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BACKGROUND: Clinical trial scenarios can be modeled using data from observational studies, providing critical information for design of real-world trials. The Huntington's Disease Integrated Staging System (HD-ISS) characterizes disease progression over an individual's lifespan and allows for flexibility in the design of trials with the goal of delaying progression. Enrichment methods can be applied to the HD-ISS to identify subgroups requiring smaller estimated sample sizes. OBJECTIVE: Investigate time to the event of functional decline (HD-ISS Stage 3) as an endpoint for trials in HD and present sample size estimates after enrichment. METHODS: We classified individuals from observational studies according to the HD-ISS. We assessed the ability of the prognostic index normed (PIN) and its components to predict time to HD-ISS Stage 3. For enrichment, we formed groups from deciles of the baseline PIN distribution for HD-ISS Stage 2 participants. We selected enrichment subgroups closer to Stage 3 transition and estimated sample sizes, using delay in the transition time as the effect size. RESULTS: In predicting time to HD-ISS Stage 3, PIN outperforms its components. Survival curves for each PIN decile show that groups with PIN from 1.48 to 2.74 have median time to Stage 3 of approximately 2 years and these are combined to create enrichment subgroups. Sample size estimates are presented by enrichment subgroup. CONCLUSIONS: PIN is predictive of functional decline. A delay of 9 months or more in the transition to Stage 3 for an enriched sample yields feasible sample size estimates, demonstrating that this approach can aid in planning future trials. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Little is known about the role of declarative memory in the ongoing perception of one's personality. Seven individuals who developed a rare and severe type of anterograde amnesia following damage to their medial temporal lobes were identified from our neurological patient registry. We examined the stability of their personality ratings on the Big Five Inventory over five retest periods and assessed the accuracy of their ratings via analyses of self-caregiver agreement. The patients portrayed a stable sense of self over the course of 1 year. However, their self-ratings differed from those provided by the caregivers. Intriguingly, these discrepancies diminished when caregivers retrospectively rated the patients' personalities prior to their brain injury, suggesting that patients' perceptions of themselves were stuck in the past. We interpret our findings to indicate that the ability to form new declarative memories is not required for maintaining a stable sense of self but may be important for updating one's sense of self over time.
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Amnesia Anterógrada , Amnesia , Humanos , Memoria , Personalidad , Estudios Retrospectivos , Lóbulo TemporalRESUMEN
The human brain is asymmetrically lateralized for certain functions (such as language processing) to regions in one hemisphere relative to the other. Asymmetries are measured with a laterality index (LI). However, traditional LI measures are limited by a lack of consensus on metrics used for its calculation. To address this limitation, source-based laterality (SBL) leverages an independent component analysis for the identification of laterality-specific alterations, identifying covarying components between hemispheres across subjects. SBL is successfully implemented with simulated data with inherent differences in laterality. SBL is then compared with a voxel-wise analysis utilizing structural data from a sample of patients with schizophrenia and controls without schizophrenia. SBL group comparisons identified three distinct temporal regions and one cerebellar region with significantly altered laterality in patients with schizophrenia relative to controls. Previous work highlights reductions in laterality (ie, reduced left gray matter volume) in patients with schizophrenia compared with controls without schizophrenia. Results from this pilot SBL project are the first, to our knowledge, to identify covarying laterality differences within discrete temporal brain regions. The authors argue SBL provides a unique focus to detect covarying laterality differences in patients with schizophrenia, facilitating the discovery of laterality aspects undetected in previous work.
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Lateralidad Funcional , Esquizofrenia/patología , Esquizofrenia/fisiopatología , Lóbulo Temporal/patología , Lóbulo Temporal/fisiopatología , Adolescente , Adulto , Mapeo Encefálico , Simulación por Computador , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Red Nerviosa/fisiopatología , Estadísticas no Paramétricas , Adulto JovenRESUMEN
The brain is highly dynamic, reorganizing its activity at different interacting spatial and temporal scales, including variation within and between brain networks. The chronnectome is a model of the brain in which nodal activity and connectivity patterns change in fundamental and recurring ways over time. Most literature assumes fixed spatial nodes/networks, ignoring the possibility that spatial nodes/networks may vary in time. Here, we introduce an approach to calculate a spatially fluid chronnectome (called the spatial chronnectome for clarity), which focuses on the variations of networks coupling at the voxel level, and identify a novel set of spatially dynamic features. Results reveal transient spatially fluid interactions between intra- and internetwork relationships in which brain networks transiently merge and separate, emphasizing dynamic segregation and integration. Brain networks also exhibit distinct spatial patterns with unique temporal characteristics, potentially explaining a broad spectrum of inconsistencies in previous studies that assumed static networks. Moreover, we show anticorrelative connections to brain networks are transient as opposed to constant across the entire scan. Preliminary assessments using a multi-site dataset reveal the ability of the approach to obtain new information and nuanced alterations that remain undetected during static analysis. Patients with schizophrenia (SZ) display transient decreases in voxel-wise network coupling within visual and auditory networks, and higher intradomain coupling variability. In summary, the spatial chronnectome represents a new direction of research enabling the study of functional networks which are transient at the voxel level, and the identification of mechanisms for within- and between-subject spatial variability.
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Encéfalo/fisiología , Conectoma/métodos , Modelos Neurológicos , Vías Nerviosas/fisiología , Esquizofrenia/fisiopatología , Adulto , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
The analysis of time-varying activity and connectivity patterns (i.e., the chronnectome) using resting-state magnetic resonance imaging has become an important part of ongoing neuroscience discussions. The majority of previous work has focused on variations of temporal coupling among fixed spatial nodes or transition of the dominant activity/connectivity pattern over time. Here, we introduce an approach to capture spatial dynamics within functional domains (FDs), as well as temporal dynamics within and between FDs. The approach models the brain as a hierarchical functional architecture with different levels of granularity, where lower levels have higher functional homogeneity and less dynamic behavior and higher levels have less homogeneity and more dynamic behavior. First, a high-order spatial independent component analysis is used to approximate functional units. A functional unit is a pattern of regions with very similar functional activity over time. Next, functional units are used to construct FDs. Finally, functional modules (FMs) are calculated from FDs, providing an overall view of brain dynamics. Results highlight the spatial fluidity within FDs, including a broad spectrum of changes in regional associations, from strong coupling to complete decoupling. Moreover, FMs capture the dynamic interplay between FDs. Patients with schizophrenia show transient reductions in functional activity and state connectivity across several FDs, particularly the subcortical domain. Activity and connectivity differences convey unique information in many cases (e.g., the default mode) highlighting their complementarity information. The proposed hierarchical model to capture FD spatiotemporal variations provides new insight into the macroscale chronnectome and identifies changes hidden from existing approaches.
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Encéfalo/diagnóstico por imagen , Modelos Neurológicos , Adolescente , Adulto , Encéfalo/fisiología , Mapeo Encefálico/métodos , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Background: Binge drinking is common in college students, and many drink in quantities greater than the standard definition of bingeing. Combined use of additional substances, particularly marijuana, is also common. Objectives: Increased impulsivity and sensation seeking are risk factors for bingeing, and this study was designed to characterize their association with extreme compared to standard bingeing, as well as with combined bingeing and marijuana use. Negative consequences of alcohol use were also investigated. Methods: Self-report personality measures and a measure of the negative consequences of alcohol use were given to a sample of 221 college students (109 females) sorted into a control and 4 binge groups based upon their patterns of bingeing and marijuana use. Narrowly defined, non-overlapping measures of impulsivity and sensation seeking were analyzed to assess the association of these personality measures with substance-use patterns and negative consequences of bingeing. Results: Standard bingers did not differ from non-bingeing controls on either impulsivity or sensation seeking, whereas extreme bingers had significantly higher impulsivity and sensation seeking scores than controls and also significantly higher sensation seeking than standard bingers. Exploratory analyses of a broader set of personality scales showed that a disinhibition scale was also significant predictor of substance use group. A number of personality traits significantly predicted substance use patterns as well as specific negative consequences of bingeing. Conclusions: Impulsivity, sensation seeking and disinhibition are significant associates of substance use patterns and the negative consequences of use in college students.
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Consumo de Alcohol en la Universidad/psicología , Consumo Excesivo de Bebidas Alcohólicas/psicología , Uso de la Marihuana/psicología , Personalidad , Estudiantes/psicología , Adolescente , Estudios de Casos y Controles , Femenino , Humanos , Conducta Impulsiva , Iowa , Masculino , Determinación de la Personalidad , Escalas de Valoración Psiquiátrica , Asunción de Riesgos , Universidades , Adulto JovenRESUMEN
A robust fully automated algorithm for identifying an arbitrary number of landmark points in the human brain is described and validated. The proposed method combines statistical shape models with trained brain morphometric measures to estimate midbrain landmark positions reliably and accurately. Gross morphometric constraints provided by automatically identified eye centers and the center of the head mass are shown to provide robust initialization in the presence of large rotations in the initial head orientation. Detection of primary midbrain landmarks are used as the foundation from which extended detection of an arbitrary set of secondary landmarks in different brain regions by applying a linear model estimation and principle component analysis. This estimation model sequentially uses the knowledge of each additional detected landmark as an improved foundation for improved prediction of the next landmark location. The accuracy and robustness of the presented method was evaluated by comparing the automatically generated results to two manual raters on 30 identified landmark points extracted from each of 30 T1-weighted magnetic resonance images. For the landmarks with unambiguous anatomical definitions, the average discrepancy between the algorithm results and each human observer differed by less than 1 mm from the average inter-observer variability when the algorithm was evaluated on imaging data collected from the same site as the model building data. Similar results were obtained when the same model was applied to a set of heterogeneous image volumes from seven different collection sites representing 3 scanner manufacturers. This method is reliable for general application in large-scale multi-site studies that consist of a variety of imaging data with different orientations, spacings, origins, and field strengths.
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Encéfalo/anomalías , Encéfalo/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Neuroimagen/métodos , Reconocimiento de Normas Patrones Automatizadas/métodos , Adulto , Humanos , Modelos Estadísticos , Análisis de Componente PrincipalRESUMEN
BACKGROUND: Individuals with a family history (FH+) of alcohol use disorder (AUD) have a higher risk for developing an AUD than those with no family history (FH-) of AUD. In addition, FH+ individuals tend to perform worse on neuropsychological measures and show heightened impulsivity, which may be due to underlying differences in brain structure such as cortical thickness. The primary aim of this study was to investigate differences in cortical thickness in FH+ compared to FH- adolescents. Secondary aims were to (i) investigate differences in executive functioning and impulsivity, and (ii) examine associations between brain structure and behavior. METHODS: Brain scans of 95 FH- and 93 FH+ subjects aged 13 to 18 were obtained using magnetic resonance imaging. FH+ subjects were required to have at least 1 biological parent with a history of an AUD. FH+ and FH- individuals had limited or no past alcohol use, thereby minimizing potential effects of alcohol. Subjects were evaluated on impulsivity and executive functioning tasks. Thicknesses of cortical lobes and subregions were analyzed using FreeSurfer. Regions showing group differences were examined for group-by-age interactions and correlations with neuropsychological and personality measures. RESULTS: FH+ adolescents had thinner cortices in frontal and parietal lobes, notably in the medial orbitofrontal, lateral orbitofrontal, and superior parietal cortices. The difference in cortical thickness between family history groups was strongest among the youngest subjects. FH+ subjects were also more impulsive and had poorer performance on a spatial memory task. CONCLUSIONS: These findings demonstrate frontal and parietal structural differences in FH+ adolescents that might underlie cognitive and behavioral characteristics associated with AUD risk.
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Conducta del Adolescente/fisiología , Alcoholismo/diagnóstico por imagen , Alcoholismo/genética , Corteza Cerebral/diagnóstico por imagen , Adolescente , Conducta del Adolescente/psicología , Alcoholismo/psicología , Femenino , Humanos , Conducta Impulsiva/fisiología , Imagen por Resonancia Magnética/métodos , Masculino , Tamaño de los ÓrganosRESUMEN
Huntington disease (HD) is most widely known for its selective degeneration of striatal neurons but there is also growing evidence for white matter (WM) deterioration. The primary objective of this research was to conduct a large-scale analysis using multisite diffusion-weighted imaging (DWI) tractography data to quantify diffusivity properties along major prefrontal cortex WM tracts in prodromal HD. Fifteen international sites participating in the PREDICT-HD study collected imaging and neuropsychological data on gene-positive HD participants without a clinical diagnosis (i.e., prodromal) and gene-negative control participants. The anatomical prefrontal WM tracts of the corpus callosum (PFCC), anterior thalamic radiations (ATRs), inferior fronto-occipital fasciculi (IFO), and uncinate fasciculi (UNC) were identified using streamline tractography of DWI. Within each of these tracts, tensor scalars for fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity coefficients were calculated. We divided prodromal HD subjects into three CAG-age product (CAP) groups having Low, Medium, or High probabilities of onset indexed by genetic exposure. We observed significant differences in WM properties for each of the four anatomical tracts for the High CAP group in comparison to controls. Additionally, the Medium CAP group presented differences in the ATR and IFO in comparison to controls. Furthermore, WM alterations in the PFCC, ATR, and IFO showed robust associations with neuropsychological measures of executive functioning. These results suggest long-range tracts essential for cross-region information transfer show early vulnerability in HD and may explain cognitive problems often present in the prodromal stage. Hum Brain Mapp 36:3717-3732, 2015. © 2015 Wiley Periodicals, Inc.
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Enfermedad de Huntington/patología , Corteza Prefrontal/patología , Sustancia Blanca/patología , Adulto , Anisotropía , Mapeo Encefálico , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/psicología , Imagen de Difusión Tensora , Escolaridad , Femenino , Predisposición Genética a la Enfermedad , Humanos , Enfermedad de Huntington/genética , Enfermedad de Huntington/psicología , Procesamiento de Imagen Asistido por Computador , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Valor Predictivo de las Pruebas , Probabilidad , Escalas de Valoración Psiquiátrica , Secuencias Repetitivas de Ácidos NucleicosRESUMEN
Although the impact of serial correlation (autocorrelation) in residuals of general linear models for fMRI time-series has been studied extensively, the effect of autocorrelation on functional connectivity studies has been largely neglected until recently. Some recent studies based on results from economics have questioned the conventional estimation of functional connectivity and argue that not correcting for autocorrelation in fMRI time-series results in "spurious" correlation coefficients. In this paper, first we assess the effect of autocorrelation on Pearson correlation coefficient through theoretical approximation and simulation. Then we present this effect on real fMRI data. To our knowledge this is the first work comprehensively investigating the effect of autocorrelation on functional connectivity estimates. Our results show that although FC values are altered, even following correction for autocorrelation, results of hypothesis testing on FC values remain very similar to those before correction. In real data we show this is true for main effects and also for group difference testing between healthy controls and schizophrenia patients. We further discuss model order selection in the context of autoregressive processes, effects of frequency filtering and propose a preprocessing pipeline for connectivity studies.
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Mapeo Encefálico/métodos , Encéfalo/fisiología , Imagen por Resonancia Magnética/métodos , Red Nerviosa/fisiología , Simulación por Computador , Humanos , Análisis de Regresión , Análisis Espacio-TemporalRESUMEN
Huntington's disease (HD) is a devastating neurodegenerative disease with no effective disease-modifying treatments. There is considerable interest in finding reliable indicators of disease progression to judge the efficacy of novel treatments that slow or stop disease onset before debilitating signs appear. Diffusion-weighted imaging (DWI) may provide a reliable marker of disease progression by characterizing diffusivity changes in white matter (WM) in individuals with prodromal HD. The prefrontal cortex (PFC) may play a role in HD progression due to its prominent striatal connections and documented role in executive function. This study uses DWI to characterize diffusivity in specific regions of PFC WM defined by FreeSurfer in 53 prodromal HD participants and 34 controls. Prodromal HD individuals were separated into three CAG-Age Product (CAP) groups (16 low, 22 medium, 15 high) that indexed baseline progression. Statistically significant increases in mean diffusivity (MD) and radial diffusivity (RD) among CAP groups relative to controls were seen in inferior and lateral PFC regions. For MD and RD, differences among controls and HD participants tracked with baseline disease progression. The smallest difference was for the low group and the largest for the high group. Significant correlations between Trail Making Test B (TMTB) and mean fractional anisotropy (FA) and/or RD paralleled group differences in mean MD and/or RD in several right hemisphere regions. The gradient of effects that tracked with CAP group suggests DWI may provide markers of disease progression in future longitudinal studies as increasing diffusivity abnormalities in the lateral PFC of prodromal HD individuals.
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Imagen de Difusión por Resonancia Magnética/métodos , Enfermedad de Huntington/patología , Corteza Prefrontal/patología , Adulto , Anisotropía , Progresión de la Enfermedad , Femenino , Humanos , Enfermedad de Huntington/diagnóstico , Enfermedad de Huntington/psicología , Procesamiento de Imagen Asistido por Computador/métodos , Modelos Lineales , Masculino , Persona de Mediana Edad , Fibras Nerviosas Mielínicas/patología , Pruebas Neuropsicológicas , Escalas de Valoración PsiquiátricaRESUMEN
Adolescence has been characterized as a period of both opportunity and vulnerability. Numerous clinical conditions, including substance-use disorders, often emerge during adolescence. These maladaptive behaviors have been linked to problems with cognitive control, yet few studies have investigated how rewards differentially modulate attentional processes in adolescents versus adults. Here, we trained adults and adolescents on a visual task to establish stimulus-reward associations. Later, we assessed learning in an extinction task in which previously rewarded stimuli periodically appeared as distractors. Both age groups initially demonstrated value-driven attentional capture; however, the effect persisted longer in adolescents than in adults. The results could not be explained by developmental differences in visual working memory. Given the importance of attentional control to daily behaviors and clinical conditions such as attention-deficit/hyperactivity disorder, these results reveal that cognitive control failures in adolescence may be linked to a value-based attentional-capture effect.
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Conducta del Adolescente/psicología , Atención , Recompensa , Adolescente , Adulto , Factores de Edad , Señales (Psicología) , Toma de Decisiones , Femenino , Humanos , Iowa , Aprendizaje , Masculino , Memoria a Corto Plazo , Análisis y Desempeño de Tareas , Adulto JovenRESUMEN
Oxytocin is a neuropeptide associated with prosocial behaviors, such as parent-child bonding, eye contact, and sexual activity. Intranasally-administered oxytocin has been widely used to study its effects on the brain using functional magnetic resonance imaging. Head motion is a significant confounding variable which was assessed as part of a double blind, placebo-controlled crossover study. Twenty-four mothers with drug addiction problems were initially recruited, along with 22 healthy control mothers, to test whether intranasal oxytocin enhances functional brain responses to images of their own versus unknown infant faces. Significant differences in head motion between oxytocin/placebo conditions and addiction/control groups were discovered. Administration of intranasal oxytocin was associated with more frequent counts of head motion exceeding 3 mm of framewise displacement, independent of group status (z=2.89, p=0.004). This effect was seen more strongly in the control group (z=2.30, p=0.02) than the addiction group (z=1.77, p=0.08). The addiction group was more likely to show increased head motion, independent of oxytocin or placebo condition (z=2.21, p=0.03). When examining the mean head motion across all time points, as opposed to the count of large movements, oxytocin's effect was limited to the addiction group (z=2.58, p=0.01), with a significant group by condition interaction effect observed. Intranasally-administered oxytocin may therefore have a confounding effect on functional MRI scanning results via its independent effect on head motion. These findings should be examined and replicated in other clinical populations.
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BACKGROUND: The Huntington's Disease Integrated Staging System (HD-ISS) has four stages that characterize disease progression. Classification is based on CAG length as a marker of Huntington's disease (Stage 0), striatum atrophy as a biomarker of pathogenesis (Stage 1), motor or cognitive deficits as HD signs and symptoms (Stage 2), and functional decline (Stage 3). One issue for implementation is the possibility that not all variables are measured in every study, and another issue is that the stages are broad and may benefit from progression subgrouping. OBJECTIVE: Impute stages of the HD-ISS for observational studies in which missing data precludes direct stage classification, and then define progression subgroups within stages. METHODS: A machine learning algorithm was used to impute stages. Agreement of the imputed stages with the observed stages was evaluated using graphical methods and propensity score matching. Subgroups were defined based on descriptive statistics and optimal cut-point analysis. RESULTS: There was good overall agreement between the observed stages and the imputed stages, but the algorithm tended to over-assign Stage 0 and under-assign Stage 1 for individuals who were early in progression. CONCLUSION: There is evidence that the imputed stages can be treated similarly to the observed stages for large-scale analyses. When imaging data are not available, imputation can be avoided by collapsing the first two stages using the categories of Stage≤1, Stage 2, and Stage 3. Progression subgroups defined within a stage can help to identify groups of more homogeneous individuals.
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Trastornos del Conocimiento , Disfunción Cognitiva , Enfermedad de Huntington , Humanos , Biomarcadores , Progresión de la EnfermedadRESUMEN
AIM: The current study examined the longitudinal effects of standard binge drinking (4+/5+ drinks for females/males in 2 hours) and extreme binge drinking (8+/10+ drinks for females/males in 2 hours) on resting-state functional connectivity. METHOD: 119 college students (61 males) were recruited in groups of distinct bingeing patterns at baseline: non-bingeing controls, standard and extreme bingers. Resting-state scans were first obtained when participants were freshmen/sophomores and again approximately two years later. Associations between longitudinal bingeing (reported during this two-year gap) and network connectivity were examined. Network connectivity was calculated by aggregating all edges affiliated with the same network (an edge is a functional connection between two brain regions). The relationship between longitudinal bingeing and connectivity edges was also studied using connectome-based predictive modeling (CPM). RESULTS: Greater standard bingeing was negatively associated with change in connectivity between Default Mode Network and Ventral Attention Network (DMN-VAN; False Discovery Rate corrected), controlling for initial binge groups, longitudinal network changes, motions, scanner, SES, sex, and age. The correlations between change in DMN-VAN connectivity and change in cognitive performance (Stroop, Digit Span, Letter Fluency, and Trail Making) were also tested, but the results were not significant. Lastly, CPM failed to identify a generalizable predictive model of longitudinal bingeing from change in connectivity edges. CONCLUSIONS: Binge drinking is associated with abnormality in networks implicated in attention and self-focused processes, which, in turn, have been implicated in rumination, craving, and relapse. More extensive alterations in functional connectivity might be observed with heavier or longer binge drinking pattern.
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Consumo Excesivo de Bebidas Alcohólicas , Conectoma , Consumo Excesivo de Bebidas Alcohólicas/diagnóstico por imagen , Encéfalo/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Red Nerviosa , UniversidadesRESUMEN
BACKGROUND: A number of studies in recent years have explored whole-brain dynamic connectivity using pairwise approaches. There has been less focus on trying to analyze brain dynamics in higher dimensions over time. METHODS: We introduce a new approach that analyzes time series trajectories to identify high traffic nodes in a high dimensional space. First, functional magnetic resonance imaging (fMRI) data are decomposed using spatial ICA to a set of maps and their associated time series. Next, density is calculated for each time point and high-density points are clustered to identify a small set of high traffic nodes. We validated our method using simulations and then implemented it on a real data set. RESULTS: We present a novel approach that captures dynamics within a high dimensional space and also does not use any windowing in contrast to many existing approaches. The approach enables one to characterize and study the time series in a potentially high dimensional space, rather than looking at each component pair separately. Our results show that schizophrenia patients have a lower dynamism compared to healthy controls. In addition, we find patients spend more time in nodes associated with the default mode network and less time in components strongly correlated with auditory and sensorimotor regions. Interestingly, we also found that subjects oscillate between state pairs that show opposite spatial maps, suggesting an oscillatory pattern. CONCLUSION: Our proposed method provides a novel approach to analyze the data in its native high dimensional space and can possibly provide new information that is undetectable using other methods.
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OBJECTIVES: In primary care 50-95% of patients with depression present with vegetative symptoms (VS). Based on the extant literature, older adults showing VS (but no dysphoria) may show functional impairment but this hypothesis has not been empirically tested. The goal of this study was to examine neurocognitive and daily functioning of elderly patients showing exclusively VS in comparison with patients presenting with VS and dysphoria. METHODS: Seven hundred and eighty-seven primary care patients received measures of neurocognition and daily functioning. Neurocognition was measured with the repeatable battery for the assessment of neuropsychological status (RBANS). Three groups were compared: (1) patients with two or more VS of depression without dysphoria (VS - D), (2) patients with at least one VS and dysphoria (VS + D), and (3) comparison patients without multiple VS or dysphoria. RESULTS: Nearly one third of the sample (31%) fell into the VS - D group, whereas 15% fell into the VS + D group. Both VS groups showed poorer neurocognition and activities of daily living than comparisons. Only one subtest of the RBANS (i.e., picture naming) showed a significant difference between VS + D and VS - D, and there was no significant difference on daily functioning. VS - D patients reported less frequent past history of depression and endorsed less anxiety compared to VS + D. CONCLUSIONS: Elderly patients presenting with clusters of VS with or without dysphoria show poorer neurocognitive and functional performance. Relative poorer cognition and daily functioning in VS - D are potential harbingers of further decline and consistent with under-reporting of sadness in older age.
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Actividades Cotidianas , Trastornos del Conocimiento/psicología , Trastorno Depresivo/psicología , Anciano , Anciano de 80 o más Años , Conducta Apetitiva , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/epidemiología , Fatiga/diagnóstico , Femenino , Humanos , Masculino , Trastornos de la Memoria/diagnóstico , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Trastornos del Sueño-Vigilia/diagnósticoRESUMEN
AIM: Binge drinking is common during college, and studies have shown that many college students drink in quantities that far exceed the standard binge drinking threshold. Previous research has noted personality differences in individuals who engage in binge drinking, but few studies have examined neurobiological differences in both standard bingers (4/5 drinks in two hours for females/males; sBinge) and extreme binge drinkers (8+/10+ drinks in two hours for females/males; eBinge). METHOD: The current study of 221 college students used functional magnetic resonance imaging (fMRI) to study neural activation on a stop signal task (SST) to assess behavioral inhibition and a monetary incentive delay (MID) task to assess activation to rewards and losses. Non-bingeing controls, sBinge, and eBinge freshmen and sophomores were recruited. In addition, because binge/extreme binge drinking is often associated with marijuana (MJ) use, MJ + sBinge and MJ + eBinge groups were also included. RESULTS: All five groups showed strong activation in expected key cortical and striatal regions on both the SST and the MID. However, there were no significant differences between groups either at the whole-brain level or in specific regions of interest. Behavioral performance on the fMRI tasks also did not differ between groups. CONCLUSIONS: These results suggest that our sample of individuals who engage in binge or extreme binge drinking with or without MJ co-use do not differ in brain activity on reward and inhibitory tasks. Neural differences may be present on other cognitive tasks or may emerge later after more sustained use of alcohol, MJ, and other drugs.
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BACKGROUND: Dynamic functional network connectivity (dFNC) of the brain has attracted considerable attention recently. Many approaches have been suggested to study dFNC with sliding window Pearson correlation (SWPC) being the most well-known. SWPC needs a relatively large sample size to reach a robust estimation but using large window sizes prevents us to detect rapid changes in dFNC. NEW METHOD: Here we first calculate the gradients of each time series pair and use the magnitude of these gradients to calculate weighted average of shared trajectory (WAST) as a new estimator for dFNC. RESULTS: Using WAST to compare healthy control and schizophrenia patients using a large dataset, we show disconnectivity between different regions associated with schizophrenia. In addition, WAST results reveals patients with schizophrenia stay longer in a connectivity state with negative connectivity between motor and sensory regions than do healthy controls. COMPARISON WITH EXISTING METHODS: We compare WAST with SWPC and multiplication of temporal derivatives (MTD) using different simulation scenarios. We show that WAST enables us to detect very rapid changes in dFNC (undetected by SWPC) while MTD performance is generally lower. CONCLUSIONS: As large window sizes are unable to detect short states, using shorter window size is desirable if the estimator is robust enough. We provide evidence that WAST requires fewer samples (compared to SWPC) to reach a robust estimation. As a result, we were able to identify rapidly varying dFNC patterns undetected by SWPC while still being able to robustly estimate slower dFNC patterns.
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A family history of an alcohol use disorder (AUD) has been shown to increase one's risk of developing an AUD. Additionally, a positive family history of AUD (family history positive (FHP)) has neurobiological and neuropsychopharmacological consequences, and this review summarizes differential drug response as well as neuroanatomical and neurocognitive correlates. FHP status is related to altered responses to a number of drugs, including substances with abuse liability like alcohol, opioids, amphetamines, and ketamine. FHP individuals demonstrate fewer aversive effects and more rewarding response to both alcohol and subanesthetic dose ketamine. Ketamine is a rapid-acting antidepressant, and several studies have reported that ketamine is more effective for FHP treatment-resistant depressed individuals. In short, the reviewed neurophysiological differences may contribute to ketamine's enhanced antidepressant efficacy in FHP patients. Volumetric differences in the amygdala, nucleus accumbens, neocortex, and cerebellum are commonly reported. Furthermore, FHP has also been associated with altered neurocognitive performance, e.g., increased impulsivity. The imaging and psychological literature supports a neurodevelopmental lag hypothesis in FHP youth. The review will further discuss these findings in depth.