Dissociable brainstem functional connectivity changes correlate with objective and subjective vigilance decline after total sleep deprivation in healthy male subjects.

The maintenance of vigilance relies on the activation of the cerebral cortex by the arousal system centered on the brainstem. Previous studies have suggested that both objective and subjective vigilance are susceptible to sleep deprivation. This study aims to explore the alterations in brainstem arousal system functional connectivity (FC) and its involvement in these two types of vigilance decline following total sleep deprivation (TSD). Thirty-seven healthy male subjects underwent two counterbalanced resting-state fMRI scans, once in rested wakefulness (RW) and once after 36 h of TSD. The pontine tegmental area and caudal midbrain (PTA-cMidbrain), the core regions of the brainstem arousal system, were chosen as the seeds for FC analysis. The difference in PTA-cMidbrain FC between RW and TSD conditions was then investigated, as well as its associations with objective vigilance measured by psychomotor vigilance task (PVT) and subjective vigilance measured by Stanford Sleepiness Scale. The sleep-deprived subjects showed increased PTA-cMidbrain FC with the thalamus and cerebellum and decreased PTA-cMidbrain FC with the occipital, parietal, and sensorimotor regions. TSD-induced increases in PVT reaction time were negatively correlated with altered PTA-cMidbrain FC in the dorsolateral prefrontal cortex, extrastriate visual cortex, and precuneus. TSD-induced increases in subjective sleepiness were positively correlated with altered PTA-cMidbrain FC in default mode regions including the medial prefrontal cortex and precuneus. Our results suggest that different brainstem FC patterns underlie the objective and subjective vigilance declines induced by TSD.

Regional Homogeneity Alterations in Patients with Impaired Consciousness. An Observational Resting-State fMRI Study.

PURPOSE: It is always challenging to correctly differentiate between minimally conscious state (MCS) and vegetative state/unresponsive wakefulness syndrome (VS/UWS) among disorders of consciousness (DOC) patients. However, the underlying neural mechanisms of awareness identification remain incompletely understood. METHODS: Using regional homogeneity (ReHo) analysis, we evaluated how regional connectivity of brain regions is disrupted in MCS and VS/UWS patients. Resting-state functional magnetic resonance imaging was conducted in 14 MCS patients, 25 VS/UWS patients, and 30 age-matched healthy individuals. RESULTS: We found that MCS and VS/UWS patients demonstrated DOC-dependent reduced ReHo within widespread brain regions including posterior cingulate cortices (PCC), medial prefrontal cortices (mPFC), and bilateral fronto-parieto-temporal cortices and showed increased ReHo in limbic structures. Moreover, a positive correlation between Coma Recovery Scale-Revised (CRS-R) total scores and reduced ReHo in the left precuneus was observed in VS/UWS patients, despite the linear trend was not found in MCS patients. In addition, ReHo were also observed reduced in three mainly intrinsic connectivity networks (ICNs), including default mode network (DMN), executive control network (ECN), and salience network (SN). Notably, as the clinical symptoms of consciousness disorders worsen from MCS to VS/UWS, ReHo in dorsal DMN, left ECN, and posterior SN became significantly reduced. CONCLUSION: These findings make a further understanding of the underlying neural mechanism of regional connectivity among DOC patients and provide additional neuroimaging-based biomarkers for the clinical diagnosis of MCS and VS/UWS patients.

Thoughts of death affect reward learning by modulating salience network activity.

Thoughts of death substantially influence human behavior and psychological well-being. A large number of behavioral studies have shown evidence that asking individuals to think about death or mortality salience leads to significant changes of their behaviors. These findings support the well-known terror management theory to account for the psychological mechanisms of existential anxiety. However, despite increasing findings of mortality salience effects on human behavior, how the brain responds to reminders of mortality and changes the activity underlying subsequent behavior remains poorly understood. By scanning healthy adults (N = 80) of both sexes using functional magnetic resonance imaging, we showed that, relative to reading emotionally neutral sentences, reading sentences that evoke death-related thoughts decreased the salience network activity, reduced the connectivity between the cingulate cortex and other brain regions during a subsequent resting state, and dampened the speed of learning reward-related objects and cingulate responses to loss feedback during a subsequent reward learning task. In addition, the decreased resting-state cingulate connectivity mediated the association between salience network deactivations in response to reminders of mortality and suppressed cingulate responses to loss feedback. Finally, the suppressed cingulate responses to loss feedback further predicted the dampened speed of reward learning. Our findings demonstrate sequential modulations of the salience network activity by mortality salience, which provide a neural basis for understanding human behavior under mortality threat.

Linearity, Bias, and Precision of Hepatic Proton Density Fat Fraction Measurements by Using MR Imaging: A Meta-Analysis.

Purpose To determine the linearity, bias, and precision of hepatic proton density fat fraction (PDFF) measurements by using magnetic resonance (MR) imaging across different field strengths, imager manufacturers, and reconstruction methods. Materials and Methods This meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search identified studies that evaluated the linearity and/or bias of hepatic PDFF measurements by using MR imaging (hereafter, MR imaging-PDFF) against PDFF measurements by using colocalized MR spectroscopy (hereafter, MR spectroscopy-PDFF) or the precision of MR imaging-PDFF. The quality of each study was evaluated by using the Quality Assessment of Studies of Diagnostic Accuracy 2 tool. De-identified original data sets from the selected studies were pooled. Linearity was evaluated by using linear regression between MR imaging-PDFF and MR spectroscopy-PDFF measurements. Bias, defined as the mean difference between MR imaging-PDFF and MR spectroscopy-PDFF measurements, was evaluated by using Bland-Altman analysis. Precision, defined as the agreement between repeated MR imaging-PDFF measurements, was evaluated by using a linear mixed-effects model, with field strength, imager manufacturer, reconstruction method, and region of interest as random effects. Results Twenty-three studies (1679 participants) were selected for linearity and bias analyses and 11 studies (425 participants) were selected for precision analyses. MR imaging-PDFF was linear with MR spectroscopy-PDFF (R2 = 0.96). Regression slope (0.97; P < .001) and mean Bland-Altman bias (-0.13%; 95% limits of agreement: -3.95%, 3.40%) indicated minimal underestimation by using MR imaging-PDFF. MR imaging-PDFF was precise at the region-of-interest level, with repeatability and reproducibility coefficients of 2.99% and 4.12%, respectively. Field strength, imager manufacturer, and reconstruction method each had minimal effects on reproducibility. Conclusion MR imaging-PDFF has excellent linearity, bias, and precision across different field strengths, imager manufacturers, and reconstruction methods. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on October 2, 2017.

[Quantitative evaluation of white matter development in fetus with growth restriction by diffusion tensor imaging].

OBJECTIVE: To investigate whether fetal growth restriction (FGR) has an adverse effect on white matter development. METHODS: A total of 28 full-term small for gestational age (SGA) infants were enrolled as study subjects and 15 full-term appropriate for gestational age infants were enrolled as control group. Conventional head magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were performed for all infants. The white matter was divided into 122 regions. The two groups were compared in terms of fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity of different brain regions. RESULTS: Compared with the control group, the SGA group had a significantly lower fractional anisotropy in 16 brain regions (P<0.01), a significantly higher mean diffusivity in 7 brain regions (P<0.05), a significantly higher axial diffusivity in 8 brain regions (P<0.05), and a significantly higher radial diffusivity in 16 brain regions (P<0.05). CONCLUSIONS: FGR may cause abnormalities in the maturity and integrity of white matter fiber tracts.

Neural correlates of reflection on actual versus ideal self-discrepancy.

Subjective feelings of actual/ideal self-discrepancy vary across individuals and influence one's own affective states. However, the neural correlates of actual/ideal self-discrepancy and their genetic individual differences remain unknown. We investigated neural correlates of actual/ideal self-discrepancy and their associations with the serotonin transporter promoter polymorphism (5-HTTLPR) that moderates human affective states during self-reflection. We scanned short/short and long/long allele carriers of 5-HTTLPR, using functional MRI, during reflection on the distance between actual and ideal self in personality traits. We found that larger actual/ideal self-discrepancy was associated with activations in the ventral/dorsal striatum and dorsal medial and lateral prefrontal cortices. Moreover, these brain activities were stronger in short/short than long/long allele carriers and predicted self-report of life satisfaction in short/short carriers but trait depression in long/long carriers. Our findings revealed neural substrates of actual/ideal self-discrepancy and their associations with affective states that are sensitive to individuals' genetic makeup.

Effect of gadolinium on hepatic fat quantification using multi-echo reconstruction technique with T2* correction and estimation.

OBJECTIVES: To determine whether hepatic fat quantification is affected by administration of gadolinium using a multiecho reconstruction technique with T2* correction and estimation. METHODS: Forty-eight patients underwent the investigational sequence for hepatic fat quantification at 3.0T MRI once before and twice after administration of gadopentetate dimeglumine (0.1 mmol/kg). A one-way repeated-measures analysis of variance with pairwise comparisons was conducted to evaluate the systematic bias of fat fraction (FF) and R2* measurements between three acquisitions. Bland-Altman plots were used to assess the agreements between pre- and post-contrast FF measurements in the liver. A P value <0.05 indicated statistically significant difference. RESULTS: FF measurements of liver, spleen and spine revealed no significant systematic bias between the three measurements (P > 0.05 for all). Good agreements (95 % confidence interval) of FF measurements were demonstrated between pre-contrast and post-contrast1 (-0.49 %, 0.52 %) and post-contrast2 (-0.83 %, 0.77 %). R2* increased in liver and spleen (P = 0.039, P = 0.01) after administration of gadolinium. CONCLUSIONS: Although under the impact of an increased R2* in liver and spleen post-contrast, the investigational sequence can still obtain stable fat quantification. Therefore, it could be applied post-contrast to substantially increase the efficiency of MR examination and also provide a backup for the occasional failure of FF measurements pre-contrast. KEY POINTS: • Fat quantification with IDEAL-based investigational sequence remains stable after gadolinium administration. • It can be integrated into tri-phase liver MRI without adding scan time. • This helps optimize MR protocols and provides more useful information for clinicians.

Mortality salience enhances racial in-group bias in empathic neural responses to others' suffering.

Behavioral research suggests that mortality salience (MS) leads to increased in-group identification and in-group favoritism in prosocial behavior. What remains unknown is whether and how MS influences brain activity that mediates emotional resonance with in-group and out-group members and is associated with in-group favoritism in helping behavior. The current work investigated MS effects on empathic neural responses to racial in-group and out-group members' suffering. Experiments 1 and 2 respectively recorded event related potentials (ERPs) and blood oxygen level dependent signals to pain/neutral expressions of Asian and Caucasian faces from Chinese adults who had been primed with MS or negative affect (NA). Experiment 1 found that an early frontal/central activity (P2) was more strongly modulated by pain vs. neutral expressions of Asian than Caucasian faces, but this effect was not affected by MS vs. NA priming. However, MS relative to NA priming enhanced racial in-group bias in long-latency neural response to pain expressions over the central/parietal regions (P3). Experiment 2 found that MS vs. NA priming increased racial in-group bias in empathic neural responses to pain expression in the anterior and mid-cingulate cortex. Our findings indicate that reminding mortality enhances brain activity that differentiates between racial in-group and out-group members' emotional states and suggest a neural basis of in-group favoritism under mortality threat.

Abnormal resting-state functional connectivity of the nucleus accumbens in multi-year abstinent heroin addicts.

Functional neuroimaging studies suggest that abnormal brain functional connectivity may be the neural underpinning of addiction to illicit drugs and of relapse after successful cessation therapy. Aberrant brain networks have been demonstrated in addicted patients and in newly abstinent addicts. However, it is not known whether abnormal brain connectivity patterns persist after prolonged abstinence. In this cross-sectional study, whole-brain resting-state functional magnetic resonance images (8 min) were collected from 30 heroin-addicted individuals after a long period of abstinence (more than 3 years) and from 30 healthy controls. We first examined the group differences in the resting-state functional connectivity of the nucleus accumbens (NAc), a brain region implicated in relapse-related processes, including craving and reactivity to stress following acute and protracted withdrawal from heroin. We then examined the relation between the duration of abstinence and the altered NAc functional connectivity in the heroin group. We found that, compared with controls, heroin-dependent participants exhibited significantly greater functional connectivity between the right ventromedial prefrontal cortex and the NAc and weaker functional connectivity between the NAc and the left putamen, left precuneus, and supplementary motor area. However, with longer abstinence time, the strength of NAc functional connectivity with the left putamen increased. These results indicate that dysfunction of the NAc functional network is still present in long-term-abstinent heroin-dependent individuals.

Paraneoplastic neurological syndromes (PNS) caused by occult breast cancer and metastatic carcinoma of the lymph node.

Paraneoplastic neurological syndromes (PNS) are immune-mediated, subacute, and progressive syndromes caused by remote effects of malignant tumours rather than the direct infiltration of tumours. The most common maladies related to PNS are small cell lung cancer, breast and ovarian cancer, and Hodgkin's lymphoma. Diagnoses of PNS frequently precede tumour diagnoses because the primary tumour is often occult. It is difficult for clinicians to recognise PNS, because there are various neurological symptoms and signs in the patient but few abnormal results of the examinations. The examination of paraneoplastic panels (cerebrospinal fluid (CSF) and serum) is useful in the diagnosis of PNS, but the false negatives should be considered. Due to the severe neurological morbidity and mortality caused by PNS, early diagnoses are important to allow for time to treat the underlying tumour and to obtain functional improvement. It is worth noting that regular re-examination and follow-up are crucial for reducing the rates of misdiagnosis and missed diagnosis of PNS.

Factors influencing risky decision-making in patients with cerebral infarction.

Numerous studies have found that the framing effect is common in medical scenarios, but few studies have examined the influence of the framing effect upon thrombolytic therapy for cerebral infarction. In this study, 1040 inpatients and outpatients in the department of neurology were recruited to explore whether there is a framing effect in decision-making within thrombolytic therapy, and if so, which factors influence that effect. The findings from Study 1 indicate that the framing effect occurred in patients both with and without cerebral infarction (χ(2) = 7.90, p = .005; χ(2) = 5.16, p = .023, respectively), with both groups displaying risk-seeking behavior (thrombolytic therapy) in the positive frame and no risk aversion or risk seeking in the negative frame. The results of Study 2 show that the patients preferred risk seeking in both collaborative and individual decision-making. In the collaborative decision-making group, the patients in the senior group showed the framing effect (χ(2) = 5.35, p < .05), with the patients in the positive frame (G) showing more significant risk seeking than both those in the negative frame (H) and those in the other positive frame (A, C, and E). In summary, decision-making about thrombolytic therapy in patients with cerebral infarction is influenced by the framing effect, and some influencing factors should be attended in clinical practice. Further research is necessary to guide the treatment of cerebral infarction.

Intra- and interscanner reliability and reproducibility of 3D whole-brain pseudo-continuous arterial spin-labeling MR perfusion at 3T.

PURPOSE: To assess the reliability and reproducibility of pseudo-continuous arterial spin labeling (pCASL). Intra- and interscanner reliability and reproducibility are essential before pooling perfusion imaging data. MATERIALS AND METHODS: Eight volunteers were scanned three times on two 3.0T magnetic resonance imaging (MRI) scanners using the pCASL technique. The first and third tests were conducted on scanner one, while the second test was on scanner two. The pCASL was acquired with postlabeling delay time (PLD) of 1.5 and 2.5 seconds. The cerebral blood flow (CBF) of gray matter, white matter, frontal lobe, parietal lobe, occipital lobe, temporal lobe, putamen, posterior cingulate, and thalamus were extracted for comparison. Reliability and reproducibility were measured using the intraclass correlation coefficient (ICC) and within-subject coefficients of variation (wsCV), respectively. RESULTS: The pCASL consistently had high intra- and interscanner measurement reliability and reproducibility. Reproducibility of the CBF values was higher, with PLD 2.5 seconds than with PLD 1.5 seconds. Different PLDs had considerable influence on the reproducibility of the different regions of the brain. CONCLUSION: Although excellent intra- and interscanner reliability and reproducibility could support the feasibility of cross-site pooling of ASL data, pCASL with multiple PLDs may better assess the CBF of the human brain.

Brain structural plasticity in visual and sensorimotor areas of airline pilots: A voxel-based morphometric study.

BACKGROUND AND PURPOSE: Airline pilot is a highly specialized profession that requires to response quickly and accurately in the presence of a wide variety of visual information. Although functional imaging studies have employed virtual simulation to identify brain areas that underlie various flying-related tasks, little is known about the specific patterns of structural plasticity in the airline pilot's brain. MATERIALS AND METHODS: In this study, we examined differences of gray matter and white matter volumes between 42 airline pilots and 39 non-pilots by using voxel-based morphometry, and further assessed the association between magnitude of structural alterations and flight time in the pilots. RESULTS: We found significantly increased white matter volume in the cuneus area in the pilot group compared to the non-pilot group (p < 0.05, FWE corrected). Using a relaxed threshold, it was also observed that the pilots had increased gray matter volume in the lingual gyrus, inferior frontal gyrus, supramarginal gyrus, cuneus, and postcentral gyrus, and increased white matter volume in the postcentral area (p < 0.001, uncorrected). Moreover, the pilots' flight time was positively correlated with gray matter volume in the postcentral gyrus and white matter volume in the cuneus area (p < 0.001, uncorrected). CONCLUSIONS: The morphological changes in specific visual and sensorimotor areas may provide airline pilots with neural efficiency in the visuo-motor processing related to flight.

Cognitive and neural bases of decision-making causing civilian casualties during intergroup conflict.

Civilian casualties occur during military attacks. Such 'collateral damage' is prohibited by international laws but increases with substantial consequences when intergroup conflict escalates. Here, we investigate cognitive and neural bases of decision-making processes resulting in civilian harm, using a task that simulates punishment decision-making during intergroup conflict. We test two groups of Chinese participants in a laboratory setting, and members of two ethnic groups (Jewish and Palestinian) in Israel. The results dissociate two psychological constructs, harm preference and harm avoidance, which respectively characterize punishment decision-making related to outgroup combatants and outgroup noncombatants during intergroup conflict. In particular, individuals show decreased avoidance of harming outgroup noncombatants when conflict escalates. Brain imaging (functional magnetic resonance imaging) reveals that decreased harm avoidance is predicted by inhibition of the left middle frontal activity during selection of punishment decisions. Our findings provide insight into the cognitive and neural bases of decision-making involving civilian harm during intergroup conflict.

A neurobiological association of revenge propensity during intergroup conflict.

Revenge during intergroup conflict is a human universal, but its neurobiological underpinnings remain unclear. We address this by integrating functional MRI and measurements of endogenous oxytocin in participants who view an ingroup and an outgroup member's suffering that is caused mutually (Revenge group) or by a computer (Control group). We show that intergroup conflict encountered by the Revenge group is associated with an increased level of oxytocin in saliva compared to that in the Control group. Furthermore, the medial prefrontal activity in response to ingroup pain in the Revenge group but not in the Control group mediates the association between endogenous oxytocin and the propensity to give painful electric shocks to outgroup members, regardless of whether they were directly involved in the conflict. Our findings highlight an important neurobiological correlate of revenge propensity, which may be implicated in conflict contagion across individuals in the context of intergroup conflict.

Self-construals moderate associations between trait creativity and social brain network.

Creativity is an adaptive way of thinking and plays a key role in problem solving. Recent brain imaging studies focused on structural and functional characteristics of the brain that are correlated with creativity. But whether and how the association between creativity and the brain is moderated by individuals' cultural traits remains unclear. We integrated functional magnetic resonance imaging (fMRI) and questionnaire measures (Williams creativity aptitude test) of trait creativity and self-construal (e.g., interdependence) in male adults to examine whether trait creativity is associated with neural activities underlying social cognition and whether and how the association is moderated by individuals' self-construals. We found that interdependence moderates the association between trait creativity and neural activities in the left superior temporal sulcus, right anterior insular, right temporal-parietal junction and right precentral gyrus engaged in reflection of one's own social attributes. Interdependence also moderates the association between trait creativity and neural activities in the left superior temporal sulcus and right posterior insular involved in reflection of a friend's social attributes. The link of trait creativity and the functional connectivity between the medial prefrontal cortex and postcentral gyri during reflection of a friend's social attributes is also moderated by interdependence. Participants with high and low creativity traits can be dissociated in a three-dimension space defined by integration of interdependence and the brain activity underlying reflection of one's own and the friend's attributes. Our findings suggest that trait creativity is imprinted on the social brain and the link between trait creativity and the neural activities underlying the processing of self and others is moderated by a cultural trait.

Fat poor angiomyolipoma differentiation from renal cell carcinoma at 320-slice dynamic volume CT perfusion.

PURPOSE: To compare various CT perfusion features of fat poor angiomyolipoma (AML) with those of size-matched renal cell carcinoma (RCC). METHODS: One hundred and seventy-four patients [16 with fat poor AML (mean diameter, 3.1 cm; range, 1.5-5.5 cm) and 158 with RCC (mean diameter, 3.2 cm; range, 2.4-5.4 cm)] who had undergone 320-slice dynamic volume CT perfusion were evaluated. Equivalent blood volume (BV Equiv), permeability surface-area product (PS), and blood flow (BF) of tumor were measured and analyzed. Fat poor AML was compared with each subtype of RCC (132 clear cell, 9 papillary, and 17 chromophobe). Receiver operating characteristic (ROC) curve analysis was performed for the comparison of fat poor AML and RCC. ROC curve analysis was not performed for the papillary RCC subtype because of the small number of masses of this subtype. RESULTS: BV Equiv and BF were significantly lower in fat poor AML than in clear cell RCC (P < 0.05 for both). Fat poor AML had higher BV Equiv, PS, and BF than papillary RCC (P < 0.05 for all). PS and BF in fat poor AML significantly exceeded those in chromophobe RCC (P < 0.05 for both). For differentiating fat poor AML from clear cell RCC, area under the ROC curve (AUC) of BV Equiv and BF were 0.82 and 0.69. Using the optimal threshold value, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 0.82, 0.81, 0.35, 0.97 for BV Equiv and 0.71, 0.75, 0.24, 0.96 for BF, respectively. For differentiating fat poor AML from chromophobe RCC, AUC of PS and BF were 0.77 and 0.79, respectively. The optimal sensitivity, specificity, PPV, and NPV were 0.77, 0.75, 0.75, 0.76 for PS and 0.71, 0.81, 0.72, 0.80 for BF, respectively. CONCLUSIONS: Fat poor AML and subtypes of RCCs demonstrate different perfusion features at 320-slice dynamic volume CT, allowing their differentiations with BV Equiv, PS, and BF being valuable perfusion parameters.

Could Arterial Spin Labeling Distinguish Patients in Minimally Conscious State from Patients in Vegetative State?

PURPOSE: Diagnostic error is common among patients with vegetative state (VS) and minimally conscious state (MCS). The purpose of this article is to use three-dimensional pseudo-continuous arterial spin labeling (pcASL) to compare cerebral blood flow (CBF) patterns in patients in MCS with those in VS. METHODS: Patients meeting MCS and VS criteria were identified. Two post-labeling delay (PLD) time pcASL on 3.0-Tesla magnetic resonance imaging scanner system were performed with patients in the resting awake state. After registration to T1WI structure imaging, multiple brain regions of interest of ASL CBF map were automatically separated. The average CBF value of every brain region was calculated and compared between the MCS and VS groups with t-tests. RESULTS: Fifteen patients with VS were identified, with ages ranging from 33 to 71 years. Eight patients who met the MCS criteria ranged in age from 23 to 61 years. Compared with VS, the regional CBF for MCS had a pattern of significantly increased CBF in the regions including the putamen, anterior cingulate gyrus, and medial frontal cortex. A left-lateralized pattern was observed to differentiate MCS from VS. CBF with PLD 2.5 s could find more regions of pattern differentiating MCS from VS than with PLD 1.5 s, except for the pallidum. CONCLUSION: MCS might be differentiated from VS by different ranges of regional CBF as measured by ASL. Multi-PLD ASL may serve as an adjunct method to separate MCS from VS and assess functional reserve in patients recovering from severe brain injuries.

White matter integrity correlates with residual consciousness in patients with severe brain injury.

Previous studies have suggested that white matter disruption plays an important role in disorders of consciousness (DOC) after severe brain injury. Nevertheless, the integrity of white matter architecture supporting consciousness and its relations with clinical severity in patients with DOC remain to be established. In this study, diffusion tensor imaging (DTI) data was collected from 14 DOC patients and 15 healthy control subjects. We combined tract-based spatial statistics (TBSS) with region of interest (ROI) analysis to examine differences of DTI metrics on white matter skeletons between DOC patients and healthy controls, and the association between white matter integrity and patients' residual consciousness assessed by Coma Recovery Scale-Revised (CRS-R). We found that: (1) patients with DOC had widespread white matter integrity disruptions, especially in the fornix; (2) the alteration of white matter microstructure was mainly attributed to the increase in radial diffusivity, possibly reflecting demyelination; (3) the behavioral CRS-R assessment score was positively correlated with white matter integrity in the fornix, uncinate fasciculus, pontine crossing tract, and posterior limb of internal capsule. Our results suggest that despite the widespread abnormalities of white matter following severe brain injury, the impairment of consciousness is likely to result from disruptions of key pathways that link brain regions in distributed networks.

Neural activation in response to the two sides of emotion.

Emotions are at the core of human cognition and behavior. Traditionally, emotions have been classified dichotomously as being either positive or negative. However, recent behavioral research (An et al., 2017) suggests that emotions contain both positivity and negativity. The current work investigated neural correlates of experiencing positive and negative emotions in response to happy and sad photos. Functional MRI revealed the precuneus and posterior cingulate cortex showed stronger activation when experiencing positivity compared to negativity of sadness, but not happiness, whereas the bilateral cerebellum showed greater response to positivity than negativity regardless of emotion. Results suggest that there are similarities and differences in the neural activation of positivity and negativity of happiness and sadness, consistent with previous findings (An et al., 2017). Emotion from both the neural and psychological perspectives were investigated. Further implications are discussed.