The contribution of prognostic factors to socio-demographic inequalities in breast cancer survival in Victoria, Australia

BACKGROUND

Breast cancer survival in Australia varies according to socio-economic status (SES) and between rural and urban places of residence. Part of this disparity may be due to differences in prognostic factors at the time of diagnosis.

METHODS

Women with invasive breast cancer diagnosed from 2008 until 2012 (n = 14,165) were identified from the Victorian Cancer Registry and followed up for 5 years, with death from breast cancer or other causes recorded. A prognostic score, based on stage at diagnosis, cancer grade, whether the cancer was detected via screening, reported comorbidities and age at diagnosis, was constructed for use in a mediation analysis.

RESULTS

Five-year breast cancer mortality for women with breast cancer who were in the lowest quintile of SES (10.3%) was almost double that of those in the highest quintile (5.7%). There was a small survival advantage (1.7% on average, within each socio-economic quintile) of living in inner-regional areas compared with major cities. About half of the socio-economic disparity was mediated by prognostic factors, particularly stage at diagnosis and the presence of comorbidities. The inner-regional survival advantage was not due to differences in prognostic factors.

CONCLUSIONS

Part of the socio-economic disparity in breast cancer survival could be addressed by earlier detection in, and improved general health for, more disadvantaged women. Further research is required to identify additional causes of socio-economic disparities as well as the observed inner-regional survival advantage.

Socio-economic and ethnocultural influences on geographical disparities in breast cancer screening participation in Victoria, Australia

OBJECTIVE

To examine the socio-economic and ethnocultural characteristics of geographical areas that may influence variation in breast cancer screening participation.

METHODS

In a cross-sectional analysis breast cancer screening participation for statistical areas in Victoria, Australia (2015-2017) was linked with data from the 2016 Australian Census. We selected four commonly used area-level measures of socio-economic status from the Australian Census (i) income (ii) educational level (iii) occupational status and (iv) employment profile. To assess the ethnocultural characteristics of statistical areas we used the Census measures (i) country of birth (ii) language spoken at home (iii) fluency in English (iv) religion and (v) the proportion of immigrants in an area, together with their recency of migration.

RESULTS

All the selected measures were related to screening participation. There was a high degree of association both within and between socio-economic and ethnocultural characteristics of areas as they relate to screening. Ethnocultural characteristics alone accounted for most of the explained geographical disparity in screening participation.

CONCLUSIONS

Geographical disparities in breast cancer screening participation may be due to ethnocultural factors that are confounded with socio-economic factors.

DNA Methylation in Peripheral Blood and Risk of Gastric Cancer: A Prospective Nested Case-control Study

DNA methylation in peripheral blood is a potential biomarker of gastric cancer risk which could be used for early detection. We conducted a prospective case-control study nested within the Melbourne Collaborative Cohort Study. Genomic DNA was prepared from blood samples collected a median of 12 years before diagnosis for cases (N = 168). Controls (N = 163) were matched to cases on sex, year of birth, country of birth, and blood sample type using incidence density sampling. Genome-wide DNA methylation was measured using the Infinium HumanMethylation450K Beadchip. Global measures of DNA methylation were defined as the median methylation M value, calculated for each of 13 CpG subsets representing genomic function, mean methylation and location, and reliability of measurement. Conditional logistic regression was conducted to assess associations between these global measures of methylation and gastric cancer risk, adjusting for Helicobacter pylori and other potential confounders. We tested nonlinear associations using quintiles of the global measure distribution. A genome-wide association study of DNA methylation and gastric cancer risk was also conducted (N = 484,989 CpGs) using conditional logistic regression, adjusting for potential confounders. Differentially methylated regions (DMR) were investigated using the R package DMRcate We found no evidence of associations with gastric cancer risk for individual CpGs or DMRs (P > 7.6 × 10^-6). No evidence of association was observed with global measures of methylation (OR 1.07 per SD of overall median methylation; 95% confidence interval, 0.80-1.44; P = 0.65). We found no evidence that blood DNA methylation is prospectively associated with gastric cancer risk.Prevention Relevance: We studied DNA methylation in blood to try and predict who was at risk of gastric cancer before symptoms developed, by which stage survival is poor. We did not find any such markers, but the importance of early diagnosis in gastric cancer remains, and the search for markers continues.

The role of hue in visual search for texture differences: Implications for camouflage design

The purpose of camouflage is to be inconspicuous against a given background. Colour is an important component of camouflage, and the task of designing a single camouflage pattern for use against multiple different backgrounds is particularly challenging. As it is impossible to match the colour gamut of each background exactly, the question arises which colours from the different backgrounds should be incorporated in a camouflage pattern to achieve optimal concealment. Here, we used a visual search paradigm to address this question. Observers searched multi-coloured continuous textures for target regions defined by either the presence or absence of additional hues. Targets could be either a combination of five hues against a four-hued background ("patches"), or a combination of four hues against a five-hued background ("holes"). In Experiment 1, a search asymmetry was observed for the different targets, as observers were less accurate and slower at detecting holes than patches. Additionally, we observed a linear separability effect: search for a target was more difficult when the hue that defined the target was within the gamut of distractor colours (e.g. orange amongst reds and yellows). In Experiment 2, we further investigated "hole" targets designed for two different backgrounds and found that optimal concealment against both backgrounds was achieved by including intermediate colours that represented a compromise between the common colours and the unique colours of each background. The findings provide insights into how search asymmetries can be extended to complex texture properties and help inform the design process of camouflage for multiple backgrounds.

In the eye of the beholder: A simulator study of the impact of Google Glass on driving performance

This study examined whether, and to what extent, driving is affected by reading text on Google Glass. Reading text requires a high level of visual resources and can interfere with safe driving. However, it is currently unclear if the impact of reading text on a head-mounted display, such as Google Glass (Glass), will differ from that found with more traditional head-down electronic devices, such as a dash-mounted smartphone. A total of 20 drivers (22-48 years) completed the Lane Change Test while driving undistracted and while reading text on Glass and on a smartphone. Measures of lateral vehicle control and event detection were examined along with subjective workload and secondary task performance. Results revealed that drivers' lane keeping ability was significantly impaired by reading text on both Glass and the smartphone. When using Glass, drivers also failed to detect a greater number of lane change signs compared to when using the phone or driving undistracted. In terms of subjective workload, drivers rated reading on Glass as subjectively easier than on the smartphone, which may possibly encourage greater use of this device while driving. Overall, the results suggest that, despite Glass allowing drivers to better maintain their visual attention on the forward scene, drivers are still not able to effectively divide their cognitive attention across the Glass display and the road environment, resulting in impaired driving performance.

Brief report: visual acuity in children with autism spectrum disorders

Recently, there has been heightened interest in suggestions of enhanced visual acuity in autism spectrum disorders (ASD) which was sparked by evidence that was later accepted to be methodologically flawed. However, a recent study that claimed children with ASD have enhanced visual acuity (Brosnan et al. in J Autism Dev Disord 42:2491-2497, 2012) repeated a critical methodological flaw by using an inappropriate viewing distance for a computerised acuity test, placing the findings in doubt. We examined visual acuity in 31 children with ASD and 33 controls using the 2 m 2000 Series Revised Early Treatment Diabetic Retinopathy Study chart placed at twice the conventional distance to better evaluate possible enhanced acuity. Children with ASD did not demonstrate superior acuity. The current findings strengthen the argument that reports of enhanced acuity in ASD are due to methodological flaws and challenges the reported association between visual acuity and systemising type behaviours.

The role of lightness, hue and saturation in feature-based visual attention

Visual attention is used to select part of the visual array for higher-level processing. Visual selection can be based on spatial location, but it has also been demonstrated that multiple locations can be selected simultaneously on the basis of a visual feature such as color. One task that has been used to demonstrate feature-based attention is the judgement of the symmetry of simple four-color displays. In a typical task, when symmetry is violated, four squares on either side of the display do not match. When four colors are involved, symmetry judgements are made more quickly than when only two of the four colors are involved. This indicates that symmetry judgements are made one color at a time. Previous studies have confounded lightness, hue, and saturation when defining the colors used in such displays. In three experiments, symmetry was defined by lightness alone, lightness plus hue, or by hue or saturation alone, with lightness levels randomised. The difference between judgements of two- and four-color asymmetry was maintained, showing that hue and saturation can provide the sole basis for feature-based attentional selection.

A test of the magnocellular deficit theory of dyslexia in an adult sample

An influential theory of dyslexia is based on the premise that individuals with the disorder have impaired sensitivity to rapidly changing stimuli in the visual and auditory modalities, due to a dysfunction in the magnocellular channel of the visual system and its analogue in the auditory pathway. The deficit in the auditory system is thought to cause difficulties in the segmentation of speech and the formation of accurate phonological representations, leading to problems in making the grapheme-phoneme correspondences necessary for reading. In a sample of 13 adults with a history of severe reading difficulty and 18 controls, visual contrast thresholds were measured in response to an 8-Hz flickering Gaussian blob as well as a slowly modulated 8 cycles/deg Gaussian windowed grating. Auditory thresholds were measured in response to a 4-s burst of white noise, the 2nd or 3rd second of which was amplitude modulated at 100 Hz or 1 Hz. The adult reading difficulty group exhibited normal thresholds to rapidly changing stimuli in both modalities and to the slowly modulated visual stimulus, but some showed reduced sensitivity to the 1-Hz amplitude-modulated auditory stimulus. Sensitivity to amplitude modulation at slower rates has been shown to be important for segmentation of the speech stream and so may be implicated in the reading difficulty of the affected individuals. A magnocellular deficit cannot explain this impaired sensitivity, which may be the result of a reduced echoic memory span.

Visual acuity in adults with Asperger's syndrome: no evidence for "eagle-eyed" vision

BACKGROUND

Autism spectrum conditions (ASC) are defined by criteria comprising impairments in social interaction and communication. Altered visual perception is one possible and often discussed cause of difficulties in social interaction and social communication. Recently, Ashwin et al. suggested that enhanced ability in local visual processing in ASC was due to superior visual acuity, but that study has been the subject of methodological criticism, placing the findings in doubt.

METHODS

The present study investigated visual acuity thresholds in 24 adults with Asperger's syndrome and compared their results with 25 control subjects with the 2 Meter 2000 Series Revised ETDRS Chart.

RESULTS

The distribution of visual acuities within the two groups was highly similar, and none of the participants had superior visual acuity.

CONCLUSIONS

Superior visual acuity in individuals with Asperger's syndrome could not be established, suggesting that differences in visual perception in ASC are not explained by this factor. A continued search for explanations of superior ability in local visual processing in persons with ASC is therefore warranted.

A dual-process account of auditory change detection

Listeners can be "deaf" to a substantial change in a scene comprising multiple auditory objects unless their attention has been directed to the changed object. It is unclear whether auditory change detection relies on identification of the objects in pre- and post-change scenes. We compared the rates at which listeners correctly identify changed objects with those predicted by change-detection models based on signal detection theory (SDT) and high-threshold theory (HTT). Detected changes were not identified as accurately as predicted by models based on either theory, suggesting that some changes are detected by a process that does not support change identification. Undetected changes were identified as accurately as predicted by the HTT model but much less accurately than predicted by the SDT models. The process underlying change detection was investigated further by determining receiver-operating characteristics (ROCs). ROCs did not conform to those predicted by either a SDT or a HTT model but were well modeled by a dual-process that incorporated HTT and SDT components. The dual-process model also accurately predicted the rates at which detected and undetected changes were correctly identified.

Reduced connectivity of the auditory cortex in patients with auditory hallucinations: a resting state functional magnetic resonance imaging study

BACKGROUND

Previous research has reported auditory processing deficits that are specific to schizophrenia patients with a history of auditory hallucinations (AH). One explanation for these findings is that there are abnormalities in the interhemispheric connectivity of auditory cortex pathways in AH patients; as yet this explanation has not been experimentally investigated. We assessed the interhemispheric connectivity of both primary (A1) and secondary (A2) auditory cortices in n=13 AH patients, n=13 schizophrenia patients without auditory hallucinations (non-AH) and n=16 healthy controls using functional connectivity measures from functional magnetic resonance imaging (fMRI) data.

METHOD

Functional connectivity was estimated from resting state fMRI data using regions of interest defined for each participant based on functional activation maps in response to passive listening to words. Additionally, stimulus-induced responses were regressed out of the stimulus data and the functional connectivity was estimated for the same regions to investigate the reliability of the estimates.

RESULTS

AH patients had significantly reduced interhemispheric connectivity in both A1 and A2 when compared with non-AH patients and healthy controls. The latter two groups did not show any differences in functional connectivity. Further, this pattern of findings was similar across the two datasets, indicating the reliability of our estimates.

CONCLUSIONS

These data have identified a trait deficit specific to AH patients. Since this deficit was characterized within both A1 and A2 it is expected to result in the disruption of multiple auditory functions, for example, the integration of basic auditory information between hemispheres (via A1) and higher-order language processing abilities (via A2).

Functional connectivity estimation in fMRI data: influence of preprocessing and time course selection

A number of techniques have been used to provide functional connectivity estimates for a given fMRI data set. In this study we compared two methods: a 'rest-like' method where the functional connectivity was estimated for the whitened residuals after regressing out the task-induced effects, and a within-condition method where the functional connectivity was estimated separately for each experimental condition. In both cases four pre-processing strategies were used: 1) time courses extracted from standard pre-processed data (standard); 2) adjusted time courses extracted using the volume of interest routines in SPM2 from standard pre-processed data (spm); 3) time courses extracted from ICA denoised data (standard denoised); and 4) adjusted time courses extracted from ICA denoised data (spm denoised). The temporal correlation between time series extracted from two cortical regions were statistically compared with the temporal correlation between a time series extracted from a cortical region and a time series extracted form a region placed in CSF. Since the later correlation is due to physiological noise and other artifacts, we used this comparison to investigate whether rest-like and task modulated connectivity could be estimated from the same data set. The pre-processing strategy had a significant effect on the connectivity estimates with the standard time courses providing larger connectivity values than the spm time courses for both estimation methods. The CSF comparison indicated that for our data set only rest-like connectivity could be estimated. The rest-like connectivity values were similar with connectivity estimated from resting state data.

Prediction of Functional Outcome 18 Months After a First Psychotic Episode

CONTEXT

Recent magnetic resonance imaging studies have attempted to relate volumetric brain measurements in early schizophrenia to clinical and functional outcome some years later. These studies have generally been negative, perhaps because gray and white matter volumes inaccurately assess the underlying dysfunction that might be predictive of outcome.

OBJECTIVE

To investigate the predictive value of frontal and temporal spectroscopy measures for outcome in patients with first-episode psychoses.

DESIGN

Left prefrontal cortex and left mediotemporal lobe voxels were assessed using proton magnetic resonance spectroscopy to provide the ratio of N-acetylaspartate (NAA) and choline-containing compounds to creatine and phosphocreatine (Cr) (NAA/Cr ratio). These data were used to predict outcome at 18 months after admission, as assessed by a systematic medical record audit.

SETTING

Early psychosis clinic.

PARTICIPANTS

Forty-six patients with first-episode psychosis.

MAIN OUTCOME MEASURES

We used regression models that included age at imaging and duration of untreated psychosis to predict outcome scores on the Global Assessment of Functioning Scale, Clinical Global Impression scales, and Social and Occupational Functional Assessment Scale, as well as the number of admissions during the treatment period. We then further considered the contributions of premorbid function and baseline level of negative symptoms.

RESULTS

The only spectroscopic predictor of outcome was the NAA/Cr ratio in the prefrontal cortex. Low scores on this variable were related to poorer outcome on all measures. In addition, the frontal NAA/Cr ratio explained 17% to 30% of the variance in outcome.

CONCLUSIONS

Prefrontal neuronal dysfunction is an inconsistent feature of early psychosis; rather, it is an early marker of poor prognosis across the first years of illness. The extent to which this can be used to guide treatment and whether it predicts outcome some years after first presentation are questions for further research.

A comprehensive open reading frame phylogenetic analysis of isometric positive strand ssRNA plant viruses

Rigorous large-scale whole genome comparisons are capable of providing more comprehensive and potentially more accurate descriptions of viral relationships, allowing for the effective validation and modification of current taxonomy. Using a set of 5 togaviruses as an outgroup, a comprehensive phylogeny for 115 isometric positive ssRNA plant viruses was generated based on the simultaneous comparison of over 480 ORFs found within completely sequenced genomes. With the exception of a diverse group of viruses representing the family Comoviridae, the single tree generated contained well supported branches corresponding to well established groups of viruses, including Bromoviridae, Umbravirus, Sobemovirus, and Tymoviridae. In addition, evidence for specific relationships between groups were also observed, specifically Tombusviridae + Umbravirus, and Luteoviridae + Sobemovirus. Various well established subgroups of viruses were also well resolved within the tree. In addition, some recent proposals involving the creation of new genera or the inclusion of newly described viruses into established genera were supported, while others were not. The evidence for frequent gene sharing and the potential consequences to viral taxonomy are discussed.

The validity and reliability of the Tertiary Student Values Scale (TSVS)

OBJECTIVE

To explore the factorial composition of an instrument developed to assess value orientations in tertiary students, the Tertiary Student Values Scale (TSVS), using data from culturally diverse undergraduate dental students.

METHODS

A 68-item questionnaire was used to collect the data. The questionnaire included 15 3-item subscales developed in a manner consistent with the Kluckhohn and Strodtbeck value orientation model. The psychometric properties were evaluated using a sample of students from 4 Australian dental schools. The questionnaire was administered to 364 students aged 18-50 years, mean age 21.3 years (SD 3.45 years), using a convenience sampling method. Scores on the 45 items were factor analysed using the maximum-likelihood estimation method for factor extraction with oblique rotation (oblimin). Internal consistency was examined on all of the 3-item subscales, using Cronbach's alpha.

RESULTS

The analysis indicates that the TSVS reflects the hypothesised 15-dimension construct of value orientation. Furthermore, the analysis showed that the identified 15 factors were independent of one another and were sufficiently reliable for group comparisons. With 1 exception, all subscales yielded a Cronbach's alpha > or = 0.55, the exception being 1 subscale with alpha = 0.40 (range 0.40-0.80).

CONCLUSION

Results indicated that value orientation is a complex construct, but that it is quantifiable along multiple dimensions in a psychometrically valid manner. Further refinement of this instrument would increase its value as a tool for policy makers designing educational programmes and services for culturally diverse student groups.

Early processing deficits in object working memory in first-episode schizophreniform psychosis and established schizophrenia

BACKGROUND

While there are many studies showing working-memory deficits in schizophrenia there are only a few that disentangle impairments for working-memory subprocesses such as perceptual, attentional, mnemonic and executive function.

METHOD

In this study of delay-dependent memory, 55 patients with schizophreniform psychosis, 50 with established schizophrenia and 56 healthy controls were investigated. Using the delayed matching-to-sample task from the Cambridge Neuropsychological Test Automated Battery (CANTAB), performance deficits were found in both patient groups after controlling for age and pre-morbid IQ.

RESULTS

Even after controlling for simultaneous matching-to-sample ability (i.e. perceptual matching), impaired performance in both patient groups was found as soon as the stimuli were no longer present. Impaired performance was not due to different types of errors in patients versus controls. Performance in both patient groups was comparable, except for a slight decrease of overall task performance. This suggests that the deficit is relatively stable during the course of the illness.

CONCLUSIONS

Our results suggest a deficit in patients with psychotic illness in the initial processes necessary to actively maintain information, such as the ability to form an internal representation of complex objects.

Magma-assisted rifting in Ethiopia

The rifting of continents and evolution of ocean basins is a fundamental component of plate tectonics, yet the process of continental break-up remains controversial. Plate driving forces have been estimated to be as much as an order of magnitude smaller than those required to rupture thick continental lithosphere. However, Buck has proposed that lithospheric heating by mantle upwelling and related magma production could promote lithospheric rupture at much lower stresses. Such models of mechanical versus magma-assisted extension can be tested, because they predict different temporal and spatial patterns of crustal and upper-mantle structure. Changes in plate deformation produce strain-enhanced crystal alignment and increased melt production within the upper mantle, both of which can cause seismic anisotropy. The Northern Ethiopian Rift is an ideal place to test break-up models because it formed in cratonic lithosphere with minor far-field plate stresses. Here we present evidence of seismic anisotropy in the upper mantle of this rift zone using observations of shear-wave splitting. Our observations, together with recent geological data, indicate a strong component of melt-induced anisotropy with only minor crustal stretching, supporting the magma-assisted rifting model in this area of initially cold, thick continental lithosphere.

Cultural consistency in Australian dental students from two different ethnic backgrounds

The objective of this study was to examine the value orientations of dental students from different ethnic backgrounds studying in Australian dental schools. A ninety-eight-item questionnaire was used to collect the data, including fifteen subscales developed consistent with the Kluckhohn and Strodtbeck value orientation model. To compare the value orientation structure and to determine if any ethnic differences existed, a multivariate analysis of variance called profile analysis was performed on the fifteen value subscales. Of the 401 participants, 30.2 percent were Anglo-Australian and 44.9 percent were Asian. The remainder (24.9 percent) were "Other-background residents" or "Other-international students." This article presents data from Asian (n=184) and Anglo-Australian (n=124) background respondents. Mean age was 21.7 years (s.e. 0.35 years) among Anglo-Australian and 20.8 years (s.e. 0.17 years) among Asians. Asians born overseas represented 70.7 percent (n=130) of this group. Of Australia-born Asians (n=54), 90.6 percent were first-generation Australians. When comparing their value profile, we found a significant association between ethnicity and value orientation profile scores (p<0.05). Despite the significant overall result, the strength of the association (eta(2)=0.007) indicated that this effect was trivial relative to the unexplained variance in value orientation. The findings suggest that, behind an apparent ethnic diversity, a single distinctive value profile might exist to which the majority of dental students subscribe.

Relationship of behavioural and symptomatic syndromes in schizophrenia to spatial working memory and attentional set-shifting ability

BACKGROUND

Behavioural syndromes (thought disturbance, social withdrawal, depressed behaviour and antisocial behaviour) offer a different perspective from that of symptomatic syndromes on the disability that may be associated with schizophrenia. Few studies have assessed their relationship with neuropsychological deficits. We hypothesized that these syndromes may represent behavioural manifestations of frontal-subcortical impairments, previously described in schizophrenia.

METHOD

Long-stay inpatients (n=54) and community patients (n=43) with enduring schizophrenia were assessed, using measures of symptoms and behaviour and tests of executive functioning. The relationship between syndromes and neuropsychological function was assessed using multiple regression and logistic regression analyses.

RESULTS

Significant associations were found between performance on the spatial working memory task and the psychomotor poverty symptomatic syndrome, and between attentional set-shifting ability and both disorganization symptoms and the thought disturbance behavioural syndrome. These results were not explained by the effect of premorbid IQ, geographical location, length of illness or antipsychotic medication. Length of illness was an independent predictor of attentional set-shifting ability but not of working memory performance.

CONCLUSION

The specific relationship between negative symptoms and spatial working memory is consistent with involvement of the dorsolateral prefrontal cortex. The associations between difficulty with set-shifting ability and both disorganization symptoms and behaviours may reflect inability to generalize a rule that had been learned and impaired ability to respond flexibly. The specific relationship of illness duration to set-shifting ability may suggest progressive impairment on some executive tasks. The nature of these relationships and their neurobiological and rehabilitation implications are considered.

Individual Differences in Anterior Cingulate/Paracingulate Morphology Are Related to Executive Functions in Healthy Males

The neuropsychological correlates of inter-individual variations in cortical folding are poorly understood. Anterior cingulate (AC) cortex is one region characterized by considerable variability, particularly with respect to the paracingulate sulcus (PCS), which is present in only 30-60% of individuals and more commonly found in the left cerebral hemisphere. To investigate whether inter-individual differences in this PCS asymmetry are related to cognitive performance, we classified 30 healthy right-handed males as displaying either a leftward, rightward or symmetric pattern of folding based on the incidence and extent of the PCS in each hemisphere, and compared their performance on tasks engaging executive cognitive processes associated with frontal lobe function. We found that the more common leftward PCS asymmetry was associated with better performance across verbal and non-verbal executive tasks, but that PCS variability had no effect on tasks less dependent on executive functions. These results suggest that the leftward pattern of folding is associated with a non-specific performance advantage on cognitively demanding executive function tasks, possibly due to differences in functional interactions between AC/paracingulate cortex and connected frontal regions. It therefore appears that normal variations in brain morphology are associated with individual differences in cognitive abilities.

Changes in effective connectivity models in the presence of task-correlated motion: an fMRI study

We investigated the effects of motion-correction strategy and time course selection method when structural equation modeling is applied to fMRI data in the presence of task-correlated motion. Three motion-correction methods were employed for a group of 12 subjects performing an orthographic lexical retrieval task: (1) a rigid body realignment as implemented in SPM99, (2) a rigid body realignment combined with the inclusion of motion parameters in the statistical model, and (3) the FLIRT motion correction followed by an ICA analysis aiming to identify and remove the motion-related components and the ghosting artifacts. For each motion correction, the time courses of the activated regions were selected in three ways: (1) using the voxels with the highest Z scores, (2) using the average across all the statistically significant voxels in the region of interest, and (3) using a within-region, across-subjects, singular value decomposition. The resulting models of effective connectivity were markedly different, although the activation pattern was not substantially altered by the motion-correction method. Higher values for the path coefficients were obtained for the models fitted to the covariance matrices based on the average time courses than for the covariance matrices based on a single voxel time course. Our results suggest caution with the interpretation of task-induced changes in effective connectivity since, for higher-order cognitive brain functions, multiple models can be fitted to a given data set and these models cannot be rejected on an anatomical or cognitive basis. Hum. Brain Mapping 21:49-63, 2004.

Spatial working memory ability is a marker of risk-for-psychosis

BACKGROUND

Working memory has been identified as a core cognitive deficit in schizophrenia that is associated with negative symptoms, but it is unclear whether it is impaired prior to onset of psychosis in symptomatic patients.

METHOD

Thirty-eight young people at ultra high-risk (UHR) of developing psychosis (of whom nine later became psychotic) were compared with 49 healthy controls on tests of spatial working memory (SWM) and delayed matching-to-sample (DMTS).

RESULTS

Both SWM and DMTS performance was significantly poorer in the UHR groups. Those who later became psychotic generally performed more poorly than those who did not, although this did not reach significance for any measure. A significant association between SWM errors and negative symptoms was seen in the later-psychotic group only (P = 0.02).

CONCLUSIONS

Spatial working memory abilities are impaired in those at high-risk for psychosis. The relationship between working memory and negative symptoms may be useful as a predictive tool.

The overlay interference task and object-selective visual attention

A series of experiments was carried out to examine object-based visual attention in an interference task. Observers were presented with two transparently overlapping equilateral triangles forming a "Star of David". One of these triangles was darker than the background, the other was lighter than the background. The observers were required to make a speeded choice response to the orientation of the darker triangle. The presence of the light triangle produced a robust interference effect that manifested as a slower response time. This effect was strongly modulated by the relative contrast of the target and distractor triangles. It was reduced when the light distractor triangle was separated in depth from the target triangle. Since the configuration rules out the possibility of 2-D spatial selection, it is concluded that object-based selection occurs in interference tasks and that the effectiveness of this selection is modulated by visual attributes that are not directly relevant to the task.

Morphology of the anterior cingulate cortex in young men at ultra-high risk of developing a psychotic illness

BACKGROUND

The anterior cingulate cortex (ACC) is consistently implicated in the pathophysiology of schizophrenia, and our own work has identified morphological anomalies in the ACC of people with this disorder.

AIMS

To examine whether ACC morphological anomalies are present in a group at ultra-high risk of psychosis and whether such anomalies can be used to predict the subsequent development of a psychotic illness.

METHOD

Magnetic resonance imaging of 75 healthy volunteers and 63 people at ultra-high risk of developing a psychotic disorder (all right-handed males) was used to examine ACC sulcal and gyral features.

RESULTS

Compared with the controls, significantly fewer people in the ultra-high risk group had a well-developed left paracingulate sulcus and significantly more had an interrupted left cingulate sulcus. There was no difference between those who did (n=21) and did not (n=42) subsequently develop a psychotic illness.

CONCLUSIONS

Although ACC anomalies are present in young people considered to be at ultra-high risk of psychosis, they do not identify individuals who subsequently make the transition to psychosis.

Contrast sensitivity in subgroups of developmental dyslexia

It has been proposed that developmental dyslexia is associated with a deficit in the magnocellular pathway of the visual system. Other research focuses upon the heterogeneous nature of developmental dyslexia, and evidence that subgroups of dyslexia may be identified based on selective deficits in specific component reading skills. This study tested the hypothesis that visual processing deficits may be present in different subgroups of developmental dyslexia by comparing the visual contrast sensitivity of three subgroups of dyslexic children (phonological, surface and mixed) and controls. The stimulus designed to measure magnocellular visual function was a low spatial frequency Gaussian blob, flickered sinusoidally at a temporal frequency of 8.33 Hz. The control stimulus, designed to measure parvocellular visual function, was a relatively high spatial frequency Gaussian windowed grating (8 c/deg) slowly ramped on and off. There were no significant differences between the groups of dyslexic and control children in contrast sensitivity to either stimulus. The findings do not support the existence of a magnocellular system deficit in dyslexia.

Simulation of the effects of global normalization procedures in functional MRI

We report on differences in sensitivity and false-positive rate across five methods of global normalization using resting-state fMRI data embedded with simulated activation. These methods were grand mean session scaling, proportional scaling, ANCOVA, a masking method, and an orthogonalization method. We found that global normalization by proportional scaling and ANCOVA decreased the sensitivity of the statistical analysis and induced artifactual deactivation even when the correlation between the global signal and the experimental paradigm was relatively low. The masking method and the orthogonalization method performed better from this perspective but are both restricted to certain experimental conditions. Based on the results of these simulations, we offer practical guidelines for the choice of global normalization method least likely to bias the experimental results.

Paracingulate morphologic differences in males with established schizophrenia: a magnetic resonance imaging morphometric study

BACKGROUND

Our previous work on sulcal-gyral brain morphology in healthy volunteers revealed that males were characterized by greater cortical folding in the left versus right anterior cingulate cortex. Given the evidence showing an absence or reversal of normal anatomical asymmetries in patients with schizophrenia, the current study examined the anterior cingulate cortex sulcal-gyral patterns in patients with schizophrenia.

METHODS

Using high-resolution magnetic resonance imaging, we examined anterior cingulate cortex surface morphology in a group of 55 patients with established schizophrenia and 75 healthy controls. All subjects were male and right-handed. Depending on the presence of a paracingulate sulcus and its antero-posterior extent, three types of anterior cingulate cortex sulcal patterns were identified: "prominent," "present," and "absent." Measures of overall cerebral hemispheric folding were used as independent variables and as covariates to ascertain the specificity of the findings to the anterior cingulate cortex.

RESULTS

Examination of anterior cingulate cortex morphology showed that, compared with controls, patients with schizophrenia lacked the leftward anterior cingulate cortex sulcal asymmetry, which was explained by reduced folding in the left anterior cingulate cortex. These differences were over and above differences in cortical folding across the entire left hemisphere.

CONCLUSIONS

These findings suggest that, in male patients with schizophrenia, there is a disturbance in the neurodevelopment of the left anterior cingulate cortex, as well as a more general aberration of left hemisphere development.

Assessing the evidence on case management

BACKGROUND

Evidence on the impact of case management is contradictory.

AIMS

To discuss two different systematic reviews (one conducted by the authors and one conducted through the Cochrane collaboration) that came to contradictory conclusions about the impact of case management in mental health services.

METHOD

We summarised the findings of the two reviews with respect to case management effectiveness, examined key methodological differences between the two approaches and discuss the impact of these on the validity of the results.

RESULTS

The differences in conclusions between the two reviews result from the differences in inclusion criteria, namely non-randomised trials, data from unpublished scales and data from variables with skewed distributions. The theoretical and empirical effects of these are discussed.

CONCLUSIONS

Systematic reviewers may face a trade-off between the application of strict criteria for the inclusion of studies and the amount of data available for analysis and hence statistical power. The available research suggests that case management is generally effective.

Visuospatial memory and learning in first-episode schizophreniform psychosis and established schizophrenia: a functional correlate of hippocampal pathology?

BACKGROUND

Despite a number of studies that have indicated impaired memory function in patients with schizophrenia, there have been few that have used a sensitive measure of right medial temporal lobe pathology. Given the reported findings of reduced hippocampal volume in schizophrenia, we used a theoretically sensitive test of the right medial temporal lobe to determine the nature of the visuospatial memory deficit in the disorder.

METHODS

Seventy-six patients (37 with a first-episode schizophreniform psychosis, and 39 with established schizophrenia) were compared with 41 comparison subjects on a number of tests of visuospatial memory. These included spatial working memory, spatial and pattern recognition memory and a pattern-location associative learning test.

RESULTS

Both patient groups displayed recognition memory deficits when compared to the comparison group. However, only those patients with established schizophrenia (of 9 years duration on average) were impaired on the associative learning test.

CONCLUSIONS

The results indicate either a progressive decline in visuospatial associative learning ability over the course of the disorder, or that poor visuospatial associative learning is a marker for poor prognosis. In addition, these results have implications for our understanding of the role of the right medial temporal lobe in the pathophysiology of schizophrenia.

Frontal atrophy correlates with behavioural changes in progressive supranuclear palsy

Regional brain volumes were measured in 21 patients with progressive supranuclear palsy (PSP), 17 patients with Parkinson's disease and 23 controls using 3D MRI-based volumetry. Cortical, subcortical and ventricular volume measures were correlated with global indices of motor disability and cognitive disturbance. All MRI measures, including hippocampal volume, were preserved in Parkinson's disease. Patients with PSP could be distinguished from both Parkinson's disease and controls by whole brain volume loss, ventricular dilatation and disproportionate atrophy of the frontal cortex. Caudate nucleus volume loss additionally differentiated PSP from controls, but was modest in severity and proportionate to whole brain volume loss. The present study identifies disease-specific differences in the topography of brain atrophy between PSP and Parkinson's disease, and has potential implications for the in vivo radiological differentiation of these two disorders. In PSP, the variance in frontal grey matter volume related to measures of behavioural disturbance, confirming the use of behavioural tests for ante-mortem case differentiation and suggesting that intrinsic cortical deficits contribute to these clinical disturbances.

Anterior cingulate activation during Stroop task performance: a PET to MRI coregistration study of individual patients with schizophrenia

OBJECTIVE

The authors used single-subject functional imaging analyses to 1) corroborate the findings of anterior cingulate hypoperfusion during an attentional task in schizophrenia and 2) examine whether anterior cingulate activation is associated with underlying morphology.

METHOD

Five healthy subjects and six patients with schizophrenia underwent positron emission tomography scanning while they performed the Stroop task. The medial-frontal lobes were masked out for analysis, and activation peaks were individually coregistered to each subject's magnetic resonance imaging scan.

RESULTS

Healthy subjects showed activations in both limbic and paralimbic anterior cingulate regions. Patients with schizophrenia showed only paralimbic activations, and these were apparent only in patients having a paracingulate sulcus.

CONCLUSIONS

These findings suggest that 1) patients with schizophrenia have limbic-anterior cingulate hypoperfusion during attentional tasks and 2) paralimbic activation is associated with underlying morphology.

Can contrast sensitivity functions in dyslexia be explained by inattention rather than a magnocellular deficit?

We examined whether data demonstrating contrast sensitivity losses in dyslexia that have been interpreted as evidence for loss of magnocellular visual function could be explained by inattention. Computer simulations of observers with poor concentration yielded inflated estimates of threshold that were a constant proportion of the true threshold across spatial frequencies. Data from many, but not all, studies supporting the magnocellular deficit theory are well described by these simulations, which predicted no interaction between observer group and spatial frequency. Some studies have reported significant interactions, but suffer from statistical deficiencies. This compromises some of the evidence for a magnocellular deficit in dyslexia derived from studies of threshold contrast sensitivity.

A stable single-chain variable fragment expressing transfectoma demonstrates induction of idiotype-specific cytotoxic T-cells during early growth stages of a murine B-lymphoma

The idiotypic determinants associated with the variable regions of antibody molecules are known to function as tumor-associated antigens (TAAs). However, there is no clear-cut evidence documenting their efficacy in inducing TAA-specific cytotoxic T-lymphocytes (CTLs). In most previous studies, idiopeptides were implicated in elicitation of TAA-specific CD4+ T-cells. Using a murine B-cell lymphoma, 2C3, we earlier demonstrated induction of splenic CD4+ and CD8+ T-lymphocytes directed to idiotypic Ig of the tumor. In the present study, we provide more direct evidence of the existence of Id-specific CTLs in the spleens of 2C3 bearing BALB/c mice using an scFv-transfectoma, P815A4, as a target. While both P815A4 and 2C3 cells were equally susceptible to cytolysis by the effector cells, lysis was evident only during early tumor progression. Moribund animals at the late stage of tumor growth failed to demonstrate any significant cytotoxic immune response against either tumor. Antibodies to MHC class I alleles Kd, Dd, Ld, beta2m and CD8 molecules all inhibited cytotoxicity. The CTL population from early tumor-bearers recognized 2C3 tumor in the context of all major H-2d alleles; however, in case of P815A4 cells, it was restricted to Kd and Dd alleles only. Based on these antibody inhibition studies, it appears that the idiopeptides generated in both tumors are in some way different, yet they were recognized equally by CTLs not only from the tumor-bearers but also by CTLs from 2C3-hyperimmune mice. It appears that scFv-containing transfectomas expressing antibody variable region epitopes would be useful for both elucidating CTL-defined idiopeptides and monitoring TAA-specific CTL response in tumor-bearing animals.

A longitudinal study of hippocampal volume in first episode psychosis and chronic schizophrenia

Brain abnormalities have been identified in patients with schizophrenia, but what is unclear is whether these changes are progressive over the course of the disorder. In this longitudinal study, hippocampal and temporal lobe volumes were measured at two time points in 30 patients with first episode psychosis (mean follow-up interval=1.9 years, range 0.54-4.18 years) and 12 with chronic schizophrenia (mean follow-up interval=2.3 years, range 1.03-4.12 years) and compared to 26 comparison subjects (mean follow-up interval 2.2 years, range 0.86-4.18 years). Hippocampal, temporal lobe, whole-brain and intracranial volumes (ICV) were estimated from high-resolution magnetic resonance images. Only whole-brain volume showed significant loss over the follow-up interval in both patient groups. The rate of this volume loss was not different in the first episode group compared to the chronic group. There were no changes in either hippocampal or temporal lobe volumes. The negative findings for the hippocampus and temporal lobes may mean that the abnormalities in these regions are stable features of schizophrenia. Alternatively, the period before the onset of frank psychotic symptoms may be the point of greatest risk for progressive change.

Selective bilateral hippocampal volume loss in chronic schizophrenia

BACKGROUND

The hippocampus is implicated in the pathophysiology of schizophrenia; however, volumetric changes are subtle and have limited diagnostic specificity. It is possible that the shape of the hippocampus may be more characteristic of schizophrenia.

METHODS

Forty-five patients with chronic schizophrenia and 139 healthy control subjects were scanned using magnetic resonance imaging. Hippocampi were traced manually, and two-dimensional shape information was analyzed.

RESULTS

Two shape factors were found to be adequate to represent variance in the shape of the hippocampus. One of these factors, representing volume loss behind the head of the hippocampus, provided a degree of discrimination between patients with chronic schizophrenia and healthy control subjects; however, overall hippocampal volume following appropriate adjustment for brain volume showed a similar level of discrimination. Patients with chronic schizophrenia were best characterized using these two measures together, but diagnostic specificity was only moderate.

CONCLUSIONS

This study identified that less of the hippocampus was distributed in its posterior two-thirds in patients with chronic schizophrenia, and specifically in the region just posterior to the hippocampal head. Group discrimination on the basis of hippocampal volume and shape measures was moderately good. A full three-dimensional analysis of hippocampal shape, based on large samples, would be a useful extension of the study.

POU genes in metazoans: homologs in sea anemones, snails, and earthworms

Previously undescribed POU genes were detected in several invertebrate phyla using redundant primers in a polymerase chain reaction (PCR) that targeted highly conserved sequences encoding known POU-domains. A class IV gene and a gene tentatively assigned to class VI were identified in sea anemones (Condylactis), two distinct class III genes were identified in snails (Biomphalaria), and a single class IV gene was identified in earthworms (Lumbricus). The identification of POU genes in cnidarians, mollusks, and annelids completes a survey of the major metozoan phyla. As POU genes exist in all of these organisms, they appear to be a fundamental characteristic of the metazoan lineage, and may have played a major role in the diversification of these organisms.

Spatial working memory deficits in schizophrenia: relationship with tardive dyskinesia and negative symptoms

OBJECTIVE

This study examined the interrelationship between negative symptoms, orofacial tardive dyskinesia, and specific neurocognitive processes, particularly those involved in memory and executive function, in patients with schizophrenia.

METHOD

A set of computerized neurocognitive tasks, the Cambridge Neuropsychological Test Automated Battery, was used to assess executive and memory function in 54 hospitalized patients with chronic schizophrenia. Analysis of covariance was used to examine differences between groups with or without the topographical syndromes of orofacial tardive dyskinesia and between groups with high or low negative symptom scores. Principal-components and path analyses were used to examine further the influence of negative symptoms and orofacial tardive dyskinesia on performance on tests of memory and executive function.

RESULTS

Both orofacial tardive dyskinesia and negative symptoms were significantly and independently associated with deficits on measures of spatial working memory span derived from principal-components analysis, but only orofacial tardive dyskinesia was associated with deficits on measures of spatial working memory strategy. Both were also associated with impairment on the delayed-matching-to-sample task, a test of memory. These associations were not explained by deficits in global intellectual function. Path analysis suggested that the relationships between the clinical symptoms and performance on the delayed-matching-to-sample task were mediated entirely through their relationship with the spatial working memory measures.

CONCLUSIONS

In schizophrenia, orofacial tardive dyskinesia and evident negative symptoms are relatively independent markers of compromise of the cerebral systems that mediate spatial working memory. Candidate neural circuits include the frontal-striatal-thalamic systems, particularly those involving the dorsolateral prefrontal cortex.

A brief scale for assessing patients' satisfaction with care in outpatient psychiatric services

OBJECTIVE

The authors evaluated the reliability and preliminary validity of the Charleston Psychiatric Outpatient Satisfaction Scale, a 15-item measure of patients' satisfaction designed for use in outpatient settings. The instrument uses a 5-point Likert-type response format that minimizes positive response bias and optimizes variability and predictive validity.

METHODS

The Charleston Psychiatric Outpatient Satisfaction Scale was administered to 282 patients seen in psychiatric outpatient clinics affiliated with a public-academic psychiatric institution over a one-week period in 1995.

RESULTS

The internal reliability of the instrument was high (alpha=.87), and its convergent validity was supported by the significant correlation of all items with anchor items that measured overall satisfaction with care and likelihood of recommending the clinic to others. The best predictors of overall ratings of care were the items measuring patients' satisfaction with helpfulness of the services and with the respect shown for patients' opinions about treatment. The best predictors of recommendation of the program to others were the items measuring satisfaction with matching of the treatment plan to patients' individual needs and with the respect shown for patients' opinions about treatment. Mean scores for all items ranged from 3.6 (satisfaction with parking) to 4.5 (satisfaction with helpfulness of the secretary and with the overall quality of care), indicating that overall satisfaction in this sample was high.

CONCLUSIONS

The results provide preliminary support for the reliability and validity of the Charleston Psychiatric Outpatient Satisfaction Scale:

Acculturation and dental health among Vietnamese living in Melbourne, Australia

OBJECTIVES

To describe the relationship between acculturation and oral health status, oral health knowledge and frequency of dental visits in subjects of Vietnamese background, 18 years or older, living in Melbourne, Australia.

METHODS

Oral health status was measured using the DMFS index. Oral health knowledge was estimated by responses to six specific oral preventive measures: brushing, flossing, use of fluorides, diet, and dental visits. Dental visits was measured by the number of visits in the 12 months prior to the survey. Acculturation was measured along two dimensions, psychological and behavioural, using the Psychological-Behavioural Acculturation Scale. Data were analysed using multivariate analysis to identify the combined effect of eight predictors (age, gender, occupational status, education, reason for migration, proportion of life in the host country, behavioural acculturation and psychological acculturation) against the dependent variables.

RESULTS

The analysis was conducted on a sample of 147 subjects and showed significant interactions between the acculturation variables and three outcome measures: dental caries, knowledge of preventive measures and dental visits. Results indicated that acculturation was an important intervening variable. Psychological acculturation was strongly related to the three oral health outcomes, although the effect of behavioural acculturation was also apparent regarding dental status.

CONCLUSIONS

This study offers several insights for understanding the mechanisms by which acculturation impacts oral health status. Interventions that simplify the cultural influence of immigrant groups by focusing on socio-demographic differences and even immigration variables to define risk groups might not produce predicted changes in oral health status.

"Gene-swap knock-in" cassette in mice to study allelic differences in human genes

Genetic differences in environmental toxicity and cancer susceptibility among individuals in a human population often reflect polymorphisms in the genes encoding drug-metabolizing enzymes (DMEs), drug transporters, and receptors that control DME levels. This field of study is called "ecogenetics", and a subset of this field--concerning genetic variability in response to drugs--is termed "pharmacogenetics". Although human-mouse differences might be 3- to perhaps 10-fold, human interindividual differences can be as great as 20-fold or more than 40-fold. It would be helpful, therefore, to study toxicokinetics/pharmacokinetics of particular environmental agents and drugs in mice containing these "high-" and "low-extreme" human alleles. We hope to use transgenic "knock-in" technology in order to insert human alleles in place of the orthologous mouse gene. However, the knock-in of each gene has normally been a separate event requiring the following: (a) construction of the targeting vector, (b) transfection into embryonic stem (ES) cells, (c) generation of a targeted mouse having germline transmission of the construct, and (d) backcross breeding of the knock-in mouse (at least 6-8 times) to produce a suitable genetically homogeneous background (i.e., to decrease "experimental noise"). These experiments require 1 1/2 to 2 years to complete, making this very powerful technology inefficient for routine applications. If, on the other hand, the initial knock-in targeting vector might include sequences that would allow the knocked-in gene to be exchanged (quickly and repeatedly) for one new allele after another, then testing distinctly different human polymorphic alleles in transgenic mice could be accomplished in a few months instead of several years. This "gene-swapping" technique will soon be done by zygotic injection of a "human allele cassette" into the sperm or fertilized ovum of the parental knock-in mouse inbred strain or by the cloning of whole mice from cumulus ovaricus cells or tail-snip fibroblasts containing the nucleus wherein each new human allele has already been "swapped." In mouse cells in culture using heterotypic lox sites, we and others have already succeeded in gene swapping, by exchanging one gene, including its regulatory regions, with a second gene (including its regulatory regions). It is anticipated that mouse lines carrying numerous human alleles will become commonplace early in the next millennium.

Transgenic zebrafish as sentinels for aquatic pollution

Using the golden mutant zebrafish having a decrease in interfering pigmentation, we are developing transgenic lines in which DNA motifs that respond to selected environmental pollutants are capable of activating a reporter gene that can be easily assayed. We have begun with three response elements that recognize three important classes of foreign chemicals. Aromatic hydrocarbon response elements (AHREs) respond to numerous polycyclic hydrocarbons and halogenated coplanar molecules such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD; dioxin) and polychlorinated biphenyls. Electrophile response elements (EPREs) respond to quinones and numerous other potent electrophilic oxidants. Metal response elements (MREs) respond to heavy metal cations such as mercury, copper, nickel, cadmium, and zinc. Soon, we will include estrogen response elements (EREs) to detect the effects of environmental endocrine disruptors, and retinoic acid response elements (RARE, RXRE) to detect the effects of retinoids in the environment. Each of these substances is known to be bioconcentrated in fish to varying degrees; for example, 10(-17) M TCDD in a body of water becomes concentrated to approximately 10(-12) M TCDD in a fish, where it would act upon the AHRE motif and turn on the luciferase (LUC) reporter gene. The living fish as a sentinel will not only be assayed intact in the luminometer, but--upon several days or weeks of depuration--would be usable again. To date, we have established that zebrafish transcription factors are able to recognize both mammalian and trout AHRE, EPRE, and MRE sequences in a dose-dependent and chemical-class-specific manner, and that expression of both the LUC and jellyfish green fluorescent protein (GFP) reporter genes is easily detected in zebrafish cell cultures and in the intact live zebrafish. Variations in sensitivity of this model system can be achieved by increasing the copy number of response elements and perhaps by altering the sequence of each core consensus response element and flanking regions. This transgenic technology should allow for a simple, exquisitely sensitive, and inexpensive assay for monitoring aquatic pollution. We have already initiated studies using sentinel zebrafish to monitor a public drinking water source.

Hemispheric and gender-related differences in the gross morphology of the anterior cingulate/paracingulate cortex in normal volunteers: an MRI morphometric study

The sulci and gyri found within the anterior cingulate (AC), and across the cerebrum generally, have been found to vary in location and complexity from one individual to the next, making it difficult to analyze imaging data accurately and systematically. In this study, we examined the nature of morphometric variance in the AC of the left and right cerebral hemispheres using high-resolution structural magnetic resonance imaging (MRI) acquired from 176 healthy volunteers. Depending on the presence of a paracingulate sulcus (PCS) and its antero-posterior extent, three types of AC patterns were identified: 'prominent', 'present' and 'absent'. Hemispheric comparisons across the whole sample showed the PCS to be more commonly 'prominent' in the left hemisphere and more commonly 'absent' in the right hemisphere. There was a significant gender difference, such that males showed an asymmetric pattern characterized by increased fissurization of the left AC, while females showed greater symmetry, with less fissurization of the left AC. Overall cerebral morphology, namely hemispheric volume and hemispheric fissurization, were also measured and used as independent variables as well as covariates in the analyses in order to ascertain the specificity of the results regarding AC morphology. Results showed that cerebral volume for males was larger on the right than on the left while fissurization showed the reverse asymmetry of greater leftward fissurization. In contrast, females were symmetric in both respects. The findings regarding AC morphology could not be explained by differences in these overall cerebral measures or by differences in age and handedness within the population. The results suggest that in the normal male brain, there exist morphological asymmetries at both the global and local levels that are less apparent in the female brain. The findings have implications for future studies examining the organization, development and functional anatomy of the AC.

An optimized method for estimating intracranial volume from magnetic resonance images

The accuracy and efficiency of protocols to measure intracranial volume (ICV) from volumetric magnetic resonance imaging (MRI) studies has not been formally analyzed. The ICV of 30 control participants was obtained by tracing every slice of a MRI data set on which the cranial cavity appeared, and compared with estimated ICVs calculated by progressively selecting one of every x slices (i.e., "1-in-x") as a sampling strategy. The reliability and precision of each sampling strategy was then determined. There was virtually no reduction in reliability at the 1-in-10 sampling strategy, with a reliability exceeding 0.999. ICV can be confidently traced using a 1-in-10 sampling strategy, which should result in significant time savings.