Altered single-subject gray matter structural networks in drug-naïve attention deficit hyperactivity disorder children.

Altered topological organization of brain structural covariance networks has been observed in attention deficit hyperactivity disorder (ADHD). However, results have been inconsistent, potentially related to confounding medication effects. In addition, since structural networks are traditionally constructed at the group level, variabilities in individual structural features remain to be well characterized. Structural brain imaging with MRI was performed on 84 drug-naïve children with ADHD and 83 age-matched healthy controls. Single-subject gray matter (GM) networks were obtained based on areal similarities of GM, and network topological properties were analyzed using graph theory. Group differences in each topological metric were compared using nonparametric permutation testing. Compared with healthy subjects, GM networks in ADHD patients demonstrated significantly altered topological characteristics, including higher global and local efficiency and clustering coefficient, and shorter path length. In addition, ADHD patients exhibited abnormal centrality in corticostriatal circuitry including the superior frontal gyrus, orbitofrontal gyrus, medial superior frontal gyrus, precentral gyrus, middle temporal gyrus, and pallidum (all p < .05, false discovery rate [FDR] corrected). Altered global and nodal topological efficiencies were associated with the severity of hyperactivity symptoms and the performance on the Stroop and Wisconsin Card Sorting Test tests (all p < .05, FDR corrected). ADHD combined and inattention subtypes were differentiated by nodal attributes of amygdala (p < .05, FDR corrected). Alterations in GM network topologies were observed in drug-naïve ADHD patients, in particular in frontostriatal loops and amygdala. These alterations may contribute to impaired cognitive functioning and impulsive behavior in ADHD.

Large-scale white matter network reorganization in posttraumatic stress disorder.

Recently, graph theoretical approaches applied to neuroimaging data have advanced understanding of the human brain connectome and its abnormalities in psychiatric disorders. However, little is known about the topological organization of brain white matter networks in posttraumatic stress disorder (PTSD). Seventy-six patients with PTSD and 76 age, gender, and years of education-matched trauma-exposed controls were studied after the 2008 Sichuan earthquake using diffusion tensor imaging and graph theoretical approaches. Topological properties of brain networks including global and nodal measurements and modularity were analyzed. At the global level, patients showed lower clustering coefficient (p = .016) and normalized characteristic path length (p = .035) compared with controls. At the nodal level, increased nodal centralities in left middle frontal gyrus, superior and inferior temporal gyrus and right inferior occipital gyrus were observed (p < .05, corrected for false-discovery rate). Modularity analysis revealed that PTSD patients had significantly increased inter-modular connections in the fronto-parietal module, fronto-striato-temporal module, and visual and default mode modules. These findings indicate a PTSD-related shift of white matter network topology toward randomization. This pattern was characterized by an increased global network integration, reflected by increased inter-modular connections with increased nodal centralities involving fronto-temporo-occipital regions. This study suggests that extremely stressful life experiences, when they lead to PTSD, are associated with large-scale brain white matter network topological reconfiguration at global, nodal, and modular levels.

Reduced local segregation of single-subject gray matter networks in adult PTSD.

To psychoradiologically investigate the topological organization of single-subject gray matter networks in patients with PTSD. Eighty-nine adult PTSD patients and 88 trauma-exposed controls (TEC) underwent a structural T1 magnetic resonance imaging scan. The single-subject brain structural networks were constructed based on gray matter similarity of 90 brain regions. The area under the curve (AUC) of each network metric was calculated and both global and nodal network properties were measured in graph theory analysis. We used nonparametric permutation tests to identify group differences in topological metrics. Relationships between brain network measures and clinical symptom severity were analyzed in the PTSD group. Compared with TEC, brain networks of PTSD patients were characterized by decreased clustering coefficient (Cp ) (p = .04) and local efficiency (Eloc ) (p = .04). Locally, patients with PTSD exhibited altered nodal centrality involving medial superior frontal (mSFG), inferior orbital frontal (iOFG), superior parietal (SPG), middle frontal (MFG), angular, and para-hippocampal gyri (p < .05, corrected). A negative correlation between the segregation (Cp ) of gray matter and functional networks was found in PTSD patients but not the TEC group. Analyses of topological brain gray matter networks indicate a more randomly organized brain network in PTSD. The reduced segregation in gray matter networks and its negative relation with increased segregation in the functional network indicate an inverse relation between gray matter and functional changes. The present psychoradiological findings may reflect a compensatory increase in functional network segregation following a loss of segregation in gray matter networks.

Functional Brain Connectome and Its Relation to Hoehn and Yahr Stage in Parkinson Disease.

Purpose To use resting-state functional magnetic resonance (MR) imaging and graph theory approaches to investigate the brain functional connectome and its potential relation to disease severity in Parkinson disease (PD). Materials and Methods This case-control study was approved by the local research ethics committee, and all participants provided informed consent. There were 153 right-handed patients with PD and 81 healthy control participants recruited who were matched for age, sex, and handedness to undergo a 3-T resting-state functional MR examination. The whole-brain functional connectome was constructed by thresholding the Pearson correlation matrices of 90 brain regions, and the topologic properties were analyzed by using graph theory approaches. Nonparametric permutation tests were used to compare topologic properties, and their relationship to disease severity was assessed. Results The functional connectome in PD showed abnormalities at the global level (ie, decrease in clustering coefficient, global efficiency, and local efficiency, and increase in characteristic path length) and at the nodal level (decreased nodal centralities in the sensorimotor cortex, default mode, and temporal-occipital regions; P < .001, false discovery rate corrected). Further, the nodal centralities in left postcentral gyrus and left superior temporal gyrus correlated negatively with Unified Parkinson's Disease Rating Scale III score (P = .038, false discovery rate corrected, r = -0.198; and P = .009, false discovery rate corrected, r = -0.270, respectively) and decreased with increasing Hoehn and Yahr stage in patients with PD. Conclusion The configurations of brain functional connectome in patients with PD were perturbed and correlated with disease severity, notably with those responsible for motor functions. These results provide topologic insights into understanding the neural functional changes in relation to disease severity of PD. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on September 11, 2017.

Anatomic Insights into Disrupted Small-World Networks in Pediatric Posttraumatic Stress Disorder.

Purpose To use diffusion-tensor (DT) imaging and graph theory approaches to explore the brain structural connectome in pediatric posttraumatic stress disorder (PTSD). Materials and Methods This study was approved by the relevant research ethics committee, and all participants' parents or guardians provided informed consent. Twenty-four pediatric patients with PTSD and 23 control subjects exposed to trauma but without PTSD were recruited after the 2008 Sichuan earthquake. The structural connectome was constructed by using DT imaging tractography and thresholding the mean fractional anisotropy of 90 brain regions to yield 90 × 90 partial correlation matrixes. Graph theory analysis was used to examine the group-specific topologic properties, and nonparametric permutation tests were used for group comparisons of topologic metrics. Results Both groups exhibited small-world topology. However, patients with PTSD showed an increase in the characteristic path length (P = .0248) and decreases in local efficiency (P = .0498) and global efficiency (P = .0274). Furthermore, patients with PTSD showed reduced nodal centralities, mainly in the default mode, salience, central executive, and visual regions (P < .05, corrected for false-discovery rate). The Clinician-Administered PTSD Scale score was negatively correlated with the nodal efficiency of the left superior parietal gyrus (r = -0.446, P = .043). Conclusion The structural connectome showed a shift toward "regularization," providing a structural basis for functional alterations of pediatric PTSD. These abnormalities suggest that PTSD can be understood by examining the dysfunction of large-scale spatially distributed neural networks. © RSNA, 2016.

Epidemiological characteristics of Chinese paediatric traumatic brain injury inpatients.

PRIMARY OBJECTIVE: To investigate the epidemiological characteristics of paediatric inpatients with traumatic brain injury (TBI) in China. RESEARCH DESIGN: The Chinese Trauma Database (CTD), a nationwide register system based on hospital admission data, contains diagnosis and treatment information for trauma inpatients in over 200 military-managed public-service hospitals in China. Using the ICD-9 coding, the data for children with TBI aged 0-17 years between 2001 and 2007 were retrieved. METHODS AND PROCEDURES: The demographic characteristics, admission time, injury cause, severity and treatment outcomes of paediatric inpatients with TBI were analysed. MAIN OUTCOMES AND RESULTS: A total of 26,028 paediatric inpatients with TBI (69.52% male, 30.48% female) were included in the CTD. Motor vehicle traffic (MVT) accidents, falls and assaults were the primary causes of injury. Falls were the leading cause of TBI in children aged 0-4 years, and MVT was the leading cause of TBI in children aged 5-17 years. According to the abbreviated injury scale, 37.20% of the TBI cases were mild, 25.15% were moderate, 24.81% were severe and 12.84% were critically severe. CONCLUSION: Chinese authorities should develop targeted measures to reduce children injuries based on the leading causes of TBI in the different age groups, particularly MVT, falls and assaults.

Kudiezi Injection(®) Alleviates Blood-Brain Barrier Disruption After Ischemia-Reperfusion in Rats.

OBJECTIVE: This study was designed to examine the effect of KDZ, on the BBB disruption in rat underwent MCAO and reperfusion. METHODS: Male Sprague-Dawley rats (260-280 g) were subjected to 60 minutes MCAO followed by reperfusion. KDZ (4 mL/kg) was administrated before ischemia. The Evans blue extravasation, albumin leakage, brain water content, TJ proteins, caveolin-1, p-caveolin-1, Src, and p-Src were evaluated. Neurological scores, cerebral infarction, and CBF were assessed. The binding affinity of KDZ to Src was examined. RESULTS: I/R evoked a range of insults including Evans blue extravasation, albumin leakage, brain water content increase, CBF decrease, cerebral infarction, and neurological deficits, all of which were attenuated by KDZ. Meanwhile, KDZ inhibited TJ proteins down-expression, expression of caveolin-1, phosphorylation of caveolin-1 and Src after I/R. In addition, SPR revealed binding of KDZ to Src with high affinity. CONCLUSIONS: KDZ protects BBB from disruption and improves cerebral outcomes following I/R via preventing the degradation of TJ proteins, caveolin-1 expression, and inhibiting p-caveolin-1 and p-Src, which were most likely attributable to the ability of its main ingredients to bind to Src and inhibit its phosphorylation.

Disrupted brain network topology in pediatric posttraumatic stress disorder: A resting-state fMRI study.

Children exposed to natural disasters are vulnerable to the development of posttraumatic stress disorder (PTSD). Recent studies of other neuropsychiatric disorders have used graph-based theoretical analysis to investigate the topological properties of the functional brain connectome. However, little is known about this connectome in pediatric PTSD. Twenty-eight pediatric PTSD patients and 26 trauma-exposed non-PTSD patients were recruited from 4,200 screened subjects after the 2008 Sichuan earthquake to undergo a resting-state functional magnetic resonance imaging scan. Functional connectivity between 90 brain regions from the automated anatomical labeling atlas was established using partial correlation coefficients, and the whole-brain functional connectome was constructed by applying a threshold to the resultant 90 * 90 partial correlation matrix. Graph theory analysis was then used to examine the group-specific topological properties of the two functional connectomes. Both the PTSD and non-PTSD control groups exhibited "small-world" brain network topology. However, the functional connectome of the PTSD group showed a significant increase in the clustering coefficient and a normalized characteristic path length and local efficiency, suggesting a shift toward regular networks. Furthermore, the PTSD connectomes showed both enhanced nodal centralities, mainly in the default mode- and salience-related regions, and reduced nodal centralities, mainly in the central-executive network regions. The clustering coefficient and nodal efficiency of the left superior frontal gyrus were positively correlated with the Clinician-Administered PTSD Scale. These disrupted topological properties of the functional connectome help to clarify the pathogenesis of pediatric PTSD and could be potential biomarkers of brain abnormalities.

Disrupted Functional Brain Connectome in Patients with Posttraumatic Stress Disorder.

PURPOSE: To use resting-state functional magnetic resonance (MR) imaging and graph theory approaches to systematically investigate the topological organization of the functional connectome of patients with posttraumatic stress disorder (PTSD). MATERIALS AND METHODS: This study was approved by the research ethics committee, and all subjects provided informed consent for participation. Seventy-six patients with PTSD caused by an earthquake and 76 control subjects who experienced the same disaster were matched for age, sex, and years of education. The study subjects underwent resting-state functional MR imaging. The whole-brain functional network was then constructed by thresholding partial correlation matrices of 90 brain regions. The topological organization of the constructed network was analyzed by using graph theory approaches. Nonparametric permutation tests were also used for group comparisons of topological metrics. RESULTS: Compared with the control subjects, patients with PTSD exhibited abnormalities in global properties, including a significant decrease in path length (P = .0002) and increases in the clustering coefficient (P = .0014), global efficiency (P = .0002), and local efficiency (P = .0004). Locally, the patients with PTSD exhibited increased centrality in nodes that are predominately involved in the default-mode network (DMN) and the salience network (SN), including the posterior cingulate gyrus, the precuneus, the insula, the putamen, the pallidum, and the temporal regions. CONCLUSION: These results suggest that individuals with PTSD exhibit a shift toward "small-worldization" (in which the network transforms from a random or regular network to a small-world network) rather than toward randomization; furthermore, the disequilibrium between the DMN and the SN might be associated with the pathophysiology of PTSD.

Association of serum omentin-1 levels with coronary artery disease.

AIM: Omentin-1, a novel adipokine expressed in visceral adipose tissue, is negatively correlated with insulin resistance and obesity. Decreased omentin-1 expression has been found in many chronic inflammatory diseases. However, the role of omentin-1 in coronary artery disease (CAD) has not been elucidated. The aim of the present study was to determine whether serum concentration of omentin-1 was independently associated with CAD. METHODS: One hundred and fifty five patients with CAD were divided into two groups: acute coronary syndrome (ACS) and stable angina pectoris (SAP). A total of 52 healthy participants served as controls. Serum concentrations of omentin-1 and interleukin-6 (IL-6) were measured using ELISA. The association of omentin-1 with CAD and cardiovascular disease risk factors was evaluated. RESULTS: Serum omentin-1 levels were lower in patients with ACS or SAP compared with controls (ACS, 113.08±61.43 ng/mL; SAP, 155.41±66.89 ng/mL; control, 254.00±72.9 ng/mL; P<0.01). Patients with ACS also had lower serum concentrations of omentin-1 compared with patients with SAP (P<0.01). Serum concentration of omentin-1 was negatively correlated with body mass index (r=-0.17, P<0.05) and serum IL-6 concentration (r=-0.19, P<0.05). Furthermore, multiple logistic regression analysis showed that serum omentin-1 concentrations were independently correlated with CAD. CONCLUSION: The findings suggest that serum concentrations of omentin-1 are related to CAD.

Brain Functional Networks in Type 2 Diabetes Mellitus Patients: A Resting-State Functional MRI Study.

BACKGROUND: Previous diabetes mellitus studies of cognitive impairments in the early stages have focused on changes in brain structure and function, and more recently the focus has shifted to the relationships between encephalic regions and diversification of network topology. However, studies examining network topology in diabetic brain function are still limited. METHODS: The study included 102 subjects; 55 type 2 diabetes mellitus (T2DM) patients plus 47 healthy controls. All subjects were examined by resting-state functional magnetic resonance imaging (rs-fMRI) scan. According to Automated Anatomical Labeling, the brain was divided into 90 anatomical regions, and every region corresponds to a brain network analysis node. The whole brain functional network was constructed by thresholding the correlation matrices of the 90 brain regions, and the topological properties of the network were computed based on graph theory. Then, the topological properties of the network were compared between different groups by using a non-parametric test. Finally, the associations between differences in topological properties and the clinical indicators were analyzed. RESULTS: The brain functional networks of both T2DM patients and healthy controls were found to possess small-world characteristics, i.e., normalized clustering coefficient (γ) > 1, and normalized characteristic path length (λ) close to 1. No significant differences were found in the small-world characteristics (σ). Second, the T2DM patient group displayed significant differences in node properties in certain brain regions. Correlative analytic results showed that the node degree of the right inferior temporal gyrus (ITG) and the node efficiencies of the right ITG and superior temporal gyrus of T2DM patients were positively correlated with body mass index. CONCLUSION: The brain network of T2DM patients has the same small-world characteristics as normal people, but the normalized clustering coefficient is higher and the normalized characteristic path length is lower than that of the normal control group, indicating that the brain function network of the T2DM patients has changed. The changes of node properties were mostly concentrated in frontal lobe, temporal lobe and posterior cingulate gyrus. The abnormal changes in these indices in T2DM patients might be explained as a compensatory behavior to reduce cognitive impairments, which is achieved by mobilizing additional neural resources, such as the excessive activation of the network and the efficient networking of multiple brain regions.

Mental health of Automobile Transportation Troop personnel stationed in the Western Sichuan Plateau of China.

This study investigated the mental health of military transport personnel in the Western Sichuan Plateau of China, and factors that correlate with their mental health.The Symptom Checklist 90 (SCL-90) was used to investigate the mental health status of the subjects. Their scores were compared with the national and military norm in China. Demographic factors were analyzed for associations with SCL-90 scores.Psychological problems were detected in 28.90% of total 1076 male officers and soldiers surveyed. The SCL-90 scale somatization score of these servicemen was higher than the national and military norms in China, while other scores were comparable. The reported physical health symptoms and being an only child were strongly associated with the SCL-90 scores.The mental health of military transport personnel in the China Western Sichuan Plateau should receive more attention.

Disrupted Functional Network Topology in Children and Adolescents With Post-traumatic Stress Disorder.

Neuroimaging studies in children and adolescents with post-traumatic stress disorder (PTSD) have focused on abnormal structures and the functionality of a few individual brain regions. However, little is known about alterations to the topological organization of whole-brain functional networks in children and adolescents with PTSD. To this end, we investigated the topological properties of brain functional networks derived from resting-state functional magnetic resonance imaging (r-fMRI) in patients suffering from PTSD. The r-fMRI data were obtained from 10 PTSD patients and 16 trauma-exposed non-PTSD subjects. Graph theory analysis was used to investigate the topological properties of the two groups, and group comparisons of topological metrics were performed using nonparametric permutation tests. Both the PTSD and non-PTSD groups showed the functional brain network to have a small-world architecture. However, the PTSD group exhibited alterations in global properties characterized by higher global efficiency, lower clustering coefficient, and characteristic path length, implying a shift toward randomization of the networks. The PTSD group also showed increased nodal centralities, predominately in the left middle frontal gyrus, caudate nucleus, and hippocampus, and decreased nodal centralities in the left anterior cingulate cortex, left paracentral lobule, and bilateral thalami. In addition, the clustering coefficient and nodal betweenness of the left paracentral lobule were found to be negatively and positively correlated with the re-experiencing and hyper-arousal symptoms of PTSD respectively. The findings of disrupted topological properties of functional brain networks may help to better understand the pathophysiological mechanism of PTSD in children and adolescents.

Disrupted grey matter network morphology in pediatric posttraumatic stress disorder.

Introduction: Disrupted topological organization of brain functional networks has been widely observed in posttraumatic stress disorder (PTSD). However, the topological organization of the brain grey matter (GM) network has not yet been investigated in pediatric PTSD who was more vulnerable to develop PTSD when exposed to stress. Materials and methods: Twenty two pediatric PTSD patients and 22 matched trauma-exposed controls who survived a massive earthquake (8.0 magnitude on Richter scale) in Sichuan Province of western China in 2008 underwent structural brain imaging with MRI 8-15 months after the earthquake. Brain networks were constructed based on the morphological similarity of GM across regions, and analyzed using graph theory approaches. Nonparametric permutation testing was performed to assess group differences in each topological metric. Results: Compared with controls, brain networks of PTSD patients were characterized by decreased characteristic path length (P = 0.0060) and increased clustering coefficient (P = 0.0227), global efficiency (P = 0.0085) and local efficiency (P = 0.0024). Locally, patients with PTSD exhibited increased centrality in nodes of the default-mode (DMN), central executive (CEN) and salience networks (SN), involving medial prefrontal (mPFC), parietal, anterior cingulate (ACC), occipital and olfactory cortex and hippocampus. Conclusions: Our analyses of topological brain networks in children with PTSD indicate a significantly more segregated and integrated organization. The associations and disassociations between these grey matter findings and white matter (WM) and functional changes previously reported in this sample may be important for diagnostic purposes and understanding the brain maturational effects of pediatric PTSD.

Epidemiology of traumatic brain injury older inpatients in Chinese military hospitals, 2001-2007.

The incidence of traumatic brain injury (TBI) among older people has been significantly increased. Understanding the epidemiological characteristics, the causes of injury and the outcomes of TBI among older people provides value evidence for designing preventative measures and therapeutic interventions for TBI. In this study, using ICD-9-CM codes in the Chinese Trauma Database, we identified inpatients aged 65years and older diagnosed with TBI between 2001 and 2007 in Chinese military hospitals. Demographic characteristics, admission time, injury cause, injury severity, length of stay, hospitalization costs, and outcomes were systematically described. In total, 13,802 inpatients with TBI (63.13% males and 36.87% females) were identified from over 200 Chinese military hospitals. TBI diagnoses increased by a mean yearly rate of 7.78%; the annual admission peaked during the third quarter of the year, October in particular. The leading causes of TBI were motor vehicle traffic (48.37%) and fall-related incidents (38.89%). The severity of TBI in older inpatients was classified by the Abbreviated Injury Scale as minor (24.31%), serious (19.37%), severe (37.95%), and critical (18.37%). The mean length of stay was 17.87±23.31days, the median hospitalization cost was US$795, and the case fatality rate was 9.38%. These data substantiate that the design and implementation of proven and cost-effective preventive measures focusing on the leading causes of TBI in this population is essential.

Refractory hypotension induced by Sheehan syndrome with pituitary crisis: A case report.

The present study reported on an unusual case of refractory hypotension induced by Sheehan syndrome with pituitary crisis and explored the causes and treatment of hypotension in hypopiptuitarism. Refractory hypotension is a rare and severe complication of longstanding hypopituitarism induced by Sheehan syndrome with pituitary crisis. A 48-year-old Chinese woman with pituitary crisis due to Sheehan syndrome developed refractory hypotension and received longstanding vasopressor blood pressure support and hormone replacement therapy. Besides normalized blood pressure, echocardiography over 3 months revealed partial reversibility of her cardiac function with hormone replacement therapy. Consistent numerous studies reviewed, hormone replacement therapy may improve cardiac function in patients with cardiomyopathy linked to Sheehan syndrome. A retrospective study of 77 cases with hypopituitarism encountered at Qilu Hospital of Shandong University (Jinan, China) was also performed and the incidence rate of hypotension was analyzed, revealing that the present case was the first of refractory hypotension induced by Sheehan syndrome with pituitary crisis at this institution in 16 years.

An unusual mediastinal parathyroid carcinoma coproducing PTH and PTHrP: A case report.

Parathyroid carcinoma (PTCA) is a rare disease, and ectopic PTCA is particularly rare. Parathyroid hormone-related protein (PTHrP) expression in PTCA has not been previously described in the relevant literature to the best of our knowledge. The present study reports a unique case with a mediastinal parathyroid carcinoma producing parathyroid hormone (PTH) and PTHrP. A 53-year-old man presented with hyperparathyroidism symptoms, including fatigue, chest pain, dizziness, muscular soreness, polyuria, night sweats and renal stones. However, neck ultrasound revealed no significantly abnormal thyroid or parathyroid nodules. Tc99m methoxyisobutylisonitrile (Tc99m-MIBI) scintigraphy scanning indicated an ectopic mediastinal parathyroid adenoma. Histopathological examination revealed PTCA, and the tumor tissue was coproducing PTH and PTHrP. The patient underwent successful surgical operation. Serum calcium and PTH levels remained within normal ranges, and there was no tumor recurrence observed at a 3-year follow-up appointment. Although rare, ectopic parathyroid glands may lead to malignant disease. Clinical symptoms, biochemical tests, ultrasound and Tc99m-MIBI scintigraphy scanning may assist with the diagnosis of this disease. Hypersecretion of PTHrP and PTH contributed collaboratively to the pathogenesis of hypercalcemia due to PTCA. Complete surgical resection with microscopically negative margins is the recommended treatment for PTCA and offers the best chance of a cure.

Altered brain network topology in left-behind children: A resting-state functional magnetic resonance imaging study.

Whether a lack of direct parental care affects brain function in children is an important question, particularly in developing countries where hundreds of millions of children are left behind when their parents migrate for economic or political reasons. In this study, we investigated changes in the topological architectures of brain functional networks in left-behind children (LBC). Resting-state functional magnetic resonance imaging data were obtained from 26 LBC and 21 children living within their nuclear family (non-LBC). LBC showed a significant increase in the normalized characteristic path length (λ), suggesting a decrease in efficiency in information access, and altered nodal centralities in the fronto-limbic regions and motor and sensory systems. Moreover, a decreased nodal degree and the nodal betweenness of the right rectus gyrus were positively correlated with annual family income. The present study provides the first empirical evidence that suggests that a lack of direct parental care could affect brain functional development in children, particularly involving emotional networks.

Connectome-Scale Assessments of Functional Connectivity in Children with Primary Monosymptomatic Nocturnal Enuresis.

Primary monosymptomatic nocturnal enuresis (PMNE) is a common developmental disorder in children. Previous literature has suggested that PMNE not only is a micturition disorder but also is characterized by cerebral structure abnormalities and dysfunction. However, the biological mechanisms underlying the disease are not thoroughly understood. Graph theoretical analysis has provided a unique tool to reveal the intrinsic attributes of the connectivity patterns of a complex network from a global perspective. Resting-state fMRI was performed in 20 children with PMNE and 20 healthy controls. Brain networks were constructed by computing Pearson's correlations for blood oxygenation level-dependent temporal fluctuations among the 2 groups, followed by graph-based network analyses. The functional brain networks in the PMNE patients were characterized by a significantly lower clustering coefficient, global and local efficiency, and higher characteristic path length compared with controls. PMNE patients also showed a reduced nodal efficiency in the bilateral calcarine sulcus, bilateral cuneus, bilateral lingual gyri, and right superior temporal gyrus. Our findings suggest that PMNE includes brain network alterations that may affect global communication and integration.

Functional brain connectome and sensorimotor networks in rolandic epilepsy.

PURPOSE: Rolandic epilepsy (RE) is a form of well-characterized childhood epilepsy whose focal electroencephalographic abnormalities affect the same well-delineated local brain regions. Little is known about how the focal electroencephalographic discharges interfere with the topological organization of whole-brain networks in RE patients. METHODS: Seventy-three patients RE patients and 73 healthy children underwent rsfMRI. The whole-brain functional networks were constructed by thresholding the partial correlation matrices of 90 brain regions, and their topological properties were analyzed using graph theory-based approaches. We used network-based statistics to evaluate functional connectivity. The correlations between the network properties and the clinical and cognitive characteristics were calculated. RESULTS: The global topologic organization of the functional brain network was disrupted in RE patients, as manifested by reduced clustering coefficient and local and global efficiency and increased characteristic path length. The RE patients exhibited less connectivity among the sensorimotor areas; this reduction in the mean functional connectivity in this network correlated to altered global small-world properties. The RE patients exhibited decreased nodal centralities, predominantly in the bilateral postcentral gyrus, in the frontal, parietal and temporal lobes around the rolandic fissure and in areas related to linguistics and attention control (p<0.05, FDR-corrected). The altered nodal centralities in the bilateral postcentral gyrus and the left posterior cingulate cortex were correlated with subscales in Child Behavior Checklist. CONCLUSIONS: These results support the hypothesis that RE is associated with systemic brain disorganization and that the functional defect in rolandic areas contribute to symptomatology and electrophysiology in RE. Nodal abnormalities appear to imply the disturbances in linguistics and attention observed in RE patients.