Age, Motion, Medical, and Psychiatric Associations With Incidental Findings in Brain MRI

Importance

Few investigations have evaluated rates of brain-based magnetic resonance imaging (MRI) incidental findings (IFs) in large lifespan samples, their stability over time, or their associations with health outcomes.

Objectives

To examine rates of brain-based IFs across the lifespan, their persistence, and their associations with phenotypic indicators of behavior, cognition, and health; to compare quantified motion with radiologist-reported motion and evaluate its associations with IF rates; and to explore IF consistency across multiple visits.

Design, Setting, and Participants

This cross-sectional study included participants from the Nathan Kline Institute-Rockland Sample (NKI-RS), a lifespan community-ascertained sample, and the Healthy Brain Network (HBN), a cross-sectional community self-referred pediatric sample focused on mental health and learning disorders. The NKI-RS enrolled participants (ages 6-85 years) between March 2012 and March 2020 and had longitudinal participants followed up for as long as 4 years. The HBN enrolled participants (ages 5-21 years) between August 2015 and October 2021. Clinical neuroradiology MRI reports were coded for radiologist-reported motion as well as presence, type, and clinical urgency (category 1, no abnormal findings; 2, no referral recommended; 3, consider referral; and 4, immediate referral) of IFs. MRI reports were coded from June to October 2021. Data were analyzed from November 2021 to February 2023.

Main Outcomes and Measures

Rates and type of IFs by demographic characteristics, health phenotyping, and motion artifacts; longitudinal stability of IFs; and Euler number in projecting radiologist-reported motion.

Results

A total of 1300 NKI-RS participants (781 [60.1%] female; mean [SD] age, 38.9 [21.8] years) and 2772 HBN participants (976 [35.2%] female; mean [SD] age, 10.0 [3.5] years) had health phenotyping and neuroradiology-reviewed MRI scans. IFs were common, with 284 of 2956 children (9.6%) and 608 of 1107 adults (54.9%) having IFs, but rarely of clinical concern (category 1: NKI-RS, 619 [47.6%]; HBN, 2561 [92.4%]; category 2: NKI-RS, 647 [49.8%]; HBN, 178 [6.4%]; category 3: NKI-RS, 79 [6.1%]; HBN, 30 [1.1%]; category 4: NKI-RS: 12 [0.9%]; HBN, 6 [0.2%]). Overall, 46 children (1.6%) and 79 adults (7.1%) required referral for their IFs. IF frequency increased with age. Elevated blood pressure and BMI were associated with increased T2 hyperintensities and age-related cortical atrophy. Radiologist-reported motion aligned with Euler-quantified motion, but neither were associated with IF rates.

Conclusions and Relevance

In this cross-sectional study, IFs were common, particularly with increasing age, although rarely clinically significant. While T2 hyperintensity and age-related cortical atrophy were associated with BMI and blood pressure, IFs were not associated with other behavioral, cognitive, and health phenotyping. Motion may not limit clinical IF detection.

An open-access dataset of naturalistic viewing using simultaneous EEG-fMRI

In this work, we present a dataset that combines functional magnetic imaging (fMRI) and electroencephalography (EEG) to use as a resource for understanding human brain function in these two imaging modalities. The dataset can also be used for optimizing preprocessing methods for simultaneously collected imaging data. The dataset includes simultaneously collected recordings from 22 individuals (ages: 23-51) across various visual and naturalistic stimuli. In addition, physiological, eye tracking, electrocardiography, and cognitive and behavioral data were collected along with this neuroimaging data. Visual tasks include a flickering checkerboard collected outside and inside the MRI scanner (EEG-only) and simultaneous EEG-fMRI recordings. Simultaneous recordings include rest, the visual paradigm Inscapes, and several short video movies representing naturalistic stimuli. Raw and preprocessed data are openly available to download. We present this dataset as part of an effort to provide open-access data to increase the opportunity for discoveries and understanding of the human brain and evaluate the correlation between electrical brain activity and blood oxygen level-dependent (BOLD) signals.

Omnipresence of the sensorimotor-association axis topography in the human connectome

Low-dimensional representations are increasingly used to study meaningful organizational principles within the human brain. Most notably, the sensorimotor-association axis consistently explains the most variance in the human connectome as its so-called principal gradient, suggesting that it represents a fundamental organizational principle. While recent work indicates these low dimensional representations are relatively robust, they are limited by modeling only certain aspects of the functional connectivity structure. To date, the majority of studies have restricted these approaches to the strongest connections in the brain, treating weaker or negative connections as noise despite evidence of meaningful structure among them. The present work examines connectivity gradients of the human connectome across a full range of connectivity strengths and explores the implications for outcomes of individual differences, identifying potential dependencies on thresholds and opportunities to improve prediction tasks. Interestingly, the sensorimotor-association axis emerged as the principal gradient of the human connectome across the entire range of connectivity levels. Moreover, the principal gradient of connections at intermediate strengths encoded individual differences, better followed individual-specific anatomical features, and was also more predictive of intelligence. Taken together, our results add to evidence of the sensorimotor-association axis as a fundamental principle of the brain's functional organization, since it is evident even in the connectivity structure of more lenient connectivity thresholds. These more loosely coupled connections further appear to contain valuable and potentially important information that could be used to improve our understanding of individual differences, diagnosis, and the prediction of treatment outcomes.

Concordance among indices of intrinsic brain function: Insights from inter-individual variation and temporal dynamics

Various resting-state fMRI (R-fMRI) measures have been developed to characterize intrinsic brain activity. While each of these measures has gained a growing presence in the literature, questions remain regarding the common and unique aspects these indices capture. The present work provided a comprehensive examination of inter-individual variation and intra-individual temporal variation for commonly used measures, including fractional amplitude of low frequency fluctuations, regional homogeneity, voxel-mirrored homotopic connectivity, network centrality and global signal correlation. Regardless of whether examining intra-individual or inter-individual variation, we found that these definitionally distinct R-fMRI indices tend to exhibit a relatively high degree of covariation, which doesn't exist in phase randomized surrogate data. As a measure of intrinsic brain function, concordance for R-fMRI indices was negatively correlated with age across individuals (i.e., concordance among functional indices decreased with age). To understand the functional significance of concordance, we noted that higher concordance was generally associated with higher strengths of R-fMRI indices, regardless of whether looking through the lens of inter-individual (i.e., high vs. low concordance participants) or intra-individual (i.e., high vs. low concordance states identified via temporal dynamic analyses) differences. We also noted a linear increase in functional concordance together with the R-fMRI indices through the scan, which may suggest a decrease in arousal. The current study demonstrated an enriched picture regarding the relationship among the R-fMRI indices, as well as provided new insights in examining dynamic states within and between individuals.

The real-time fMRI neurofeedback based stratification of Default Network Regulation Neuroimaging data repository

This data descriptor describes a repository of openly shared data from an experiment to assess inter-individual differences in default mode network (DMN) activity. This repository includes cross-sectional functional magnetic resonance imaging (fMRI) data from the Multi Source Interference Task, to assess DMN deactivation, the Moral Dilemma Task, to assess DMN activation, a resting state fMRI scan, and a DMN neurofeedback paradigm, to assess DMN modulation, along with accompanying behavioral and cognitive measures. We report technical validation from n=125 participants of the final targeted sample of 180 participants. Each session includes acquisition of one whole-brain anatomical scan and whole-brain echo-planar imaging (EPI) scans, acquired during the aforementioned tasks and resting state. The data includes several self-report measures related to perseverative thinking, emotion regulation, and imaginative processes, along with a behavioral measure of rapid visual information processing. Technical validation of the data confirms that the tasks deactivate and activate the DMN as expected. Group level analysis of the neurofeedback data indicates that the participants are able to modulate their DMN with considerable inter-subject variability. Preliminary analysis of behavioral responses and specifically self-reported sleep indicate that as many as 73 participants may need to be excluded from an analysis depending on the hypothesis being tested. The present data are linked to the enhanced Nathan Kline Institute, Rockland Sample and builds on the comprehensive neuroimaging and deep phenotyping available therein. As limited information is presently available about individual differences in the capacity to directly modulate the default mode network, these data provide a unique opportunity to examine DMN modulation ability in relation to numerous phenotypic characteristics.

Differential profiles in auditory social cognition deficits between adults with autism and schizophrenia spectrum disorders: A preliminary analysis

Impairment in social cognition, including emotion recognition, has been extensively studied in both Autism Spectrum Disorders (ASD) and Schizophrenia (SZ). However, the relative patterns of deficit between disorders have been studied to a lesser degree. Here, we applied a social cognition battery incorporating both auditory (AER) and visual (VER) emotion recognition measures to a group of 19 high-functioning individuals with ASD relative to 92 individuals with SZ, and 73 healthy control adult participants. We examined group differences and correlates of basic auditory processing and processing speed. Individuals with SZ were impaired in both AER and VER while ASD individuals were impaired in VER only. In contrast to SZ participants, those with ASD showed intact basic auditory function. Our finding of a dissociation between AER and VER deficits in ASD relative to Sz support modality-specific theories of emotion recognition dysfunction. Future studies should focus on visual system-specific contributions to social cognitive impairment in ASD.

Relationship of trauma symptoms to amygdala-based functional brain changes in adolescents

In this pilot study, amygdala connectivity related to trauma symptoms was explored using resting-state functional magnetic resonance imaging (R-fMRI) in 23 healthy adolescents ages 13-17 years with no psychiatric diagnoses. Adolescents completed a self-report trauma symptom checklist and a R-fMRI scan. We examined the relationship of trauma symptoms to resting-state functional connectivity of the amygdala. Increasing self-report of trauma symptoms by adolescents was associated with increasing functional connectivity with the right amygdala and a local limbic cluster and decreasing functional connectivity with the amygdala and a long-range frontoparietal cluster to the left amygdala, which can be a hallmark of immaturity. These pilot findings in adolescents provide preliminary evidence that even mild trauma symptoms can be linked to the configuration of brain networks associated with the amygdala.

The NKI-Rockland Sample: A Model for Accelerating the Pace of Discovery Science in Psychiatry

The National Institute of Mental Health strategic plan for advancing psychiatric neuroscience calls for an acceleration of discovery and the delineation of developmental trajectories for risk and resilience across the lifespan. To attain these objectives, sufficiently powered datasets with broad and deep phenotypic characterization, state-of-the-art neuroimaging, and genetic samples must be generated and made openly available to the scientific community. The enhanced Nathan Kline Institute-Rockland Sample (NKI-RS) is a response to this need. NKI-RS is an ongoing, institutionally centered endeavor aimed at creating a large-scale (N > 1000), deeply phenotyped, community-ascertained, lifespan sample (ages 6-85 years old) with advanced neuroimaging and genetics. These data will be publically shared, openly, and prospectively (i.e., on a weekly basis). Herein, we describe the conceptual basis of the NKI-RS, including study design, sampling considerations, and steps to synchronize phenotypic and neuroimaging assessment. Additionally, we describe our process for sharing the data with the scientific community while protecting participant confidentiality, maintaining an adequate database, and certifying data integrity. The pilot phase of the NKI-RS, including challenges in recruiting, characterizing, imaging, and sharing data, is discussed while also explaining how this experience informed the final design of the enhanced NKI-RS. It is our hope that familiarity with the conceptual underpinnings of the enhanced NKI-RS will facilitate harmonization with future data collection efforts aimed at advancing psychiatric neuroscience and nosology.

Extracting information from functional connectivity maps via function-on-scalar regression

Functional connectivity of an individual human brain is often studied by acquiring a resting state functional magnetic resonance imaging scan, and mapping the correlation of each voxel's BOLD time series with that of a seed region. As large collections of such maps become available, including multisite data sets, there is an increasing need for ways to distill the information in these maps in a readily visualized form. Here we propose a two-step analytic strategy. First, we construct connectivity-distance profiles, which summarize the connectivity of each voxel in the brain as a function of distance from the seed, a functional relationship that has attracted much recent interest. Next, these profile functions are regressed on predictors of interest, whether categorical (e.g., acquisition site or diagnostic group) or continuous (e.g., age). This procedure can provide insight into the roles of multiple sources of variation, and detect large-scale patterns not easily available from conventional analyses. We illustrate the proposed methods with a resting state data set pooled across four imaging sites.

Age-related differences in the involvement of the prefrontal cortex in attentional control

We investigated the relative involvement of cortical regions supporting attentional control in older and younger adults during performance on a modified version of the Stroop task. Participants were exposed to two different types of incongruent trials. One of these, an incongruent-ineligible condition, produces conflict at the non-response level, while the second, an incongruent-eligible condition, produces conflict at both non-response and response levels of information processing. Greater attentional control is needed to perform the incongruent-eligible condition compared to other conditions. We examined the cortical recruitment associated with this task in an event-related functional magnetic resonance imaging paradigm in 25 older and 25 younger adults. Our results indicated that while younger adults demonstrated an increase in the activation of cortical regions responsible for maintaining attentional control in response to increased levels of conflict, such sensitivity and flexibility of the cortical regions to increased attentional control demands was absent in older adults. These results suggest a limitation in older adults' capabilities for flexibly recruiting the attentional network in response to increasing attentional demands.

Dedifferentiation in the visual cortex: an fMRI investigation of individual differences in older adults

Dedifferentiation, or decreased processing specificity, has been suggested to represent a ubiquitous characteristic of cognitive aging. In this study, we examined both age-related differences and intra-group differences in neural specificity in the ventral visual cortex for color, words, faces and places. Our results demonstrated that neural dedifferentiation was not ubiquitous across stimulus categories. Neural dedifferentiation was also relatively stable, across age, in a group of older adults. Older adults with more overall gray matter showed less neural dedifferentiation in the visual cortex. However, regional gray matter volume was not associated with neural dedifferentiation. We illustrate these effects using a discriminability metric, a signal detection theory measure, for neural dedifferentiation that takes into account both magnitude and variance of brain activation. The dedifferentiation measure provides a quantitative means to examine activation patterns and individual difference factors associated with neural dedifferentiation, and to test theories of behavioral dedifferentiation in cognitive aging literature.

Greater intake of vitamins B6 and B12 spares gray matter in healthy elderly: a voxel-based morphometry study

Previous studies have reported that high concentrations of homocysteine and lower concentrations of vitamins B6, B12, and folate increase the risk for cognitive decline and pathology in aging populations. In this cross-sectional study, high resolution magnetic resonance imaging (MRI) scans and a 3-day food diary were collected on 32 community-dwelling adults between the ages of 59 and 79. We examined the relation between vitamins B6, B12, and folate intake on cortical volume using an optimized voxel-based morphometry (VBM) method and global gray and white matter volume after correcting for age, sex, body mass index, calorie intake, and education. All participants met or surpassed the recommended daily intake for these vitamins. In the VBM analysis, we found that adults with greater vitamin B6 intake had greater gray matter volume along the medial wall, anterior cingulate cortex, medial parietal cortex, middle temporal gyrus, and superior frontal gyrus, whereas people with greater B12 intake had greater volume in the left and right superior parietal sulcus. These effects were driven by vitamin supplementation and were negated when only examining vitamin intake from diet. Folate had no effect on brain volume. Furthermore, there was no relationship between vitamins B6, B12, or folate intake on global brain volume measures, indicating that VBM methods are more sensitive for detecting localized differences in gray matter volume than global measures. These results are discussed in relation to a growing literature on vitamin intake on age-related neurocognitive deterioration.

The neural correlates of an expanded functional field of view

The size of the functional field of view (FFOV) predicts driving safety in older adults ( Owsley et al., 1998), and practice-related changes in the FFOV may transfer to driving safety ( Roenker, Cissell, Ball, Wadley, & Edwards, 2003). We used functional magnetic resonance imaging (fMRI) and behavioral measures to examine how practice with the FFOV task changes older adults' attentional function. Behavioral data collected outside of the MRI revealed that participants in the training group showed larger improvements across conditions than did those in the control group. fMRI data revealed training-related changes in activation in a number of brain regions. In the right precentral gyrus and right inferior frontal gyrus, increases in activation between fMRI sessions correlated positively with increases in accuracy between behavioral sessions. Practice with the FFOV task improves older adults' attentional function by increasing their recruitment of regions traditionally associated with orienting visual attention.

Aerobic exercise training increases brain volume in aging humans

BACKGROUND

The present study examined whether aerobic fitness training of older humans can increase brain volume in regions associated with age-related decline in both brain structure and cognition.

METHODS

Fifty-nine healthy but sedentary community-dwelling volunteers, aged 60-79 years, participated in the 6-month randomized clinical trial. Half of the older adults served in the aerobic training group, the other half of the older adults participated in the toning and stretching control group. Twenty young adults served as controls for the magnetic resonance imaging (MRI), and did not participate in the exercise intervention. High spatial resolution estimates of gray and white matter volume, derived from 3D spoiled gradient recalled acquisition MRI images, were collected before and after the 6-month fitness intervention. Estimates of maximal oxygen uptake (VO2) were also obtained.

RESULTS

Significant increases in brain volume, in both gray and white matter regions, were found as a function of fitness training for the older adults who participated in the aerobic fitness training but not for the older adults who participated in the stretching and toning (nonaerobic) control group. As predicted, no significant changes in either gray or white matter volume were detected for our younger participants.

CONCLUSIONS

These results suggest that cardiovascular fitness is associated with the sparing of brain tissue in aging humans. Furthermore, these results suggest a strong biological basis for the role of aerobic fitness in maintaining and enhancing central nervous system health and cognitive functioning in older adults.

Cardiorespiratory fitness: A predictor of cortical plasticity in multiple sclerosis

Deficits in cognitive abilities are commonly observed among individuals with multiple sclerosis (MS). Recent neuroimaging studies have provided evidence for the existence of cortical plasticity in MS, with cognitively impaired participants recruiting additional brain areas to perform challenging tasks. The existence of altered cerebral activations in MS provides hope for the utilization of neural resources to reduce cognitive deficits that challenge everyday living in MS by employing alternative interventions such as cognitive and fitness training. In this study, we examined whether higher physical fitness levels enhance cognitive and neural plasticity in MS patients. The present study is the first to investigate the impact of cardiorespiratory fitness on cerebrovascular functioning of MS patients. 24 participants with relapsing-remitting MS were recruited for the study. All participants went through a fitness assessment and were scanned in a 3 T MRI system during the Paced Visual Serial Addition Test (PVSAT). Higher fitness levels were associated with faster behavioral performance and greater recruitment of right IFG/MFG, a region of the cerebral cortex recruited by MS patients during performance of PVSAT to purportedly compensate for the cognitive deterioration attributable to MS. In contrast, lower levels of fitness were associated with enhanced ACC activity, suggestive of the presence of greater interference and the potential for error in lower fit MS participants. These results are promising, suggesting the need for further investigation of the utility of aerobic fitness training as a possible method to support the development of additional cortical resources in an attempt to counter the cognitive decline resulting from MS.

Exercise, cognition, and the aging brain

We provide a brief review of the literature on exercise effects on brain and cognition. To this end, we focus on both prospective and retrospective human epidemiological studies that have examined the influence of exercise and physical activity on cognition and dementia. We then examine the relatively small set of human randomized clinical trials that have, for the most part, focused on exercise training effects on cognition. Next, we discuss animal research that has examined the molecular, cellular, and behavioral effects of exercise training. Finally, we conclude with a summary and brief discussion of important future directions of research on fitness cognition and brain.

Training-induced plasticity in older adults: effects of training on hemispheric asymmetry

The extent to which cortical plasticity is retained in old age remains an understudied question, despite large social and scientific implications of such a result. Neuroimaging research reports individual differences in age-related activation, thereby educing speculation that some degree of plasticity may remain throughout life. We conducted a randomized longitudinal dual-task training study to investigate if performance improvements (a) change the magnitude or pattern of fMRI activation, thereby suggesting some plasticity retention in old age and (b) result in a reduction in asymmetry and an increase in age differences in fMRI activation as a compensatory model of performance-related activation predicts. Performance improvements were correlated with an increase in hemispheric asymmetry and a reduction in age differences in ventral and dorsal prefrontal activation. These results provide evidence for plasticity in old age and are discussed in relation to an alternative argument for the role of reduced asymmetry in performance improvements.

Training-induced functional activation changes in dual-task processing: an FMRI study

Although training-induced changes in brain activity have been previously examined, plasticity associated with executive functions remains understudied. In this study, we examined training-related changes in cortical activity during a dual task requiring executive control. Two functional magnetic resonance imaging (fMRI) sessions, one before training and one after training, were performed on both a control group and a training group. Using a region-of-interest analysis, we examined Time x Group and Time x Group x Condition interactions to isolate training-dependent changes in activation. We found that most regions involved in dual-task processing before training showed reductions in activation after training. Many of the decreases in activation were correlated with improved performance on the task. We also found an area in the dorsolateral prefrontal cortex that showed an increase in activation for the training group for the dual-task condition, which was also correlated with improved performance. These results are discussed in relation to the efficacy of training protocols for modulating attention and executive functions, dual-task processing, and fMRI correlates of plasticity.

Interactive effects of fitness and hormone treatment on brain health in postmenopausal women

Recent research in rodents suggests that extended and chronic hormone therapy can exacerbate memory impairments and irreversibly damage cells. However, aerobic fitness regimens have been shown to spare brain tissue and cognitive function. In addition, interactions between estrogen treatment and exercise have been reported in rodents. However, whether aerobic fitness and hormone treatments show interactive effects on human brain tissue and cognition has yet to be determined. Here we report two unique and important results: (a) HRT treatment up to 10 years in duration spares gray matter in prefrontal cortex and is associated with better performance on measures of executive function, whereas HRT treatment beyond 10 years in duration increases the degree of prefrontal deterioration and amplifies the decline on measures of executive functioning (b) higher fitness levels augment the effects of shorter durations of hormone treatment and ameliorate the declines associated with prolonged hormone treatment.

Fitness, aging and neurocognitive function

In this manuscript we provide a brief review of the recent literature that has examined the relationship among fitness training, cognition and brain. We began with a discussion of the non-human animal literature that has examined the relationship among these factors. Next we discuss recent epidemiological studies of the relationship between physical activity and fitness and cognition and age-related disease such as Alzheimer's dementia. We then discuss the results of randomized clinical trials of fitness training on human cognition. Finally, we conclude with a review of the nascent literature that has begun to employ neuroimaging techniques to examine fitness training effects on human brain. In general, the results are promising and suggest that fitness may serve a neuroprotective function for aging humans.

Neural correlates of dual-task performance after minimizing task-preparation

Previous dual-task neuroimaging studies have not discriminated between brain regions involved in preparing to make more than one response from those involved in the management and execution of two tasks. To isolate the effects of dual-task processing while minimizing effects related to task-preparatory processes, we employed a blocked event-related design in which single trials and dual trials were randomly and unpredictably intermixed for one block (mixed block) and presented in isolation of one another during other blocks (pure blocks). Any differences between dual-task and single-task trials within the mixed block would be related to dual-task performance while minimizing any effects related to preparatory differences between the conditions. For this comparison, we found dual-task-related activation throughout inferior prefrontal, temporal, extrastriate, and parietal cortices and the basal ganglia. In addition, when comparing the single task within the mixed block with the single task presented in the pure block of trials, the regions involved in processes important in the mixed block yet unrelated to dual-task operations could be specified. In this comparison, we report a pattern of activation in right inferior prefrontal and superior parietal cortices. Our results argue that a variety of neural regions remain active during dual-task performance even after minimizing task-preparatory processes, but some regions implicated in dual-task performance in previous studies may have been due to task-preparation processes. Furthermore, our results suggest that dual-task operations activate the same brain areas as the single tasks, but to a greater magnitude than the single tasks. These results are discussed in relation to current conceptions of the neural correlates of dual-task performance.

A structural equation modeling analysis of attentional control: an event-related fMRI study

We report here the first investigation of the effective connectivity between neural structures supporting attentional control using structural equation modeling and functional magnetic resonance imaging (fMRI). Attentional control was examined by employing a modified version of the flanker task. We found that the inconsistent condition elicited a significantly greater number of path coefficients than the consistent condition. In addition, we report that the strength of the prefrontal paths common to both conditions were not different, but that the remaining six paths were different between conditions. Importantly, these results suggest that the relationship between regions supporting attentional control differ between task conditions but the strength of the relationship between some prefrontal regions is invariant between task conditions. Additionally, we found that the paths were significantly lateralized to the right hemisphere. These results are discussed in relation to theories of the function of each region in attentional control.

Selective sparing of brain tissue in postmenopausal women receiving hormone replacement therapy

Determining the benefits and/or drawbacks of hormone replacement therapy (HRT) on women's health is an imperative public health goal. Research in rodents suggests benefits of estrogen on neuronal growth and function. However, little research has investigated the effects of HRT on brain tissue in humans. We used high-resolution magnetic resonance imaging and an optimized voxel-based morphometric technique to examine the effects of HRT on brain volume in postmenopausal women. We report two main results: (a) HRT is associated with the sparing of grey matter in prefrontal, parietal, and temporal brain regions and white matter in medial temporal lobe regions, and (b) longer durations of therapy are associated with greater sparing of grey matter tissue. HRT should be considered a possible mediator of age-related neural decline in both grey and white matter tissues.

Environmental Influences on Cognitive and Brain Plasticity During Aging

In the current article, we provide a critical review of the extant literature that has focused on environmental influences on cognitive and brain plasticity over the adult life span. The review includes both human epidemiological, and human and nonhuman cross-sectional and longitudinal research. We review a number of factors that have been suggested to reduce age-related cognitive decline including both formal and informal education, leisure pursuits, intellectual engagement, and expertise in different skill domains. We also examine the literature on cognitive and physical fitness training. We conclude with a discussion of the gaps in the literature and suggestions for future research.

Cardiovascular fitness and neurocognitive function in older adults: a brief review

We provide a brief review of the extant research on the influence of cardiovascular fitness training on brain and cognition. The review includes an examination of the non-human animal literature that has reported molecular, cellular, and behavioral consequences of fitness interventions. We relate this literature to human studies of the relationship between fitness and cognition, as well as the nascent literature on fitness influences on human brain structure and function with state-of-the art neuroimaging techniques. We also consider the important topic of participant adherence in clinical exercise trials. Finally, we suggest future directions for studies of cardiovascular fitness, aging, and neurocognitive function.

Behavioral conflict, anterior cingulate cortex, and experiment duration: implications of diverging data

We investigated the relationship between behavioral measures of conflict and the degree of activity in the anterior cingulate cortex (ACC). We reanalyzed an existing data set that employed the Stroop task using functional magnetic resonance imaging [Milham et al., Brain Cogn 2002;49:277-296]. Although we found no changes in the behavioral measures of conflict from the first to the second half of task performance, we found a reliable reduction in the activity of the anterior cingulate cortex. This result suggests the lack of a strong relationship between behavioral measurements of conflict and anterior cingulate activity. A concomitant increase in dorsolateral prefrontal cortex activity was also found, which may reflect a tradeoff in the neural substrates involved in supporting conflict resolution, detection, or monitoring processes. A second analysis of the data revealed that the duration of an experiment can dramatically affect interpretations of the results, including the roles in which particular regions are thought to play in cognition. These results are discussed in relation to current conceptions of ACC's role in attentional control. In addition, we discuss the implication of our results with current conceptions of conflict and of its instantiation in the brain. Hum. Brain Mapping 21:96-105, 2004.

Cardiovascular fitness, cortical plasticity, and aging

Cardiovascular fitness is thought to offset declines in cognitive performance, but little is known about the cortical mechanisms that underlie these changes in humans. Research using animal models shows that aerobic training increases cortical capillary supplies, the number of synaptic connections, and the development of new neurons. The end result is a brain that is more efficient, plastic, and adaptive, which translates into better performance in aging animals. Here, in two separate experiments, we demonstrate for the first time to our knowledge, in humans that increases in cardiovascular fitness results in increased functioning of key aspects of the attentional network of the brain during a cognitively challenging task. Specifically, highly fit (Study 1) or aerobically trained (Study 2) persons show greater task-related activity in regions of the prefrontal and parietal cortices that are involved in spatial selection and inhibitory functioning, when compared with low-fit (Study 1) or nonaerobic control (Study 2) participants. Additionally, in both studies there exist groupwise differences in activation of the anterior cingulate cortex, which is thought to monitor for conflict in the attentional system, and signal the need for adaptation in the attentional network. These data suggest that increased cardiovascular fitness can affect improvements in the plasticity of the aging human brain, and may serve to reduce both biological and cognitive senescence in humans.

Enhancing brain and cognitive function of older adults through fitness training

The present article provides a brief review of the human and animal literature that has investigated the relationship between fitness training and brain and cognitive function. The animal research clearly suggests that improvements in fitness can lead to both morphological and functional changes in the brains of older animals. Results of a recent meta-analysis suggest that fitness training can also have beneficial effects on human cognition, particularly on tasks requiring executive control processing. These effects are also moderated by a number of factors, including the proportion of men and women in the intervention studies, the length of training sessions, the age of the participants, and the combination of fitness training regimes. The article also discusses preliminary results that link, for the first time, fitness training and differences in human brain structure and function. Finally, we discuss the important issue of participant adherence to fitness training programs and the factors that influence fitness participation.

Aerobic fitness reduces brain tissue loss in aging humans

BACKGROUND

The human brain gradually loses tissue from the third decade of life onward, with concomitant declines in cognitive performance. Given the projected rapid growth in aged populations, and the staggering costs associated with geriatric care, identifying mechanisms that may reduce or reverse cerebral deterioration is rapidly emerging as an important public health goal. Previous research has demonstrated that aerobic fitness training improves cognitive function in older adults and can improve brain health in aging laboratory animals, suggesting that aerobic fitness may provide a mechanism to improve cerebral health in aging humans. We examined the relationship between aerobic fitness and in vivo brain tissue density in an older adult population, using voxel-based morphometric techniques.

METHODS

We acquired high-resolution magnetic resonance imaging scans from 55 older adults. These images were segmented into gray and white matter maps, registered into stereotaxic space, and examined for systematic variation in tissue density as a function of age, aerobic fitness, and a number of other health markers.

RESULTS

Consistent with previous studies of aging and brain volume, we found robust declines in tissue densities as a function of age in the frontal, parietal, and temporal cortices. More importantly, we found that losses in these areas were substantially reduced as a function of cardiovascular fitness, even when we statistically controlled for other moderator variables.

CONCLUSIONS

These findings extend the scope of beneficial effects of aerobic exercise beyond cardiovascular health, and they suggest a strong solid biological basis for the benefits of exercise on the brain health of older adults.

The impact of stereotype threat on age differences in memory performance

This study investigated the hypothesis that age differences in memory performance may be influenced by stereotype threat associated with negative cultural beliefs about the impact of aging on memory. Recall was examined in 48 young and 48 older adults under conditions varying in the degree of induced threat. Conditions that maximize threat resulted in lower performance in older adults relative to both younger adults and to older adults who did not experience threat. The degree to which threat affected older adults' performance increased along with the value that these individuals placed on their memory ability. Older adults' memory performance across experimental conditions was observed to covary with degree of activation of the negative aging stereotype, providing support for the hypothesized relationship between stereotype activation and performance. Finally, stereotype threat also influenced mnemonic strategy use, which in turn partially mediated the impact of threat on recall. These results emphasize the important role played by contextual factors in determining age differences in memory performance.

Instructional manipulations and age differences in memory: now you see them, now you don't

The instructions for most explicit memory tests use language that emphasizes the memorial component of the task. This language may put older adults at a disadvantage relative to younger adults because older adults believe that their memories have deteriorated. Consequently, typical explicit memory tests may overestimate age-related decline in cognitive performance. In 2 experiments, older and younger adults performed a memory test on newly learned trivia. In both experiments, age differences were obtained when the instructions emphasized the memory component of the task (memory emphasis) but not when the instructions did not emphasize memory (memory neutral). These findings suggest that aspects of the testing situation. such as experimental instructions, may exaggerate age differences in memory performance and need to be considered when designing studies investigating age differences in memory.

The role of prototypes in the mental representation of temporally related events

Four experiments investigated the conditions in which people use a prototypic event sequence to comprehend a situation-specific sequence of events. Results of Experiment 1 confirmed Trafimow and Wyer's (1993) findings that when participants use a prototype (e.g., a cultural script) to comprehend a new sequence of events concerning a hypothetical person, events that are thematically unrelated to the prototype facilitate the recall of prototypic ones. When participants do not employ a prototype, however, thematically unrelated events interfere with the recall of the prototypic ones. These findings establish a criterion for determining whether prototypes are used as a basis for comprehending an event sequence. Experiment 2 showed that the formation and use of a prototype to comprehend a novel event sequence increases with the number of exemplars to which persons have been exposed before the sequence is encountered. However, Experiments 3 and 4 indicated that people often do not use prototypes to interpret sequences of behaviors that they imagine either themselves or a well-known other performing. This is true even though they personally perform the sequence of behaviors on a daily basis and even though a prototypic representation of the event sequence exists in memory.

Instructional manipulations and age differences in memory: now you see them, now you don't

The instructions for most explicit memory tests use language that emphasizes the memorial component of the task. This language may put older adults at a disadvantage relative to younger adults because older adults believe that their memories have deteriorated. Consequently, typical explicit memory tests may overestimate age-related decline in cognitive performance. In 2 experiments, older and younger adults performed a memory test on newly learned trivia. In both experiments, age differences were obtained when the instructions emphasized the memory component of the task (memory emphasis) but not when the instructions did not emphasize memory (memory neutral). These findings suggest that aspects of the testing situation. such as experimental instructions, may exaggerate age differences in memory performance and need to be considered when designing studies investigating age differences in memory.

Cultural variation in the use of current life satisfaction to predict the future

Three studies examined cultural and situational influences on the tendency for people to use their current life satisfaction to predict future life events. On the basis of the self-enhancement literature, it was predicted that either writing about a positive personal experience or reading about another's negative experience would lead European Americans to focus their attention on internal attributes and thus would lead them to use their current life satisfaction in predicting the future. Conversely, on the basis of the self-criticism literature, it was predicted that these same conditions would lead Asian Americans to focus their attention on external factors and, therefore, would decrease their likelihood of using their current life satisfaction to predict the future. Studies 1 and 2 supported these hypotheses. Study 3 showed that these patterns could be obtained by subliminally priming concepts associated with individualism and collectivism.

Cultural variation in the use of current life satisfaction to predict the future

Three studies examined cultural and situational influences on the tendency for people to use their current life satisfaction to predict future life events. On the basis of the self-enhancement literature, it was predicted that either writing about a positive personal experience or reading about another's negative experience would lead European Americans to focus their attention on internal attributes and thus would lead them to use their current life satisfaction in predicting the future. Conversely, on the basis of the self-criticism literature, it was predicted that these same conditions would lead Asian Americans to focus their attention on external factors and, therefore, would decrease their likelihood of using their current life satisfaction to predict the future. Studies 1 and 2 supported these hypotheses. Study 3 showed that these patterns could be obtained by subliminally priming concepts associated with individualism and collectivism.