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1.
Cereb Cortex ; 33(17): 9756-9763, 2023 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-37415080

RESUMO

Theoretical models group maladaptive behaviors in addiction into neurocognitive domains such as incentive salience (IS), negative emotionality (NE), and executive functioning (EF). Alterations in these domains lead to relapse in alcohol use disorder (AUD). We examine whether microstructural measures in the white matter pathways supporting these domains are associated with relapse in AUD. Diffusion kurtosis imaging data were collected from 53 individuals with AUD during early abstinence. We used probabilistic tractography to delineate the fornix (IS), uncinate fasciculus (NE), and anterior thalamic radiation (EF) in each participant and extracted mean fractional anisotropy (FA) and kurtosis fractional anisotropy (KFA) within each tract. Binary (abstained vs. relapsed) and continuous (number of days abstinent) relapse measures were collected over a 4-month period. Across tracts, anisotropy measures were typically (i) lower in those that relapsed during the follow-up period and (ii) positively associated with the duration of sustained abstinence during the follow-up period. However, only KFA in the right fornix reached significance in our sample. The association between microstructural measures in these fiber tracts and treatment outcome in a small sample highlights the potential utility of the three-factor model of addiction and the role of white matter alterations in AUD.


Assuntos
Alcoolismo , Substância Branca , Humanos , Alcoolismo/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Consumo de Bebidas Alcoólicas , Imagem de Tensor de Difusão/métodos , Doença Crônica , Recidiva , Anisotropia , Encéfalo/diagnóstico por imagem
2.
Hum Brain Mapp ; 44(17): 6275-6287, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37750607

RESUMO

In many clinical trials involving transcranial electrical stimulation (tES), target electrodes are typically placed over DLPFC with the assumption that this will primarily stimulate the underlying brain region. However, our study aimed to evaluate the electric fields (EF) that are actually delivered and identify prefrontal regions that may be inadvertently targeted in DLPFC tES. Head models were generated from the Human Connectome Project database's T1 + T2-weighted MRIs of 80 healthy adults. Two common DLPFC montages were simulated; symmetric-F4/F3, and asymmetric-F4/Fp1. Averaged EF was extracted from (1) the center of the target electrode (F4), and (2) the top 1% of voxels showing the strongest EF in individualized EF maps. Interindividual variabilities were quantified with the standard deviation of EF peak location/value. Similar steps were repeated with 66 participants with methamphetamine use disorder (MUDs) as an independent clinical population. In healthy adults, the group-level location of EF peaks was situated in the medial-frontopolar, and the individualized EF peaks were positioned in a cube with a volume of 29 cm3 /46 cm3 (symmetric/asymmetric montages). EFs in the frontopolar area were significantly higher than EF "under" the target electrode in both symmetric (peak: 0.41 ± 0.06, F4:0.22 ± 0.04) and asymmetric (peak: 0.38 ± 0.04, F4:0.2 ± 0.04) montages (Heges'g > 0.7). Similar results with slight between-group differences were found in MUDs. We highlighted that in common DLPFC tES montages, in addition to interindividual/intergroup variability, the frontopolar received the highest EFs rather than DLPFC as the main target. We specifically recommended considering the potential involvement of the frontopolar area as a mechanism underlying the effectiveness of DLPFC tES protocols.


Assuntos
Córtex Pré-Frontal Dorsolateral , Estimulação Transcraniana por Corrente Contínua , Adulto , Humanos , Estimulação Transcraniana por Corrente Contínua/métodos , Encéfalo/fisiologia , Eletrodos , Córtex Pré-Frontal/diagnóstico por imagem
3.
Hum Brain Mapp ; 44(6): 2620-2635, 2023 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-36840728

RESUMO

Resting-state functional network connectivity (rsFNC) has shown utility for identifying characteristic functional brain patterns in individuals with psychiatric and mood disorders, providing a promising avenue for biomarker development. However, several factors have precluded widespread clinical adoption of rsFNC diagnostics, namely a lack of standardized approaches for capturing comparable and reproducible imaging markers across individuals, as well as the disagreement on the amount of data required to robustly detect intrinsic connectivity networks (ICNs) and diagnostically relevant patterns of rsFNC at the individual subject level. Recently, spatially constrained independent component analysis (scICA) has been proposed as an automated method for extracting ICNs standardized to a chosen network template while still preserving individual variation. Leveraging the scICA methodology, which solves the former challenge of standardized neuroimaging markers, we investigate the latter challenge of identifying a minimally sufficient data length for clinical applications of resting-state fMRI (rsfMRI). Using a dataset containing rsfMRI scans of individuals with schizophrenia and controls (M = 310) as well as simulated rsfMRI, we evaluated the robustness of ICN and rsFNC estimates at both the subject- and group-level, as well as the performance of diagnostic classification, with respect to the length of the rsfMRI time course. We found individual estimates of ICNs and rsFNC from the full-length (5 min) reference time course were sufficiently approximated with just 3-3.5 min of data (r = 0.85, 0.88, respectively), and significant differences in group-average rsFNC could be sufficiently approximated with even less data, just 2 min (r = 0.86). These results from the shorter clinical data were largely consistent with the results from validation experiments using longer time series from both simulated (30 min) and real-world (14 min) datasets, in which estimates of subject-level FNC were reliably estimated with 3-5 min of data. Moreover, in the real-world data we found rsFNC and ICN estimates generated across the full range of data lengths (0.5-14 min) more reliably matched those generated from the first 5 min of scan time than those generated from the last 5 min, suggesting increased influence of "late scan" noise factors such as fatigue or drowsiness may limit the reliability of FNC from data collected after 10+ min of scan time, further supporting the notion of shorter scans. Lastly, a diagnostic classification model trained on just 2 min of data retained 97%-98% classification accuracy relative to that of the full-length reference model. Our results suggest that, when decomposed with scICA, rsfMRI scans of just 2-5 min show good clinical utility without significant loss of individual FNC information of longer scan lengths.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Reprodutibilidade dos Testes , Encéfalo/diagnóstico por imagem , Neuroimagem , Transtornos do Humor , Mapeamento Encefálico/métodos
4.
Mol Psychiatry ; 27(5): 2448-2456, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35422467

RESUMO

N-methyl-D-aspartate receptor (NMDAR) hypofunction is a leading pathophysiological model of schizophrenia. Resting-state functional magnetic resonance imaging (rsfMRI) studies demonstrate a thalamic dysconnectivity pattern in schizophrenia involving excessive connectivity with sensory regions and deficient connectivity with frontal, cerebellar, and thalamic regions. The NMDAR antagonist ketamine, when administered at sub-anesthetic doses to healthy volunteers, induces transient schizophrenia-like symptoms and alters rsfMRI thalamic connectivity. However, the extent to which ketamine-induced thalamic dysconnectivity resembles schizophrenia thalamic dysconnectivity has not been directly tested. The current double-blind, placebo-controlled study derived an NMDAR hypofunction model of thalamic dysconnectivity from healthy volunteers undergoing ketamine infusions during rsfMRI. To assess whether ketamine-induced thalamic dysconnectivity was mediated by excess glutamate release, we tested whether pre-treatment with lamotrigine, a glutamate release inhibitor, attenuated ketamine's effects. Ketamine produced robust thalamo-cortical hyper-connectivity with sensory and motor regions that was not reduced by lamotrigine pre-treatment. To test whether the ketamine thalamic dysconnectivity pattern resembled the schizophrenia pattern, a whole-brain template representing ketamine's thalamic dysconnectivity effect was correlated with individual participant rsfMRI thalamic dysconnectivity maps, generating "ketamine similarity coefficients" for people with chronic (SZ) and early illness (ESZ) schizophrenia, individuals at clinical high-risk for psychosis (CHR-P), and healthy controls (HC). Similarity coefficients were higher in SZ and ESZ than in HC, with CHR-P showing an intermediate trend. Higher ketamine similarity coefficients correlated with greater hallucination severity in SZ. Thus, NMDAR hypofunction, modeled with ketamine, reproduces the thalamic hyper-connectivity observed in schizophrenia across its illness course, including the CHR-P period preceding psychosis onset, and may contribute to hallucination severity.


Assuntos
Ketamina , Esquizofrenia , Glutamatos/efeitos adversos , Alucinações , Humanos , Ketamina/farmacologia , Lamotrigina/efeitos adversos , Imageamento por Ressonância Magnética , Receptores de N-Metil-D-Aspartato , Esquizofrenia/tratamento farmacológico
5.
Int J Eat Disord ; 56(11): 2012-2021, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37548100

RESUMO

OBJECTIVE: Precision medicine (i.e., individually tailored treatments) represents an optimal goal for treating complex psychiatric disorders, including eating disorders. Within the eating disorders field, most treatment development efforts have been limited in their ability to identify individual-level models of eating disorder psychopathology and to develop and apply an individually tailored treatment for a given individual's personalized model of psychopathology. In addition, research is still needed to identify causal relationships within a given individual's model of eating disorder psychopathology. Addressing this limitation of the current state of precision medicine-related research in the field will allow us to progress toward advancing research and practice for eating disorders treatment. METHOD: We present a novel set of analytic tools, causal discovery analysis (CDA) methods, which can facilitate increasingly fine-grained, person-specific models of causal relations among cognitive, behavioral, and affective symptoms. RESULTS: CDA can advance the identification of an individual's causal model that maintains that individuals' eating disorder psychopathology. DISCUSSION: In the current article, we (1) introduce CDA methods as a set of promising analytic tools for developing precision medicine methods for eating disorders including the potential strengths and weaknesses of CDA, (2) provide recommendations for future studies utilizing this approach, and (3) outline the potential clinical implications of using CDA to generate personalized models of eating disorder psychopathology. PUBLIC SIGNIFICANCE STATEMENT: CDA provides a novel statistical approach for identifying causal relationships among variables of interest for a given individual. Person-specific causal models may offer a promising approach to individualized treatment planning and inform future personalized treatment development efforts for eating disorders.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Medicina de Precisão , Humanos , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Psicopatologia
6.
Behav Res Methods ; 55(8): 4260-4268, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-36526886

RESUMO

Mobile technologies can be used for behavioral assessments to associate changes in behavior with environmental context and its influence on mental health and disease. Research on real-time motor control with a joystick, analyzed using a computational proportion-derivative (PD) modeling approach, has shown that model parameters can be estimated with high reliability and are related both to self-reported fear and to brain structures important for affective regulation, such as the anterior cingulate cortex. Here we introduce a mobile version of this paradigm, the rapid assessment of motor processing (RAMP) paradigm, and show that it provides robust, reliable, and accessible behavioral measurements relevant to mental health. A smartphone version of a previous joystick sensorimotor task was developed in which participants control a virtual car to a stop sign and stop. A sample of 89 adults performed the task, with 66 completing a second retest session. A PD modeling approach was applied to compute Kp (drive) and Kd (damping) parameters. Both Kp and Kd exhibited high test-retest reliabilities (ICC .81 and .78, respectively). Replicating a previous finding from a different sample with the joystick version of the task, both Kp and Kd were negatively associated with self-reported fear. The RAMP paradigm, a mobile sensorimotor assessment, can be used to assess drive and damping during motor control, which is robustly associated with subjective affect. This paradigm could be useful for examining dynamic contextual modulation of affect-related processing, which could improve assessment of the effects of interventions for psychiatric disorders in a real-world context.


Assuntos
Encéfalo , Medo , Adulto , Humanos , Reprodutibilidade dos Testes , Encéfalo/fisiologia , Autorrelato , Smartphone
7.
J Neurophysiol ; 128(1): 197-217, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35675446

RESUMO

Brain parcellations play a crucial role in the analysis of brain imaging data sets, as they can significantly affect the outcome of the analysis. In recent years, several novel approaches for constructing MRI-based brain parcellations have been developed with promising results. In the absence of ground truth, several evaluation approaches have been used to evaluate currently available brain parcellations. In this article, we review and critique methods used for evaluating functional brain parcellations constructed using fMRI data sets. We also describe how some of these evaluation methods have been used to estimate the optimal parcellation granularity. We provide a critical discussion of the current approach to the problem of identifying the optimal brain parcellation that is suited for a given neuroimaging study. We argue that the criteria for an optimal brain parcellation must depend on the application the parcellation is intended for. We describe a teleological approach to the evaluation of brain parcellations, where brain parcellations are evaluated in different contexts and optimal brain parcellations for each context are identified separately. We conclude by discussing several directions for further research that would result in improved evaluation strategies.


Assuntos
Mapeamento Encefálico , Processamento de Imagem Assistida por Computador , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Neuroimagem
8.
Mol Genet Metab ; 135(2): 122-132, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35012890

RESUMO

OBJECTIVE: To assess our hypothesis that brain macrostructure is different in individuals with mucopolysaccharidosis type I (MPS I) and healthy controls (HC), we conducted a comprehensive multicenter study using a uniform quantitative magnetic resonance imaging (qMRI) protocol, with analyses that account for the effects of disease phenotype, age, and cognition. METHODS: Brain MRIs in 23 individuals with attenuated (MPS IA) and 38 with severe MPS I (MPS IH), aged 4-25 years, enrolled under the study protocol NCT01870375, were compared to 98 healthy controls. RESULTS: Cortical and subcortical gray matter, white matter, corpus callosum, ventricular and choroid plexus volumes in MPS I significantly differed from HC. Thicker cortex, lower white matter and corpus callosum volumes were already present at the youngest MPS I participants aged 4-5 years. Age-related differences were observed in both MPS I groups, but most markedly in MPS IH, particularly in cortical gray matter metrics. IQ scores were inversely associated with ventricular volume in both MPS I groups and were positively associated with cortical thickness only in MPS IA. CONCLUSIONS: Quantitatively-derived MRI measures distinguished MPS I participants from HC as well as severe from attenuated forms. Age-related neurodevelopmental trajectories in both MPS I forms differed from HC. The extent to which brain structure is altered by disease, potentially spared by treatment, and how it relates to neurocognitive dysfunction needs further exploration.


Assuntos
Mucopolissacaridose I , Substância Branca , Encéfalo/patologia , Humanos , Imageamento por Ressonância Magnética , Mucopolissacaridose I/patologia , Neuroimagem , Substância Branca/patologia
9.
Alcohol Clin Exp Res ; 46(10): 1913-1924, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36059269

RESUMO

BACKGROUND: Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood-to-alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals. METHOD: We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4-6 weeks. Mood-alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling. RESULTS: Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood. CONCLUSION: Traditional group-level analyses and corresponding population-wide theories assume relative homogeneity within populations in mood-alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood-alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings.


Assuntos
Afeto , Avaliação Momentânea Ecológica , Adulto Jovem , Humanos , Afeto/fisiologia , Estudantes/psicologia , Adaptação Psicológica , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia
10.
Cereb Cortex ; 31(5): 2494-2504, 2021 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-33415334

RESUMO

The clinical presentation of binge eating disorder (BED) and data emerging from task-based functional neuroimaging research suggests that this disorder may be associated with alterations in reward processing. However, there is a dearth of research investigating the functional organization of brain networks that mediate reward in BED. To address this gap, 27 adults with BED and 21 weight-matched healthy controls (WMC) completed a multimodel assessment consisting of a resting functional magnetic resonance imaging scan, behavioral tasks measuring reward-based decision-making (i.e., delay discounting and reversal learning), and self-report assessing clinical symptoms. A seed-based approach was employed to examine the resting state functional connectivity (rsFC) of the striatum (nucleus accumbens [NAcc] and ventral and dorsal caudate), a collection of regions implicated in reward processing. Compared with WMC, the BED group exhibited lower rsFC of striatal seeds, with frontal regions mediating executive functioning (e.g., superior frontal gyrus [SFG]) and posterior, parietal, and temporal regions implicated in emotional processing. Lower NAcc-SFG rsFC was associated with more difficulties with reversal learning and binge eating frequency in the BED group. Results suggest that hypoconnectivity of striatal networks that integrate self-regulation and reward processing may promote the clinical phenomenology of BED. Interventions for BED may benefit from targeting these circuit-based disturbances.


Assuntos
Transtorno da Compulsão Alimentar/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Adulto , Transtorno da Compulsão Alimentar/fisiopatologia , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/fisiopatologia , Desvalorização pelo Atraso/fisiologia , Função Executiva/fisiologia , Feminino , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Núcleo Accumbens/diagnóstico por imagem , Núcleo Accumbens/fisiopatologia , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiopatologia , Reversão de Aprendizagem/fisiologia , Recompensa , Adulto Jovem
11.
Neuroimage ; 241: 118439, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34339830

RESUMO

Investigations within the Human Connectome Project have expanded to include studies focusing on brain disorders. This paper describes one of the investigations focused on psychotic psychopathology: The psychosis Human Connectome Project (P-HCP). The data collected as part of this project were multimodal and derived from clinical assessments of psychopathology, cognitive assessments, instrument-based motor assessments, blood specimens, and magnetic resonance imaging (MRI) data. The dataset will be made publicly available through the NIMH Data Archive. In this report we provide specific information on how the sample of participants was obtained and characterized and describe the experimental tasks and procedures used to probe neural functions involved in psychotic disorders that may also mark genetic liability for psychotic psychopathology. Our goal in this paper is to outline the data acquisition process so that researchers intending to use these publicly available data can plan their analyses. MRI data described in this paper are limited to data acquired at 3 Tesla. A companion paper describes the study's 7 Tesla image acquisition protocol in detail, which is focused on visual perceptual functions in psychotic psychopathology.


Assuntos
Encéfalo/diagnóstico por imagem , Conectoma/métodos , Imageamento por Ressonância Magnética/métodos , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/genética , Adulto , Estudos Transversais , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Seleção de Pacientes , Transtornos Psicóticos/psicologia
12.
Neuroimage ; 238: 118210, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34062266

RESUMO

Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.


Assuntos
Imageamento por Ressonância Magnética/ética , Neuroimagem/ética , Países em Desenvolvimento , Ética em Pesquisa , Humanos
13.
Hum Brain Mapp ; 42(7): 2147-2158, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33566375

RESUMO

The hippocampus and amygdala are important structures in the posttraumatic stress disorder (PTSD); however, the exact relationship between these structures and stress or PTSD remains unclear. Moreover, they consist of several functionally distinct subfields/subregions that may serve different roles in the neuropathophysiology of PTSD. Here we present a subregional profile of the hippocampus and amygdala in 145 survivors of a major earthquake and 56 non-traumatized healthy controls (HCs). We found that the bilateral hippocampus and left amygdala were significantly smaller in survivors than in HCs, and there was no difference between survivors with (n = 69) and without PTSD (trauma-exposed controls [TCs], n = 76). Analyses revealed similar results in most subfields/subregions, except that the right hippocampal body (in a head-body-tail segmentation scheme), right presubiculum, and left amygdala medial nuclei (Me) were significantly larger in PTSD patients than in TCs but smaller than in HCs. Larger hippocampal body were associated with the time since trauma in PTSD patients. The volume of the right cortical nucleus (Co) was negatively correlated with the severity of symptoms in the PTSD group but positively correlated with the same measurement in the TC group. This correlation between symptom severity and Co volume was significantly different between the PTSD and TCs. Together, we demonstrated that generalized smaller volumes in the hippocampus and amygdala were more likely to be trauma-related than PTSD-specific, and their subfields/subregions were distinctively affected. Notably, larger left Me, right hippocampal body and presubiculum were PTSD-specific; these could be preexisting factors for PTSD or reflect rapid posttraumatic reshaping.


Assuntos
Tonsila do Cerebelo/patologia , Hipocampo/patologia , Trauma Psicológico/patologia , Transtornos de Estresse Pós-Traumáticos/patologia , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Terremotos , Feminino , Hipocampo/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Trauma Psicológico/diagnóstico por imagem , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Sobreviventes , Fatores de Tempo
14.
BMC Psychiatry ; 21(1): 35, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33435926

RESUMO

BACKGROUND: Although repetitive transcranial magnetic stimulation ('TMS') is becoming a gold standard treatment for pharmacoresistant depression, we lack neural target biomarkers for identifying who is most likely to respond to TMS and why. To address this gap in knowledge we evaluate neural targets defined by activation and functional connectivity of the dorsolateral prefrontal cortex-anchored cognitive control circuit, regions of the default mode network and attention circuit, and interactions with the subgenual anterior cingulate. We evaluate whether these targets and interactions between them change in a dose-dependent manner, whether changes in these neural targets correspond to changes in cognitive behavioral performance, and whether baseline and early change in neural target and cognitive behavioral performance predict subsequent symptom severity, suicidality, and quality of life outcomes. This study is designed as a pragmatic, mechanistic trial partnering with the National Clinical TMS Program of the Veteran's Health Administration. METHODS: Target enrollment consists of 100 veterans with pharmacoresistant Major Depressive Disorder (MDD). All veterans will receive a clinical course of TMS and will be assessed at 'baseline' pre-TMS commencement, 'first week' after initiation of TMS (targeting five sessions) and 'post-treatment' at the completion of TMS (targeting 30 sessions). Veterans will be assessed using functional magnetic resonance imaging (fMRI), a cognitive behavioral performance battery, and established questionnaires. Multivariate linear mixed models will be used to assess whether neural targets change with TMS as a function of dose (Aim 1), whether extent and change of neural target relates to and predicts extent of behavioral performance (Aim 3), and whether extent of neural target change predicts improvement in symptom severity, suicidality, and quality of life (Aim 3). For all three aims, we will also assess the contribution of baseline moderators such as biological sex and age. DISCUSSION: To our knowledge, our study will be the first pragmatic, mechanistic observational trial to use fMRI imaging and cognitive-behavioral performance as biomarkers of TMS treatment response in pharmacoresistant MDD. The results of this trial will allow providers to select suitable candidates for TMS treatment and better predict treatment response by assessing circuit connectivity and cognitive-behavioral performance at baseline and during early treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04663481 , December 5th, 2020, retrospectively registered. The first veteran was enrolled October 30th, 2020.


Assuntos
Transtorno Depressivo Maior , Veteranos , Biomarcadores , Depressão , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/terapia , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Córtex Pré-Frontal/diagnóstico por imagem , Qualidade de Vida , Estimulação Magnética Transcraniana
15.
Neuroimage ; 211: 116598, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32032738

RESUMO

BACKGROUND: Deficits in plasticity underlie many severe psychiatric disorders. Transcranial direct current stimulation (tDCS) is a promising method for modulating plasticity. However, given its non-focal nature, there are open questions as to how targeting and outcome specificity can best be achieved. OBJECTIVE: Understanding how tDCS interacts with concurrent brain activity is necessary for the rational advancement of tDCS. In the present study, we use an event-related potential (ERP) paradigm to assess the stimulus-specific effects of tDCS on cortical plasticity. METHODS: 22 healthy volunteers underwent a blinded, sham-controlled plasticity paradigm in a crossover design. High frequency presentation of auditory stimuli was used to induce potentiation in specific components of the ERP. We investigated whether anodal tDCS targeting the auditory cortex would modulate plasticity induction across time. Two pure tones were used as stimuli, only one of the tones, the target tone, was used for plasticity induction. Plasticity was quantified as change in the mean amplitude of the N100 component relative to baseline. RESULTS: TDCS significantly modulated plasticity in the target tone compared to sham (p â€‹= â€‹0.02) but had no effect on the control tone (p â€‹= â€‹0.73). This effect was time dependent, with tDCS effects no longer apparent 30 â€‹min after stimulation. CONCLUSIONS: Our results indicate that tDCS can modulate cortical plasticity in the auditory cortex in an activity-dependent manner. These findings bolster the idea that tDCS can be an effective tool to target and modulate plasticity both for research and therapeutic purposes.


Assuntos
Córtex Auditivo/fisiologia , Percepção Auditiva/fisiologia , Eletroencefalografia , Potenciais Evocados Auditivos/fisiologia , Plasticidade Neuronal/fisiologia , Estimulação Transcraniana por Corrente Contínua , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Adulto Jovem
16.
Psychol Med ; 50(8): 1267-1277, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31155012

RESUMO

BACKGROUND: Schizophrenia is associated with robust hippocampal volume deficits but subregion volume deficits, their associations with cognition, and contributing genes remain to be determined. METHODS: Hippocampal formation (HF) subregion volumes were obtained using FreeSurfer 6.0 from individuals with schizophrenia (n = 176, mean age ± s.d. = 39.0 ± 11.5, 132 males) and healthy volunteers (n = 173, mean age ± s.d. = 37.6 ± 11.3, 123 males) with similar mean age, gender, handedness, and race distributions. Relationships between the HF subregion volume with the largest between group difference, neuropsychological performance, and single-nucleotide polymorphisms were assessed. RESULTS: This study found a significant group by region interaction on hippocampal subregion volumes. Compared to healthy volunteers, individuals with schizophrenia had significantly smaller dentate gyrus (DG) (Cohen's d = -0.57), Cornu Ammonis (CA) 4, molecular layer of the hippocampus, hippocampal tail, and CA 1 volumes, when statistically controlling for intracranial volume; DG (d = -0.43) and CA 4 volumes remained significantly smaller when statistically controlling for mean hippocampal volume. DG volume showed the largest between group difference and significant positive associations with visual memory and speed of processing in the overall sample. Genome-wide association analysis with DG volume as the quantitative phenotype identified rs56055643 (ß = 10.8, p < 5 × 10-8, 95% CI 7.0-14.5) on chromosome 3 in high linkage disequilibrium with MOBP. Gene-based analyses identified associations between SLC25A38 and RPSA and DG volume. CONCLUSIONS: This study suggests that DG dysfunction is fundamentally involved in schizophrenia pathophysiology, that it may contribute to cognitive abnormalities in schizophrenia, and that underlying biological mechanisms may involve contributions from MOBP, SLC25A38, and RPSA.


Assuntos
Giro Denteado/patologia , Esquizofrenia/genética , Esquizofrenia/patologia , Adulto , Estudos de Casos e Controles , Cognição , Feminino , Estudo de Associação Genômica Ampla , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Proteínas de Transporte da Membrana Mitocondrial/genética , Proteínas da Mielina/genética , Tamanho do Órgão , Receptores de Laminina/genética , Análise de Regressão , Proteínas Ribossômicas/genética
17.
Stress ; 23(1): 105-115, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418329

RESUMO

Transcendental meditation (TM) is effective in alleviating stress and anxiety and promoting well-being. While the underlying biological mechanisms of TM are not yet fully explored, the hypothalamic-pituitary-adrenal (HPA) axis represents an index providing important clues embodying the stress system cascade. In this pilot study, young adults were randomly assigned to TM training followed by 8 weeks of meditation practice or a wait-list control condition. TM was conducted over 8 weeks. Thirty-four young adult participants were randomized; 27 participants completed the HPA outcome assessments (41% male). To assess HPA axis functioning, salivary samples to assess cortisol awakening response (CAR) that were collected in the morning, both at baseline and at week-4. Salivary cortisol in the context of a social stressor using the Trier Social Stress Test (TSST) was collected at week-8. The results indicate that participants who were randomly assigned to TM had lower awakening salivary cortisol levels and a greater drop in CAR from baseline to week-4 than the control group. There were no significant differences in HPA axis functioning in the context of the TSST. Primary limitations of this randomized controlled trial were the small sample size, the use of a wait-list as opposed to an active control, and the limited scope of HPA axis assessments. The results of this pilot study provide tentative evidence that TM may impact biological stress system functioning and suggests that this may be a worthwhile avenue to continue to examine. It will also be useful to extend these findings to a broader array of meditative and mindful practices, particularly for those who are experiencing more distress.


Assuntos
Sistema Hipotálamo-Hipofisário/fisiopatologia , Meditação/psicologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Estresse Psicológico/fisiopatologia , Estresse Psicológico/terapia , Ansiedade/psicologia , Feminino , Humanos , Hidrocortisona , Masculino , Atenção Plena , Projetos Piloto , Saliva , Estresse Psicológico/psicologia , Adulto Jovem
18.
Alcohol Clin Exp Res ; 44(8): 1598-1608, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32524616

RESUMO

BACKGROUND: Prenatal alcohol exposure (PAE) is associated with a variety of structural abnormalities in the brain, including several within the para-limbic system. Children with PAE have higher rates of internalizing disorders, including depression and anxiety, which may be related to underlying limbic system anomalies. METHODS: Children aged 8 to 16 with PAE (n = 41) or without PAE (n = 36) underwent an magnetic resonance imaging of the brain and parents completed behavioral questionnaires about their children. Semi-automated procedures (FreeSurfer) were used to derive para-limbic volumes from T1-weighted anatomical images. RESULTS: There were significant group differences (PAE vs. nonexposed controls) in the caudate, hippocampus, and the putamen; children with PAE had smaller volumes in these regions even after controlling for total intracranial volume. A trend-level association was seen between caudate volume and internalizing symptoms in children with PAE; smaller caudate volumes (presumably reflecting less optimal neurodevelopment) were associated with higher levels of anxiety and depression symptoms in these children. CONCLUSIONS: Caudate structure may be disproportionately affected by PAE and may be associated with the later development of internalizing symptoms in those affected by PAE.


Assuntos
Ansiedade/diagnóstico por imagem , Núcleo Caudado/diagnóstico por imagem , Depressores do Sistema Nervoso Central/efeitos adversos , Depressão/diagnóstico por imagem , Etanol/efeitos adversos , Hipocampo/diagnóstico por imagem , Efeitos Tardios da Exposição Pré-Natal/diagnóstico por imagem , Putamen/diagnóstico por imagem , Adolescente , Ansiedade/psicologia , Núcleo Caudado/patologia , Criança , Depressão/psicologia , Feminino , Hipocampo/patologia , Humanos , Sistema Límbico/diagnóstico por imagem , Sistema Límbico/patologia , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/psicologia , Putamen/patologia
19.
Neuroimage ; 184: 843-854, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30300752

RESUMO

Multimodal, imaging-genomics techniques offer a platform for understanding genetic influences on brain abnormalities in psychiatric disorders. Such approaches utilize the information available from both imaging and genomics data and identify their association. Particularly for complex disorders such as schizophrenia, the relationship between imaging and genomic features may be better understood by incorporating additional information provided by advanced multimodal modeling. In this study, we propose a novel framework to combine features corresponding to functional magnetic resonance imaging (functional) and single nucleotide polymorphism (SNP) data from 61 schizophrenia (SZ) patients and 87 healthy controls (HC). In particular, the features for the functional and genetic modalities include dynamic (i.e., time-varying) functional network connectivity (dFNC) features and the SNP data, respectively. The dFNC features are estimated from component time-courses, obtained using group independent component analysis (ICA), by computing sliding-window functional network connectivity, and then estimating subject specific states from this dFNC data using a k-means clustering approach. For each subject, both the functional (dFNC states) and SNP data are selected as features for a parallel ICA (pICA) based imaging-genomic framework. This analysis identified a significant association between a SNP component (defined by large clusters of functionally related SNPs statistically correlated with phenotype components) and time-varying or dFNC component (defined by clusters of related connectivity links among distant brain regions distributed across discrete dynamic states, and statistically correlated with genomic components) in schizophrenia. Importantly, the polygenetic risk score (PRS) for SZ (computed as a linearly weighted sum of the genotype profiles with weights derived from the odds ratios of the psychiatric genomics consortium (PGC)) was negatively correlated with the significant dFNC component, which were mostly present within a state that exhibited a lower occupancy rate in individuals with SZ compared with HC, hence identifying a potential dFNC imaging biomarker for schizophrenia. Taken together, the current findings provide preliminary evidence for a link between dFNC measures and genetic risk, suggesting the application of dFNC patterns as biomarkers in imaging genetic association study.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/fisiopatologia , Esquizofrenia/genética , Esquizofrenia/fisiopatologia , Adulto , Análise por Conglomerados , Feminino , Predisposição Genética para Doença , Genômica , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiopatologia , Projetos Piloto , Polimorfismo de Nucleotídeo Único , Esquizofrenia/diagnóstico por imagem
20.
Hum Brain Mapp ; 40(2): 652-662, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30251758

RESUMO

Neurobiological disturbances associated with reward and/or habit learning are theorized to maintain symptoms of anorexia nervosa (AN). Although research has investigated responses in brain regions associated with reward and habit to disorder-specific cues (e.g., food) and presumed rewards (e.g., money), little is known about the functional organization of the circuits underlying these constructs independent of stimulus. This study aimed to provide initial data on the synchrony of networks associated with reward and habit in AN by comparing resting-state functional connectivity (RSFC) patterns between AN and healthy control (HC) participants in these circuits and delineating how these patterns relate to symptoms. Using theoretically selected seeds in the nucleus accumbens (NAcc), ventral caudate, and dorsal caudate, reflecting a continuum from reward- to habit- oriented regions, RSFC patterns were compared between AN restricting subtype (n = 19) and HC (n = 19) participants (cluster threshold: p < .01). Exploratory correlations between RSFC z-scores and Eating Disorder Examination (EDE) scores, BMI, and illness duration were conducted. The AN group demonstrated lower RSFC between the NAcc and superior frontal gyrus, between the ventral caudate and frontal and posterior regions, and between the dorsal caudate and frontal, temporal, and posterior regions. In the AN group, lower NAcc- superior frontal gyrus RSFC correlated with greater EDE Global scores (r = -.58, CI: -.83, -.13). These resting-state synchrony disruptions of the ventral and dorsal frontostriatal circuits, considered in context of the broader literature, support the utility of further investigating possible reward and habit disturbances supporting symptoms in AN.


Assuntos
Anorexia Nervosa/fisiopatologia , Núcleo Caudado/fisiopatologia , Córtex Cerebral/fisiopatologia , Conectoma , Hábitos , Rede Nervosa/fisiopatologia , Núcleo Accumbens/fisiopatologia , Recompensa , Adolescente , Adulto , Anorexia Nervosa/diagnóstico por imagem , Núcleo Caudado/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Rede Nervosa/diagnóstico por imagem , Núcleo Accumbens/diagnóstico por imagem , Adulto Jovem
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