Structural abnormalities in thalamo-prefrontal tracks revealed by high angular resolution diffusion imaging predict working memory scores in concussed children.

Because of their high prevalence, heterogeneous clinical presentation, and wide-ranging sequelae, concussions are a challenging neurological condition, especially in children. Shearing forces transmitted across the brain during concussions often result in white matter damage. The neuropathological impact of concussions has been discerned from animal studies and includes inflammation, demyelination, and axonal loss. These pathologies can overlap during the sub-acute stage of recovery. However, due to the challenges of accurately modeling complex white matter structure, these neuropathologies have not yet been differentiated in children in vivo. In the present study, we leveraged recent advances in diffusion imaging modeling, tractography, and tractometry to better understand the neuropathology underlying working memory problems in concussion. Studying a sample of 16 concussed and 46 healthy youths, we used novel tractography methods to isolate 11 working memory tracks. Along these tracks, we measured fractional anisotropy, diffusivities, track volume, apparent fiber density, and free water fraction. In three tracks connecting the right thalamus to the right dorsolateral prefrontal cortex (DLPFC), we found microstructural differences suggestive of myelin alterations. In another track connecting the left anterior-cingulate cortex with the left DLPFC, we found microstructural changes suggestive of axonal loss. Structural differences and tractography reconstructions were reproduced using test-retest analyses. White matter structure in the three thalamo-prefrontal tracks, but not the cingulo-prefrontal track, appeared to play a key role in working memory function. The present results improve understanding of working memory neuropathology in concussions, which constitutes an important step toward developing neuropathologically informed biomarkers of concussion in children.

The role of the pallidothalamic fibre tracts in deep brain stimulation for dystonia: A diffusion MRI tractography study.

BACKGROUND: Deep Brain Stimulation (DBS) of the Globus pallidus internus (GPi) is gold standard treatment in medically refractory dystonia. Recent evidence indicates that stimulation effects are also due to axonal modulation and affection of a fibre network. For the GPi, the pallidothalamic tracts are known to be the major motor efferent pathways. The aim of this study is to explore the anatomic vicinity of these tracts and DBS electrodes in dystonia applying diffusion tractography. METHODS: Diffusion MRI was acquired in ten patients presenting for DBS for dystonia. We applied both a conventionally used probabilistic tractography algorithm (FSL) as well as a probabilistic streamline tracking approach, based on constrained spherical deconvolution and particle filtering with anatomic priors, to the datasets. DBS electrodes were coregistered to the diffusion datasets. RESULTS: We were able to delineate the pallidothalamic tracts in all patients. Using the streamline approach, we were able to distinguish between the two sub-components of the tracts, the ansa lenticularis and the fasciculus lenticularis. Clinically efficient DBS electrodes displayed a close anatomic vicinity pathway of the pallidothalamic tracts, and their course was consistent with previous tracer labelling studies. Although we present only anatomic data, we interpret these findings as evidence of the possible involvement of fibre tracts to the clinical effect in DBS. Electrophysiological intraoperative recordings would be needed to complement our findings. In the future, a clear and individual delineation of the pallidothalamic tracts could optimize the stereotactic process of optimal electrode localization. Hum Brain Mapp 38:1224-1232, 2017. © 2016 Wiley Periodicals, Inc.

Structural network underlying visuospatial imagery in humans.

INTRODUCTION: Several neuroimaging studies have shown that visuospatial imagery is associated with a multitude of activation nodes spanning occipital, parietal, temporal and frontal brain areas. However, the anatomical connectivity profile linking these areas is not well understood. Specifically, it is unknown whether cortical areas activated during visuospatial imagery are directly connected to one another, or whether few act as hubs which facilitate indirect connections between distant sites. Addressing this is important since mental imagery tasks are commonly used in clinical settings to assess complex cognitive functions such as spatial orientation. METHODS: We recorded functional magnetic resonance imaging (fMRI) data while participants (N = 18) performed a visuospatial imagery task. In the same subjects, we acquired diffusion MRI (dMRI) and used state-of-the-art tractography robust to fiber crossings to reconstruct the white matter tracts linking the fMRI activation sites. For each pair of these sites, we then computed the fraction of subjects showing a connection between them. RESULTS: Robust fMRI activation was observed in cortical areas spanning the dorsal (extrastriate, parietal and prefrontal areas) and ventral (temporal and lingual areas) pathways, as well as moderate deactivation in striate visual cortex. In over 80% of subjects, striate cortex showed anatomical connectivity with extrastriate (medial occipital) and lingual (posterior cingulate cortex-PCC) sites with the latter showing divergent connections to ventral (parahippocampus) and dorsal (BA7) activation areas. CONCLUSION: Our results demonstrate that posterior cingulate cortex is not only activated by visuospatial imagery, but also serves as an anatomical hub linking activity in occipital, parietal and temporal areas. This finding adds to the growing body of evidence pointing to PCC as a connector hub which may facilitate integration across widespread cortical areas.