Topological FDR for neuroimaging.

In this technical note, we describe and validate a topological false discovery rate (FDR) procedure for statistical parametric mapping. This procedure is designed to deal with signal that is continuous and has, in principle, unbounded spatial support. We therefore infer on topological features of the signal, such as the existence of local maxima or peaks above some threshold. Using results from random field theory, we assign a p-value to each maximum in an SPM and identify an adaptive threshold that controls false discovery rate, using the Benjamini and Hochberg (BH) procedure (1995). This provides a natural complement to conventional family wise error (FWE) control on local maxima. We use simulations to contrast these procedures; both in terms of their relative number of discoveries and their spatial accuracy (via the distribution of the Euclidian distance between true and discovered activations). We also assessed two other procedures: cluster-wise and voxel-wise FDR procedures. Our results suggest that (a) FDR control of maxima or peaks is more sensitive than FWE control of peaks with minimal cost in terms of false-positives, (b) voxel-wise FDR is substantially less accurate than topological FWE or FDR control. Finally, we present an illustrative application using an fMRI study of visual attention.

Aerial spraying of 2,4,5-T and human birth malformations: an epidemiological investigation.

An investigation of the rate of birth malformations in the Northland region of New Zealand provides no evidence to associate spraying of 2,4,5-trichlorophenoxyacetic acid with the occurrence of any malformation of the central nervous system, including spina bifida. A statistically significant association between spray and malformation is found in the case of talipes. Whether this association indicates a causal relation remains to be established.

Structural maturation of neural pathways in children and adolescents: in vivo study.

Structural maturation of fiber tracts in the human brain, including an increase in the diameter and myelination of axons, may play a role in cognitive development during childhood and adolescence. A computational analysis of structural magnetic resonance images obtained in 111 children and adolescents revealed age-related increases in white matter density in fiber tracts constituting putative corticospinal and frontotemporal pathways. The maturation of the corticospinal tract was bilateral, whereas that of the frontotemporal pathway was found predominantly in the left (speech-dominant) hemisphere. These findings provide evidence for a gradual maturation, during late childhood and adolescence, of fiber pathways presumably supporting motor and speech functions.

Unmyelinated tactile afferents signal touch and project to insular cortex.

There is dual tactile innervation of the human hairy skin: in addition to fast-conducting myelinated afferent fibers, there is a system of slow-conducting unmyelinated (C) afferents that respond to light touch. In a unique patient lacking large myelinated afferents, we found that activation of C tactile (CT) afferents produced a faint sensation of pleasant touch. Functional magnetic resonance imaging (fMRI) analysis during CT stimulation showed activation of the insular region, but not of somatosensory areas S1 and S2. These findings identify CT as a system for limbic touch that may underlie emotional, hormonal and affiliative responses to caress-like, skin-to-skin contact between individuals.

Episodic memory impairment in patients with Alzheimer's disease is correlated with entorhinal cortex atrophy. A voxel-based morphometry study.

The aims of this study were to investigate the pattern of cortical atrophy and the relationships between memory performances and the brain regions in Alzheimer's Disease (AD). optimized voxel-based morphometry (VBM) was applied to the MRI brain images of 18 probable AD and 18 healthy subjects (HS). Patients performed verbal and visuo-spatial episodic and shortterm memory tests. Contrasting of AD group with HS, and anatomobehavioural correlations were carried out in order to identify regional atrophic changes and neuro-cognitive aspects in AD group. We found evidence of gray matter (GM) volume reduction in AD in the medial temporal, parietal and frontal areas bilaterally and in the left anterior thalamic nuclei. Performance on the episodic memory delayed recall tests co-varied with GM volume in the left entorhinal cortex. The pattern of cortical atrophy likely reflects the heterogeneous level of dementia severity in our AD group. The anatomical region affected in the left hemisphere indicates a sufferance at multiple levels of the Polysynaptic Hippocampal Pathway, which is involved in declarative memory. Findings on the entorhinal cortex and the delayed memory scores support the role of the entorhinal cortex in episodic memory. Damage to the entorhinal cortex, deafferenting the hippocampus from neocortical inputs, interferes with episodic memory consolidation in AD patients.

Wisconsin Card Sorting revisited: distinct neural circuits participating in different stages of the task identified by event-related functional magnetic resonance imaging.

The Wisconsin Card Sorting Task (WCST) has been used to assess dysfunction of the prefrontal cortex and basal ganglia. Previous brain imaging studies have focused on identifying activity related to the set-shifting requirement of the WCST. The present study used event-related functional magnetic resonance imaging (fMRI) to study the pattern of activation during four distinct stages in the performance of this task. Eleven subjects were scanned while performing the WCST and a control task involving matching two identical cards. The results demonstrated specific involvement of different prefrontal areas during different stages of task performance. The mid-dorsolateral prefrontal cortex (area 9/46) increased activity while subjects received either positive or negative feedback, that is at the point when the current information must be related to earlier events stored in working memory. This is consistent with the proposed role of the mid-dorsolateral prefrontal cortex in the monitoring of events in working memory. By contrast, a cortical basal ganglia loop involving the mid-ventrolateral prefrontal cortex (area 47/12), caudate nucleus, and mediodorsal thalamus increased activity specifically during the reception of negative feedback, which signals the need for a mental shift to a new response set. The posterior prefrontal cortex response was less specific; increases in activity occurred during both the reception of feedback and the response period, indicating a role in the association of specific actions to stimuli. The putamen exhibited increased activity while matching after negative feedback but not while matching after positive feedback, implying greater involvement during novel than routine actions.

A three-dimensional statistical analysis for CBF activation studies in human brain.

Many studies of brain function with positron emission tomography (PET) involve the interpretation of a subtracted PET image, usually the difference between two images under baseline and stimulation conditions. The purpose of these studies is to see which areas of the brain are activated by the stimulation condition. In many cognitive studies, the activation is so slight that the experiment must be repeated on several subjects and the subtracted images are averaged to improve the signal-to-noise ratio. The averaged image is then standardized to have unit variance and then searched for local maxima. The main problem facing investigators is which of these local maxima are statistically significant. We describe a simple method for determining an approximate p value for the global maximum based on the theory of Gaussian random fields. The p value is proportional to the volume searched divided by the product of the full widths at half-maximum of the image reconstruction process or number of resolution elements. Rather than working with local maxima, our method focuses on the Euler characteristic of the set of voxels with a value larger than a given threshold. The Euler characteristic depends only on the topology of the regions of high activation, irrespective of their shape. For large threshold values this is approximately the same as the number of isolated regions of activation above the threshold. We can thus not only determine if any activation has taken place, but we can also estimate how many isolated regions of activation are present.

The effect of nimodipine on the evolution of human cerebral infarction studied by PET.

Fourteen patients were studied by positron emission tomography (PET) within 48 h of onset of a hemispheric ischemic stroke and again 7 days later. After the first set of PET scans, the patients were randomized to receive either nimodipine (n = 7) or a carrier solution (n = 7) by intravenous infusion. The infusions were maintained until the end of the second PET studies. CBF, cerebral blood volume (CBV), oxygen extraction ratio (OER), CMRO2, and CMRglc were measured each time. These metabolic and perfusion measurements were performed by standard methods. A surface map of each metabolic and perfusion measurement in the cortical mantle was generated by interpolating between the available slices. The various surface maps representing the physiological characteristics determined in the same or subsequent studies were aligned so that all data sets could be analyzed identically using an array of square regions of interest (ROIs). The functional status of each ROI was recorded at the two intervals following the cerebrovascular accident to characterize the evolution of the infarct, penumbra, and normal brain regions. We presumed the ischemic penumbra to be cortical regions in the proximity of the infarct and perfused at CBF values between 12 and 18 ml/100 g/min on the first PET scan, while densely ischemic regions had CBF of less than 12 nl/100 g/min and normally perfused brain greater than 18 ml/100 g/min. In the densely ischemic zone, CBF increased more in the nimodipine-treated group than in the carrier group. As well, in this region nimodipine reversed the decline in CMRO2 noted in the carrier group, the difference in the changes being significant. In the penumbra zone, comparable trends were noted in OER and CMRO2 but the difference in the changes between the two groups did not reach statistical significance. Changes in CMRglc and CBV were comparable between the two groups in both cortical regions.

Stability of regional cerebral glucose metabolism in the normal brain measured by positron emission tomography.

Cerebral glucose utilization (LCMRGI) was measured using the [18F]fluorodeoxyglucose method with PET in two groups of ten healthy young volunteers, each scanned in a resting state under different methodological conditions. In addition, five subjects had a second scan within 48 hr. Mean hemispheric values averaged 45.8 +/- 3.3 mumol/100 g/min in the right cerebral hemisphere and 47.0 +/- 3.7 mumol/100 g/min in the left hemisphere. A four-way analysis of variance (group, sex, region, hemisphere) was carried out on the results using three different methods of data manipulation: (a) the raw values of glucose utilization, (b) LCMRGI values "normalized" by the mean hemispheric gray matter LCMRGI value, and (c) log transformed LCMRGI values. For all analysis techniques, significantly higher LCMRGI values were consistently seen in the left mid and posterior temporal area and caudate nucleus relative to the right, and in the right occipital region relative to the left. The coefficient of variation of intrasubject regional differences (9.9%) was significantly smaller than the coefficient of variation for regions between subjects (16.5%). No differences were noted between the sexes and no effect of repeat procedures was seen in subjects having multiple scans. In addition, inter-regional LCMRGI correlations were examined both in values from the 20 normal subjects, as well as in a set of hypothetical "abnormal" values. Results were compared with those reported from other PET centers; despite certain methodological differences, the intersubject and inter-regional variation of LCMRGI is fairly constant.

Angiographic screening and elective surgery of familial cerebral aneurysms: a decision analysis.

Up to 6% of cerebral aneurysms may be familial. Because the pattern of inheritance and the prevalence of aneurysms within families are unknown, the management of family members at risk of harboring a cerebral aneurysm is currently empirical. We established the prevalence of aneurysms in the second generation of individuals with familial cerebral aneurysms and determined the possible benefit of angiographic screening and elective surgery of such individuals by using a simple decision analysis model. Four consecutive families were identified in whom the mother and a child had a ruptured cerebral aneurysm. A total of 19 siblings at risk in the second generation were identified. Fifteen underwent elective cerebral angiography: one had a cerebral aneurysm and two had an infundibulum at the origin of the posterior communicating artery. Including the previously known aneurysms, the prevalence of aneurysms in the second generation was thus established at 29.4%. A decision analysis was performed with 2% as the annual risk of rupture, 72.7% as the risk of death or disability with rupture, 0.1% as the risk of angiography, and 6.5% as the risk of surgery. The benefit in years of survival free of sequelae resulting from angiographic screening and elective surgery (intervention) over natural history was computed for life expectancy corresponding to each quinquennial age group from age 15 to 100 years. Intervention equaled natural history, in terms of years of survival expected with each choice, at a life expectancy of 10.6 years, corresponding to age 76.5 years for men and 80 years for women, and produced a net gain of at least 1 year for patients whose life expectancy was 32 years or more, corresponding to age 53.5 years for women and 49 years for men. Greater benefit was achieved with increasing life expectancy (younger age). The prevalence of aneurysms in the second generation when a mother and child have an aneurysm is 29.4%. Intervention produces a benefit of at least 1 year of survival free of sequelae over natural history in such individuals if their life expectancy is 32 years or more.

Detecting activation in fMRI data.

We present a simple approach to the analysis of fMRI data collected from several runs, sessions and subjects. We take advantage of the spatial nature of the data to reduce the noise in certain key parameters, achieving an increase in degrees of freedom for a mixed effects analysis. Our main interest is the analysis of the resulting images of test statistics using the geometry of random fields. We show how the Euler characteristic of the excursion set plays a key role in setting the threshold of the image to detect regions of the brain activated by a stimulus.

Surgery of unruptured, asymptomatic aneurysms: a decision analysis.

BACKGROUND: Asymptomatic cerebral aneurysms are diagnosed more frequently since the advent of computed tomography and magnetic resonance imaging. Their management is currently empirical. We have used decision analysis to place it on a more analytical basis. METHODS: Decision analysis was used to determine the benefit in years of survival free of sequelae resulting from elective surgery of unruptured aneurysms over natural history. We took 2% as the annual rate of rupture (r), 73% as the risk of death or disability with rupture (M), and 6.5% for the average risk of elective surgery (S). Benefit was calculated from the equation L([1-(1-r)L]M/2-S) [1] for life expectancy (L) corresponding to each quinquennial age group from age 15 to 100 years. Sensitivity analysis was performed to take into account increasing risk of elective surgery based on the size, and accessibility of the aneurysm, and variable risks of rupture and outcome. RESULTS: A gain of at least one year of survival free of neurological sequelae is achieved by surgery compared to natural history for patients whose life expectancy is 19.5 years, corresponding to age 63.5 years for males and 68 years for females. The life expectancy at which a benefit accrues is longer (the patient is younger) for larger, less accessible aneurysms, for lower rates of rupture, and for lesser risks of death or disability from rupture. CONCLUSIONS: Elective surgery of unruptured asymptomatic aneurysms achieves an increased survival over the natural history of at least one year free of neurological sequelae in patients whose life expectancy is 19.5 years or more, using our baseline assumptions. Using equation [1], the corresponding life expectancy producing this benefit can be calculated to account for the increased surgical risk of large, poorly accessible aneurysms and for factors affecting natural history.

Congenital malformations in the newborn in Northland: 1966-1977.

A survey of all hospital births in the Northland region of New Zealand during 1966-1977 has been carried out. There were 23 591 births during this period, of which 374 had significant malformations diagnosed in hospital. There were 243 stillbirths, 148 neonatal deaths; 334 infants with diagnosed malformations survived to discharge. Rates of stillbirth, neonatal death and malformation were higher amongst Maoris than amongst non-Maoris. The commoner malformations (with incidence rates per thousand births) were: talipes (5.2), spina bifida, congenital heart defects, cleft lip and/or cleft palate (1.5), and anencephalus (1.0). Anencephalus was commoner amongst females than males; talipes and isolated cleft palate were commoner amongst Maoris, anencephalus and spina bifida amongst non-Maoris. There is some evidence that whereas the rate of stillbirth has declined over the period, the rate of neonatal death has risen.

Longitudinal and cross-sectional analysis of atrophy in pharmacoresistant temporal lobe epilepsy.

BACKGROUND: Whether recurrent epileptic seizures induce brain damage is debated. Disease progression in epilepsy has been evaluated only in a few community-based studies involving patients with seizures well controlled by medication. These studies concluded that epilepsy does not inevitably lead to global cerebral damage. OBJECTIVE: To track the progression of neocortical atrophy in pharmacoresistant temporal lobe epilepsy (TLE) using longitudinal and cross-sectional designs. METHODS: Using a fully automated measure of cortical thickness on MRI, we studied a homogeneous sample of patients with pharmacoresistant TLE. In the longitudinal analysis (n = 18), fixed-effect models were used to quantify cortical atrophy over a mean interscan interval of 2.5 years (range = 7 to 90 months). In the cross-sectional analysis (n = 121), we correlated epilepsy duration and thickness. To dissociate normal aging from pathologic progression, we compared aging effects in TLE to healthy controls. RESULTS: The longitudinal analysis mapped progression in ipsilateral temporopolar and central and contralateral orbitofrontal, insular, and angular regions. In patients with more than 14 years of disease, atrophy progressed more rapidly in frontocentral and parietal regions that in those with shorter duration. The cross-sectional study showed progressive atrophy in the mesial and superolateral frontal, and parietal cortices. CONCLUSIONS: Our combined cross-sectional and longitudinal analysis in patients with pharmacoresistant temporal lobe epilepsy demonstrated progressive neocortical atrophy over a mean interval of 2.5 years that is distinct from normal aging, likely representing seizure-induced damage. The cumulative character of atrophy underlies the importance of early surgical treatment in this group of patients.

Detecting fMRI activation allowing for unknown latency of the hemodynamic response.

Several authors have suggested allowing for unknown latency of the hemodynamic response by incorporation of hemodynamic derivative terms into the linear model for the statistical analysis of fMRI data. In this paper, we show how to use random field theory to provide a P value for local maxima of two test statistics that have been recently proposed for detecting activation based on this analysis.

Inference for magnitudes and delays of responses in the FIAC data using BRAINSTAT/FMRISTAT.

We used straightforward linear mixed effects models as described in Worsley et al. together with recent advances in smoothing to control the degrees of freedom, and random field theory based on discrete local maxima. This has been implemented in BRAINSTAT, a Python version of FMRISTAT. Our main novelty is voxel-wise inference for both magnitude and delay (latency) of the hemodynamic response. Our analysis appears to be more sensitive than that of Dehaene-Lambertz et al. Our main findings are greater magnitude (1.08% +/- 0.17%) and delay (0.153 +/- 0.035 s) for different sentences compared to same sentences, together with a smaller but still significantly greater magnitude for different speaker compared to same speaker (0.47% +/- 0.08%).

An improved theoretical P value for SPMs based on discrete local maxima.

We present a new continuity correction to the P value for local maxima of a statistical parametric map that bridges the gap between small FWHM, when the Bonferroni correction is accurate, and large FWHM, when random field theory is accurate. The new method, based on discrete local maxima, is always an upper bound (like the Bonferroni), but lower and hence more accurate for large FWHM, without increasing false positives. It resulted in P values that were approximately 43% lower than the best of Bonferroni or random field theory methods when applied to a typical fMRI data set.

Spatial smoothing of autocorrelations to control the degrees of freedom in fMRI analysis.

In the statistical analysis of fMRI data, the parameter of primary interest is the effect of a contrast; of secondary interest is its standard error, and of tertiary interest is the standard error of this standard error, or equivalently, the degrees of freedom (df). In a ReML (Restricted Maximum Likelihood) analysis, we show how spatial smoothing of temporal autocorrelations increases the effective df (but not the smoothness of primary or secondary parameter estimates), so that the amount of smoothing can be chosen in advance to achieve a target df, typically 100. This has already been done at the second level of a hierarchical analysis by smoothing the ratio of random to fixed effects variances (Worsley, K.J., Liao, C., Aston, J.A.D., Petre, V., Duncan, G.H., Morales, F., Evans, A.C., 2002. A general statistical analysis for fMRI data. NeuroImage, 15:1-15); we now show how to do it at the first level, by smoothing autocorrelation parameters. The proposed method is extremely fast and it does not require any image processing. It can be used in conjunction with other regularization methods (Gautama, T., Van Hulle, M.M., in press. Optimal spatial regularisation of autocorrelation estimates in fMRI analysis. NeuroImage.) to avoid unnecessary smoothing beyond 100 df. Our results on a typical 6-min, TR = 3, 1.5-T fMRI data set show that 8.5-mm smoothing is needed to achieve 100 df, and this results in roughly a doubling of detected activations.

An overview and some new developments in the statistical analysis of PET and fMRI data.

The first part of this paper gives an overview of a simplified approach to the statistical analysis of PET and fMRI data, including new developments and future directions. The second part outlines a new method, based on multivariate linear models (MLM), for characterising the response in PET and fMRI data, which overcomes some of the drawbacks of current methods such as SSM, SVD, PLS and CVA.