and the correspondingly reduced small-world attributes were associated with cognitive impairment.
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Affiliation(s)
- Xiaoyu Zhu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Kunlin Ni
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Huiwen Tan
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yishu Liu
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yin Zeng
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Bing Yu
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Li Xiao
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- Sleep Medicine Center, Shengjing Hospital of China Medical University, Shenyang, China
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16
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Järvelä M, Raatikainen V, Kotila A, Kananen J, Korhonen V, Uddin LQ, Ansakorpi H, Kiviniemi V. Lag Analysis of Fast fMRI Reveals Delayed Information Flow Between the Default Mode and Other Networks in Narcolepsy. Cereb Cortex Commun 2020; 1:tgaa073. [PMID: 34296133 PMCID: PMC8153076 DOI: 10.1093/texcom/tgaa073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 11/12/2022] Open
Abstract
Narcolepsy is a chronic neurological disease characterized by dysfunction of the hypocretin system in brain causing disruption in the wake-promoting system. In addition to sleep attacks and cataplexy, patients with narcolepsy commonly report cognitive symptoms while objective deficits in sustained attention and executive function have been observed. Prior resting-state functional magnetic resonance imaging (fMRI) studies in narcolepsy have reported decreased inter/intranetwork connectivity regarding the default mode network (DMN). Recently developed fast fMRI data acquisition allows more precise detection of brain signal propagation with a novel dynamic lag analysis. In this study, we used fast fMRI data to analyze dynamics of inter resting-state network (RSN) information signaling between narcolepsy type 1 patients (NT1, n = 23) and age- and sex-matched healthy controls (HC, n = 23). We investigated dynamic connectivity properties between positive and negative peaks and, furthermore, their anticorrelative (pos-neg) counterparts. The lag distributions were significantly (P < 0.005, familywise error rate corrected) altered in 24 RSN pairs in NT1. The DMN was involved in 83% of the altered RSN pairs. We conclude that narcolepsy type 1 is characterized with delayed and monotonic inter-RSN information flow especially involving anticorrelations, which are known to be characteristic behavior of the DMN regarding neurocognition.
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Affiliation(s)
- M Järvelä
- Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, 90220 Oulu, Finland
| | - V Raatikainen
- Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, 90220 Oulu, Finland
| | - A Kotila
- Research Unit of Logopedics, University of Oulu, 90014 Oulu, Finland
| | - J Kananen
- Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, 90220 Oulu, Finland
| | - V Korhonen
- Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, 90220 Oulu, Finland
| | - L Q Uddin
- Department of Psychology, University of Miami, Coral Gables, 33124 FL, USA
| | - H Ansakorpi
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90014 Oulu, Finland
| | - V Kiviniemi
- Department of Diagnostic Radiology, Medical Research Center (MRC), Oulu University Hospital, 90220 Oulu, Finland
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