Evidence of rapid ongoing brain development beyond 2 years of age detected by fiber tracking

Brain-Computer Interfaces for Children With Complex Communication Needs and Limited Mobility: A Systematic Review

Brain-computer interfaces (BCIs) represent a new frontier in the effort to maximize the ability of individuals with profound motor impairments to interact and communicate. While much literature points to BCIs' promise as an alternative access pathway, there have historically been few applications involving children and young adults with severe physical disabilities. As research is emerging in this sphere, this article aims to evaluate the current state of translating BCIs to the pediatric population. A systematic review was conducted using the Scopus, PubMed, and Ovid Medline databases. Studies of children and adolescents that reported BCI performance published in English in peer-reviewed journals between 2008 and May 2020 were included. Twelve publications were identified, providing strong evidence for continued research in pediatric BCIs. Research evidence was generally at multiple case study or exploratory study level, with modest sample sizes. Seven studies focused on BCIs for communication and five on mobility. Articles were categorized and grouped based on type of measurement (i.e., non-invasive and invasive), and the type of brain signal (i.e., sensory evoked potentials or movement-related potentials). Strengths and limitations of studies were identified and used to provide requirements for clinical translation of pediatric BCIs. This systematic review presents the state-of-the-art of pediatric BCIs focused on developing advanced technology to support children and youth with communication disabilities or limited manual ability. Despite a few research studies addressing the application of BCIs for communication and mobility in children, results are encouraging and future works should focus on customizable pediatric access technologies based on brain activity.

Myelination may be impaired in neonates following birth asphyxia

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Myelination is a developmental process that intensifies after birth during the first years of life.

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We used a T2* mapping sequence to assess myelination in healthy and critically ill neonates with neonatal encephalopathy.

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Birth asphyxia, in addition to causing the previously well-described direct injury to the brain, may impair myelination.

Background

Myelination is a developmental process that begins during the end of gestation, intensifies after birth over the first years of life, and continues well into adolescence. Any event leading to brain injury around the time of birth and during the perinatal period, such as birth asphyxia, may impair this critical process. Currently, the impact of such brain injury related to birth asphyxia on the myelination process is unknown.

Objective

To assess the myelination pattern over the first month of life in neonates with neonatal encephalopathy (NE) developing brain injury, compared to neonates without injury (i.e., healthy neonates and neonates with NE who do not develop brain injury).

Methods

Brain magnetic resonance imaging (MRI) was performed around day of life 2, 10, and 30 in healthy neonates and near-term/term neonates with NE who were treated with hypothermia. We evaluated myelination in various regions of interest using a T2* mapping sequence. In each region of interest, we compared the T2* values of the neonates with NE with brain injury to the values of the neonates without injury, according to the MRI timing, by using a repeated measures generalized linear mixed model.

Results

We obtained 74 MRI scans over the first month of life for 6 healthy neonates, 17 neonates with NE who were treated with hypothermia and did not develop brain injury, and 16 neonates with NE who were treated with hypothermia and developed brain injury. The T2* values significantly increased in the neonates with NE who developed injury in the posterior limbs of the internal capsule (day 2: p < 0.001; day 10: p < 0.001; and day 30: p < 0.001), the thalami (day 2: p = 0.001; day 10: p = 0.006; and day 30: p = 0.016), the lentiform nuclei (day 2: p = 0.005), the anterior white matter (day 2: p = 0.002; day 10: p = 0.006; and day 30: p = 0.002), the posterior white matter (day 2: p = 0.001; day 10: p = 0.008; and day 30: p = 0.03), the genu of the corpus callosum (day 2: p = 0.01; and day 10: p = 0.006), and the optic radiations (day 30: p < 0.001).

Conclusion

In the neonates with NE who were treated with hypothermia and developed brain injury, birth asphyxia impaired myelination in the regions that are myelinated at birth or soon after birth (the posterior limbs of internal capsule, the thalami, and the lentiform nuclei), in the regions where the myelination process begins only after the perinatal period (optic radiations), and in the regions where this process does not occur until months after birth (anterior/posterior white matter), which suggests that birth asphyxia, in addition to causing the previously well-described direct injury to the brain, may impair myelination.

Assessment of myelination in infants and young children by T1 relaxation time measurements using the magnetization-prepared 2 rapid acquisition gradient echoes sequence

BACKGROUND

Axonal myelination is an important maturation process in the developing brain. Increasing myelin content correlates with the longitudinal relaxation rate (R1=1/T1) in magnetic resonance imaging (MRI).

OBJECTIVE

By using magnetization-prepared 2 rapid acquisition gradient echoes (MP2RAGE) on a 3-T MRI system, we provide R1 values and myelination rates for infants and young children.

MATERIALS AND METHODS

Average R1 values in white and grey matter regions in 94 children without pathological MRI findings (age range: 3 months to 6 years) were measured and fitted by a saturating-exponential growth model. For comparison, R1 values of 36 children with different brain pathologies are presented. The findings were related to a qualitative evaluation using T2, magnetization-prepared rapid acquisition gradient echo (MP-RAGE) and MP2RAGE.

RESULTS

R1 changes rapidly in the first 16 months of life, then much slower thereafter. R1 is highest in pre-myelinated structures in the youngest subjects, such as the posterior limb of the internal capsule (0.74-0.76±0.04 s^-1) and lowest for the corpus callosum (0.37-0.44±0.03 s^-1). The myelination rate is fastest in the corpus callosum and slowest in the deep grey matter. R1 is decreased in hypo- and dysmyelination disorders. Myelin maturation is clearly visible on MP2RAGE, especially in the first year of life.

CONCLUSION

MP2RAGE permits a quantitative R1 mapping method with an examination time of approximately 6 min. The age-dependent R1 values for children without MRI-identified brain pathologies are well described by a saturating-exponential function with time constants depending on the investigated brain region. This model can serve as a reference for this age group and to search for indications of subtle pathologies. Moreover, the MP2RAGE sequence can also be used for the qualitative assessment of myelinated structures.

Pre- and Post-therapy Assessment of Clinical Outcomes and White Matter Integrity in Autism Spectrum Disorder: Pilot Study

Objective: This pilot study aims to identify white matter (WM) tract abnormalities in Autism Spectrum Disorders (ASD) toddlers and pre-schoolers by Diffusion Tensor Imaging (DTI), and to correlate imaging findings with clinical improvement after early interventional and Applied Behavior Analysis (ABA) therapies by Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP). Methods: DTI scans were performed on 17 ASD toddlers/pre-schoolers and seven age-matched controls. Nine ASD patients had follow-up MRI 12 months following early intervention and ABA therapy. VB-MAPP was assessed and compared at diagnosis, 6 and 12 months after therapies. Tract-Based Spatial Statistics (TBSS) was used to measure fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial (RD) diffusivity. Results: VB-MAPP scores improved at 6 and 12 months after early intervention and ABA therapy compared to scores at baseline. TBSS analysis showed significant FA decrease and/or RD increase in ASD patients before therapy vs. controls in inferior fronto-occipital fasciculi, uncinate fasciculi, left superior fronto-occipital fasciculus, forceps minor, left superior fronto-occipital fasciculus, right superior longitudinal fasciculus, corona radiate bilaterally, and left external capsule. A significantly FA increase in 21 tracts and ROIs is reported in post- vs. pre-therapy DTI analysis. Conclusion: DTI findings highlighted ASD patient WM abnormalities at diagnosis and confirmed the benefits of 12 months of early intervention and ABA therapy on clinical and neuro imaging outcomes.

Workshops of the Sixth International Brain-Computer Interface Meeting: brain-computer interfaces past, present, and future

The Sixth International Brain-Computer Interface (BCI) Meeting was held 30 May-3 June 2016 at the Asilomar Conference Grounds, Pacific Grove, California, USA. The conference included 28 workshops covering topics in BCI and brain-machine interface research. Topics included BCI for specific populations or applications, advancing BCI research through use of specific signals or technological advances, and translational and commercial issues to bring both implanted and non-invasive BCIs to market. BCI research is growing and expanding in the breadth of its applications, the depth of knowledge it can produce, and the practical benefit it can provide both for those with physical impairments and the general public. Here we provide summaries of each workshop, illustrating the breadth and depth of BCI research and highlighting important issues and calls for action to support future research and development.

A longitudinal functional analysis framework for analysis of white matter tract statistics

Many longitudinal imaging studies have been/are being widely conducted to use diffusion tensor imaging (DTI) to better understand white matter maturation in normal controls and diseased subjects. There is an urgent demand for the development of statistical methods for analyzing diffusion properties along major fiber tracts obtained from longitudinal DTI studies. Jointly analyzing fiber-tract diffusion properties and covariates from longitudinal studies raises several major challenges including (i) infinite-dimensional functional response data, (ii) complex spatial-temporal correlation structure, and (iii) complex spatial smoothness. To address these challenges, this article is to develop a longitudinal functional analysis framework (LFAF) to delineate the dynamic changes of diffusion properties along major fiber tracts and their association with a set of covariates of interest (e.g., age and group status) and the structure of the variability of these white matter tract properties in various longitudinal studies. Our LFAF consists of a functional mixed effects model for addressing all three challenges, an efficient method for spatially smoothing varying coefficient functions, an estimation method for estimating the spatial-temporal correlation structure, a test procedure with a global test statistic for testing hypotheses of interest associated with functional response, and a simultaneous confidence band for quantifying the uncertainty in the estimated coefficient functions. Simulated data are used to evaluate the finite sample performance of LFAF and to demonstrate that LFAF significantly outperforms a voxel-wise mixed model method. We apply LFAF to study the spatial-temporal dynamics of white-matter fiber tracts in a clinical study of neurodevelopment.

FMEM: functional mixed effects modeling for the analysis of longitudinal white matter Tract data

Many longitudinal imaging studies have collected repeated diffusion tensor magnetic resonance imaging data to understand white matter maturation and structural connectivity pattern in normal controls and diseased subjects. There is an urgent demand for the development of statistical methods for the analysis of diffusion properties along fiber tracts and clinical data obtained from longitudinal studies. Jointly analyzing repeated fiber-tract diffusion properties and covariates (e.g., age or gender) raises several major challenges including (i) infinite-dimensional functional response data, (ii) complex spatial-temporal correlation structure, and (iii) complex spatial smoothness. To address these challenges, this article is to develop a functional mixed effects modeling (FMEM) framework to delineate the dynamic changes of diffusion properties along major fiber tracts and their association with a set of covariates of interest and the structure of the variability of these white matter tract properties in various longitudinal studies. Our FMEM consists of a functional mixed effects model for addressing all three challenges, an efficient method for spatially smoothing varying coefficient functions, an estimation method for estimating the spatial-temporal correlation structure, a test procedure with local and global test statistics for testing hypotheses of interest associated with functional response, and a simultaneous confidence band for quantifying the uncertainty in the estimated coefficient functions. Simulated data are used to evaluate the finite sample performance of FMEM and to demonstrate that FMEM significantly outperforms the standard pointwise mixed effects modeling approach. We apply FMEM to study the spatial-temporal dynamics of white-matter fiber tracts in a clinical study of neurodevelopment.

Assessment of structural connectivity in the preterm brain at term equivalent age using diffusion MRI and T2 relaxometry: a network-based analysis

Preterm birth is associated with a high prevalence of adverse neurodevelopmental outcome. Non-invasive techniques which can probe the neural correlates underpinning these deficits are required. This can be achieved by measuring the structural network of connections within the preterm infant's brain using diffusion MRI and tractography. We used diffusion MRI and T₂ relaxometry to identify connections with altered white matter properties in preterm infants compared to term infants. Diffusion and T₂ data were obtained from 9 term neonates and 18 preterm-born infants (born <32 weeks gestational age) at term equivalent age. Probabilistic tractography incorporating multiple fibre orientations was used in combination with the Johns Hopkins neonatal brain atlas to calculate the structural network of connections. Connections of altered diffusivity or T₂, as well as their relationship with gestational age at birth and postmenstrual age at the time of MRI, were identified using the network based statistic framework. A total of 433 connections were assessed. FA was significantly reduced in 17, and T₂ significantly increased in 18 connections in preterm infants, following correction for multiple comparisons. Cortical networks associated with affected connections mainly involved left frontal and temporal cortical areas: regions which are associated with working memory, verbal comprehension and higher cognitive function – deficits which are often observed later in children and adults born preterm. Gestational age at birth correlated with T₂, but not diffusion in several connections. We found no association between diffusion or T₂ and postmenstrual age at the time of MRI in preterm infants. This study demonstrates that alterations in the structural network of connections can be identified in preterm infants at term equivalent age, and that incorporation of non-diffusion measures such as T₂ in the connectome framework provides complementary information for the assessment of brain development.

Diffusion tensor imaging of normal brain development

Diffusion tensor imaging (DTI) is an MRI technique that can measure the macroscopic structural organization in brain tissues. DTI has been shown to provide information complementary to relaxation-based MRI about the changes in the brain's microstructure. In the pediatric population, DTI enables quantitative observation of the maturation process of white matter structures. Its ability to delineate various brain structures during developmental stages makes it an effective tool with which to characterize both the normal and abnormal anatomy of the developing brain. This review will highlight the advantages, as well as the common technical pitfalls of pediatric DTI. In addition, image quantification strategies for various DTI-derived parameters and the normal brain developmental changes associated with these parameters are discussed.

Analysis of corpus callosum diffusion tensor imaging parameters in infants

Radial diffusivity is a diffusion tensor imaging (DTI) metric that has received increased attention in recent studies as a parameter that may better reflect myelination than the more commonly-used fractional anisotropy (FA). This study compared rates of radial diffusivity decrease against FA increase and axial diffusivity decrease on DTI maps in the corpus callosum of normal infants during the first postnatal year. Fifty-three normal infants (range: 0-52 weeks adjusted for gestational age) underwent six-direction DTI on a 1.5 Tesla scanner (b= 1,000 s/mm(2), one excitation). A single individual placed regions of interest on FA maps in the genu 1) and radial diffusivity (i.e., λ and splenium to obtain axial (i.e., 3)/2]), FA and ADC. We calculated mean and median values for FA, λ 2+λ[ ADC, radial diffusivity and axial diffusivity in each of four 13-week epochs and measured the percent change over the first year of life. Within the genu, radial diffusivity decreased 36%, FA increased 25%, ADC decreased 22% and axial diffusivity decreased 10%. Within the splenium, radial diffusivity decreased 53%, FA increased 43%, ADC decreased 38%, and axial diffusivity decreased 23%. For both genu and splenium, the greatest difference was seen in radial diffusivity values, followed in order by FA, ADC and axial diffusivity. Furthermore, decreases in radial diffusivity were on the order of two to threefold greater than those in axial diffusivity. The high rate of radial diffusivity decrease compared to axial diffusivity decrease is consistent with myelination. Decreases in radial diffusivity were greater than increases in FA values. This finding is further support of the concept that radial diffusivity and FA values represent two different types of microstructural change during development of white matter.

Quantitative tract-based white matter development from birth to age 2years

Few large-scale studies have been done to characterize the normal human brain white matter growth in the first years of life. We investigated white matter maturation patterns in major fiber pathways in a large cohort of healthy young children from birth to age two using diffusion parameters fractional anisotropy (FA), radial diffusivity (RD) and axial diffusivity (RD). Ten fiber pathways, including commissural, association and projection tracts, were examined with tract-based analysis, providing more detailed and continuous spatial developmental patterns compared to conventional ROI based methods. All DTI data sets were transformed to a population specific atlas with a group-wise longitudinal large deformation diffeomorphic registration approach. Diffusion measurements were analyzed along the major fiber tracts obtained in the atlas space. All fiber bundles show increasing FA values and decreasing radial and axial diffusivities during development in the first 2years of life. The changing rates of the diffusion indices are faster in the first year than the second year for all tracts. RD and FA show larger percentage changes in the first and second years than AD. The gender effects on the diffusion measures are small. Along different spatial locations of fiber tracts, maturation does not always follow the same speed. Temporal and spatial diffusion changes near cortical regions are in general smaller than changes in central regions. Overall developmental patterns revealed in our study confirm the general rules of white matter maturation. This work shows a promising framework to study and analyze white matter maturation in a tract-based fashion. Compared to most previous studies that are ROI-based, our approach has the potential to discover localized development patterns associated with fiber tracts of interest.

Diffusion-tensor imaging assessment of white matter maturation in childhood and adolescence

OBJECTIVE

The purpose of this study was to test a first hypothesis that fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values continue to change in late childhood and adolescence and a second hypothesis that less mature white matter (WM) regions have a higher rate of change than WM regions that are relatively more mature.

SUBJECTS AND METHODS

Eighty-seven healthy children (50 girls, 37 boys; mean age, 11.2 ± 3.6 years; range, 4.2-17.7 years) underwent six-direction diffusion-tensor imaging with a 3-T MRI system. Three neuroradiologists independently drew regions of interest in 10 WM regions and measured FA and ADC values. To test the first hypothesis, we correlated these values with subject age by linear regression analysis (p < 0.05). To test the second hypothesis, we determined whether regions with lower FA and higher ADC in the 4- to 7-year old group had a higher slope of FA increase and ADC decrease over the entire age range. For this assessment, we used linear regression analysis (p < 0.05) and curve fitting.

RESULTS

In the test of the first hypothesis, increases in FA with age were noted in all WM regions and were statistically significant in six regions. Decreases in ADC values with age were noted in all brain regions except the genu of the corpus callosum. In all other regions except the splenium of the corpus callosum, the decreases were statistically significant. In the test of the second hypothesis, the relation between FA in the 4- to 7-year-old subjects and the FA increase in the entire sample was best described with a linear equation. The rate of age-related FA increase tended to be greater with lower initial FA (r = -0.384, p = 0.271). The relation between ADC in the 4- to 7-year-old subjects and ADC decrease in the entire population was best described with a second-order equation. The rate of age-related ADC decrease tended to be greater with higher initial ADC (r = 0.846, p = 0.001). For ADC values of 100 or less at age 4-7 years, the rate of ADC change with age tended to be decrease as initial ADC increased.

CONCLUSION

In general, both hypotheses were verified. Overall, FA values continue to increase and ADC values continue to decrease during childhood and adolescence. The most rapid changes were found in WM regions that were least mature in the first few years of the study period.

The effects of napping on cognitive function in preschoolers

OBJECTIVE

To determine the relationship between napping and cognitive function in preschool-aged children.

METHODS

Daytime napping, nighttime sleep, and cognitive function were assessed in 59 typically developing children aged 3 to 5 years, who were enrolled in full-time childcare. Participants wore an actigraphy watch for 7 days to measure sleep and napping patterns and completed neuropsychological testing emphasizing attention, response control, and vocabulary. Parents of participants completed behavior ratings and sleep logs during the study. Sleep/wake cycles were scored with the Sadeh algorithm.

RESULTS

Children who napped more on weekdays were also more likely to nap during weekends. Weekday napping and nighttime sleep were inversely correlated, such that those who napped more slept less at night, although total weekday sleep remained relatively constant. Weekday napping was significantly (negatively) correlated with vocabulary and auditory attention span, and weekday nighttime sleep was positively correlated with vocabulary. Nighttime sleep was also significantly negatively correlated with performance, such that those who slept less at night made more impulsive errors on a computerized go/no-go test.

CONCLUSIONS

Daytime napping is actually negatively correlated with neurocognitive function in preschoolers. Nighttime sleep seems to be more critical for development of cognitive performance. Cessation of napping may serve as a developmental milestone of brain maturation. Children who nap less do not appear to be sleep deprived, especially if they compensate with increased nighttime sleep. An alternative explanation is that children who sleep less at night are sleep deprived and require a nap. A randomized trial of nap restriction would be the next step in understanding the relationship between napping and neurocognitive performance.

Atlas-based analysis of neurodevelopment from infancy to adulthood using diffusion tensor imaging and applications for automated abnormality detection

Quantification of normal brain maturation is a crucial step in understanding developmental abnormalities in brain anatomy and function. The aim of this study was to develop atlas-based tools for time-dependent quantitative image analysis, and to characterize the anatomical changes that occur from 2years of age to adulthood. We used large deformation diffeomorphic metric mapping to register diffusion tensor images of normal participants into the common coordinates and used a pre-segmented atlas to segment the entire brain into 176 structures. Both voxel- and atlas-based analyses reported a structure that showed distinctive changes in terms of its volume and diffusivity measures. In the white matter, fractional anisotropy (FA) linearly increased with age in logarithmic scale, while diffusivity indices, such as apparent diffusion coefficient (ADC), and axial and radial diffusivity, decreased at a different rate in several regions. The average, variability, and the time course of each measured parameter are incorporated into the atlas, which can be used for automated detection of developmental abnormalities. As a demonstration of future application studies, the brainstem anatomy of cerebral palsy patients was evaluated and the altered anatomy was delineated.

Longitudinal comparison of pre- and postoperative diffusion tensor imaging parameters in young children with hydrocephalus

OBJECT

The goal in this study was to compare the integrity of white matter before and after ventriculoperitoneal (VP) shunt insertion by evaluating the anisotropic diffusion properties with the aid of diffusion tensor (DT) imaging in young children with hydrocephalus.

METHODS

The authors retrospectively identified 10 children with hydrocephalus who underwent both pre- and postoperative DT imaging studies. The DT imaging parameters (fractional anisotropy [FA], mean diffusivity, axial diffusivity, and radial diffusivity) were computed and compared longitudinally in the splenium and genu of the corpus callosum (gCC) and in the anterior and posterior limbs of the internal capsule (PLIC). The patients' values on DT imaging at the pre- and postshunt stages were compared with the corresponding age-matched controls as well as with a large cohort of healthy children in the database.

RESULTS

In the gCC, 7 of 10 children had abnormally low preoperative FA values, 6 of which normalized postoperatively. All 3 of the 10 children who had normal preoperative FA values had normal FA values postoperatively as well. In the PLIC, 7 of 10 children had abnormally high FA values, 6 of which normalized postoperatively, whereas the other one had abnormally low postoperative FA. Of the remaining 3 children, 2 had abnormally low preoperative FA values in the PLIC; this normalized in 1 patient after surgery. The other child had a normal preoperative FA value that became abnormally low postoperatively. When comparing the presurgery frequency of abnormally low, normal, and abnormally high FA values to those postsurgery, there was a statistically significant longitudinal difference in both gCC (p = 0.02) and PLIC (p = 0.002).

CONCLUSIONS

In this first longitudinal DT imaging study of young children with hydrocephalus, DT imaging anisotropy yielded abnormal results in several white matter regions of the brain, and trended toward normalization following VP shunt placement.

Quantitative diffusion tensor imaging tractography metrics are associated with cognitive performance among HIV-infected patients

There have been many studies examining HIV-infection-related alterations of magnetic resonance imaging (MRI) diffusion metrics. However, examining scalar diffusion metrics ignores the orientation aspect of diffusion imaging, which can be captured with tractography. We examined five different tractography metrics obtained from global tractography maps (global tractography FA, average tube length, normalized number of streamtubes, normalized weighted streamtube length, and normalized total number of tubes generated) for differences between HIV positive and negative patients and the association between the metrics and clinical variables of disease severity. We also examined the relationship between these metrics and cognitive performance across a wide range of cognitive domains for the HIV positive and negative patient groups separately. The results demonstrated a significant difference between the groups for global tractography FA (t = 2.13, p = 0.04), but not for any of the other tractography metrics examined (p-value range = 0.39 to 0.95). There were also several significant associations between the tractography metrics and cognitive performance (i.e., tapping rates, switching 1 and 2, verbal interference, mazes; r > or = 0.42) for HIV infected patients. In particular, associations were noted between tractography metrics, speed of processing, fine motor control/speed, and executive function for the HIV-infected patients. These findings suggest that tractography metrics capture clinically relevant information regarding cognitive performance among HIV infected patients and suggests the importance of subtle white matter changes in examining cognitive performance.

Corpus callosum abnormalities in pediatric bipolar disorder

The corpus callosum (CC) is a midline white matter brain region that is important in interhemispheric communication and coordination. CC abnormalities are associated with a variety of psychiatric conditions, including increased vulnerability for psychotic illness, stressful early-life experiences, marijuana use, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, borderline personality disorder, dementia, schizophrenia and bipolar disorder. CC abnormalities in bipolar disorder have been identified in both pediatric and adult populations. In adults, a consistent finding has been a reduction in CC size, as well as abnormal axonal orientation or structure. Axonal abnormalities have also been noted in pediatric populations, but overall CC size reductions have not thus far been demonstrated. Furthermore, there are unique gender differences in the expression of CC abnormalities in pediatric populations, possibly related to androgen changes during puberty. The protean number of conditions in which the CC is involved is reflective of its central role in normal brain function and its potential as an early marker of neuropathology in psychiatric illness. Specifically, in bipolar disorder it has the potential to be useful as an early preclinical marker of disease or disease risk.

Anisotropy of callosal motor fibers in combination with transcranial magnetic stimulation in the course of motor development

OBJECTIVES

The corpus callosum (CC) represents a key structure for hand motor development and is accessible to investigation by diffusion tensor magnetic resonance imaging (DTI) and transcranial magnetic stimulation (TMS). To identify quantifiable markers for motor development, we combined DTI with TMS.

MATERIALS AND METHODS

We examined groups of 11 healthy preschool-aged children, 10 healthy adolescents, and 10 healthy adults with both, DTI and TMS/ipsilateral silent period (iSP). DTI-values for fractional anisotropy (FA) were calculated for areas I to V of the CC. ISP-values for latency, duration, and extent of electromyography suppression were calculated.

RESULTS

FA was significantly lower in areas II to IV of the CC in children as compared with adults (P < 0.05). In area III, where callosal motor fibers cross the CC, FA differed significantly between children and adolescents (P < 0.05). TMS parameters demonstrated significant age-related differences in duration and extent of iSP (P < 0.05). No significant differences were detected regarding latency of iSP.

CONCLUSIONS

The maturation of callosal motor fiber connectivity seems to reflect the degree of interhemispheric inhibition between the motor cortices with anisotropy of callosal motor fibers being a potential marker for motor development.

Early white-matter abnormalities of the ventral frontostriatal pathway in fragile X syndrome

AIM

Fragile X syndrome is associated with cognitive deficits in inhibitory control and with abnormal neuronal morphology and development.

METHOD

In this study, we used a diffusion tensor imaging (DTI) tractography approach to reconstruct white-matter fibers in the ventral frontostriatal pathway in young males with fragile X syndrome (n=17; mean age 2y 9mo, SD 7mo, range 1y 7mo-3y 10mo), and two age-matched comparison groups: (1) typically developing (n=13; mean age 2y 3mo, SD 7mo, range 1y 7mo-3y 6mo) and (2) developmentally delayed (n=8; mean age 3y, SD 4mo, range 2y 9mo-3y 8mo).

RESULTS

We observed that young males with fragile X syndrome exhibited increased density of DTI reconstructed fibers than those in the typically developing (p=0.001) and developmentally delayed (p=0.001) groups. Aberrant white-matter structure was localized in the left ventral frontostriatal pathway. Greater relative fiber density was found to be associated with lower IQ (Mullen composite scores) in the typically developing group (p=0.008).

INTERPRETATION

These data suggest that diminished or absent fragile X mental retardation 1 protein expression can selectively alter white-matter anatomy during early brain development and, in particular, neural pathways. The results also point to an early neurobiological marker for an important component of cognitive dysfunction associated with fragile X syndrome.

Diffusion tensor tractography quantification of the human corpus callosum fiber pathways across the lifespan

Several anatomical attributes of the human corpus callosum (CC) including the midsagittal cross-sectional area, thickness, and volume, have been used to assess CC integrity. We extended our previous lifespan quantitative diffusion tensor imaging (DTI) study of the regional CC midsagittal areas to include the CC volumes obtained from DTI fiber tracking. In addition to the entire CC tracked subvolumes we normalized volume with respect to each subject's intracranial volume (ICV) and the corresponding DTI metrics of the different specialized fiber pathways of the CC on a cohort of 99 right-handed children and adults aged 7-59 years. Results indicated that the CC absolute volume, the normalized volume fraction, and the fractional anisotropy followed inverted U-shaped curves, while the radial diffusivities followed a U-shaped curve reflecting white matter progressive and regressive myelination dynamics that continue into young adulthood. Our study provides for the first time normative baseline macro- and microstructural age trajectories of the human CC subvolumes across the lifespan that can be helpful for normative behavioral and clinical studies.