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Females versus males are less frequently diagnosed with autism spectrum disorder (ASD), and while understanding sex differences is critical to delineating the systems biology of the condition, female ASD is understudied. We integrated functional MRI and genetic data in a sex-balanced sample of ASD and typically developing youth (8-17 years old) to characterize female-specific pathways of ASD risk. Our primary objectives were to: (i) characterize female ASD (n = 45) brain response to human motion, relative to matched typically developing female youth (n = 45); and (ii) evaluate whether genetic data could provide further insight into the potential relevance of these brain functional differences. For our first objective we found that ASD females showed markedly reduced response versus typically developing females, particularly in sensorimotor, striatal, and frontal regions. This difference between ASD and typically developing females does not resemble differences between ASD (n = 47) and typically developing males (n = 47), even though neural response did not significantly differ between female and male ASD. For our second objective, we found that ASD females (n = 61), versus males (n = 66), showed larger median size of rare copy number variants containing gene(s) expressed in early life (10 postconceptual weeks to 2 years) in regions implicated by the typically developing female > female functional MRI contrast. Post hoc analyses suggested this difference was primarily driven by copy number variants containing gene(s) expressed in striatum. This striatal finding was reproducible among n = 2075 probands (291 female) from an independent cohort. Together, our findings suggest that striatal impacts may contribute to pathways of risk in female ASD and advocate caution in drawing conclusions regarding female ASD based on male-predominant cohorts.
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Trastorno del Espectro Autista/genética , Trastorno del Espectro Autista/fisiopatología , Caracteres Sexuales , Adolescente , Niño , Cuerpo Estriado/metabolismo , Cuerpo Estriado/fisiopatología , Variaciones en el Número de Copia de ADN , Femenino , Genotipo , Humanos , Imagen por Resonancia Magnética , Masculino , Neuroimagen/métodosRESUMEN
In this report, we present a case study involving an older, female patient with a history of pediatric traumatic brain injury (TBI). Magnetic resonance imaging and diffusion tensor imaging volumes were acquired from the volunteer in question, her brain volumetrics and morphometrics were extracted, and these were then systematically compared against corresponding metrics obtained from a large sample of older healthy control (HC) subjects as well as from subjects in various stages of mild cognitive impairment (MCI) and Alzheimer disease (AD). Our analyses find the patient's brain morphometry and connectivity most similar to those of patients classified as having early-onset MCI, in contrast to HC, late MCI, and AD samples. Our examination will be of particular interest to those interested in assessing the clinical course in older patients having suffered TBI earlier in life, in contradistinction to those who experience incidents of head injury during aging.
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Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/diagnóstico por imagen , Disfunción Cognitiva/diagnóstico por imagen , Disfunción Cognitiva/etiología , Anciano , Enfermedad de Alzheimer , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Lesiones Traumáticas del Encéfalo/fisiopatología , Niño , Disfunción Cognitiva/fisiopatología , Reserva Cognitiva , Imagen de Difusión Tensora , Femenino , Voluntarios Sanos , Humanos , Imagen por Resonancia Magnética , Presenilinas , Factores de RiesgoRESUMEN
The origin, structure, and function of the claustrum, as well as its role in neural computation, have remained a mystery since its discovery in the 17th century. Assessing the in vivo connectivity of the claustrum may bring forth useful insights with relevance to model the overall functionality of the claustrum itself. Using structural and diffusion tensor neuroimaging in N = 100 healthy subjects, we found that the claustrum has the highest connectivity in the brain by regional volume. Network theoretical analyses revealed that (a) the claustrum is a primary contributor to global brain network architecture, and that (b) significant connectivity dependencies exist between the claustrum, frontal lobe, and cingulate regions. These results illustrate that the claustrum is ideally located within the human central nervous system (CNS) connectome to serve as the putative "gate keeper" of neural information for consciousness awareness. Our findings support and underscore prior theoretical contributions about the involvement of the claustrum in higher cognitive function and its relevance in devastating neurological disease.
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Ganglios Basales/anatomía & histología , Conectoma/métodos , Imagen de Difusión Tensora/métodos , Sustancia Gris/anatomía & histología , Red Nerviosa/anatomía & histología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/anatomía & histología , Adulto JovenRESUMEN
OBJECTIVE: To demonstrate a set of approaches using diffusion tensor imaging (DTI) tractography whereby pathology-affected white matter (WM) fibres in patients with intracerebral haemorrhage (ICH) can be selectively visualized. METHODS: Using structural neuroimaging and DTI volumes acquired longitudinally from three representative patients with ICH, the spatial configuration of ICH-related trauma is delineated and the WM fibre bundles intersecting each ICH lesion are identified and visualized. Both the extent of ICH lesions as well as the proportion of WM fibres intersecting the ICH pathology are quantified and compared across subjects. RESULTS: This method successfully demonstrates longitudinal volumetric differences in ICH lesion load and differences across time in the percentage of fibres which intersect the primary injury. CONCLUSIONS: Because neurological conditions such as intracerebral haemorrhage (ICH) frequently exhibit pathology-related effects which lead to the exertion of mechanical pressure upon surrounding tissues and, thereby, to the deformation and/or displacement of WM fibres, DTI fibre tractography is highly suitable for assessing longitudinal changes in WM fibre integrity and mechanical displacement.
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Hemorragia Cerebral/patología , Imagen de Difusión por Resonancia Magnética/métodos , Imagen de Difusión Tensora/métodos , Adulto , Encéfalo/irrigación sanguínea , Encéfalo/patología , Mapeo Encefálico/métodos , Femenino , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Sustancia Blanca/patologíaRESUMEN
Cortical network architecture has predominantly been investigated visually using graph theory representations. In the context of human connectomics, such representations are not however always satisfactory because canonical methods for vertex-edge relationship representation do not always offer optimal insight regarding functional and structural neural connectivity. This article introduces an innovative framework for the depiction of human connectomics by employing a circular visualization method which is highly suitable to the exploration of central nervous system architecture. This type of representation, which we name a 'connectogram', has the capability of classifying neuroconnectivity relationships intuitively and elegantly. A multimodal protocol for MRI/DTI neuroimaging data acquisition is here combined with automatic image segmentation to (1) extract cortical and non-cortical anatomical structures, (2) calculate associated volumetrics and morphometrics, and (3) determine patient-specific connectivity profiles to generate subject-level and population-level connectograms. The scalability of our approach is demonstrated for a population of 50 adults. Two essential advantages of the connectogram are (1) the enormous potential for mapping and analyzing the human connectome, and (2) the unconstrained ability to expand and extend this analysis framework to the investigation of clinical populations and animal models.
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Mapeo Encefálico/métodos , Encéfalo/anatomía & histología , Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Red Nerviosa/anatomía & histología , Adulto , Corteza Cerebral/anatomía & histología , Humanos , MasculinoRESUMEN
Autism Spectrum Disorder (ASD) is a developmental condition characterized by social and communication differences. Recent research suggests ASD affects 1-in-44 children in the United States. ASD is diagnosed more commonly in males, though it is unclear whether this diagnostic disparity is a result of a biological predisposition or limitations in diagnostic tools, or both. One hypothesis centers on the 'female protective effect,' which is the theory that females are biologically more resistant to the autism phenotype than males. In this examination, phenotypic data were acquired and combined from four leading research institutions and subjected to multivariate linear discriminant analysis. A linear discriminant model was trained on the training set and then deployed on the test set to predict group membership. Multivariate analyses of variance were performed to confirm the significance of the overall analysis, and individual analyses of variance were performed to confirm the significance of each of the resulting linear discriminant axes. Two discriminant dimensions were identified between the groups: a dimension separating groups by the diagnosis of ASD (LD1: 87% of variance explained); and a dimension reflective of a diagnosis-by-sex interaction (LD2: 11% of variance explained). The strongest discriminant coefficients for the first discriminant axis divided the sample in domains with known differences between ASD and comparison groups, such as social difficulties and restricted repetitive behavior. The discriminant coefficients for the second discriminant axis reveal a more nuanced disparity between boys with ASD and girls with ASD, including executive functioning and high-order behavioral domains as the dominant discriminators. These results indicate that phenotypic differences between males and females with and without ASD are identifiable using parent report measures, which could be utilized to provide additional specificity to the diagnosis of ASD in female patients, potentially leading to more targeted clinical strategies and therapeutic interventions. The study helps to isolate a phenotypic basis for future empirical work on the female protective effect using neuroimaging, EEG, and genomic methodologies.
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Despite substantial efforts, it remains difficult to identify reliable neuroanatomic biomarkers of autism spectrum disorder (ASD) based on magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Studies which use standard statistical methods to approach this task have been hampered by numerous challenges, many of which are innate to the mathematical formulation and assumptions of general linear models (GLM). Although the potential of alternative approaches such as machine learning (ML) to identify robust neuroanatomic correlates of psychiatric disease has long been acknowledged, few studies have attempted to evaluate the abilities of ML to identify structural brain abnormalities associated with ASD. Here we use a sample of 110 ASD patients and 83 typically developing (TD) volunteers (95 females) to assess the suitability of support vector machines (SVMs, a robust type of ML) as an alternative to standard statistical inference for identifying structural brain features which can reliably distinguish ASD patients from TD subjects of either sex, thereby facilitating the study of the interaction between ASD diagnosis and sex. We find that SVMs can perform these tasks with high accuracy and that the neuroanatomic correlates of ASD identified using SVMs overlap substantially with those found using conventional statistical methods. Our results confirm and establish SVMs as powerful ML tools for the study of ASD-related structural brain abnormalities. Additionally, they provide novel insights into the volumetric, morphometric, and connectomic correlates of this epidemiologically significant disorder.
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[This corrects the article on p. 205 in vol. 7, PMID: 28101064.].
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Autism spectrum disorder (ASD) encompasses a set of neurodevelopmental conditions whose striking sex-related disparity (with an estimated male-to-female ratio of 4:1) remains unknown. Here we use magnetic resonance imaging (MRI) and diffusion weighted imaging (DWI) to identify the brain structure correlates of the sex-by-ASD diagnosis interaction in a carefully selected cohort of 110 ASD patients (55 females) and 83 typically-developing (TD) subjects (40 females). The interaction was found to be predicated primarily upon white matter connectivity density innervating, bilaterally, the lateral aspect of the temporal lobe, the temporo-parieto-occipital junction and the medial parietal lobe. By contrast, regional gray matter (GM) thickness and volume are not found to modulate this interaction significantly. When interpreted in the context of previous studies, our findings add considerable weight to three long-standing hypotheses according to which the sex disparity of ASD incidence is (A) due to WM connectivity rather than to GM differences, (B) modulated to a large extent by temporoparietal connectivity, and (C) accompanied by brain function differences driven by these effects. Our results contribute substantially to the task of unraveling the biological mechanisms giving rise to the sex disparity in ASD incidence, whose clinical implications are significant.
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Trastorno del Espectro Autista/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Caracteres Sexuales , Sustancia Blanca/diagnóstico por imagen , Adolescente , Mapeo Encefálico , Niño , Conectoma , Imagen de Difusión por Resonancia Magnética , Femenino , Sustancia Gris/diagnóstico por imagen , Humanos , Masculino , Neuroimagen , Tamaño de los ÓrganosRESUMEN
Ongoing debate exists within the resting-state functional MRI (fMRI) literature over how intrinsic connectivity is altered in the autistic brain, with reports of general over-connectivity, under-connectivity, and/or a combination of both. Classifying autism using brain connectivity is complicated by the heterogeneous nature of the condition, allowing for the possibility of widely variable connectivity patterns among individuals with the disorder. Further differences in reported results may be attributable to the age and sex of participants included, designs of the resting-state scan, and to the analysis technique used to evaluate the data. This review systematically examines the resting-state fMRI autism literature to date and compares studies in an attempt to draw overall conclusions that are presently challenging. We also propose future direction for rs-fMRI use to categorize individuals with autism spectrum disorder, serve as a possible diagnostic tool, and best utilize data-sharing initiatives.
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Mapping aging-related brain structure and connectivity changes can be helpful for assessing physiological brain age (PBA), which is distinct from chronological age (CA) because genetic and environmental factors affect individuals differently. This study proposes an approach whereby structural and connectomic information can be combined to estimate PBA as an early biomarker of brain aging. In a cohort of 136 healthy adults, magnetic resonance and diffusion tensor imaging are respectively used to measure cortical thickness over the entire cortical mantle as well as connectivity properties (mean connectivity density and mean fractional anisotropy) for white matter connections. Using multivariate regression, these measurements are then employed to (1) illustrate how CA can be predicated--and thereby also how PBA can be estimated--and to conclude that (2) healthy aging is associated with significant connectome changes during adulthood. Our study illustrates a connectomically-informed statistical approach to PBA estimation, with potential applicability to the clinical identification of patients who exhibit accelerated brain aging, and who are consequently at higher risk for developing mild cognitive impairment or dementia.
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Envejecimiento/patología , Encéfalo/patología , Conectoma/métodos , Imagen de Difusión Tensora/métodos , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Encéfalo/crecimiento & desarrollo , Estudios de Cohortes , Interpretación Estadística de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Tamaño de los Órganos , Adulto JovenRESUMEN
Under the umbrella of the National Database for Clinical Trials (NDCT) related to mental illnesses, the National Database for Autism Research (NDAR) seeks to gather, curate, and make openly available neuroimaging data from NIH-funded studies of autism spectrum disorder (ASD). NDAR has recently made its database accessible through the LONI Pipeline workflow design and execution environment to enable large-scale analyses of cortical architecture and function via local, cluster, or "cloud"-based computing resources. This presents a unique opportunity to overcome many of the customary limitations to fostering biomedical neuroimaging as a science of discovery. Providing open access to primary neuroimaging data, workflow methods, and high-performance computing will increase uniformity in data collection protocols, encourage greater reliability of published data, results replication, and broaden the range of researchers now able to perform larger studies than ever before. To illustrate the use of NDAR and LONI Pipeline for performing several commonly performed neuroimaging processing steps and analyses, this paper presents example workflows useful for ASD neuroimaging researchers seeking to begin using this valuable combination of online data and computational resources. We discuss the utility of such database and workflow processing interactivity as a motivation for the sharing of additional primary data in ASD research and elsewhere.
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Trastorno del Espectro Autista/patología , Bases de Datos Factuales , Almacenamiento y Recuperación de la Información/métodos , Neuroimagen/estadística & datos numéricos , Nube Computacional , Humanos , Difusión de la Información/métodos , Programas Informáticos , Flujo de TrabajoRESUMEN
The claustrum seems to have been waiting for the science of connectomics. Due to its tiny size, the structure has remained remarkably difficult to study until modern technological and mathematical advancements like graph theory, connectomics, diffusion tensor imaging, HARDI, and excitotoxic lesioning. That does not mean, however, that early methods allowed researchers to assess micro-connectomics. In fact, the claustrum is such an enigma that the only things known for certain about it are its histology, and that it is extraordinarily well connected. In this literature review, we provide background details on the claustrum and the history of its study in the human and in other animal species. By providing an explanation of the neuroimaging and histology methods have been undertaken to study the claustrum thus far-and the conclusions these studies have drawn-we illustrate this example of how the shift from micro-connectomics to macro-connectomics advances the field of neuroscience and improves our capacity to understand the brain.
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Throughout the past few decades, the ability to treat and rehabilitate traumatic brain injury (TBI) patients has become critically reliant upon the use of neuroimaging to acquire adequate knowledge of injury-related effects upon brain function and recovery. As a result, the need for TBI neuroimaging analysis methods has increased in recent years due to the recognition that spatiotemporal computational analyses of TBI evolution are useful for capturing the effects of TBI dynamics. At the same time, however, the advent of such methods has brought about the need to analyze, manage, and integrate TBI neuroimaging data using informatically inspired approaches which can take full advantage of their large dimensionality and informational complexity. Given this perspective, we here discuss the neuroinformatics challenges for TBI neuroimaging analysis in the context of structural, connectivity, and functional paradigms. Within each of these, the availability of a wide range of neuroimaging modalities can be leveraged to fully understand the heterogeneity of TBI pathology; consequently, large-scale computer hardware resources and next-generation processing software are often required for efficient data storage, management, and analysis of TBI neuroimaging data. However, each of these paradigms poses challenges in the context of informatics such that the ability to address them is critical for augmenting current capabilities to perform neuroimaging analysis of TBI and to improve therapeutic efficacy.
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OBJECTIVE: To inverse-localize epileptiform cortical electrical activity recorded from severe traumatic brain injury (TBI) patients using electroencephalography (EEG). METHODS: Three acute TBI cases were imaged using computed tomography (CT) and multimodal magnetic resonance imaging (MRI). Semi-automatic segmentation was performed to partition the complete TBI head into 25 distinct tissue types, including 6 tissue types accounting for pathology. Segmentations were employed to generate a finite element method model of the head, and EEG activity generators were modeled as dipolar currents distributed over the cortical surface. RESULTS: We demonstrate anatomically faithful localization of EEG generators responsible for epileptiform discharges in severe TBI. By accounting for injury-related tissue conductivity changes, our work offers the most realistic implementation currently available for the inverse estimation of cortical activity in TBI. CONCLUSION: Whereas standard localization techniques are available for electrical activity mapping in uninjured brains, they are rarely applied to acute TBI. Modern models of TBI-induced pathology can inform the localization of epileptogenic foci, improve surgical efficacy, contribute to the improvement of critical care monitoring and provide guidance for patient-tailored treatment. With approaches such as this, neurosurgeons and neurologists can study brain activity in acute TBI and obtain insights regarding injury effects upon brain metabolism and clinical outcome.
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Lesiones Encefálicas/fisiopatología , Lesiones Encefálicas/cirugía , Encéfalo/fisiopatología , Electroencefalografía , Procedimientos Neuroquirúrgicos/métodos , Cirugía Asistida por Computador/métodos , Adulto , Mapeo Encefálico , Epilepsia/diagnóstico , Epilepsia/fisiopatología , Femenino , Escala de Coma de Glasgow , Escala de Consecuencias de Glasgow , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Monitoreo Intraoperatorio , Resultado del TratamientoRESUMEN
OBJECTIVE: EEG source localization is demonstrated in three cases of acute traumatic brain injury (TBI) with progressive lesion loads using anatomically faithful models of the head which account for pathology. METHODS: Multimodal magnetic resonance imaging (MRI) volumes were used to generate head models via the finite element method (FEM). A total of 25 tissue types-including 6 types accounting for pathology-were included. To determine the effects of TBI upon source localization accuracy, a minimum-norm operator was used to perform inverse localization and to determine the accuracy of the latter. RESULTS: The importance of using a more comprehensive number of tissue types is confirmed in both health and in TBI. Pathology omission is found to cause substantial inaccuracies in EEG forward matrix calculations, with lead field sensitivity being underestimated by as much as ≈ 200% in (peri-) contusional regions when TBI-related changes are ignored. Failing to account for such conductivity changes is found to misestimate substantial localization error by up to 35 mm. CONCLUSIONS: Changes in head conductivity profiles should be accounted for when performing EEG modeling in acute TBI. SIGNIFICANCE: Given the challenges of inverse localization in TBI, this framework can benefit neurotrauma patients by providing useful insights on pathophysiology.
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Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/fisiopatología , Encéfalo/anatomía & histología , Encéfalo/fisiología , Electroencefalografía , Modelos Anatómicos , Modelos Neurológicos , Adulto , Encéfalo/patología , Encéfalo/fisiopatología , Lesiones Encefálicas/patología , Cabeza/anatomía & histología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Valores de Referencia , Adulto JovenRESUMEN
With the introduction of diffusion tensor imaging (DTI), structural differences in white matter (WM) architecture between psychiatric populations and healthy controls can be systematically observed and measured. In particular, DTI-tractography can be used to assess WM characteristics over the entire extent of WM tracts and aggregated fiber bundles. Using 64-direction DTI scanning in 27 participants with bipolar disorder (BD) and 26 age-and-gender-matched healthy control subjects, we compared relative length, density, and fractional anisotrophy (FA) of WM tracts involved in emotion regulation or theorized to be important neural components in BD neuropathology. We interactively isolated 22 known white matter tracts using region-of-interest placement (TrackVis software program) and then computed relative tract length, density, and integrity. BD subjects demonstrated significantly shorter WM tracts in the genu, body and splenium of the corpus callosum compared to healthy controls. Additionally, bipolar subjects exhibited reduced fiber density in the genu and body of the corpus callosum, and in the inferior longitudinal fasciculus bilaterally. In the left uncinate fasciculus, however, BD subjects exhibited significantly greater fiber density than healthy controls. There were no significant differences between groups in WM tract FA for those tracts that began and ended in the brain. The significance of differences in tract length and fiber density in BD is discussed.
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Trastorno Bipolar/patología , Cuerpo Calloso/patología , Imagen de Difusión Tensora , Fibras Nerviosas Mielínicas/patología , Adulto , Anisotropía , Trastorno Bipolar/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor/tratamiento farmacológico , Trastornos del Humor/patología , Psicotrópicos/uso terapéuticoRESUMEN
White matter (WM) mapping of the human brain using neuroimaging techniques has gained considerable interest in the neuroscience community. Using diffusion weighted (DWI) and magnetic resonance imaging (MRI), WM fiber pathways between brain regions may be systematically assessed to make inferences concerning their role in normal brain function, influence on behavior, as well as concerning the consequences of network-level brain damage. In this paper, we investigate the detailed connectomics in a noted example of severe traumatic brain injury (TBI) which has proved important to and controversial in the history of neuroscience. We model the WM damage in the notable case of Phineas P. Gage, in whom a "tamping iron" was accidentally shot through his skull and brain, resulting in profound behavioral changes. The specific effects of this injury on Mr. Gage's WM connectivity have not previously been considered in detail. Using computed tomography (CT) image data of the Gage skull in conjunction with modern anatomical MRI and diffusion imaging data obtained in contemporary right handed male subjects (aged 25-36), we computationally simulate the passage of the iron through the skull on the basis of reported and observed skull fiducial landmarks and assess the extent of cortical gray matter (GM) and WM damage. Specifically, we find that while considerable damage was, indeed, localized to the left frontal cortex, the impact on measures of network connectedness between directly affected and other brain areas was profound, widespread, and a probable contributor to both the reported acute as well as long-term behavioral changes. Yet, while significantly affecting several likely network hubs, damage to Mr. Gage's WM network may not have been more severe than expected from that of a similarly sized "average" brain lesion. These results provide new insight into the remarkable brain injury experienced by this noteworthy patient.
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Lesiones Encefálicas/historia , Lóbulo Frontal/patología , Fibras Nerviosas Mielínicas/patología , Adulto , Lesiones Encefálicas/complicaciones , Lesiones Encefálicas/patología , Lóbulo Frontal/lesiones , Historia del Siglo XIX , Humanos , Imagen por Resonancia Magnética , Masculino , Neuroimagen/historia , Trastornos de la Personalidad/etiología , Tomografía Computarizada por Rayos X , VermontRESUMEN
Available approaches to the investigation of traumatic brain injury (TBI) are frequently hampered, to some extent, by the unsatisfactory abilities of existing methodologies to efficiently define and represent affected structural connectivity and functional mechanisms underlying TBI-related pathology. In this paper, we describe a patient-tailored framework which allows mapping and characterization of TBI-related structural damage to the brain via multimodal neuroimaging and personalized connectomics. Specifically, we introduce a graphically driven approach for the assessment of trauma-related atrophy of white matter connections between cortical structures, with relevance to the quantification of TBI chronic case evolution. This approach allows one to inform the formulation of graphical neurophysiological and neuropsychological TBI profiles based on the particular structural deficits of the affected patient. In addition, it allows one to relate the findings supplied by our workflow to the existing body of research that focuses on the functional roles of the cortical structures being targeted. A graphical means for representing patient TBI status is relevant to the emerging field of personalized medicine and to the investigation of neural atrophy.