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Mayer AR, Quinn DK. Neuroimaging Biomarkers of New-Onset Psychiatric Disorders Following Traumatic Brain Injury. Biol Psychiatry 2022; 91:459-469. [PMID: 34334188 PMCID: PMC8665933 DOI: 10.1016/j.biopsych.2021.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/24/2021] [Accepted: 06/06/2021] [Indexed: 02/07/2023]
Abstract
Traumatic brain injury (TBI) has traditionally been associated with cognitive and behavioral changes during both the acute and chronic phases of injury. Because of its noninvasive nature, neuroimaging has the potential to provide unique information on underlying macroscopic and microscopic biological mechanisms that may serve as causative agents for these neuropsychiatric sequelae. This broad scoping review identifies at least 4 common macroscopic pathways that exist between TBI and new-onset psychiatric disorders, as well as several examples of how neuroimaging is currently being utilized in clinical research. The review then critically examines the strengths and limitations of neuroimaging for elucidating TBI-related microscopic pathology, such as microstructural changes, neuroinflammation, proteinopathies, blood-brain barrier damage, and disruptions in cellular signaling. A summary is then provided for how neuroimaging is currently being used to investigate TBI-related pathology in new-onset neurocognitive disorders, depression, and posttraumatic stress disorder. Identified gaps in the literature include a lack of prospective studies to definitively associate imaging findings with the development of new-onset psychiatric disorders, as well as antemortem imaging studies subsequently confirmed with postmortem correlates in the same study cohort. Although the spatial resolution and specificity of imaging biomarkers has greatly improved over the last 2 decades, we conclude that neuroimaging biomarkers do not yet exist for the definitive in vivo diagnosis of cellular pathology. This represents a necessary next step for further elucidating causal relationships between TBI and new-onset psychiatric disorders.
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Affiliation(s)
- Andrew R. Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM 87106,Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87131,Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131,Department of Psychology, University of New Mexico, Albuquerque, NM 87131,Corresponding author: Andrew Mayer, Ph.D., The Mind Research Network, Pete & Nancy Domenici Hall, 1101 Yale Blvd. NE, Albuquerque, NM 87106 USA; Tel: 505-272-0769; Fax: 505-272-8002;
| | - Davin K. Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87131
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2
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Schumm SN, Gabrieli D, Meaney DF. Neuronal Degeneration Impairs Rhythms Between Connected Microcircuits. Front Comput Neurosci 2020; 14:18. [PMID: 32194390 PMCID: PMC7063469 DOI: 10.3389/fncom.2020.00018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 02/11/2020] [Indexed: 11/23/2022] Open
Abstract
Synchronization of neural activity across brain regions is critical to processes that include perception, learning, and memory. After traumatic brain injury (TBI), neuronal degeneration is one possible effect and can alter communication between neural circuits. Consequently, synchronization between neurons may change and can contribute to both lasting changes in functional brain networks and cognitive impairment in patients. However, fundamental principles relating exactly how TBI at the cellular scale affects synchronization of mesoscale circuits are not well understood. In this work, we use computational networks of Izhikevich integrate-and-fire neurons to study synchronized, oscillatory activity between clusters of neurons, which also adapt according to spike-timing-dependent plasticity (STDP). We study how the connections within and between these neuronal clusters change as unidirectional connections form between the two neuronal populations. In turn, we examine how neuronal deletion, intended to mimic the temporary or permanent loss of neurons in the mesoscale circuit, affects these dynamics. We determine synchronization of two neuronal circuits requires very modest connectivity between these populations; approximately 10% of neurons projecting from one circuit to another circuit will result in high synchronization. In addition, we find that synchronization level inversely affects the strength of connection between neuronal microcircuits - moderately synchronized microcircuits develop stronger intercluster connections than do highly synchronized circuits. Finally, we find that highly synchronized circuits are largely protected against the effects of neuronal deletion but may display changes in frequency properties across circuits with targeted neuronal loss. Together, our results suggest that strongly and weakly connected regions differ in their inherent resilience to damage and may serve different roles in a larger network.
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Affiliation(s)
- Samantha N. Schumm
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - David Gabrieli
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
| | - David F. Meaney
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, United States
- Penn Center for Brain Injury and Repair, Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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3
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Mogadam A, Keller AE, Taylor MJ, Lerch JP, Anagnostou E, Pang EW. Mental flexibility: An MEG investigation in typically developing children. Brain Cogn 2017; 120:58-66. [PMID: 29065995 DOI: 10.1016/j.bandc.2017.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 09/22/2017] [Accepted: 10/01/2017] [Indexed: 02/04/2023]
Abstract
Mental flexibility is a core property of cognitive executive functions, relying on an extended frontoparietal network in the brain. fMRI research comparing typically developing children and adults has found that children from an early age recruit the same "classic" brain areas associated with mental flexibility as adults; however, there is evidence that the timing of activation may be different. To investigate the temporal dynamics of brain activity associated with mental flexibility in children, we recruited 22 typically developing children (8-15 years) to complete a set-shifting task in the MEG. Our results showed that while the children relied on the same frontoparietal network of mental flexibility, there was a different emphasis on active brain regions, with children preferentially using their posterior parietal cortices. Additional areas such as the temporal pole and the premotor areas were also recruited, potentially playing a supporting role. Although children shared the same window of peak activity as adults, 75-350ms, we found a significant decrease in activation latency with increasing age, suggesting the presence of developmental differences in timing of brain activity in areas supporting mental flexibility during childhood.
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Affiliation(s)
- Alexandra Mogadam
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada; Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada
| | - Anne E Keller
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, Hospital for Sick Children, Toronto, Canada
| | - Margot J Taylor
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada; Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, Hospital for Sick Children, Toronto, Canada; Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Canada; Departments of Psychology & Medical Imaging, University of Toronto, Canada
| | - Jason P Lerch
- Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Mouse Imaging Centre, Hospital for Sick Children, Toronto, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Canada
| | - Evdokia Anagnostou
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada; Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, Hospital for Sick Children, Toronto, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Elizabeth W Pang
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Canada; Neurosciences and Mental Health, SickKids Research Institute, Toronto, Canada; Division of Neurology, Hospital for Sick Children, Toronto, Canada.
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Carrick FR, Clark JF, Pagnacco G, Antonucci MM, Hankir A, Zaman R, Oggero E. Head-Eye Vestibular Motion Therapy Affects the Mental and Physical Health of Severe Chronic Postconcussion Patients. Front Neurol 2017; 8:414. [PMID: 28878731 PMCID: PMC5572417 DOI: 10.3389/fneur.2017.00414] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/31/2017] [Indexed: 01/05/2023] Open
Abstract
Context Approximately 1.8–3.6 million annual traumatic brain injuries occur in the United States. An evidence-based treatment for concussions that is reliable and effective has not been available. Objective The objective of this study is to test whether head–eye vestibular motion (HEVM) therapy is associated with decreased symptoms and increased function in postconcussive syndrome (PCS) patients that have been severely impaired for greater than 6 months after a mild traumatic brain injury. Design Retrospective clinical chart review. Setting and participants Tertiary Specialist Brain Rehabilitation Center. Interventions All subjects underwent comprehensive neurological examinations including measurement of eye and head movement. The seven modules of the C3 Logix Comprehensive Concussion Management System were used for pre- and postmeasurements of outcome of HEVM therapy. Materials and methods We utilized an objective validated measurement of physical and mental health characteristics of our patients before and after a 1-week HEVM rehabilitation program. We included only PCS patients that were disabled from work or school for a period of time exceeding 6 months after suffering a sports concussion. These subjects all were enrolled in a 5-day HEVM rehabilitation program at our Institutional Brain Center with pre- and post-C3 Logix testing outcomes. Results There were statistical and substantive significant decreases in PCS symptom severity after treatment and statistical and substantive significant increases in standardized assessment of concussion scores. The outcomes were associated with positive changes in mental and physical health issues. This is a retrospective review and no control group has been included in this study. These are major limitations with retrospective reviews and further investigations with prospective designs including a randomized controlled study are necessary to further our understanding. Conclusion Head–eye vestibular motion therapy of 5 days duration is associated with statistical and substantive significant decreases of symptom severity associated with chronic PCS.
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Affiliation(s)
- Frederick Robert Carrick
- Bedfordshire Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.,Neurology, Carrick Institute, Cape Canaveral, FL, United States.,Harvard Macy Institute and MGH Institute of Health Professions, Boston, MA, United States
| | - Joseph F Clark
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Guido Pagnacco
- Neurology, Carrick Institute, Cape Canaveral, FL, United States.,Electrical and Computer Engineering Department, University of Wyoming, Laramie, WY, United States
| | - Matthew M Antonucci
- Neurology, Carrick Institute, Cape Canaveral, FL, United States.,Neurology, Plasticity Brain Center, Orlando, FL, United States
| | - Ahmed Hankir
- Bedfordshire Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.,Psychiatry, Carrick Institute, Cape Canaveral, FL, United States
| | - Rashid Zaman
- Bedfordshire Centre for Mental Health Research in Association with University of Cambridge, Cambridge, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Elena Oggero
- Neurology, Carrick Institute, Cape Canaveral, FL, United States.,Electrical and Computer Engineering Department, University of Wyoming, Laramie, WY, United States
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Koerte IK, Nichols E, Tripodis Y, Schultz V, Lehner S, Igbinoba R, Chuang AZ, Mayinger M, Klier EM, Muehlmann M, Kaufmann D, Lepage C, Heinen F, Schulte-Körne G, Zafonte R, Shenton ME, Sereno AB. Impaired Cognitive Performance in Youth Athletes Exposed to Repetitive Head Impacts. J Neurotrauma 2017; 34:2389-2395. [PMID: 28381107 DOI: 10.1089/neu.2016.4960] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Worldwide, more than 22 million children and adolescents are exposed to repetitive head impacts (RHI) in soccer. Evidence indicates cumulative effects on brain structure, but it is not known whether exposure to RHI affects cognitive improvement in adolescents. The aim of the study was to determine whether exposure to RHI while heading the ball in soccer affects improvement in cognitive performance in adolescents over time. The study group consisted of a convenience sample of 16 male soccer players (mean age 15.7 ± 0.7 years). A comparison cohort of 14 male non-contact sports athletes (mean age 14.9 ± 1.1 years) was recruited from competitive athletic clubs and group-matched in age. Using the ProPoint and AntiPoint tasks, sensorimotor and cognitive functions were measured over both immediate (pre- vs. post-training) as well as across multiple time points within a play season. The number and type of head impacts that occurred during the training were counted. The main outcome measure was the change in response time (RT) in the ProPoint and AntiPoint tasks. The immediate (pre- vs. post-training) and longer-term (across a play season) change in RT was analyzed, and the effect of the number and type of head impacts was tested. Thirty athletes with and without exposure to RHI demonstrated a decrease in RT in both tasks immediately after training. Over the play season, both groups showed improvement in sensorimotor function. While the control group also improved in cognitive performance, the soccer players did not, however. Further, the more long headers performed, the slower the improvement in RT over the season. Youth athletes experience an immediate cognitive improvement after training most likely because of physical exercise. Results of this study also suggest an association between exposure to specific RHI (long headers) and lack of improvement in cognitive performance in youth athletes over time.
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Affiliation(s)
- Inga K Koerte
- 1 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität , Munich, Germany .,2 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , and Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Nichols
- 1 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität , Munich, Germany
| | - Yorghos Tripodis
- 3 Department of Biostatistics, Boston University School of Public Health , Boston, Massachusetts
| | - Vivian Schultz
- 1 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität , Munich, Germany .,2 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , and Harvard Medical School, Boston, Massachusetts
| | - Stefan Lehner
- 4 Department of Applied Sciences and Mechatronics, University of Applied Sciences , Munich, Germany
| | - Randy Igbinoba
- 5 Department of Neurobiology and Anatomy, McGovern Medical School, University of Texas Health Science Center , Houston, Texas
| | - Alice Z Chuang
- 6 Department of Ophthalmology and Visual Science, McGovern Medical School, University of Texas Health Science Center , Houston, Texas
| | - Michael Mayinger
- 1 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität , Munich, Germany .,2 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , and Harvard Medical School, Boston, Massachusetts
| | - Eliana M Klier
- 5 Department of Neurobiology and Anatomy, McGovern Medical School, University of Texas Health Science Center , Houston, Texas
| | - Marc Muehlmann
- 7 Institute for Clinical Radiology , Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Christian Lepage
- 2 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , and Harvard Medical School, Boston, Massachusetts
| | - Florian Heinen
- 9 Department of Pediatric Neurology, Dr. von Hauner Children's Hospital , Ludwig-Maximilians- Universität, Munich, Germany
| | - Gerd Schulte-Körne
- 1 Department of Child and Adolescent Psychiatry, Psychosomatic, and Psychotherapy, Ludwig-Maximilians-Universität , Munich, Germany
| | - Ross Zafonte
- 10 Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women's Hospital , Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | - Martha E Shenton
- 2 Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital , and Harvard Medical School, Boston, Massachusetts.,11 VA Boston Healthcare System , Boston, Massachusetts
| | - Anne B Sereno
- 5 Department of Neurobiology and Anatomy, McGovern Medical School, University of Texas Health Science Center , Houston, Texas
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Stress-altered synaptic plasticity and DAMP signaling in the hippocampus-PFC axis; elucidating the significance of IGF-1/IGF-1R/CaMKIIα expression in neural changes associated with a prolonged exposure therapy. Neuroscience 2017; 353:147-165. [PMID: 28438613 DOI: 10.1016/j.neuroscience.2017.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 12/20/2022]
Abstract
Traumatic stress patients showed significant improvement in behavior after a prolonged exposure to an unrelated stimulus. This treatment method attempts to promote extinction of the fear memory associated with the initial traumatic experience. However, the subsequent prolonged exposure to such stimulus creates an additional layer of neural stress. Although the mechanism remains unclear, prolonged exposure therapy (PET) likely involves changes in synaptic plasticity, neurotransmitter function and inflammation; especially in parts of the brain concerned with the formation and retrieval of fear memory (Hippocampus and Prefrontal Cortex: PFC). Since certain synaptic proteins are also involved in danger-associated molecular pattern signaling (DAMP), we identified the significance of IGF-1/IGF-1R/CaMKIIα expression as a potential link between the concurrent progression of synaptic and inflammatory changes in stress. Thus, a comparison between IGF-1/IGF-1R/CaMKIIα, synaptic and DAMP proteins in stress and PET may highlight the significance of PET on synaptic morphology and neuronal inflammatory response. In behaviorally characterized Sprague-Dawley rats, there was a significant decline in neural IGF-1 (p<0.001), hippocampal (p<0.001) and cortical (p<0.05) IGF-1R expression. These animals showed a significant loss of presynaptic markers (synaptophysin; p<0.001), and changes in neurotransmitters (VGLUT2, Tyrosine hydroxylase, GABA, ChAT). Furthermore, naïve stressed rats recorded a significant decrease in post-synaptic marker (PSD-95; p<0.01) and synaptic regulator (CaMKIIα; p<0.001). As part of the synaptic response to a decrease in brain CaMKIIα, small ion conductance channel (KCa2.2) was upregulated in the brain of naïve stressed rats (p<0.01). After a PET, an increase in IGF-1 (p<0.05) and IGF-1R was recorded in the Stress-PET group (p<0.001). As such, hippocampal (p<0.001), but not cortical (ns) synaptophysin expression increased in Stress-PET. Although PSD-95 was relatively unchanged in the hippocampus and PFC, CaMKIIα (p<0.001) and KCa2.2 (p<0.01) were upregulated in Stress-PET, and may be involved in extinction of fear memory-related synaptic potentials. These changes were also associated with a normalized neurotransmitter function, and a significant reduction in open space avoidance; when the animals were assessed in elevated plus maze (EPM). In addition to a decrease in IGF-1/IGF-1R, an increase in activated hippocampal and cortical microglia was seen in stress (p<0.05) and after a PET (Stress-PET; p<0.001). Furthermore, this was linked with a significant increase in HMGB1 (Hippocampus: p<0.001, PFC: p<0.05) and TLR4 expression (Hippocampus: p<0.01; PFC: ns) in the neurons. Taken together, this study showed that traumatic stress and subsequent PET involves an event-dependent alteration of IGF1/IGF-1R/CaMKIIα. Firstly, we showed a direct relationship between IGF-1/IGF-1R expression, presynaptic function (synaptophysin) and neurotransmitter activity in stress and PET. Secondly, we identified the possible role of CaMKIIα in post-synaptic function and regulation of small ion conductance channels. Lastly, we highlighted some of the possible links between IGF1/IGF-1R/CaMKIIα, the expression of DAMP proteins, Microglia activation, and its implication on synaptic plasticity during stress and PET.
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Denhardt DT. Effect of stress on human biology: Epigenetics, adaptation, inheritance, and social significance. J Cell Physiol 2017; 233:1975-1984. [PMID: 28158904 DOI: 10.1002/jcp.25837] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 12/21/2022]
Abstract
I present a brief introduction to epigenetics, focused primarily on methylation of the genome and various regulatory RNAs, modifications of associated histones, and their importance in enabling us to adapt to real and changing environmental, developmental, and social circumstances. Following this is a more extensive overview of how it impacts our inheritance, our entire life (which changes as we age), and how we interact with others. Throughout, I emphasize the critical influence that stress, of many varieties exerts, via epigenetic means, on much of how we live and survive, mostly in the brain. I end with a short section on multigenerational transmission, drugs, and the importance of both social life and early life experiences in the development of adult diseases. There will be nothing about cancer. Although epigenetics is critical in that field, it is a whole different cobweb of complications (some involving stress).
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Affiliation(s)
- David T Denhardt
- Division of Life Sciences, Rutgers University, New Brunswick, New Jersey
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