Effects of acute stress on risky decision-making are related to neuroticism: An fMRI study of the Balloon Analogue Risk Task.

BACKGROUND: Decision making under acute stress is frequent in daily life. While evidence suggests for a modulatory role of neuroticism on risky decision-making behaviors, the neural correlates underlying the association between neuroticism and risky decision-making under acute stress remain to be elucidated. METHODS: Based on a modified Balloon Analogue Risk Task (BART) with concurrent functional magnetic resonance imaging, we evaluated the effect of acute stress on risk-taking behavior in 27 healthy male adults, and further assessed stress-induced changes in brain activation according to the individual differences in neuroticism. RESULTS: Higher trait neuroticism levels positively correlated with increased stress-modulated activation of the right dorsal anterior cingulate cortex during risk-taking, and negatively correlated with decreased stress-modulated activation of the right dorsolateral prefrontal cortex during cash-outs. LIMITATIONS: Only male participants were recruited. CONCLUSIONS: We found a positive correlation between neuroticism and greater risk-taking behavior under acute stress. These results extend our understanding of the increased risk-taking propensity in high neurotic individuals under acute stress.

Correlation of abnormal brain changes with perinatal factors in very preterm infants based on diffusion tensor imaging.

Background: It remains unclear whether very preterm (VP) infants have the same level of brain structure and function as full-term (FT) infants. In addition, the relationship between potential differences in brain white matter microstructure and network connectivity and specific perinatal factors has not been well characterized. Objective: This study aimed to investigate the existence of potential differences in brain white matter microstructure and network connectivity between VP and FT infants at term-equivalent age (TEA) and examine the potential association of these differences with perinatal factors. Methods: A total of 83 infants were prospectively selected for this study: 43 VP infants (gestational age, or GA: 27-32 weeks) and 40 FT infants (GA: 37-44 weeks). All infants at TEA underwent both conventional magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Significant differences in white matter fractional anisotropy (FA) and mean diffusivity (MD) images between the VP and FT groups were observed using tract-based spatial statistics (TBSS). The fibers were tracked between each pair of regions in the individual space, using the automated anatomical labeling (AAL) atlas. Then, a structural brain network was constructed, where the connection between each pair of nodes was defined by the number of fibers. Network-based statistics (NBS) were used to examine differences in brain network connectivity between the VP and FT groups. Additionally, multivariate linear regression was conducted to investigate potential correlations between fiber bundle numbers and network metrics (global efficiency, local efficiency, and small-worldness) and perinatal factors. Results: Significant differences in FA were observed between the VP and FT groups in several regions. These differences were found to be significantly associated with perinatal factors such as bronchopulmonary dysplasia (BPD), activity, pulse, grimace, appearance, respiratory (APGAR) score, gestational hypertension, and infection. Significant differences in network connectivity were observed between the VP and FT groups. Linear regression results showed significant correlations between maternal years of education, weight, the APGAR score, GA at birth, and network metrics in the VP group. Conclusions: The findings of this study shed light on the influence of perinatal factors on brain development in VP infants. These results may serve as a basis for clinical intervention and treatment to improve the outcome of preterm infants.

The automatic evaluation of steno-occlusive changes in time-of-flight magnetic resonance angiography of moyamoya patients using a 3D coordinate attention residual network.

Background: Moyamoya disease (MMD) is a rare cerebrovascular occlusive disease with progressive stenosis of the terminal portion of internal cerebral artery (ICA) and its main branches, which can cause complications, such as high risks of disability and increased mortality. Accurate and timely diagnosis may be difficult for physicians who are unfamiliar to MMD. Therefore, this study aims to achieve a preoperative deep-learning-based evaluation of MMD by detecting steno-occlusive changes in the middle cerebral artery or distal ICA areas. Methods: A fine-tuned deep learning model was developed using a three-dimensional (3D) coordinate attention residual network (3D CA-ResNet). This study enrolled 50 preoperative patients with MMD and 50 controls, and the corresponding time of flight magnetic resonance angiography (TOF-MRA) imaging data were acquired. The 3D CA-ResNet was trained based on sub-volumes and tested using patch-based and subject-based methods. The performance of the 3D CA-ResNet, as evaluated by the area under the curve (AUC) of receiving-operator characteristic, was compared with that of three other conventional 3D networks. Results: With the resulting network, the patch-based test achieved an AUC value of 0.94 for the 3D CA-ResNet in 480 patches from 10 test patients and 10 test controls, which is significantly higher than the results of the others. The 3D CA-ResNet correctly classified the MMD patients and normal healthy controls, and the vascular lesion distribution in subjects with the disease was investigated by generating a stenosis probability map and 3D vascular structure segmentation. Conclusions: The results demonstrated the reliability of the proposed 3D CA-ResNet in detecting stenotic areas on TOF-MRA imaging, and it outperformed three other models in identifying vascular steno-occlusive changes in patients with MMD.

Altered functional connectivity and regional brain activity in a triple-network model in minimally conscious state and vegetative-state/unresponsive wakefulness syndrome patients: A resting-state functional magnetic resonance imaging study.

The purpose of this study was to investigate changes in functional connectivity and regional brain activity between and within the default mode network (DMN), salience network (SN), and executive control network (ECN) among individuals with disorders of consciousness (DOC) in the conditions of minimally conscious state (MCS) and vegetative-state/unresponsive wakefulness syndrome (VS/UWS). Twenty-five VS/UWS patients, 14 MCS patients, and 30 healthy individuals as normal control, completed resting-state fMRI scans. ROI-wise functional connectivity and fractional amplitude of low-frequency fluctuation (fALFF) were implemented to examine group differences. All ROI-wise and fALFF analyses masks were identified from the triple-network model. ROI-wise analyses indicated significantly decreased functional connectivity between posterior cingulate cortex (DMN)-left anterior insula (SN), right anterior insula (SN)-left dorsolateral prefrontal cortex (ECN), and right anterior insula (SN)-right amygdala (SN) in VS/UWS patients compared to MCS patients. Moreover, fALFF were observed reduced in the triple-network across all DOC patients, and as the clinical manifestations of DOC deteriorated from MCS to VS/UWS, fALFF in dorsal DMN, anterior/posterior SN, and left ECN became significantly reduced. Moreover, a positive correlation between fALFF of the left ECN and Coma Recovery Scale-Revised (CRS-R) total scores was found across all DOC patients. These findings contribute to a better understanding of the underlying neural mechanism of functional connectivity and regional brain activity in DOC patients, and this triple-network model provides new connectivity pattern changes that may be integrated in future diagnostic tools based on the neural signatures of conscious states.

Regional Homogeneity Alterations in Patients with Impaired Consciousness. An Observational Resting-State fMRI Study.

PURPOSE: It is always challenging to correctly differentiate between minimally conscious state (MCS) and vegetative state/unresponsive wakefulness syndrome (VS/UWS) among disorders of consciousness (DOC) patients. However, the underlying neural mechanisms of awareness identification remain incompletely understood. METHODS: Using regional homogeneity (ReHo) analysis, we evaluated how regional connectivity of brain regions is disrupted in MCS and VS/UWS patients. Resting-state functional magnetic resonance imaging was conducted in 14 MCS patients, 25 VS/UWS patients, and 30 age-matched healthy individuals. RESULTS: We found that MCS and VS/UWS patients demonstrated DOC-dependent reduced ReHo within widespread brain regions including posterior cingulate cortices (PCC), medial prefrontal cortices (mPFC), and bilateral fronto-parieto-temporal cortices and showed increased ReHo in limbic structures. Moreover, a positive correlation between Coma Recovery Scale-Revised (CRS-R) total scores and reduced ReHo in the left precuneus was observed in VS/UWS patients, despite the linear trend was not found in MCS patients. In addition, ReHo were also observed reduced in three mainly intrinsic connectivity networks (ICNs), including default mode network (DMN), executive control network (ECN), and salience network (SN). Notably, as the clinical symptoms of consciousness disorders worsen from MCS to VS/UWS, ReHo in dorsal DMN, left ECN, and posterior SN became significantly reduced. CONCLUSION: These findings make a further understanding of the underlying neural mechanism of regional connectivity among DOC patients and provide additional neuroimaging-based biomarkers for the clinical diagnosis of MCS and VS/UWS patients.

Endogenous cortisol-related alterations of right anterior insula functional connectivity under acute stress.

BACKGROUND: Previous studies have suggested that the right anterior insula (rAI) plays a vital role in salience processing and stress-related disorders. In this study, we aimed to investigate the relationship between rAI functional connectivity changes and individual differences in cortisol responses after acute stress, in order to provide insights into psychiatric illness vulnerabilities. METHODS: Thirty-five young men were enrolled in a randomized, counterbalanced two-session study, with aversive movie clip combined with electrical shocks as stress stimulation and the neutral movie clip as control stimulation. Resting-state fMRI data was acquired after movie exposure. The rAI was chosen as seed for functional connectivity analysis. We then examined the effect of acute stress on rAI functional connectivity and its association with individuals' cortisol response. RESULTS: We found decreased rAI functional connectivity in the fronto-parietal regions, but increased functional connectivity in the visual and somatosensory areas following acute stress. Moreover, stress-induced cortisol response was significantly positively correlated with the rAI functional connectivity in the medial prefrontal cortex, and negatively correlated with the orbital-frontal cortex, lingual gyrus, and middle temporal gyrus. LIMITATIONS: Only young Chinese males without any trauma experience were recruited in this study. CONCLUSIONS: The results suggested tight link between specific rAI functional connectivity alterations and individual stress reactivity, which may help elucidate the potential neurobiological mechanism underlying vulnerability to stress-related disorders.

[Meta-analysis of Platelet Lymphocyte Ratio as A Prognostic Factor for
Non-small Cell Lung Cancer].

BACKGROUND: Current research shows that platelet to lymphocyte ratio (PLR) has important prognostic value in renal cell carcinoma, esophageal cancer, gastric cancer, liver cancer and colon cancer. The aim of the study is to evaluate the prognostic value of PLR in non-small cell lung cancer (NSCLC) through meta-analysis. METHODS: Literature search for PubMed, EMBASE, Web of Science, Medline, Cochrane Library, China National Knowledge Internet (CNKI), China Biomedical Medicine disc (CBMdisc), VIP, Wanfang Database using computer electronic system to study the association between PLR and overall survival (OS) and disease-free survival (DFS). Each eligible study data is extracted and a meta-analysis is performed using the hazard risk (HR) and 95% confidence interval (95%CI) to assess the prognostic value of PLR, the time limit for the search is to build the library until November 2018. RESULTS: We include a total of 15 research literatures involving 5,524 patients for meta-analysis. According to the results of the meta-analysis: The OS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.69, 95%CI: 1.45-1.97, P<0.000,01, I²=46.2%, Pheterogeneity=0.026); the DFS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.41, 95%CI: 1.14-1.74, P=0.001, I²=46.2%, Pheterogeneity=0.026). Subgroup analysis show that the OS of the higher PLR group is still significantly lower than the lower PLR group (P<0.05) after grouping by ethnicity, sample size, PLR cutoff value and treatment. CONCLUSIONS: Increased PLR is associated with poor prognosis in NSCLC, so PLR may be an important biological predictive marker for NSCLC patients, however, its clinical application still needs to be verified through more research in the future.

Disrupted Interactions Between Arousal and Cortical Awareness Networks in MCS and VS/UWS Patients: Evidence from Resting-state Functional Imaging Connectivity.

Clinical patients in a vegetative state or unresponsive wakefulness syndrome (VS/UWS) demonstrate distinct arousal-awareness dissociation; the neuropathological mechanisms underlying such dissociation remain poorly understood. Here, we systematically examined how functional connectivity from the brainstem areas regulating arousal to the cortical networks supporting internal and external awareness is disrupted in minimally conscious state (MCS) and VS/UWS patients. Resting-state functional imaging was conducted in 23 MCS patients, 31 VS/UWS patients, and 20 age-matched healthy individuals. A hierarchical cluster analysis was conducted using all voxel-based signals in the brainstem to identify the specific areas for arousal. We found that the pontine tegmentum area (PTA) and caudal midbrain area persistently formed a distinct cluster that exclusively showed extensive connections with the cortical networks supporting internal and external awareness in healthy individuals, confirming their role in arousal. We show that functional connectivity from the PTA and caudal midbrain area to the cortical-awareness-supporting networks were significantly reduced in MCS and VS/UWS patients; importantly, as the clinical symptoms of consciousness disorders deepen from MCS to VS/UWS, functional connectivity strength became significantly reduced, changing from presenting no significant connections in MCS to widespread negative connections in VS/UWS. Additionally, we observed increased connectivity from the PTA and caudal midbrain area to limbic structures, the brainstem areas, and the cerebellum in MCS and VS/UWS patients, consistent with prior studies. These findings offer important insights into the neural network mechanisms underlying the long-observed arousal-awareness dissociation in VS/UWS patients and provide additional neuroimaging-based biomarkers for the clinical diagnosis of MCS and VS/UWS patients.

The antipsychotic drug quetiapine stimulates oligodendrocyte differentiation by modulating the cell cycle.

Recent studies have revealed that oligodendrocyte differentiation deficits and de-myelination occur in the brains of schizophrenic patients. Cell cycle proteins play a critical role in modulating oligodendrocyte proliferation and differentiation. In our previous studies, we found that cuprizone, a copper chelant, induces oligodendrocyte loss and demyelination, and this effect can be alleviated by using the atypical antipsychotic drug quetiapine. To explore the mechanisms of quetiapine in oligodendrocyte development, we examined the effects of quetiapine on cell cycle progression. Quetiapine promoted cell cycle exit and blocked the mitogenic effect of PDGF in cultured rat cortical oligodendrocyte progenitor cells (OPCs). Quetiapine accelerated OPC differentiation in vitro. Moreover, the systemic administration of quetiapine up-regulated p21 mRNA expression, a cyclin-dependent kinase inhibitor, in mice. Knocking down p21 expression by RNA interference enhanced proliferation and delayed differentiation. Our results suggest that cell cycle regulation may contribute to the differentiation-promoting effect of quetiapine.

Neuroticism is associated with altered resting-state functional connectivity of amygdala following acute stress exposure.

The amygdala, a subcortical structure responsible for fear and vigilance, is central to the stress circuitry. Aberrant amygdala connectivity with the cortical and subcortical regions is found in patients with stress-related disorders, and in healthy subjects following acute stress exposure. However, the extent to which the stress-induced alteration of amygdala functional connectivity correlates with risk-related personality measures remains unclear. Using resting-state functional magnetic resonance imaging, we evaluated the effect of acute stress, induced by aversive movies accompanied by a mild electric shock, on the functional connectivity of the basolateral amygdala (BLA) and centromedial amygdala (CMA) in 35 healthy men, and assessed the association between changes in amygdala functional connectivity and individual differences in neuroticism. We found increased BLA functional connectivity with the posterior cingulate cortex/retrosplenial and increased CMA functional connectivity with the medial prefrontal cortex following acute stress exposure. Moreover, neuroticism was positively correlated with altered functional coupling of the basolateral subregions with the anterior insular cortex, dorsal anterior cingulate cortex, and pregenual anterior cingulate cortex, which are involved in salience processing. These findings suggest that neurotic individuals may be more prone to hypervigilance following acute stress, which may potentially link neuroticism to the neurobiology underlying increased susceptibility to stress-related disorders.

Impact of aberrant cerebral perfusion on resting-state functional MRI: A preliminary investigation of Moyamoya disease.

The impact of chronic cerebral hypoperfusion on resting-state blood oxygen level-dependent signal fluctuations remains unknown. We aimed to determine whether chronic ischemia induces changes in amplitude of low-frequency fluctuations (ALFF) and to investigate the correlation between ALFF and perfusion-weighted magnetic resonance imaging (PWI) parameters in patients with moyamoya disease (MMD). Thirty patients with pre- and postoperative resting-state functional magnetic resonance imaging and PWI were included, and thirty normal controls underwent resting-state functional magnetic resonance imaging. A decrease in preoperative frontal lobe ALFF was observed in patients with MMD. Postoperative frontal lobe ALFF showed moderate improvement but still remained lower than those in normal controls. The values of mean transit time and time-to-peak, but not cerebral blood volume and cerebral blood flow, correlated significantly with frontal lobe ALFF. Moreover, there were significant negative correlations between changes in frontal lobe PWI parameters and changes in frontal lobe ALFF on both operated side and contralateral side after the unilateral revascularization surgery. Our results demonstrate that reduced ALFF are closely related to the abnormal PWI parameters and vary with the alteration of cerebral perfusion in patients with MMD.

Clinical assessment of cerebral hemodynamics in Moyamoya disease via multiple inversion time arterial spin labeling and dynamic susceptibility contrast-magnetic resonance imaging: A comparative study.

BACKGROUND AND PURPOSE: For Moyamoya disease (MMD) patients, accurate hemodynamic assessment is critical for treatment selection and efficacy assessment. This study aims to investigate the clinical value of mTI-ASL in assessing the cerebral hemodynamics of MMD patients before and after revascularization, relative to DSC-MRI. MATERIALS AND METHODS: Forty-one MMD patients underwent mTI-ASL and DSC-MRI during blood perfusion. Quantitative parameters for the bilateral supply vessels of middle and anterior cerebral arteries, including DSC-TTP, DSC-CBF, ASL-BAT, and ASL-CBF were measured. The correlations between DSC-ΔTTP (TTPhemisphere - TTPbrainstem) and ASL-ΔBAT (BAThemisphere - BATbrainstem) and between DSC-CBF and ASL-CBF were determined. The consistency between the two techniques in assessing the cerebral ischemic state before and after revascularization was analyzed. RESULTS: DSC-ΔTTP and ASL-ΔBAT (r=0.36, P<0.001) and DSC-CBF and ASL-CBF (r=0.32, P<0.001) exhibited significant correlation on 824 regions of interest (ROIs) and similar numbers of ischemic areas on 902 ROIs (κ=0.82, P<0.001). The ischemic scores were 3.17±3.02 and 2.98±2.81 by DSC-MRI and ASL-MRI, respectively (ICC=0.92). For 15 surgically treated patients, the scores for blood perfusion improvement on the operated side were 3.13±1.68 and 3.27±1.33 with DSC-TTP and ASL-BAT, respectively (ICC=0.94). CONCLUSION: Compared to DSC-MRI, mTI-ASL can assess the cerebral hemodynamics in MMD and evaluate ischemic state before revascularization and ischemia reduction after revascularization effectively. And mTI-ASL is more advantageous because it does not require contrast agents.