Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103641
Objective
The pathogenesis of depression in patients with Parkinson’s disease (PD) is poorly understood. Therefore, this study aimed to explore the changes in γ-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) levels in patients with PD with or without depression determined using MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS).
Materials and methods
A total of 83 patients with primary PD and 24 healthy controls were included. Patients with PD were categorized into depressed PD (DPD, n = 19) and nondepressed PD (NDPD, n = 64) based on the 17-item Hamilton Depression Rating Scale. All participants underwent T1-weighted imaging and MEGA-PRESS sequence to acquire GABA+ and Glx values. The MEGA-PRESS sequence was conducted using 18.48 mL voxels in the left thalamus and medial frontal cortex. The GABA+, Glx, and creatine values were quantified using Gannet 3.1 software.
Results
The GABA+ and Glx values were not significantly disparate between patients with PD and controls in the thalamus and medial frontal cortex. However, the levels of N-acetyl aspartate/creatine and choline/creatine in the left thalamus were significantly lower in patients with PD than in controls (P = .031, P = .009). The GABA+/Water and GABA+/Creatine in the medial frontal cortex were higher in DPD than in NDPD (P = .001, P = .004). The effects of depression on Glx or other metabolite levels were not evident, and no significant difference in metabolite values was noted in the left thalamus among all groups (P > .05).
Conclusions
GABA+ levels increased in the medial frontal cortex in DPD, which may be more closely related to depressive pathology. Thus, alterations in GABAergic function in special brain structures may be related to the clinical manifestations of PD symptoms, and hence mediating this function might help in treating depression in PD.
{"title":"GABAergic imbalance in Parkinson’s disease–related depression determined with MEGA-PRESS","authors":"","doi":"10.1016/j.nicl.2024.103641","DOIUrl":"10.1016/j.nicl.2024.103641","url":null,"abstract":"<div><h3>Objective</h3><p>The pathogenesis of depression in patients with Parkinson’s disease (PD) is poorly understood. Therefore, this study aimed to explore the changes in γ-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) levels in patients with PD with or without depression determined using MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS).</p></div><div><h3>Materials and methods</h3><p>A total of 83 patients with primary PD and 24 healthy controls were included. Patients with PD were categorized into depressed PD (DPD, <em>n</em> = 19) and nondepressed PD (NDPD, <em>n</em> = 64) based on the 17-item Hamilton Depression Rating Scale. All participants underwent T1-weighted imaging and MEGA-PRESS sequence to acquire GABA+ and Glx values. The MEGA-PRESS sequence was conducted using 18.48 mL voxels in the left thalamus and medial frontal cortex. The GABA+, Glx, and creatine values were quantified using Gannet 3.1 software.</p></div><div><h3>Results</h3><p>The GABA+ and Glx values were not significantly disparate between patients with PD and controls in the thalamus and medial frontal cortex. However, the levels of N-acetyl aspartate/creatine and choline/creatine in the left thalamus were significantly lower in patients with PD than in controls (<em>P</em> = .031, <em>P</em> = .009). The GABA+/Water and GABA+/Creatine in the medial frontal cortex were higher in DPD than in NDPD (<em>P</em> = .001, <em>P</em> = .004). The effects of depression on Glx or other metabolite levels were not evident, and no significant difference in metabolite values was noted in the left thalamus among all groups (<em>P</em> > .05).</p></div><div><h3>Conclusions</h3><p>GABA+ levels increased in the medial frontal cortex in DPD, which may be more closely related to depressive pathology. Thus, alterations in GABAergic function in special brain structures may be related to the clinical manifestations of PD symptoms, and hence mediating this function might help in treating depression in PD.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000809/pdfft?md5=a32ba540d1ce5e88ab3d43f7c31e05cc&pid=1-s2.0-S2213158224000809-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103634
Dror Shir , Jonathan Graff-Radford , Angela J. Fought , Timothy G. Lesnick , Scott A. Przybelski , Maria Vassilaki , Val J. Lowe , David S. Knopman , Mary M. Machulda , Ronald C. Petersen , Clifford R. Jack Jr , Michelle M. Mielke , Prashanthi Vemuri
Introduction
AD and CVD, which frequently co-occur, are leading causes of age-related cognitive decline. We assessed how demographic factors, socioeconomic status (SES) as indicated by education and occupation, vascular risk factors, and a range of biomarkers associated with both CVD (including white matter hyperintensities [WMH], diffusion MRI abnormalities, infarctions, and microbleeds) and AD (comprising amyloid-PET and tau-PET) collectively influence cognitive function.
Methods
In this cross-sectional population study, structural equation models were utilized to understand these associations in 449 participants (mean age (SD) = 74.5 (8.4) years; 56% male; 7.5% cognitively impaired).
Results
(1) Higher SES had a protective effect on cognition with mediation through the vascular pathway. (2) The effect of amyloid directly on cognition and through tau was 11-fold larger than the indirect effect of amyloid on cognition through WMH. (3) There is a significant effect of vascular risk on tau deposition.
Discussion
The utilized biomarkers captured the impact of CVD and AD on cognition. The overall effect of vascular risk and SES on these biomarkers are complex and need further investigation.
导言:老年痴呆症和心血管疾病经常并发,是导致老年认知能力下降的主要原因。我们评估了人口统计学因素、教育和职业所显示的社会经济地位(SES)、血管风险因素以及一系列与心血管疾病(包括白质高密度[WMH]、弥散磁共振成像异常、梗塞和微出血)和注意力缺失症(包括淀粉样蛋白-PET和tau-PET)相关的生物标志物如何共同影响认知功能。结果(1)较高的社会经济地位对认知有保护作用,并通过血管途径进行调节。(2)淀粉样蛋白直接或通过 tau 对认知的影响比淀粉样蛋白通过 WMH 对认知的间接影响大 11 倍。(3) 血管风险对 tau 沉积有显著影响。血管风险和社会经济地位对这些生物标志物的总体影响非常复杂,需要进一步研究。
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Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103652
Cushing’s disease (CD) represents a state of cortisol excess, serving as a model to investigate the effects of prolonged hypercortisolism on functional brain. Potential alterations in the functional connectome of the brain may explain frequently reported cognitive deficits and affective disorders in CD patients. This study aims to elucidate the effects of chronic hypercortisolism on the principal functional gradient, which represents a hierarchical architecture with gradual transitions across cognitive processes, by integrating connectomics and transcriptomics approaches. Utilizing resting-state functional magnetic resonance imaging data from 140 participants (86 CD patients, 54 healthy controls) recruited at a single center, we explored the alterations in the principal gradient in CD patients. Further, we thoroughly explored the underlying associative mechanisms of the observed characteristic alterations with cognitive function domains, biological attributes, and neuropsychiatric representations, as well as gene expression profiles. Compared to healthy controls, CD patients demonstrated changes in connectome patterns in both primary and higher-order networks, exhibiting an overall converged trend along the principal gradient axis. The gradient values in CD patients’ right prefrontal cortex and bilateral sensorimotor cortices exhibited a significant correlation with cortisol levels. Moreover, the cortical regions showing gradient alterations were principally associated with sensory information processing and higher-cognitive functions, as well as correlated with the gene expression patterns which involved synaptic components and function. The findings suggest that converged alterations in the principal gradient in CD patients may mediate the relationship between hypercortisolism and cognitive impairments, potentially involving genes regulating synaptic components and function.
库欣病(Cushing's disease,CD)是皮质醇过剩的一种表现,是研究长期皮质醇过多对大脑功能影响的一个模型。大脑功能连接组的潜在改变可能是经常报道的库欣病患者认知障碍和情感障碍的原因。本研究旨在通过整合连接组学和转录组学方法,阐明慢性皮质醇过多症对主要功能梯度的影响。利用在一个中心招募的 140 名参与者(86 名 CD 患者,54 名健康对照组)的静息态功能磁共振成像数据,我们探讨了 CD 患者主要梯度的改变。此外,我们还深入探讨了所观察到的特征性改变与认知功能领域、生物属性、神经精神表征以及基因表达谱之间的关联机制。与健康对照组相比,CD 患者的初级网络和高阶网络的连接组模式都发生了变化,并沿着主梯度轴呈现出整体趋同的趋势。CD 患者右侧前额叶皮层和双侧感觉运动皮层的梯度值与皮质醇水平呈显著相关。此外,出现梯度变化的皮层区域主要与感觉信息处理和高级认知功能有关,并与涉及突触成分和功能的基因表达模式相关。研究结果表明,皮质醇过多症患者的主要梯度变化可能介导了皮质醇过多症与认知障碍之间的关系,可能涉及调节突触成分和功能的基因。
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Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103662
Objective
Aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH) cause an abrupt rise in intracranial pressure, resulting in shearing forces, causing damage to the white matter tracts. This study aims to investigate whole-brain white matter abnormalities with diffusion kurtosis imaging (DKI) after both aSAH and anSAH and explores whether these abnormalities are associated with impaired cognitive functioning.
Methods
Five months post-ictus, 34 patients with aSAH, 24 patients with anSAH and 17 healthy controls (HC) underwent DKI MRI scanning and neuropsychological assessment (measuring verbal memory, psychomotor speed, executive control, and social cognition). Differences in DKI measures (fractional anisotropy, mean diffusivity, axial diffusivity [AD], radial diffusivity, and mean kurtosis) were examined using tract-based spatial statistics. Significant voxel masks were then correlated with neuropsychological scores.
Results
All DKI measures differed significantly between patients with aSAH and HC, but no significant differences were found between patients with anSAH and HC. Although the two SAH groups did not differ significantly on all DKI parameters, effect sizes indicated that the anSAH group might be more similar to HC. Cognitive impairments were found for both SAH groups relative to HC. No significant associations were found between these impairments and white matter abnormalities in the aSAH group, but lower psychomotor speed scores were associated with higher AD values (r = -0.41, p = 0.04) in patients with anSAH.
Conclusions
Patients with aSAH showed significant white matter diffusion abnormalities, while the anSAH group, despite cognitive deficits, did not. However, there were no significant differences between the SAH groups, and no correlations between DKI metrics and cognitive measures, except for one test on psychomotor speed in the anSAH group. Overall, this study suggests that while anSAH may not be as severe as aSAH, it is still not a benign condition. Further research with larger anSAH cohorts is necessary to gain a more precise understanding of white matter injuries, particularly regarding their prevalence.
目的动脉瘤性蛛网膜下腔出血(aSAH)和血管造影阴性蛛网膜下腔出血(anSAH)会导致颅内压突然升高,从而产生剪切力,造成白质束损伤。本研究旨在通过弥散峰度成像(DKI)研究蛛网膜下腔出血和无蛛网膜下腔出血后的全脑白质异常,并探讨这些异常是否与认知功能受损有关。方法34名蛛网膜下腔出血患者、24名无蛛网膜下腔出血患者和17名健康对照组(HC)在发病后5个月接受了DKI MRI扫描和神经心理学评估(测量言语记忆、精神运动速度、执行控制和社会认知)。使用基于道的空间统计方法检查了 DKI 测量(分数各向异性、平均扩散率、轴向扩散率 [AD]、径向扩散率和平均峰度)的差异。结果所有 DKI 测量结果在 aSAH 和 HC 患者之间均存在显著差异,但在 anSAH 和 HC 患者之间未发现显著差异。尽管两组SAH患者在所有DKI参数上都没有明显差异,但效应大小表明,anSAH组可能与HC组更为相似。与 HC 相比,两组 SAH 患者均存在认知障碍。在 aSAH 组中,这些损伤与白质异常之间没有发现明显的关联,但在 anSAH 患者中,较低的精神运动速度评分与较高的 AD 值相关(r = -0.41,p = 0.04)。然而,SAH 组之间没有明显差异,DKI 指标与认知指标之间也没有相关性,只有 anSAH 组的一项精神运动速度测试除外。总之,这项研究表明,虽然anSAH可能不像aSAH那么严重,但它仍然不是一种良性疾病。为了更准确地了解白质损伤,尤其是其发病率,有必要对更多的无SAH患者进行进一步研究。
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Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103606
Christian Kiss , Sebastian Wurth , Bettina Heschl , Michael Khalil , Thomas Gattringer , Christian Enzinger , Stefan Ropele
Introduction
Brain viscoelasticity as assessed by magnetic resonance elastography (MRE) has been discussed as a promising surrogate of microstructural alterations due to neurodegenerative processes. Existing studies indicate that multiple sclerosis (MS) is associated with a global reduction in brain stiffness. However, no study to date systematically investigated the MS-related characteristics of brain viscoelasticity separately in normal-appearing white matter (NAWM), deep gray matter (DGM) and T2-hyperintense white matter (WM) lesions.
Methods
70 MS patients and 42 healthy volunteers underwent whole-cerebral MRE using a stimulated echo sequence (DENSE) with a low-frequency mechanical excitation at 20 Hertz. The magnitude (Pa) and phase angle (rad) of the complex shear modulus were reconstructed by multifrequency dual elasto-visco (MDEV) inversion and related to structural imaging and clinical parameters.
Results
We observed in the thalamus to be higher by 4.3 % in patients relative to healthy controls (1.11 ± 0.07 vs. 1.06 ± 0.07, p < 0.0001). Higher Expanded Disability Status Scale (EDSS) scores were negatively associated with in the basal ganglia (p = 0.01). We measured to be lower in MS lesions compared to surrounding NAWM (p = 0.001), which was most prominent for lesions in the temporal lobe (1.01 ± 0.22 vs. 1.06 ± 0.19, p = 0.003). Age was associated with lower values of (p = 0.04) and (p = 0.004) in the thalamus of patients. No alteration in NAWM stiffness relative to WM in healthy controls was observed.
Conclusion
Low-frequency elastography in MS patients reveals age-independent alterations in the viscoelasticity of deep gray matter at early stages of disease.
导言:通过磁共振弹性成像(MRE)评估的脑粘弹性被认为是神经退行性过程引起的微观结构改变的一种有前途的替代物。现有研究表明,多发性硬化症(MS)与大脑硬度的全面降低有关。然而,迄今为止还没有研究系统地分别调查了正常外观白质(NAWM)、深灰质(DGM)和 T2-高密度白质(WM)病变中脑粘弹性的 MS 相关特征。结果我们观察到丘脑中的φ比健康对照组高4.3%(1.11 ± 0.07 vs. 1.06 ± 0.07, p <0.0001)。较高的扩展残疾状况量表(EDSS)评分与基底节的φ呈负相关(p = 0.01)。我们测得 MS 病变的 φ 低于周围的 NAWM(p = 0.001),这在颞叶病变中最为明显(1.01 ± 0.22 vs. 1.06 ± 0.19,p = 0.003)。年龄与患者丘脑中较低的|G∗|值(p = 0.04)和φ值(p = 0.004)有关。结论多发性硬化症患者的低频弹性成像显示,在疾病的早期阶段,深灰质粘弹性的改变与年龄无关。
{"title":"Low-frequency MR elastography reveals altered deep gray matter viscoelasticity in multiple sclerosis","authors":"Christian Kiss , Sebastian Wurth , Bettina Heschl , Michael Khalil , Thomas Gattringer , Christian Enzinger , Stefan Ropele","doi":"10.1016/j.nicl.2024.103606","DOIUrl":"https://doi.org/10.1016/j.nicl.2024.103606","url":null,"abstract":"<div><h3>Introduction</h3><p>Brain viscoelasticity as assessed by magnetic resonance elastography (MRE) has been discussed as a promising surrogate of microstructural alterations due to neurodegenerative processes. Existing studies indicate that multiple sclerosis (MS) is associated with a global reduction in brain stiffness. However, no study to date systematically investigated the MS-related characteristics of brain viscoelasticity separately in normal-appearing white matter (NAWM), deep gray matter (DGM) and T2-hyperintense white matter (WM) lesions.</p></div><div><h3>Methods</h3><p>70 MS patients and 42 healthy volunteers underwent whole-cerebral MRE using a stimulated echo sequence (DENSE) with a low-frequency mechanical excitation at 20 Hertz. The magnitude <span><math><mrow><mo>|</mo><msup><mrow><mi>G</mi></mrow><mrow><mo>∗</mo></mrow></msup><mo>|</mo></mrow></math></span> (Pa) and phase angle <span><math><mi>φ</mi></math></span> (rad) of the complex shear modulus <span><math><msup><mrow><mi>G</mi></mrow><mrow><mo>∗</mo></mrow></msup></math></span> were reconstructed by multifrequency dual elasto-visco (MDEV) inversion and related to structural imaging and clinical parameters.</p></div><div><h3>Results</h3><p>We observed <span><math><mi>φ</mi></math></span> in the thalamus to be higher by 4.3 % in patients relative to healthy controls (1.11 ± 0.07 vs. 1.06 ± 0.07, p < 0.0001). Higher Expanded Disability Status Scale (EDSS) scores were negatively associated with <span><math><mi>φ</mi></math></span> in the basal ganglia (p = 0.01). We measured <span><math><mi>φ</mi></math></span> to be lower in MS lesions compared to surrounding NAWM (p = 0.001), which was most prominent for lesions in the temporal lobe (1.01 ± 0.22 vs. 1.06 ± 0.19, p = 0.003). Age was associated with lower values of <span><math><mrow><mrow><mo>|</mo></mrow><msup><mrow><mi>G</mi></mrow><mrow><mo>∗</mo></mrow></msup><mrow><mo>|</mo></mrow></mrow></math></span> (p = 0.04) and <span><math><mi>φ</mi></math></span> (p = 0.004) in the thalamus of patients. No alteration in NAWM stiffness relative to WM in healthy controls was observed.</p></div><div><h3>Conclusion</h3><p>Low-frequency elastography in MS patients reveals age-independent alterations in the viscoelasticity of deep gray matter at early stages of disease.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000457/pdfft?md5=c1a858ebe064c2eaf6577a9879dccac2&pid=1-s2.0-S2213158224000457-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103628
Jie Hu , Guiqin Chen , Zhen Zeng , Haifeng Ran , Ruoxi Zhang , Qiane Yu , Yuxin Xie , Yulun He , Fuqin Wang , Xuhong Li , Kexing Huang , Heng Liu , Tijiang Zhang
Objective
Benign childhood epilepsy with centrotemporal spikes (BECTS) affects brain network hierarchy and cognitive function; however, it remains unclear how hierarchical change affects cognition in patients with BECTS. A major aim of this study was to examine changes in the macro-network function hierarchy in BECTS and its potential contribution to cognitive function.
Methods
Overall, the study included 50 children with BECTS and 69 healthy controls. Connectome gradient analysis was used to determine the brain network hierarchy of each group. By comparing gradient scores at each voxel level and network between groups, we assessed changes in whole-brain voxel-level and network hierarchy. Functional connectivity was used to detect the functional reorganization of epilepsy caused by these abnormal brain regions based on these aberrant gradients. Lastly, we explored the relationships between the change gradient and functional connectivity values and clinical variables and further predicted the cognitive function associated with BECTS gradient changes.
Results
In children with BECTS, the gradient was extended at different network and voxel levels. The gradient scores frontoparietal network was increased in the principal gradient of patients with BECTS. The left precentral gyrus (PCG) and right angular gyrus gradient scores were significantly increased in the principal gradient of children with BECTS. Moreover, in regions of the brain with abnormal principal gradients, functional connectivity was disrupted. The left PCG gradient score of children with BECTS was correlated with the verbal intelligence quotient (VIQ), and the disruption of functional connectivity in brain regions with abnormal principal gradients was closely related to cognitive function. VIQ was significantly predicted by the principal gradient map of patients.
Significance
The results indicate connectome gradient disruption in children with BECTS and its relationship to cognitive function, thereby increasing our understanding of the functional connectome hierarchy and providing potential biomarkers for cognitive function of children with BECTS.
{"title":"Systematically altered connectome gradient in benign childhood epilepsy with centrotemporal spikes: Potential effect on cognitive function","authors":"Jie Hu , Guiqin Chen , Zhen Zeng , Haifeng Ran , Ruoxi Zhang , Qiane Yu , Yuxin Xie , Yulun He , Fuqin Wang , Xuhong Li , Kexing Huang , Heng Liu , Tijiang Zhang","doi":"10.1016/j.nicl.2024.103628","DOIUrl":"10.1016/j.nicl.2024.103628","url":null,"abstract":"<div><h3>Objective</h3><p>Benign childhood epilepsy with centrotemporal spikes (BECTS) affects brain network hierarchy and cognitive function; however, it<!--> <!-->remains<!--> <!-->unclear<!--> <!-->how<!--> <!-->hierarchical change<!--> <!-->affects<!--> <!-->cognition in patients with BECTS. A major aim of this study was to examine changes in the macro-network function hierarchy in BECTS and its potential contribution to cognitive function.</p></div><div><h3>Methods</h3><p>Overall, the study included 50 children with BECTS and 69 healthy controls. Connectome gradient analysis was used to determine the brain network hierarchy of each group. By comparing gradient scores at each voxel level and network between groups, we assessed changes in whole-brain voxel-level and network hierarchy. Functional connectivity was used to detect the functional reorganization of epilepsy caused by these abnormal brain regions based on these aberrant gradients. Lastly, we explored the relationships between the change gradient and functional connectivity values and clinical variables and further predicted the cognitive function associated with BECTS gradient changes.</p></div><div><h3>Results</h3><p>In children with BECTS, the gradient was extended at different network and voxel levels. The gradient scores frontoparietal network was increased in the principal gradient of patients with BECTS. The left precentral gyrus (PCG) and right angular gyrus gradient scores were significantly increased in the principal gradient of children with BECTS. Moreover, in regions of the brain with abnormal principal gradients, functional connectivity was disrupted. The left PCG gradient score of children with BECTS was correlated with the verbal intelligence quotient (VIQ), and the disruption of functional connectivity in brain regions with abnormal principal gradients was closely related to cognitive function. VIQ was significantly predicted by the principal gradient map of patients.</p></div><div><h3>Significance</h3><p>The results indicate connectome gradient disruption in children with BECTS and its relationship to cognitive function, thereby increasing our understanding of the functional connectome hierarchy and providing potential biomarkers for cognitive function of children with BECTS.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000676/pdfft?md5=9586f843991905e691d3ff366c8ee888&pid=1-s2.0-S2213158224000676-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141228830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103623
Na Gao , Hantao Chen , Xutao Guo , Xingyu Hao , Ting Ma
Longitudinal hippocampal atrophy is commonly used as progressive marker assisting clinical diagnose of dementia. However, precise quantification of the atrophy is limited by longitudinal segmentation errors resulting from MRI artifacts across multiple independent scans. To accurately segment the hippocampal morphology from longitudinal 3T T1-weighted MR images, we propose a diffeomorphic geodesic guided deep learning method called the GeoLongSeg to mitigate the longitudinal variabilities that unrelated to diseases by enhancing intra-individual morphological consistency. Specifically, we integrate geodesic shape regression, an evolutional model that estimates smooth deformation process of anatomical shapes, into a two-stage segmentation network. We adopt a 3D U-Net in the first-stage network with an enhanced attention mechanism for independent segmentation. Then, a hippocampal shape evolutional trajectory is estimated by geodesic shape regression and fed into the second network to refine the independent segmentation. We verify that GeoLongSeg outperforms other four state-of-the-art segmentation pipelines in longitudinal morphological consistency evaluated by test–retest reliability, variance ratio and atrophy trajectories. When assessing hippocampal atrophy in longitudinal data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), results based on GeoLongSeg exhibit spatial and temporal local atrophy in bilateral hippocampi of dementia patients. These features derived from GeoLongSeg segmentation exhibit the greatest discriminatory capability compared to the outcomes of other methods in distinguishing between patients and normal controls. Overall, GeoLongSeg provides an accurate and efficient segmentation network for extracting hippocampal morphology from longitudinal MR images, which assist precise atrophy measurement of the hippocampus in early stage of dementia.
{"title":"Geodesic shape regression based deep learning segmentation for assessing longitudinal hippocampal atrophy in dementia progression","authors":"Na Gao , Hantao Chen , Xutao Guo , Xingyu Hao , Ting Ma","doi":"10.1016/j.nicl.2024.103623","DOIUrl":"10.1016/j.nicl.2024.103623","url":null,"abstract":"<div><p>Longitudinal hippocampal atrophy is commonly used as progressive marker assisting clinical diagnose of dementia. However, precise quantification of the atrophy is limited by longitudinal segmentation errors resulting from MRI artifacts across multiple independent scans. To accurately segment the hippocampal morphology from longitudinal 3T T1-weighted MR images, we propose a diffeomorphic geodesic guided deep learning method called the GeoLongSeg to mitigate the longitudinal variabilities that unrelated to diseases by enhancing intra-individual morphological consistency. Specifically, we integrate geodesic shape regression, an evolutional model that estimates smooth deformation process of anatomical shapes, into a two-stage segmentation network. We adopt a 3D U-Net in the first-stage network with an enhanced attention mechanism for independent segmentation. Then, a hippocampal shape evolutional trajectory is estimated by geodesic shape regression and fed into the second network to refine the independent segmentation. We verify that GeoLongSeg outperforms other four state-of-the-art segmentation pipelines in longitudinal morphological consistency evaluated by test–retest reliability, variance ratio and atrophy trajectories. When assessing hippocampal atrophy in longitudinal data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), results based on GeoLongSeg exhibit spatial and temporal local atrophy in bilateral hippocampi of dementia patients. These features derived from GeoLongSeg segmentation exhibit the greatest discriminatory capability compared to the outcomes of other methods in distinguishing between patients and normal controls. Overall, GeoLongSeg provides an accurate and efficient segmentation network for extracting hippocampal morphology from longitudinal MR images, which assist precise atrophy measurement of the hippocampus in early stage of dementia.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000627/pdfft?md5=6100e9886602669d06ca1e2540750aed&pid=1-s2.0-S2213158224000627-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103624
David Romascano , Michael Rebsamen , Piotr Radojewski , Timo Blattner , Richard McKinley , Roland Wiest , Christian Rummel
Over the past decades, morphometric analysis of brain MRI has contributed substantially to the understanding of healthy brain structure, development and aging as well as to improved characterisation of disease related pathologies. Certified commercial tools based on normative modeling of these metrics are meanwhile available for diagnostic purposes, but they are cost intensive and their clinical evaluation is still in its infancy. Here we have compared the performance of “ScanOMetrics”, an open-source research-level tool for detection of statistical anomalies in individual MRI scans, depending on whether it is operated on the output of FreeSurfer or of the deep learning based brain morphometry tool DL + DiReCT. When applied to the public OASIS3 dataset, containing patients with Alzheimer’s disease (AD) and healthy controls (HC), cortical thickness anomalies in patient scans were mainly detected in regions that are known as predilection areas of cortical atrophy in AD, regardless of the software used for extraction of the metrics. By contrast, anomaly detections in HCs were up to twenty-fold reduced and spatially unspecific using both DL + DiReCT and FreeSurfer. Progression of the atrophy pattern with clinical dementia rating (CDR) was clearly observable with both methods. DL + DiReCT provided results in less than 25 min, more than 15 times faster than FreeSurfer. This difference in computation time might be relevant when considering application of this or similar methodology as diagnostic decision support for neuroradiologists.
过去几十年来,脑部核磁共振成像的形态计量分析极大地促进了人们对健康脑部结构、发育和衰老的了解,并改善了与疾病相关的病理特征。目前,基于这些度量标准建模的认证商业工具可用于诊断目的,但它们成本高昂,临床评估仍处于起步阶段。在此,我们比较了 "ScanOMetrics "的性能,这是一款用于检测单个核磁共振成像扫描中统计异常的开源研究级工具,其性能取决于是在 FreeSurfer 的输出上运行,还是在基于深度学习的大脑形态测量工具 DL + DiReCT 的输出上运行。当应用于包含阿尔茨海默病(AD)患者和健康对照组(HC)的公共 OASIS3 数据集时,无论使用哪种软件提取指标,患者扫描中的皮层厚度异常都主要在已知的 AD 皮层萎缩偏好区域被检测到。相比之下,使用DL + DiReCT和FreeSurfer,HCs的异常检测率降低了20倍,而且在空间上没有特异性。这两种方法都能清楚地观察到萎缩模式随临床痴呆评级(CDR)的进展。DL + DiReCT 在不到 25 分钟的时间内就得出了结果,比 FreeSurfer 快 15 倍以上。在考虑将这种方法或类似方法用作神经放射科医生的诊断决策支持时,计算时间上的这种差异可能是有意义的。
{"title":"Cortical thickness and grey-matter volume anomaly detection in individual MRI scans: Comparison of two methods","authors":"David Romascano , Michael Rebsamen , Piotr Radojewski , Timo Blattner , Richard McKinley , Roland Wiest , Christian Rummel","doi":"10.1016/j.nicl.2024.103624","DOIUrl":"10.1016/j.nicl.2024.103624","url":null,"abstract":"<div><p>Over the past decades, morphometric analysis of brain MRI has contributed substantially to the understanding of healthy brain structure, development and aging as well as to improved characterisation of disease related pathologies. Certified commercial tools based on normative modeling of these metrics are meanwhile available for diagnostic purposes, but they are cost intensive and their clinical evaluation is still in its infancy. Here we have compared the performance of “ScanOMetrics”, an open-source research-level tool for detection of statistical anomalies in individual MRI scans, depending on whether it is operated on the output of FreeSurfer or of the deep learning based brain morphometry tool DL + DiReCT. When applied to the public OASIS3 dataset, containing patients with Alzheimer’s disease (AD) and healthy controls (HC), cortical thickness anomalies in patient scans were mainly detected in regions that are known as predilection areas of cortical atrophy in AD, regardless of the software used for extraction of the metrics. By contrast, anomaly detections in HCs were up to twenty-fold reduced and spatially unspecific using both DL + DiReCT and FreeSurfer. Progression of the atrophy pattern with clinical dementia rating (CDR) was clearly observable with both methods. DL + DiReCT provided results in less than 25 min, more than 15 times faster than FreeSurfer. This difference in computation time might be relevant when considering application of this or similar methodology as diagnostic decision support for neuroradiologists.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000639/pdfft?md5=bbf1ef4b7b027cf3cde10aa48655cbe2&pid=1-s2.0-S2213158224000639-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103649
Diminished basal parasympathetic nervous system activity is a feature of frontotemporal dementia that relates to left frontoinsula dysfunction and empathy impairment. Individuals with a pathogenic expansion of the hexanucleotide repeat in chromosome 9 open reading frame 72 (C9orf72), the most common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis, provide a unique opportunity to examine whether parasympathetic activity is disrupted in genetic forms of frontotemporal dementia and to investigate when parasympathetic deficits manifest in the pathophysiological cascade. We measured baseline respiratory sinus arrhythmia, a parasympathetic measure of heart rate variability, over two minutes in a sample of 102 participants that included 19 asymptomatic expansion carriers (C9+ asymp), 14 expansion carriers with mild cognitive impairment (C9+ MCI), 16 symptomatic expansion carriers with frontotemporal dementia (C9+ FTD), and 53 expansion-negative healthy controls (C9- HC) who also underwent structural magnetic resonance imaging. In follow-up analyses, we compared baseline respiratory sinus arrhythmia in the C9+ FTD group with an independent age-, sex-, and clinical severity-matched group of 26 people with sporadic behavioral variant frontotemporal dementia. The Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating-Sum of Boxes score was used to quantify behavioral symptom severity, and informant ratings on the Interpersonal Reactivity Index provided measures of participants’ current emotional (empathic concern) and cognitive (perspective-taking) empathy. Results indicated that the C9+ FTD group had lower baseline respiratory sinus arrhythmia than the C9+ MCI, C9+ asymp, and C9- HC groups, a deficit that was comparable to that of sporadic behavioral variant frontotemporal dementia. Linear regression analyses indicated that lower baseline respiratory sinus arrhythmia was associated with worse behavioral symptom severity and lower empathic concern and perspective-taking across the C9orf72 expansion carrier clinical spectrum. Whole-brain voxel-based morphometry analyses in participants with C9orf72 pathogenic expansions found that lower baseline respiratory sinus arrhythmia correlated with smaller gray matter volume in the left frontoinsula and bilateral thalamus, key structures that support parasympathetic function, and in the bilateral parietal lobes, occipital lobes, and cerebellum, regions that are also vulnerable in individuals with C9orf72 expansions. This study provides novel evidence that basal parasympathetic functioning is diminished in FTD due to C9orf72 expansions and suggests that baseline respiratory sinus arrhythmia may be a potential non-invasive biomarker that is sensitive
{"title":"Basal parasympathetic deficits in C9orf72 hexanucleotide repeat expansion carriers relate to smaller frontoinsula and thalamus volume and lower empathy","authors":"","doi":"10.1016/j.nicl.2024.103649","DOIUrl":"10.1016/j.nicl.2024.103649","url":null,"abstract":"<div><p>Diminished basal parasympathetic nervous system activity is a feature of frontotemporal dementia that relates to left frontoinsula dysfunction and empathy impairment. Individuals with a pathogenic expansion of the hexanucleotide repeat in chromosome 9 open reading frame 72 (<em>C9orf72</em>), the most common genetic cause of frontotemporal dementia and amyotrophic lateral sclerosis, provide a unique opportunity to examine whether parasympathetic activity is disrupted in genetic forms of frontotemporal dementia and to investigate when parasympathetic deficits manifest in the pathophysiological cascade. We measured baseline respiratory sinus arrhythmia, a parasympathetic measure of heart rate variability, over two minutes in a sample of 102 participants that included 19 asymptomatic expansion carriers (<em>C9</em><sup>+</sup> asymp), 14 expansion carriers with mild cognitive impairment (<em>C9</em><sup>+</sup> MCI), 16 symptomatic expansion carriers with frontotemporal dementia (<em>C9</em><sup>+</sup> FTD), and 53 expansion-negative healthy controls (<em>C9<sup>-</sup></em> HC) who also underwent structural magnetic resonance imaging. In follow-up analyses, we compared baseline respiratory sinus arrhythmia in the <em>C9</em><sup>+</sup> FTD group with an independent age-, sex-, and clinical severity-matched group of 26 people with sporadic behavioral variant frontotemporal dementia. The Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating-Sum of Boxes score was used to quantify behavioral symptom severity, and informant ratings on the Interpersonal Reactivity Index provided measures of participants’ current emotional (empathic concern) and cognitive (perspective-taking) empathy. Results indicated that the <em>C9</em><sup>+</sup> FTD group had lower baseline respiratory sinus arrhythmia than the <em>C9</em><sup>+</sup> MCI, <em>C9</em><sup>+</sup> asymp, and <em>C9<sup>-</sup></em> HC groups, a deficit that was comparable to that of sporadic behavioral variant frontotemporal dementia. Linear regression analyses indicated that lower baseline respiratory sinus arrhythmia was associated with worse behavioral symptom severity and lower empathic concern and perspective-taking across the <em>C9orf72</em> expansion carrier clinical spectrum. Whole-brain voxel-based morphometry analyses in participants with <em>C9orf72</em> pathogenic expansions found that lower baseline respiratory sinus arrhythmia correlated with smaller gray matter volume in the left frontoinsula and bilateral thalamus, key structures that support parasympathetic function, and in the bilateral parietal lobes, occipital lobes, and cerebellum, regions that are also vulnerable in individuals with <em>C9orf72</em> expansions. This study provides novel evidence that basal parasympathetic functioning is diminished in FTD due to <em>C9orf72</em> expansions and suggests that baseline respiratory sinus arrhythmia may be a potential non-invasive biomarker that is sensitive ","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000883/pdfft?md5=b01a758cd4635dc715fed1f5daffee95&pid=1-s2.0-S2213158224000883-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141796712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.nicl.2024.103572
K.A. Donald , C.J. Hendrikse , A. Roos , C.J. Wedderburn , S. Subramoney , J.E. Ringshaw , L. Bradford , N. Hoffman , T. Burd , K.L. Narr , R.P. Woods , H.J. Zar , S.H. Joshi , D.J. Stein
Prenatal alcohol exposure (PAE) can affect brain development in early life, but few studies have investigated the effects of PAE on trajectories of white matter tract maturation in young children. Here we used diffusion weighted imaging (DWI) repeated over three time points, to measure the effects of PAE on patterns of white matter microstructural development during the pre-school years. Participants were drawn from the Drakenstein Child Health Study (DCHS), an ongoing birth cohort study conducted in a peri-urban community in the Western Cape, South Africa. A total of 342 scans acquired from 237 children as neonates (N = 82 scans: 30 PAE; 52 controls) and at ages 2–3 (N = 121 scans: 27 PAE; 94 controls) and 6–7 years (N = 139 scans: 45 PAE; 94 controls) were included. Maternal alcohol use during pregnancy and other antenatal covariates were collected from 28 to 32 weeks’ gestation. Linear mixed effects models with restricted maxium likelihood to accommodate missing data were implemented to investigate the effects of PAE on fractional anisotropy (FA) and mean diffusivity (MD) in specific white matter tracts over time, while adjusting for child sex and maternal education. We found significant PAE-by-time effects on trajectories of FA development in the left superior cerebellar peduncle (SCP-L: p = 0.001; survived FDR correction) and right superior longitudinal fasciculus (SLF-R: p = 0.046), suggesting altered white matter development among children with PAE. Compared with controls, children with PAE demonstrated a more rapid change in FA in these tracts from the neonatal period to 2–3 years of age, followed by a more tapered trajectory for the period from 2–3 to 6–7 years of age, with these trajectories differing from unexposed control children. Given their supporting roles in various aspects of neurocognitive functioning (i.e., motor regulation, learning, memory, language), altered patterns of maturation in the SCP and SLF may contribute to a spectrum of physical, social, emotional, and cognitive difficulties often experienced by children with PAE. This study highlights the value of repeated early imaging in longitudinal studies of PAE, and focus for early childhood as a critical window of potential susceptibility as well as an opportunity for early intervention.
{"title":"Prenatal alcohol exposure and white matter microstructural changes across the first 6–7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort","authors":"K.A. Donald , C.J. Hendrikse , A. Roos , C.J. Wedderburn , S. Subramoney , J.E. Ringshaw , L. Bradford , N. Hoffman , T. Burd , K.L. Narr , R.P. Woods , H.J. Zar , S.H. Joshi , D.J. Stein","doi":"10.1016/j.nicl.2024.103572","DOIUrl":"10.1016/j.nicl.2024.103572","url":null,"abstract":"<div><p>Prenatal alcohol exposure (PAE) can affect brain development in early life, but few studies have investigated the effects of PAE on <em>trajectories</em> of white matter tract maturation in young children. Here we used diffusion weighted imaging (DWI) repeated over three time points, to measure the effects of PAE on patterns of white matter microstructural development during the pre-school years. Participants were drawn from the Drakenstein Child Health Study (DCHS), an ongoing birth cohort study conducted in a peri-urban community in the Western Cape, South Africa. A total of 342 scans acquired from 237 children as neonates (N = 82 scans: 30 PAE; 52 controls) and at ages 2–3 (N = 121 scans: 27 PAE; 94 controls) and 6–7 years (N = 139 scans: 45 PAE; 94 controls) were included. Maternal alcohol use during pregnancy and other antenatal covariates were collected from 28 to 32 weeks’ gestation. Linear mixed effects models with restricted maxium likelihood to accommodate missing data were implemented to investigate the effects of PAE on fractional anisotropy (FA) and mean diffusivity (MD) in specific white matter tracts over time, while adjusting for child sex and maternal education. We found significant PAE-by-time effects on trajectories of FA development in the left superior cerebellar peduncle (SCP-L: p = 0.001; survived FDR correction) and right superior longitudinal fasciculus (SLF-R: p = 0.046), suggesting altered white matter development among children with PAE. Compared with controls, children with PAE demonstrated a more rapid change in FA in these tracts from the neonatal period to 2–3 years of age, followed by a more tapered trajectory for the period from 2–3 to 6–7 years of age, with these trajectories differing from unexposed control children. Given their supporting roles in various aspects of neurocognitive functioning (i.e., motor regulation, learning, memory, language), altered patterns of maturation in the SCP and SLF may contribute to a spectrum of physical, social, emotional, and cognitive difficulties often experienced by children with PAE. This study highlights the value of repeated early imaging in longitudinal studies of PAE, and focus for early childhood as a critical window of potential susceptibility as well as an opportunity for early intervention.</p></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213158224000111/pdfft?md5=da617d60a35415f08a97ed0ef727e46e&pid=1-s2.0-S2213158224000111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139589701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}