Using normative modeling to assess pharmacological treatment effect on brain state in patients with schizophrenia.

Quantifying individual differences in neuroimaging metrics is attracting interest in clinical studies with mental disorders. Schizophrenia is diagnosed exclusively based on symptoms, and the biological heterogeneity makes it difficult to accurately assess pharmacological treatment effects on the brain state. Using the Cambridge Centre for Ageing and Neuroscience data set, we built normative models of brain states and mapped the deviations of the brain characteristics of each patient, to test whether deviations were related to symptoms, and further investigated the pharmacological treatment effect on deviation distributions. Specifically, we found that the patients can be divided into 2 groups: the normalized group had a normalization trend and milder symptoms at baseline, and the other group showed a more severe deviation trend. The baseline severity of the depression as well as the overall symptoms could predict the deviation of the static characteristics for the dorsal and ventral attention networks after treatment. In contrast, the positive symptoms could predict the deviations of the dynamic fluctuations for the default mode and dorsal attention networks after treatment. This work evaluates the effect of pharmacological treatment on static and dynamic brain states using an individualized approach, which may assist in understanding the heterogeneity of the illness pathology as well as the treatment response.

Age-atypical brain functional networks in autism spectrum disorder: a normative modeling approach.

BACKGROUND: Despite extensive research into the neural basis of autism spectrum disorder (ASD), the presence of substantial biological and clinical heterogeneity among diagnosed individuals remains a major barrier. Commonly used case‒control designs assume homogeneity among subjects, which limits their ability to identify biological heterogeneity, while normative modeling pinpoints deviations from typical functional network development at individual level. METHODS: Using a world-wide multi-site database known as Autism Brain Imaging Data Exchange, we analyzed individuals with ASD and typically developed (TD) controls (total n = 1218) aged 5-40 years, generating individualized whole-brain network functional connectivity (FC) maps of age-related atypicality in ASD. We then used local polynomial regression to estimate a networkwise normative model of development and explored correlations between ASD symptoms and brain networks. RESULTS: We identified a subset exhibiting highly atypical individual-level FC, exceeding 2 standard deviation from the normative value. We also identified clinically relevant networks (mainly default mode network) at cohort level, since the outlier rates decreased with age in TD participants, but increased in those with autism. Moreover, deviations were linked to severity of repetitive behaviors and social communication symptoms. CONCLUSIONS: Individuals with ASD exhibit distinct, highly individualized trajectories of brain functional network development. In addition, distinct developmental trajectories were observed among ASD and TD individuals, suggesting that it may be challenging to identify true differences in network characteristics by comparing young children with ASD to their TD peers. This study enhances understanding of the biological heterogeneity of the disorder and can inform precision medicine.

Gray matter atrophy is constrained by normal structural brain network architecture in depression.

BACKGROUND: There is growing evidence that gray matter atrophy is constrained by normal brain network (or connectome) architecture in neuropsychiatric disorders. However, whether this finding holds true in individuals with depression remains unknown. In this study, we aimed to investigate the association between gray matter atrophy and normal connectome architecture at individual level in depression. METHODS: In this study, 297 patients with depression and 256 healthy controls (HCs) from two independent Chinese dataset were included: a discovery dataset (105 never-treated first-episode patients and matched 130 HCs) and a replication dataset (106 patients and matched 126 HCs). For each patient, individualized regional atrophy was assessed using normative model and brain regions whose structural connectome profiles in HCs most resembled the atrophy patterns were identified as putative epicenters using a backfoward stepwise regression analysis. RESULTS: In general, the structural connectome architecture of the identified disease epicenters significantly explained 44% (±16%) variance of gray matter atrophy. While patients with depression demonstrated tremendous interindividual variations in the number and distribution of disease epicenters, several disease epicenters with higher participation coefficient than randomly selected regions, including the hippocampus, thalamus, and medial frontal gyrus were significantly shared by depression. Other brain regions with strong structural connections to the disease epicenters exhibited greater vulnerability. In addition, the association between connectome and gray matter atrophy uncovered two distinct subgroups with different ages of onset. CONCLUSIONS: These results suggest that gray matter atrophy is constrained by structural brain connectome and elucidate the possible pathological progression in depression.

Heterogeneous brain dynamic functional connectivity patterns in first-episode drug-naive patients with major depressive disorder.

It remains challenging to identify depression accurately due to its biological heterogeneity. As people suffering from depression are associated with functional brain network alterations, we investigated subtypes of patients with first-episode drug-naive (FEDN) depression based on brain network characteristics. This study included data from 91 FEDN patients and 91 matched healthy individuals obtained from the International Big-Data Center for Depression Research. Twenty large-scale functional connectivity networks were computed using group information guided independent component analysis. A multivariate unsupervised normative modeling method was used to identify subtypes of FEDN and their associated networks, focusing on individual-level variability among the patients for quantifying deviations of their brain networks from the normative range. Two patient subtypes were identified with distinctive abnormal functional network patterns, consisting of 10 informative connectivity networks, including the default mode network and frontoparietal network. 16% of patients belonged to subtype I with larger extreme deviations from the normal range and shorter illness duration, while 84% belonged to subtype II with weaker extreme deviations and longer illness duration. Moreover, the structural changes in subtype II patients were more complex than the subtype I patients. Compared with healthy controls, both increased and decreased gray matter (GM) abnormalities were identified in widely distributed brain regions in subtype II patients. In contrast, most abnormalities were decreased GM in subtype I. The informative functional network connectivity patterns gleaned from the imaging data can facilitate the accurate identification of FEDN-MDD subtypes and their associated neurobiological heterogeneity.

Normative Analysis of Individual Brain Differences Based on a Population MRI-Based Atlas of Cynomolgus Macaques.

The developmental trajectory of the primate brain varies substantially with aging across subjects. However, this ubiquitous variability between individuals in brain structure is difficult to quantify and has thus essentially been ignored. Based on a large-scale structural magnetic resonance imaging dataset acquired from 162 cynomolgus macaques, we create a species-specific 3D template atlas of the macaque brain, and deploy normative modeling to characterize individual variations of cortical thickness (CT) and regional gray matter volume (GMV). We observed an overall decrease in total GMV and mean CT, and an increase in white matter volume from juvenile to early adult. Specifically, CT and regional GMV were greater in prefrontal and temporal cortices relative to early unimodal areas. Age-dependent trajectories of thickness and volume for each cortical region revealed an increase in the medial temporal lobe, and decreases in all other regions. A low percentage of highly individualized deviations of CT and GMV were identified (0.0021%, 0.0043%, respectively, P < 0.05, false discovery rate [FDR]-corrected). Our approach provides a natural framework to parse individual neuroanatomical differences for use as a reference standard in macaque brain research, potentially enabling inferences regarding the degree to which behavioral or symptomatic variables map onto brain structure in future disease studies.

The Vulvar Vernacular: Dilemmas Experienced and Strategies Recommended by Women with Chronic Genital Pain.

This manuscript uses Goldsmith's (2004) normative model of social support to explore conversations women have with a romantic partner about vulvodynia. Twenty-six women with vulvodynia participated in semi-structured interviews in which they described conversational goals, discussed challenges, and offered advice to others managing vulvodynia. As this study was concerned with interactions with romantic partners both present and past, women with vulvodynia, not their partners, were the targets of recruiting efforts. Two key communicative dilemmas emerged from the data analysis: (a) I need to talk to you, but I can't, and (b) I want to be honest, but not too honest. These dilemmas represent ambiguity about the causes and duration of pain and the implications that being unable to have pain-free intercourse has for their relationships and identities as women. Three strategies, communicative practices for managing dilemmas, also emerged: (a) reframe the illness, (b) refocus the relationship, and (c) redefine intimacy. The theoretical and practical implications of this research are socially situated within timely conversation about women, their bodies, and their roles.

Delineating the Heterogeneity of Alzheimer's Disease and Mild Cognitive Impairment Using Normative Models of Dynamic Brain Functional Networks.

BACKGROUND: Alzheimer's disease (AD), which has been identified as the most common type of dementia, presents considerable heterogeneity in its clinical manifestations. Early intervention at the stage of mild cognitive impairment (MCI) holds potential in AD prevention. However, characterizing the heterogeneity of neurobiological abnormalities and identifying MCI subtypes pose significant challenges. METHODS: We constructed sex-specific normative age models of dynamic brain functional networks and mapped the deviations of the brain characteristics for individuals from multiple datasets, including 295 patients with AD, 441 patients with MCI, and 1160 normal control participants. Then, based on these individual deviation patterns, subtypes for both AD and MCI were identified using the clustering method, and their similarities and differences were comprehensively assessed. RESULTS: Individuals with AD and MCI were clustered into 2 subtypes, and these subtypes exhibited significant differences in their intrinsic brain functional phenotypes and spatial atrophy patterns, as well as in disease progression and cognitive decline trajectories. The subtypes with positive deviations in AD and MCI shared similar deviation patterns, as did those with negative deviations. There was a potential transformation of MCI with negative deviation patterns into AD, and participants with MCI had a more severe cognitive decline rate. CONCLUSIONS: In this study, we quantified neurophysiological heterogeneity by analyzing deviation patterns from the dynamic functional connectome normative model and identified disease subtypes of AD and MCI using a comprehensive resting-state functional magnetic resonance imaging multicenter dataset. The findings provide new insights for developing early prevention and personalized treatment strategies for AD.

Natural ventilation cooling effectiveness classification for building design addressing climate characteristics.

The evaluation of natural ventilation potential for effective sustainable options and innovative green building design strategies is of great interest to architects, researchers and governments. From a retrospective review, we found that the potential evaluation of natural ventilation (NV) cooling effectiveness in the same category based on similar meteorological uncertainty, research objectives and objects showed significant differences. Uncertainties added and uncertainty propagation (both model form uncertainties and parameter uncertainties) could result in large discrepancies between simulation outcomes and real scenarios, especially in the design performance modeling (DPM) phase. In this conceptual design stage, a few parameters are available and therefore decisive. It is necessary to review and identify the key performance indicators and explore the extent to which deviations are caused by inconsistencies or biases in model information. As a basis for more concrete research, we propose statistical tests based on quantitative evaluations to explore the rule of natural ventilation potential volatility and identify whether there is a significant potential improvement resulting from the critical parameter enhancement with the optimal relationship. The showcase is applied in China, where there has been a significant amount of criticism regarding the current building climate zoning due to the perceived coarseness of the system and where there has been an active exploration into the possibility of redefining building climate zoning with a view toward improving its accuracy and effectiveness.

Smart self-propelled particles: a framework to investigate the cognitive bases of movement.

Decision-making and movement of single animals or group of animals are often treated and investigated as separate processes. However, many decisions are taken while moving in a given space. In other words, both processes are optimized at the same time, and optimal decision-making processes are only understood in the light of movement constraints. To fully understand the rationale of decisions embedded in an environment (and therefore the underlying evolutionary processes), it is instrumental to develop theories of spatial decision-making. Here, we present a framework specifically developed to address this issue by the means of artificial neural networks and genetic algorithms. Specifically, we investigate a simple task in which single agents need to learn to explore their square arena without leaving its boundaries. We show that agents evolve by developing increasingly optimal strategies to solve a spatially embedded learning task while not having an initial arbitrary model of movements. The process allows the agents to learn how to move (i.e. by avoiding the arena walls) in order to make increasingly optimal decisions (improving their exploration of the arena). Ultimately, this framework makes predictions of possibly optimal behavioural strategies for tasks combining learning and movement.

Understanding the heterogeneity of dynamic functional connectivity patterns in first-episode drug naïve depression using normative models.

BACKGROUND: The heterogeneity of the clinical symptoms and presumptive neural pathologies has stunted progress toward identifying reproducible biomarkers and limited therapeutic interventions' effectiveness for the first episode drug-naïve major depressive disorders (FEDN-MDD). This study combined the dynamic features of fMRI data and normative modeling to quantitative and individualized metrics for delineating the biological heterogeneity of FEDN-MDD. METHOD: Two hundred seventy-four adults with FEDN-MDD and 832 healthy controls from International Big-Data Center for Depression Research were included. Subject-specific dynamic brain networks and network fluctuation characteristics were computed for each subject using the group information-guided independent component analysis. Then, we mapped the heterogeneity of the dynamic features (network fluctuation characteristics and dynamic functional connectivity within brain networks) in the patients group via normative modeling. RESULTS: The FEDN-MDD whose network fluctuation characteristics deviate from the normative model also showed significant differences within the default mode network, executive control network, and limbic network compared with healthy controls. Furthermore, the network fluctuation characteristics are significantly increased in patients with FEDN-MDD. About 4.74 % of the patients showed a deviation of dynamic functional connectivity, and only 3.35 % of the controls deviated from the normative model in above 100 connectivities. More patients than healthy controls showed extreme dynamic variabilities in above 100 connectivities. CONCLUSIONS: This work evaluates the efficacy of an individualized approach based on normative modeling for understanding the heterogeneity of abnormal dynamic functional connectivity patterns in FEDN-MDD, and could be used as complementary to classical case-control comparisons.

Normative model detects abnormal functional connectivity in psychiatric disorders.

Introduction: The diagnosis of psychiatric disorders is mostly based on the clinical evaluation of the patient's signs and symptoms. Deep learning binary-based classification models have been developed to improve the diagnosis but have not yet reached clinical practice, in part due to the heterogeneity of such disorders. Here, we propose a normative model based on autoencoders. Methods: We trained our autoencoder on resting-state functional magnetic resonance imaging (rs-fMRI) data from healthy controls. The model was then tested on schizophrenia (SCZ), bipolar disorder (BD), and attention-deficit hyperactivity disorder (ADHD) patients to estimate how each patient deviated from the norm and associate it with abnormal functional brain networks' (FBNs) connectivity. Rs-fMRI data processing was conducted within the FMRIB Software Library (FSL), which included independent component analysis and dual regression. Pearson's correlation coefficients between the extracted blood oxygen level-dependent (BOLD) time series of all FBNs were calculated, and a correlation matrix was generated for each subject. Results and discussion: We found that the functional connectivity related to the basal ganglia network seems to play an important role in the neuropathology of BD and SCZ, whereas in ADHD, its role is less evident. Moreover, the abnormal connectivity between the basal ganglia network and the language network is more specific to BD. The connectivity between the higher visual network and the right executive control and the connectivity between the anterior salience network and the precuneus networks are the most relevant in SCZ and ADHD, respectively. The results demonstrate that the proposed model could identify functional connectivity patterns that characterize different psychiatric disorders, in agreement with the literature. The abnormal connectivity patterns from the two independent SCZ groups of patients were similar, demonstrating that the presented normative model was also generalizable. However, the group-level differences did not withstand individual-level analysis implying that psychiatric disorders are highly heterogeneous. These findings suggest that a precision-based medical approach, focusing on each patient's specific functional network changes may be more beneficial than the traditional group-based diagnostic classification.

Information maximization explains state-dependent synaptic plasticity and memory reorganization during non-rapid eye movement sleep.

Slow waves during the non-rapid eye movement (NREM) sleep reflect the alternating up and down states of cortical neurons; global and local slow waves promote memory consolidation and forgetting, respectively. Furthermore, distinct spike-timing-dependent plasticity (STDP) operates in these up and down states. The contribution of different plasticity rules to neural information coding and memory reorganization remains unknown. Here, we show that optimal synaptic plasticity for information maximization in a cortical neuron model provides a unified explanation for these phenomena. The model indicates that the optimal synaptic plasticity is biased toward depression as the baseline firing rate increases. This property explains the distinct STDP observed in the up and down states. Furthermore, it explains how global and local slow waves predominantly potentiate and depress synapses, respectively, if the background firing rate of excitatory neurons declines with the spatial scale of waves as the model predicts. The model provides a unifying account of the role of NREM sleep, bridging neural information coding, synaptic plasticity, and memory reorganization.

Hierarchical temporal prediction captures motion processing along the visual pathway.

Visual neurons respond selectively to features that become increasingly complex from the eyes to the cortex. Retinal neurons prefer flashing spots of light, primary visual cortical (V1) neurons prefer moving bars, and those in higher cortical areas favor complex features like moving textures. Previously, we showed that V1 simple cell tuning can be accounted for by a basic model implementing temporal prediction - representing features that predict future sensory input from past input (Singer et al., 2018). Here, we show that hierarchical application of temporal prediction can capture how tuning properties change across at least two levels of the visual system. This suggests that the brain does not efficiently represent all incoming information; instead, it selectively represents sensory inputs that help in predicting the future. When applied hierarchically, temporal prediction extracts time-varying features that depend on increasingly high-level statistics of the sensory input.

Mapping Neurophysiological Subtypes of Major Depressive Disorder Using Normative Models of the Functional Connectome.

BACKGROUND: Major depressive disorder (MDD) is a highly heterogeneous disorder that typically emerges in adolescence and can occur throughout adulthood. Studies aimed at quantitatively uncovering the heterogeneity of individual functional connectome abnormalities in MDD and identifying reproducibly distinct neurophysiological MDD subtypes across the lifespan, which could provide promising insights for precise diagnosis and treatment prediction, are still lacking. METHODS: Leveraging resting-state functional magnetic resonance imaging data from 1148 patients with MDD and 1079 healthy control participants (ages 11-93), we conducted the largest multisite analysis to date for neurophysiological MDD subtyping. First, we characterized typical lifespan trajectories of functional connectivity strength based on the normative model and quantitatively mapped the heterogeneous individual deviations among patients with MDD. Then, we identified neurobiological MDD subtypes using an unsupervised clustering algorithm and evaluated intersite reproducibility. Finally, we validated the subtype differences in baseline clinical variables and longitudinal treatment predictive capacity. RESULTS: Our findings indicated great intersubject heterogeneity in the spatial distribution and severity of functional connectome deviations among patients with MDD, which inspired the identification of 2 reproducible neurophysiological subtypes. Subtype 1 showed severe deviations, with positive deviations in the default mode, limbic, and subcortical areas and negative deviations in the sensorimotor and attention areas. Subtype 2 showed a moderate but converse deviation pattern. More importantly, subtype differences were observed in depressive item scores and the predictive ability of baseline deviations for antidepressant treatment outcomes. CONCLUSIONS: These findings shed light on our understanding of different neurobiological mechanisms underlying the clinical heterogeneity of MDD and are essential for developing personalized treatments for this disorder.

Cortical adaptation to sound reverberation.

In almost every natural environment, sounds are reflected by nearby objects, producing many delayed and distorted copies of the original sound, known as reverberation. Our brains usually cope well with reverberation, allowing us to recognize sound sources regardless of their environments. In contrast, reverberation can cause severe difficulties for speech recognition algorithms and hearing-impaired people. The present study examines how the auditory system copes with reverberation. We trained a linear model to recover a rich set of natural, anechoic sounds from their simulated reverberant counterparts. The model neurons achieved this by extending the inhibitory component of their receptive filters for more reverberant spaces, and did so in a frequency-dependent manner. These predicted effects were observed in the responses of auditory cortical neurons of ferrets in the same simulated reverberant environments. Together, these results suggest that auditory cortical neurons adapt to reverberation by adjusting their filtering properties in a manner consistent with dereverberation.

Detection of advanced brain aging in schizophrenia and its structural underpinning by using normative brain age metrics.

Conceptualizing mental disorders as deviations from normative functioning provides a statistical perspective for understanding the individual heterogeneity underlying psychiatric disorders. To broaden the understanding of the idiosyncrasy of brain aging in schizophrenia, we introduced an imaging-derived brain age paradigm combined with normative modeling as novel brain age metrics. We constructed brain age models based on GM, WM, and their combination (multimodality) features of 482 normal participants. The normalized predicted age difference (nPAD) was estimated in 147 individuals with schizophrenia and their 130 demographically matched controls through normative models of brain age metrics and compared between the groups. Regression analyses were also performed to investigate the associations of nPAD with illness duration, onset age, symptom severity, and intelligence quotient. Finally, regional contributions to advanced brain aging in schizophrenia were investigated. The results showed that the individuals exhibited significantly higher nPAD (P < 0.001), indicating advanced normative brain age than the normal controls in GM, WM, and multimodality models. The nPAD measure based on WM was positively associated with the negative symptom score (P = 0.009), and negatively associated with the intelligence quotient (P = 0.039) and onset age (P = 0.006). The imaging features that contributed to nPAD mostly involved the prefrontal, temporal, and parietal lobes, especially the precuneus and uncinate fasciculus. This study demonstrates that normative brain age metrics could detect advanced brain aging and associated clinical and neuroanatomical features in schizophrenia. The proposed nPAD measures may be useful to investigate aberrant brain aging in mental disorders and their brain-phenotype relationships.

Charting brain growth and aging at high spatial precision.

Defining reference models for population variation, and the ability to study individual deviations is essential for understanding inter-individual variability and its relation to the onset and progression of medical conditions. In this work, we assembled a reference cohort of neuroimaging data from 82 sites (N=58,836; ages 2-100) and used normative modeling to characterize lifespan trajectories of cortical thickness and subcortical volume. Models are validated against a manually quality checked subset (N=24,354) and we provide an interface for transferring to new data sources. We showcase the clinical value by applying the models to a transdiagnostic psychiatric sample (N=1985), showing they can be used to quantify variability underlying multiple disorders whilst also refining case-control inferences. These models will be augmented with additional samples and imaging modalities as they become available. This provides a common reference platform to bind results from different studies and ultimately paves the way for personalized clinical decision-making.

Towards the smart tourism destination: Key factors in information source use on the tourist shopping journey.

This paper aims to contribute to the knowledge on how the Smart Tourism Destination (STD) might enhance the Tourist Shopping Journey (TSJ) through offering information sources that meet visitors' needs and preferences. The CAN (Cognitive-Affective-Normative) model was employed to explore the antecedents of using information sources for purchases made in destinations. The importance of the cognitive variables performance and effort expectancy in the purchasing process are highlighted: tourists are pragmatic when consulting information sources in destinations. This study contributes to the knowledge of the role of information sources in TSJ behaviour, and can help managers in the development of STD strategies and services. It also opens new research lines by considering the TSJ as a hitherto unexamined holistic process.

Understanding Heterogeneity in Clinical Cohorts Using Normative Models: Beyond Case-Control Studies.

BACKGROUND: Despite many successes, the case-control approach is problematic in biomedical science. It introduces an artificial symmetry whereby all clinical groups (e.g., patients and control subjects) are assumed to be well defined, when biologically they are often highly heterogeneous. By definition, it also precludes inference over the validity of the diagnostic labels. In response, the National Institute of Mental Health Research Domain Criteria proposes to map relationships between symptom dimensions and broad behavioral and biological domains, cutting across diagnostic categories. However, to date, Research Domain Criteria have prompted few methods to meaningfully stratify clinical cohorts. METHODS: We introduce normative modeling for parsing heterogeneity in clinical cohorts, while allowing predictions at an individual subject level. This approach aims to map variation within the cohort and is distinct from, and complementary to, existing approaches that address heterogeneity by employing clustering techniques to fractionate cohorts. To demonstrate this approach, we mapped the relationship between trait impulsivity and reward-related brain activity in a large healthy cohort (N = 491). RESULTS: We identify participants who are outliers within this distribution and show that the degree of deviation (outlier magnitude) relates to specific attention-deficit/hyperactivity disorder symptoms (hyperactivity, but not inattention) on the basis of individualized patterns of abnormality. CONCLUSIONS: Normative modeling provides a natural framework to study disorders at the individual participant level without dichotomizing the cohort. Instead, disease can be considered as an extreme of the normal range or as-possibly idiosyncratic-deviation from normal functioning. It also enables inferences over the degree to which behavioral variables, including diagnostic labels, map onto biology.

Neural Variability and Sampling-Based Probabilistic Representations in the Visual Cortex.

Neural responses in the visual cortex are variable, and there is now an abundance of data characterizing how the magnitude and structure of this variability depends on the stimulus. Current theories of cortical computation fail to account for these data; they either ignore variability altogether or only model its unstructured Poisson-like aspects. We develop a theory in which the cortex performs probabilistic inference such that population activity patterns represent statistical samples from the inferred probability distribution. Our main prediction is that perceptual uncertainty is directly encoded by the variability, rather than the average, of cortical responses. Through direct comparisons to previously published data as well as original data analyses, we show that a sampling-based probabilistic representation accounts for the structure of noise, signal, and spontaneous response variability and correlations in the primary visual cortex. These results suggest a novel role for neural variability in cortical dynamics and computations.