Edge-Based General Linear Models Capture Moment-to-Moment Fluctuations in Attention.

Although we must prioritize the processing of task-relevant information to navigate life, our ability to do so fluctuates across time. Previous work has identified fMRI functional connectivity (FC) networks that predict an individual's ability to sustain attention and vary with attentional state from 1 min to the next. However, traditional dynamic FC approaches typically lack the temporal precision to capture moment-to-moment network fluctuations. Recently, researchers have "unfurled" traditional FC matrices in "edge cofluctuation time series" which measure timepoint-by-timepoint cofluctuations between regions. Here we apply event-based and parametric fMRI analyses to edge time series to capture moment-to-moment fluctuations in networks related to attention. In two independent fMRI datasets examining young adults of both sexes in which participants performed a sustained attention task, we identified a reliable set of edges that rapidly deflects in response to rare task events. Another set of edges varies with continuous fluctuations in attention and overlaps with a previously defined set of edges associated with individual differences in sustained attention. Demonstrating that edge-based analyses are not simply redundant with traditional regions-of-interest-based approaches, up to one-third of reliably deflected edges were not predicted from univariate activity patterns alone. These results reveal the large potential in combining traditional fMRI analyses with edge time series to identify rapid reconfigurations in networks across the brain.

Differences in the functional brain architecture of sustained attention and working memory in youth and adults.

Sustained attention (SA) and working memory (WM) are critical processes, but the brain networks supporting these abilities in development are unknown. We characterized the functional brain architecture of SA and WM in 9- to 11-year-old children and adults. First, we found that adult network predictors of SA generalized to predict individual differences and fluctuations in SA in youth. A WM model predicted WM performance both across and within children-and captured individual differences in later recognition memory-but underperformed in youth relative to adults. We next characterized functional connections differentially related to SA and WM in youth compared to adults. Results revealed 2 network configurations: a dominant architecture predicting performance in both age groups and a secondary architecture, more prominent for WM than SA, predicting performance in each age group differently. Thus, functional connectivity (FC) predicts SA and WM in youth, with networks predicting WM performance differing more between youths and adults than those predicting SA.

Individualized Structural Perturbations on Normative Brain Connectome Restrict Deep Brain Stimulation Outcomes in Parkinson's Disease.

BACKGROUND: Patients with Parkinson's disease (PD) respond to deep brain stimulation (DBS) variably. However, how brain substrates restrict DBS outcomes remains unclear. OBJECTIVE: In this article, we aim to identify prognostic brain signatures for explaining the response variability. METHODS: We retrospectively investigated a cohort of patients with PD (n = 141) between 2017 and 2022, and defined DBS outcomes as the improvement ratio of clinical motor scores. We used a deviation index to quantify individual perturbations on a reference structural covariance network acquired with preoperative T1-weighted magnetic resonance imaging. The neurobiological perturbations of patients were represented as z scored indices based on the chronological perturbations measured on a group of normal aging adults. RESULTS: After applying stringent statistical tests (z > 2.5) and correcting for false discoveries (P < 0.01), we found that accelerated deviations mainly affected the prefrontal cortex, motor strip, limbic system, and cerebellum in PD. Particularly, a negative network within the accelerated deviations, expressed as "more preoperative deviations, less postoperative improvements," could predict DBS outcomes (mean absolute error = 0.09, R2 = 0.15). Moreover, a fusion of personal brain predictors and medical responses significantly improved traditional evaluations of DBS outcomes. Notably, the most important brain predictor, a pathway connecting the cognitive unit (prefrontal cortex) and motor control unit (cerebellum and motor strip), partially mediates DBS outcomes with the age at surgery. CONCLUSIONS: Our findings suggest that individual structural perturbations on the cognitive motor control circuit are critical for modulating DBS outcomes. Interventions toward the circuit have the potential for additional clinical improvements. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Functional connectome stability and optimality are markers of cognitive performance.

Patterns of whole-brain fMRI functional connectivity, or connectomes, are unique to individuals. Previous work has identified subsets of functional connections within these patterns whose strength predicts aspects of attention and cognition. However, overall features of these connectomes, such as how stable they are over time and how similar they are to a group-average (typical) or high-performance (optimal) connectivity pattern, may also reflect cognitive and attentional abilities. Here, we test whether individuals who express more stable, typical, optimal, and distinctive patterns of functional connectivity perform better on cognitive tasks using data from three independent samples. We find that individuals with more stable task-based functional connectivity patterns perform better on attention and working memory tasks, even when controlling for behavioral performance stability. Additionally, we find initial evidence that individuals with more typical and optimal patterns of functional connectivity also perform better on these tasks. These results demonstrate that functional connectome stability within individuals and similarity across individuals predicts individual differences in cognition.

Predicting multilingual effects on executive function and individual connectomes in children: An ABCD study.

While there is a substantial amount of work studying multilingualism's effect on cognitive functions, little is known about how the multilingual experience modulates the brain as a whole. In this study, we analyzed data of over 1,000 children from the Adolescent Brain Cognitive Development (ABCD) Study to examine whether monolinguals and multilinguals differ in executive function, functional brain connectivity, and brain-behavior associations. We observed significantly better performance from multilingual children than monolinguals in working-memory tasks. In one finding, we were able to classify multilinguals from monolinguals using only their whole-brain functional connectome at rest and during an emotional n-back task. Compared to monolinguals, the multilingual group had different functional connectivity mainly in the occipital lobe and subcortical areas during the emotional n-back task and in the occipital lobe and prefrontal cortex at rest. In contrast, we did not find any differences in behavioral performance and functional connectivity when performing a stop-signal task. As a second finding, we investigated the degree to which behavior is reflected in the brain by implementing a connectome-based behavior prediction approach. The multilingual group showed a significant correlation between observed and connectome-predicted individual working-memory performance scores, while the monolingual group did not show any correlations. Overall, our observations suggest that multilingualism enhances executive function and reliably modulates the corresponding brain functional connectome, distinguishing multilinguals from monolinguals even at the developmental stage.

A cognitive state transformation model for task-general and task-specific subsystems of the brain connectome.

The human brain flexibly controls different cognitive behaviors, such as memory and attention, to satisfy contextual demands. Much progress has been made to reveal task-induced modulations in the whole-brain functional connectome, but we still lack a way to model context-dependent changes. Here, we present a novel connectome-to-connectome (C2C) transformation framework that enables us to model the brain's functional reorganization from one connectome state to another in response to specific task goals. Using functional magnetic resonance imaging data from the Human Connectome Project, we demonstrate that the C2C model accurately generates an individual's task-related connectomes from their task-free (resting-state) connectome with a high degree of specificity across seven different cognitive states. Moreover, the C2C model amplifies behaviorally relevant individual differences in the task-free connectome, thereby improving behavioral predictions with increased power, achieving similar performance with just a third of the subjects needed when relying on resting-state data alone. Finally, the C2C model reveals how the brain reorganizes between cognitive states. Our observations support the existence of reliable state-specific subsystems in the brain and demonstrate that we can quantitatively model how the connectome reconfigures to different cognitive states, enabling more accurate predictions of behavior with fewer subjects.

Functional Connectivity during Encoding Predicts Individual Differences in Long-Term Memory.

What is the neural basis of individual differences in the ability to hold information in long-term memory (LTM)? Here, we first characterize two whole-brain functional connectivity networks based on fMRI data acquired during an n-back task that robustly predict individual differences in two important forms of LTM, recognition and recollection. We then focus on the recognition memory model and contrast it with a working memory model. Although functional connectivity during the n-back task also predicts working memory performance and the two networks have some shared components, they are also largely distinct from each other: The recognition memory model performance remains robust when we control for working memory, and vice versa. Functional connectivity only within regions traditionally associated with LTM formation, such as the medial temporal lobe and those that show univariate subsequent memory effect, have little predictive power for both forms of LTM. Interestingly, the interactions between these regions and other brain regions play a more substantial role in predicting recollection memory than recognition memory. These results demonstrate that individual differences in LTM are dependent on the configuration of a whole-brain functional network including but not limited to regions associated with LTM during encoding and that such a network is separable from what supports the retention of information in working memory.

Distributed Patterns of Functional Connectivity Predict Working Memory Performance in Novel Healthy and Memory-impaired Individuals.

Individual differences in working memory relate to performance differences in general cognitive ability. The neural bases of such individual differences, however, remain poorly understood. Here, using a data-driven technique known as connectome-based predictive modeling, we built models to predict individual working memory performance from whole-brain functional connectivity patterns. Using n-back or rest data from the Human Connectome Project, connectome-based predictive models significantly predicted novel individuals' 2-back accuracy. Model predictions also correlated with measures of fluid intelligence and, with less strength, sustained attention. Separate fluid intelligence models predicted working memory score, as did sustained attention models, again with less strength. Anatomical feature analysis revealed significant overlap between working memory and fluid intelligence models, particularly in utilization of prefrontal and parietal regions, and less overlap in predictive features between working memory and sustained attention models. Furthermore, showing the generality of these models, the working memory model developed from Human Connectome Project data generalized to predict memory in an independent data set of 157 older adults (mean age = 69 years; 48 healthy, 54 amnestic mild cognitive impairment, 55 Alzheimer disease). The present results demonstrate that distributed functional connectivity patterns predict individual variation in working memory capability across the adult life span, correlating with constructs including fluid intelligence and sustained attention.

Multivariate approaches improve the reliability and validity of functional connectivity and prediction of individual behaviors.

Brain functional connectivity features can predict cognition and behavior at the level of the individual. Most studies measure univariate signals, correlating timecourses from the average of constituent voxels in each node. While straightforward, this approach overlooks the spatial patterns of voxel-wise signals within individual nodes. Given that multivariate spatial activity patterns across voxels can improve fMRI measures of mental representations, here we asked whether using voxel-wise timecourses can better characterize region-by-region interactions relative to univariate approaches. Using two fMRI datasets, the Human Connectome Project sample and a local test-retest sample, we measured multivariate functional connectivity with multivariate distance correlation and univariate connectivity with Pearson's correlation. We compared multivariate and univariate connectivity estimates, demonstrating that relative to univariate estimates, multivariate estimates exhibited higher reliability at both the edge-level and connectome-level, stronger prediction of individual differences, and greater sensitivity to brain states within individuals. Our findings suggest that multivariate estimates reliably provide more powerful information about an individual's functional brain organization and its relation to cognitive skills.

Dynamic functional connectivity during task performance and rest predicts individual differences in attention across studies.

Dynamic functional connectivity (DFC) aims to maximize resolvable information from functional brain scans by considering temporal changes in network structure. Recent work has demonstrated that static, i.e. time-invariant resting-state and task-based FC predicts individual differences in behavior, including attention. Here, we show that DFC predicts attention performance across individuals. Sliding-window FC matrices were generated from fMRI data collected during rest and attention task performance by calculating Pearson's r between every pair of nodes of a whole-brain atlas within overlapping 10-60s time segments. Next, variance in r values across windows was taken to quantify temporal variability in the strength of each connection, resulting in a DFC connectome for each individual. In a leave-one-subject-out-cross-validation approach, partial-least-square-regression (PLSR) models were then trained to predict attention task performance from DFC matrices. Predicted and observed attention scores were significantly correlated, indicating successful out-of-sample predictions across rest and task conditions. Combining DFC and static FC features numerically improves predictions over either model alone, but the improvement was not statistically significant. Moreover, dynamic and combined models generalized to two independent data sets (participants performing the Attention Network Task and the stop-signal task). Edges with significant PLSR coefficients concentrated in visual, motor, and executive-control brain networks; moreover, most of these coefficients were negative. Thus, better attention may rely on more stable, i.e. less variable, information flow between brain regions.

Brain-State Extraction Algorithm Based on the State Transition (BEST): A Dynamic Functional Brain Network Analysis in fMRI Study.

Spatial pattern of the brain network changes dynamically. This change is closely linked to the brain-state transition, which vary depending on a dynamic stream of thoughts. To date, many dynamic methods have been developed for decoding brain-states. However, most of them only consider changes over time, not the brain-state transition itself. Here, we propose a novel dynamic functional connectivity analysis method, brain-state extraction algorithm based on state transition (BEST), which constructs connectivity matrices from the duration of brain-states and decodes the proper number of brain-states in a data-driven way. To set the duration of each brain-state, we detected brain-state transition time-points using spatial standard deviation of the brain activity pattern that changes over time. Furthermore, we also used Bayesian information criterion to the clustering method to estimate and extract the number of brain-states. Through validations, it was proved that BEST could find brain-state transition time-points and could estimate the proper number of brain-states without any a priori knowledge. It has also shown that BEST can be applied to resting state fMRI data and provide stable and consistent results.

Connectome-based predictive modeling of attention: Comparing different functional connectivity features and prediction methods across datasets.

Connectome-based predictive modeling (CPM; Finn et al., 2015; Shen et al., 2017) was recently developed to predict individual differences in traits and behaviors, including fluid intelligence (Finn et al., 2015) and sustained attention (Rosenberg et al., 2016a), from functional brain connectivity (FC) measured with fMRI. Here, using the CPM framework, we compared the predictive power of three different measures of FC (Pearson's correlation, accordance, and discordance) and two different prediction algorithms (linear and partial least square [PLS] regression) for attention function. Accordance and discordance are recently proposed FC measures that respectively track in-phase synchronization and out-of-phase anti-correlation (Meskaldji et al., 2015). We defined connectome-based models using task-based or resting-state FC data, and tested the effects of (1) functional connectivity measure and (2) feature-selection/prediction algorithm on individualized attention predictions. Models were internally validated in a training dataset using leave-one-subject-out cross-validation, and externally validated with three independent datasets. The training dataset included fMRI data collected while participants performed a sustained attention task and rested (N = 25; Rosenberg et al., 2016a). The validation datasets included: 1) data collected during performance of a stop-signal task and at rest (N = 83, including 19 participants who were administered methylphenidate prior to scanning; Farr et al., 2014a; Rosenberg et al., 2016b), 2) data collected during Attention Network Task performance and rest (N = 41, Rosenberg et al., in press), and 3) resting-state data and ADHD symptom severity from the ADHD-200 Consortium (N = 113; Rosenberg et al., 2016a). Models defined using all combinations of functional connectivity measure (Pearson's correlation, accordance, and discordance) and prediction algorithm (linear and PLS regression) predicted attentional abilities, with correlations between predicted and observed measures of attention as high as 0.9 for internal validation, and 0.6 for external validation (all p's < 0.05). Models trained on task data outperformed models trained on rest data. Pearson's correlation and accordance features generally showed a small numerical advantage over discordance features, while PLS regression models were usually better than linear regression models. Overall, in addition to correlation features combined with linear models (Rosenberg et al., 2016a), it is useful to consider accordance features and PLS regression for CPM.

Momentary level of slow default mode network activity is associated with distinct propagation and connectivity patterns in the anesthetized mouse cortex.

Complex spatiotemporal changes of slow spontaneous activity occur in the form of propagating waves in the cortex, leading to the transient formation of a specific activation topography, followed by a transition in the topography. The topographies resemble the stimulation-induced activation patterns and the underlying structural projections, suggesting that they contain motifs of task-related activation. However, little is known about how propagation-mediated transitions between topographies are structured in terms of functional connectivity. Therefore, we investigated whether specific topographies or regions are associated with transitions involving long-range connections and hub modulation. We hypothesized that the activity level of the default mode network (DMN) at a given topography would affect the pattern of upcoming transitions, since high activity levels of the DMN are a distinct feature of the brain at rest. Using mesoscale voltage-sensitive dye imaging in the cortex of lightly anesthetized mice, we revealed that momentary levels of DMN activity are associated with distinct patterns of activity propagation and functional connectivity. High levels of DMN activity led to activity propagation across secondary and association cortices, increasing the centrality of a main hub region, whereas low-level activity led to global, diffuse, yet efficient changes in functional connectivity. Furthermore, low levels of activity resulted in increased long-range connectivity between frontal and posterior regions of the cortex. Our results indicate that DMN activity is associated with functional connectivity and wave propagation patterns, raising the possibility that the DMN may be involved in the modulation of long-range information processing associated with upcoming transitions. NEW & NOTEWORTHY Using voltage-sensitive dye imaging with high spatiotemporal resolution, we have revealed that increased DMN activity is associated with activity propagation to secondary/association cortices, whereas decreased activity is associated with stronger long-range frontal-posterior connections in the mouse cortex. Hub metric and global functional connectivity parameters were accompanied by activity level changes. These results indicate that the DMN may aid in modulating the structure of transitions.

Normalization of cortical thickness measurements across different T1 magnetic resonance imaging protocols by novel W-Score standardization.

BACKGROUND: The use of different 3D T1-weighted magnetic resonance (T1 MR) imaging protocols induces image incompatibility across multicenter studies, negating the many advantages of multicenter studies. A few methods have been developed to address this problem, but significant image incompatibility still remains. Thus, we developed a novel and convenient method to improve image compatibility. METHODS: W-score standardization creates quality reference values by using a healthy group to obtain normalized disease values. We developed a protocol-specific w-score standardization to control the protocol effect, which is applied to each protocol separately. We used three data sets. In dataset 1, brain T1 MR images of normal controls (NC) and patients with Alzheimer's disease (AD) from two centers, acquired with different T1 MR protocols, were used (Protocol 1 and 2, n = 45/group). In dataset 2, data from six subjects, who underwent MRI with two different protocols (Protocol 1 and 2), were used with different repetition times, echo times, and slice thicknesses. In dataset 3, T1 MR images from a large number of healthy normal controls (Protocol 1: n = 148, Protocol 2: n = 343) were collected for w-score standardization. The protocol effect and disease effect on subjects' cortical thickness were analyzed before and after the application of protocol-specific w-score standardization. RESULTS: As expected, different protocols resulted in differing cortical thickness measurements in both NC and AD subjects. Different measurements were obtained for the same subject when imaged with different protocols. Multivariate pattern difference between measurements was observed between the protocols. Classification accuracy between two protocols was nearly 90%. After applying protocol-specific w-score standardization, the differences between the protocols substantially decreased. Most importantly, protocol-specific w-score standardization reduced both univariate and multivariate differences in the images while maintaining the AD disease effect. Compared to conventional regression methods, our method showed the best performance for in terms of controlling the protocol effect while preserving disease information. CONCLUSIONS: Protocol-specific w-score standardization effectively resolved the concerns of conventional regression methods. It showed the best performance for improving the compatibility of a T1 MR post-processed feature, cortical thickness.

Degree-based statistic and center persistency for brain connectivity analysis.

Brain connectivity analyses have been widely performed to investigate the organization and functioning of the brain, or to observe changes in neurological or psychiatric conditions. However, connectivity analysis inevitably introduces the problem of mass-univariate hypothesis testing. Although, several cluster-wise correction methods have been suggested to address this problem and shown to provide high sensitivity, these approaches fundamentally have two drawbacks: the lack of spatial specificity (localization power) and the arbitrariness of an initial cluster-forming threshold. In this study, we propose a novel method, degree-based statistic (DBS), performing cluster-wise inference. DBS is designed to overcome the above-mentioned two shortcomings. From a network perspective, a few brain regions are of critical importance and considered to play pivotal roles in network integration. Regarding this notion, DBS defines a cluster as a set of edges of which one ending node is shared. This definition enables the efficient detection of clusters and their center nodes. Furthermore, a new measure of a cluster, center persistency (CP) was introduced. The efficiency of DBS with a known "ground truth" simulation was demonstrated. Then they applied DBS to two experimental datasets and showed that DBS successfully detects the persistent clusters. In conclusion, by adopting a graph theoretical concept of degrees and borrowing the concept of persistence from algebraic topology, DBS could sensitively identify clusters with centric nodes that would play pivotal roles in an effect of interest. DBS is potentially widely applicable to variable cognitive or clinical situations and allows us to obtain statistically reliable and easily interpretable results. Hum Brain Mapp 38:165-181, 2017. © 2016 Wiley Periodicals, Inc.

Default Mode Network Functional Connectivity in Early and Late Mild Cognitive Impairment: Results From the Alzheimer's Disease Neuroimaging Initiative.

BACKGROUND: Default mode network (DMN) functional connectivity is one of the neuroimaging candidate biomarkers of Alzheimer disease. However, no studies have investigated DMN connectivity at different stages of mild cognitive impairment (MCI). The aim of this study was to investigate patterns of DMN connectivity and its breakdown among cognitively normal (CN), early MCI (EMCI), and late MCI (LMCI) subjects. METHODS: Magnetic resonance imaging data and neuropsychological test scores from 130 subjects (CN=43, EMCI=47, LMCI=40) were obtained from the Alzheimer's Disease Neuroimaging Initiative. DMN functional connectivity was extracted using independent components analysis and compared between groups. RESULTS: Functional connectivity in the precuneus, bilateral medial frontal, parahippocampal, middle temporal, right superior temporal, and left angular gyri was decreased in EMCI subjects compared with CN subjects. When the 2 MCI groups were directly compared, LMCI subjects exhibited decreased functional connectivity in the precuneus, bilateral medial frontal gyri, and left angular gyrus. There was no significant difference in gray matter volume among the 3 groups. Amyloid-positive EMCI subjects revealed more widespread breakdown of DMN connectivity than amyloid-negative EMCI subjects. A quantitative index of DMN connectivity correlated well with measures of cognitive performance. CONCLUSIONS: Our results suggest that the breakdown of DMN connectivity may occur in the early stage of MCI.

The relationship between cognitive performance and insulin resistance in non-diabetic patients with mild cognitive impairment.

OBJECTIVE: Insulin resistance (IR) is a distinct and early feature of type 2 diabetes mellitus and metabolic syndrome. IR is thought to play a vital role in cognitive impairment. We conducted this study to understand the early characteristics of cognitive dysfunctions attributable to IR. METHODS: This study included 85 consecutive non-diabetic elderly participants with mild cognitive impairment (MCI). IR was estimated with the homeostasis model assessment of insulin resistance (HOMA-IR). Cognitive performances were analyzed as a function of scores on the HOMA-IR. RESULTS: The group analysis those with and without IR did not show any differences in the cognitive performance although higher HOMA-IR was closely associated with lower performances in immediate recall on the Seoul Verbal Learning Test (SVLT-I) (r = -0.244, p = 0.026) and Controlled Oral Word Association Test (COWAT) (r = -0.270, p = 0.013). In subgroup analysis by APOE status, SVLT-delayed (p = 0.027) and COWAT (p = 0.016) scores were found to be significantly lower in the IR than the non-IR among those with APOE ε4 allele. In multiple regression analysis, impairment on the COWAT remained significantly correlated with scores on HOMA-IR (ß = -0.271, t = -2.340, p = 0.022). However, IR status was identified to interact with APOE ε4 carriership toward poor performances in the COWAT (ß = -0.335, t = -2.285, p = 0.026). CONCLUSION: This study found a domain-specific impact of HOMA-IR scores on cognitive performances in non-diabetic patients with MCI. This association was profound only in APOE ε4carriers.

Progressive changes in hippocampal resting-state connectivity across cognitive impairment: a cross-sectional study from normal to Alzheimer disease.

We investigate the changes in functional connectivity of the left and right hippocampus by comparing the resting-state low-frequency fluctuations in the blood oxygen level-dependent signal from these regions with relation to Alzheimer disease (AD) progression. AD patients were divided into subgroups based on the clinical dementia rating (CDR) scores. Patients with amnestic mild cognitive impairment (aMCI) were also analyzed as an intermediate stage between normal controls and AD. We found that the total functional connectivity of both the right and left hippocampus was maintained during aMCI and the early stages of AD and that it decreased in the later stages of AD. However, when total functional connectivity was broken down into specific regions of the brain, we observed increased or decreased connectivity to specific regions beginning with aMCI. Direct correlation analysis in seeding the left hippocampus revealed a significant decrease in the functional connectivity with the posterior cingulate cortex region and lateral parietal areas, and an increase in functional connectivity in and the anterior cingulate cortex beginning with aMCI. In this study, we were able to quantify the deterioration of resting-state hippocampal connectivity with disease severity and formation of compensatory recruitment in the early stages of AD.

Edge-based general linear models capture high-frequency fluctuations in attention.

Although we must prioritize the processing of task-relevant information to navigate life, our ability to do so fluctuates across time. Previous work has identified fMRI functional connectivity (FC) networks that predict an individual's ability to sustain attention and vary with attentional state from one minute to the next. However, traditional dynamic FC approaches typically lack the temporal precision to capture moment-by-moment network fluctuations. Recently, researchers have 'unfurled' traditional FC matrices in 'edge cofluctuation time series' which measure time point-by-time point cofluctuations between regions. Here we apply event-based and parametric fMRI analyses to edge time series to capture high-frequency fluctuations in networks related to attention. In two independent fMRI datasets in which participants performed a sustained attention task, we identified a reliable set of edges that rapidly deflects in response to rare task events. Another set of edges varies with continuous fluctuations in attention and overlaps with a previously defined set of edges associated with individual differences in sustained attention. Demonstrating that edge-based analyses are not simply redundant with traditional regions-of-interest based approaches, up to one-third of reliably deflected edges were not predicted from univariate activity patterns alone. These results reveal the large potential in combining traditional fMRI analyses with edge time series to identify rapid reconfigurations in networks across the brain.

Associations of physical frailty with health outcomes and brain structure in 483 033 middle-aged and older adults: a population-based study from the UK Biobank.

BACKGROUND: Physical frailty is a state of increased vulnerability to stressors and is associated with serious health issues. However, how frailty affects and is affected by numerous other factors, including mental health and brain structure, remains underexplored. We aimed to investigate the mutual effects of frailty and health using large, multidimensional data. METHODS: For this population-based study, we used data from the UK Biobank to examine the pattern and direction of association between physical frailty and 325 health-related measures across multiple domains, using linear mixed-effect models and adjusting for numerous confounders. Participants were included if complete data were available for all five indicators of frailty, all covariates, and at least one health measure. We further examined the association between frailty and brain structure and the role of this association in mediating the relationship between frailty and health outcomes. FINDINGS: 483 033 participants aged 38-73 years were included in the study at baseline (between Dec 19, 2006, and Oct 1, 2010); at a median follow-up of 9 years (IQR 8-10), behavioural data were available for 46 501 participants and neuroimaging data for 40 210 participants. The severity of physical frailty was significantly associated with decreased cognitive performance (Cohen's d=0·025-0·162), increased early-life risks (d=0·026-0·111), unhealthy lifestyle (d=0·013-0·394), poor physical fitness (d=0·007-0·668), increased symptoms of poor mental health (d=0·032-0·607), severe environmental pollution (d=0·013-0·064), and adverse biochemical markers (d=0·025-0·198). Some associations were bidirectional, with the strongest effects on mental health measures. The severity of frailty correlated with increased total white matter hyperintensity and lower grey matter volume, particularly in subcortical regions (d=0·027-0·082), which significantly mediated the association between frailty and health-related outcomes, although the mediated effects were small. INTERPRETATION: Physical frailty is associated with diverse unfavourable health-related outcomes, which can be mediated by differences in brain structure. Our findings offer a framework for guiding preventative strategies targeting both frailty and psychiatric disorders. FUNDING: National Institute of Mental Health, National Science Foundation.