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1.
Front Psychiatry ; 14: 1060770, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36816419

RESUMEN

Background: Major depressive disorder (MDD) is a prevalent health problem with complex pathophysiology that is not clearly understood. Prior work has implicated the hippocampus in MDD, but how hippocampal subfields influence or are affected by MDD requires further characterization with high-resolution data. This will help ascertain the accuracy and reproducibility of previous subfield findings in depression as well as correlate subfield volumes with MDD symptom scores. The objective of this study was to assess volumetric differences in hippocampal subfields between MDD patients globally and healthy controls (HC) as well as between a subset of treatment-resistant depression (TRD) patients and HC using automatic segmentation of hippocampal subfields (ASHS) software and ultra-high field MRI. Methods: Thirty-five MDD patients and 28 HC underwent imaging using 7-Tesla MRI. ASHS software was applied to the imaging data to perform automated hippocampal segmentation and provide volumetrics for analysis. An exploratory analysis was also performed on associations between symptom scores for diagnostic testing and hippocampal subfield volumes. Results: Compared to HC, MDD and TRD patients showed reduced right-hemisphere CA2/3 subfield volume (p = 0.01, η 2 = 0.31 and p = 0.3, η 2 = 0.44, respectively). Additionally, negative associations were found between subfield volumes and life-stressor checklist scores, including left CA1 (p = 0.041, f 2 = 0.419), left CA4/DG (p = 0.010, f 2 = 0.584), right subiculum total (p = 0.038, f 2 = 0.354), left hippocampus total (p = 0.015, f 2 = 0.134), and right hippocampus total (p = 0.034, f 2 = 0.110). Caution should be exercised in interpreting these results due to the small sample size and low power. Conclusion: Determining biomarkers for MDD and TRD pathophysiology through segmentation on high-resolution MRI data and understanding the effects of stress on these regions can enable better assessment of biological response to treatment selection and may elucidate the underlying mechanisms of depression.

2.
Int J Methods Psychiatr Res ; 32(4): e1955, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36448238

RESUMEN

OBJECTIVES: Traumatic stress has been associated with increased risk for brain alterations and development of anxiety disorders. Studies conducted in posttraumatic patients have shown white-mater volume and diffusion alterations in the corpus-callosum. Decreased cognitive performance has been demonstrated in acute stress disorder and posttraumatic patients. However, whether cognitive alterations result from stress related neuropathology or reflect a predisposition is not known. In the current study, we examined in healthy controls, whether individual differences in anxiety are associated with those cognitive and brain alterations reported in stress related pathologies. METHODS: Twenty healthy volunteers were evaluated for anxiety using the state-trait inventory (STAI), and were tested for memory performance. Brain imaging was employed to extract volumetric and diffusion characteristics of the corpus-callosum. RESULTS: Significant correlations were found between trait anxiety and all three diffusion parameters (fractional-anisotropy, mean and radial-diffusivity). Associative-memory performance and corpus-callosum volume were also significantly correlated. CONCLUSION: We suggest that cognitive and brain alterations, as tested in the current work and reported in stress related pathologies, are present early and possibly persist throughout life. Our findings support the hypothesis that individual differences in trait anxiety predispose individuals towards negative cognitive outcomes and brain alterations, and potentially to stress related disorders.


Asunto(s)
Encéfalo , Sustancia Blanca , Humanos , Encéfalo/diagnóstico por imagen , Cuerpo Calloso/patología , Sustancia Blanca/diagnóstico por imagen , Trastornos de Ansiedad/diagnóstico por imagen , Ansiedad
3.
Neuroimage ; 264: 119704, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-36349598

RESUMEN

The ventral tegmental area (VTA) is one of the major sources of dopamine in the brain and has been associated with reward prediction, error-based reward learning, volitional drive and anhedonia. However, precise anatomical investigations of the VTA have been prevented by the use of standard-resolution MRI, reliance on subjective manual tracings, and lack of quantitative measures of dopamine-related signal. Here, we combine ultra-high field 400 µm3 quantitative MRI with dopamine-related signal mapping, and a mixture of machine learning and supervised computational techniques to delineate the VTA in a transdiagnostic sample of subjects with and without depression and anxiety disorders. Subjects also underwent cognitive testing to measure intrinsic and extrinsic motivational tone. Fifty-one subjects were scanned in total, including healthy control (HC) and mood/anxiety (MA) disorder subjects. MA subjects had significantly larger VTA volumes compared to HC but significantly lower signal intensity within VTA compared to HC, indicating reduced structural integrity of the dopaminergic VTA. Interestingly, while VTA integrity did not significantly correlate with self-reported depression or anxiety symptoms, it was correlated with an objective cognitive measure of extrinsic motivation, whereby lower VTA integrity was associated with lower motivation. This is the first study to demonstrate a computational pipeline for detecting and delineating the VTA in human subjects with 400 µm3 resolution. We highlight the use of objective transdiagnostic measures of cognitive function that link neural integrity to behavior across clinical and non-clinical groups.


Asunto(s)
Dopamina , Área Tegmental Ventral , Humanos , Área Tegmental Ventral/diagnóstico por imagen , Recompensa , Ansiedad/diagnóstico por imagen , Motivación , Trastornos de Ansiedad
4.
Stud Health Technol Inform ; 290: 1120-1121, 2022 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-35673235

RESUMEN

Digital Pills are a drug-device technology that allow for the combination of traditional medications with a monitoring system that automatically records data about medication adherence and patients' physiological data. They are a promising innovation in digital medicine; however, their use has raised a number of ethical concerns. In this paper, we outline some of the main Digital Pills technologies and explore key ethical challenges surrounding their use. In this paper, we introduce educational materials we have developed that provide an insight into the technologies and ethical aspects that underpin Digital Pills.


Asunto(s)
Cumplimiento de la Medicación , Principios Morales , Humanos , Tecnología
5.
Transl Psychiatry ; 12(1): 209, 2022 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-35589678

RESUMEN

The hippocampus and amygdala limbic structures are critical to the etiology of major depressive disorder (MDD). However, there are no high-resolution characterizations of the role of their subregions in the whole brain network (connectome). Connectomic examination of these subregions can uncover disorder-related patterns that are otherwise missed when treated as single structures. 38 MDD patients and 40 healthy controls (HC) underwent anatomical and diffusion imaging using 7-Tesla MRI. Whole-brain segmentation was performed along with hippocampus and amygdala subregion segmentation, each representing a node in the connectome. Graph theory analysis was applied to examine the importance of the limbic subregions within the brain network using centrality features measured by node strength (sum of weights of the node's connections), Betweenness (number of shortest paths that traverse the node), and clustering coefficient (how connected the node's neighbors are to one another and forming a cluster). Compared to HC, MDD patients showed decreased node strength of the right hippocampus cornu ammonis (CA) 3/4, indicating decreased connectivity to the rest of the brain, and decreased clustering coefficient of the right dentate gyrus, implying it is less embedded in a cluster. Additionally, within the MDD group, the greater the embedding of the right amygdala central nucleus (CeA) in a cluster, the greater the severity of depressive symptoms. The altered role of these limbic subregions in the whole-brain connectome is related to diagnosis and depression severity, contributing to our understanding of the limbic system involvement in MDD and may elucidate the underlying mechanisms of depression.


Asunto(s)
Conectoma , Trastorno Depresivo Mayor , Amígdala del Cerebelo/diagnóstico por imagen , Encéfalo , Trastorno Depresivo Mayor/diagnóstico por imagen , Hipocampo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética
6.
Epilepsy Behav Rep ; 18: 100530, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35492510

RESUMEN

Purpose: Epilepsy patients exhibit morphological differences on neuroimaging compared to age-matched healthy controls, including cortical and sub-cortical volume loss and altered gray-white matter ratios. The objective was to develop a model of normal aging using the 7T MRIs of healthy controls. This model can then be used to determine if the changes in epilepsy patients resemble the changes seen in aging, and potentially give a marker for the severity of those changes. Methods: Sixty-nine healthy controls (24F/45M, mean age 36.5 ± 10.5 years) and forty-four epilepsy patients (24F/20M, 33.2 ± 9.9 years) non-lesional at 3T were scanned with volumetric T1-MPRAGE at 7T. These images were segmented and quantified using FreeSurfer. A linear regression-based model trained on healthy controls was developed to predict ages using derived imaging features among the epilepsy patient cohort. The model used 114 features with significant linear correlation with age. Results: The regression-based model estimated brain age with mean absolute error (MAE) of 6.6 years among controls. Comparable prediction accuracy of 6.9 years MAE was seen epilepsy patients. T-test of mean absolute error showed no difference in the prediction accuracy with controls and epilepsy patients (p = 0.68). However, average signed error showed elevated (+5.0 years, p = 0.0007) predicted age differences (PAD; brain-PAD=, predicted minus biological age) among epilepsy patients. Morphological metrics in the medial temporal lobe were major contributors to PAD. Additionally, patients with seizure frequency greater than once a week showed significantly elevated brain-PAD (+8.2 ± 5.3 years, n = 13) compared to patients with lower seizure frequency (3.7 ± 6.5 years, n = 31, p = 0.033). Major conclusions: Morphological patterns suggestive of premature aging were observed in non-lesional epilepsy patients vs. controls and in high seizure frequency patients vs. low frequency patients. Modeling brain age with 7T MRI may provide a sensitive imaging marker to assess the differential effects of the aging process in diseases such as epilepsy.

7.
Br J Anaesth ; 128(1): 65-76, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34802696

RESUMEN

BACKGROUND: Arousal and awareness are two important components of consciousness states. Functional neuroimaging has furthered our understanding of cortical and thalamocortical mechanisms of awareness. Investigating the relationship between subcortical functional connectivity and arousal has been challenging owing to the relatively small size of brainstem structures and thalamic nuclei, and their depth in the brain. METHODS: Resting state functional MRI scans of 72 healthy volunteers were acquired before, during, 1 h after, and 1 day after sevoflurane general anaesthesia. Functional connectivity of subcortical regions of interest vs whole brain and homotopic functional connectivity for assessment of left-right symmetry analyses of both cortical and subcortical regions of interest were performed. Both analyses used high resolution atlases generated from deep brain stimulation applications. RESULTS: Functional connectivity in subcortical loci within the thalamus and of the ascending reticular activating system was sharply restricted under anaesthesia, featuring a general lateralisation of connectivity. Similarly, left-right homology was sharply reduced under anaesthesia. Subcortical bilateral functional connectivity was not fully restored after emergence from anaesthesia, although greater restoration was seen between ascending reticular activating system loci and specific thalamic nuclei thought to be involved in promoting and maintaining arousal. Functional connectivity was fully restored to baseline by the following day. CONCLUSIONS: Functional connectivity in the subcortex is sharply restricted and lateralised under general anaesthesia. This restriction may play a part in loss and return of consciousness. CLINICAL TRIAL REGISTRATION: NCT02275026.


Asunto(s)
Anestésicos por Inhalación/farmacología , Encéfalo/diagnóstico por imagen , Imagen por Resonancia Magnética , Sevoflurano/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Anestesia General/métodos , Anestésicos por Inhalación/administración & dosificación , Nivel de Alerta , Concienciación , Femenino , Neuroimagen Funcional , Humanos , Masculino , Persona de Mediana Edad , Sevoflurano/administración & dosificación
8.
J Headache Pain ; 22(1): 112, 2021 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-34556025

RESUMEN

BACKGROUND: Trigeminal Neuralgia (TN) is a chronic neurological disease that is strongly associated with neurovascular compression (NVC) of the trigeminal nerve near its root entry zone. The trigeminal nerve at the site of NVC has been extensively studied but limbic structures that are potentially involved in TN have not been adequately characterized. Specifically, the hippocampus is a stress-sensitive region which may be structurally impacted by chronic TN pain. As the center of the emotion-related network, the amygdala is closely related to stress regulation and may be associated with TN pain as well. The thalamus, which is involved in the trigeminal sensory pathway and nociception, may play a role in pain processing of TN. The objective of this study was to assess structural alterations in the trigeminal nerve and subregions of the hippocampus, amygdala, and thalamus in TN patients using ultra-high field MRI and examine quantitative differences in these structures compared with healthy controls. METHODS: Thirteen TN patients and 13 matched controls were scanned at 7-Tesla MRI with high resolution, T1-weighted imaging. Nerve cross sectional area (CSA) was measured and an automated algorithm was used to segment hippocampal, amygdaloid, and thalamic subregions. Nerve CSA and limbic structure subnuclei volumes were compared between TN patients and controls. RESULTS: CSA of the posterior cisternal nerve on the symptomatic side was smaller in patients (3.75 mm2) compared with side-matched controls (5.77 mm2, p = 0.006). In TN patients, basal subnucleus amygdala volume (0.347 mm3) was reduced on the symptomatic side compared with controls (0.401 mm3, p = 0.025) and the paralaminar subnucleus volume (0.04 mm3) was also reduced on the symptomatic side compared with controls (0.05 mm3, p = 0.009). The central lateral thalamic subnucleus was larger in TN patients on both the symptomatic side (0.033 mm3) and asymptomatic side (0.035 mm3), compared with the corresponding sides in controls (0.025 mm3 on both sides, p = 0.048 and p = 0.003 respectively). The inferior and lateral pulvinar thalamic subnuclei were both reduced in TN patients on the symptomatic side (0.2 mm3 and 0.17 mm3 respectively) compared to controls (0.23 mm3, p = 0.04 and 0.18 mm3, p = 0.04 respectively). No significant findings were found in the hippocampal subfields analyzed. CONCLUSIONS: These findings, generated through a highly sensitive 7 T MRI protocol, provide compelling support for the theory that TN neurobiology is a complex amalgamation of local structural changes within the trigeminal nerve and structural alterations in subnuclei of limbic structures directly and indirectly involved in nociception and pain processing.


Asunto(s)
Dolor Crónico , Neuralgia del Trigémino , Benchmarking , Humanos , Imagen por Resonancia Magnética , Nervio Trigémino , Neuralgia del Trigémino/diagnóstico por imagen
9.
Br J Anaesth ; 125(4): 529-538, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32800503

RESUMEN

BACKGROUND: A growing body of literature addresses the possible long-term cognitive effects of anaesthetics, but no study has delineated the normal trajectory of neural recovery attributable to anaesthesia alone in adults. We obtained resting-state functional MRI scans on 72 healthy human volunteers between ages 40 and 80 (median: 59) yr before, during, and after general anaesthesia with sevoflurane, in the absence of surgery, as part of a larger study on cognitive function postanaesthesia. METHODS: Region-of-interest analysis, independent component analysis, and seed-to-voxel analysis were used to characterise resting-state functional connectivity and to differentiate between correlated and anticorrelated connectivity before, during, and after general anaesthesia. RESULTS: Whilst positively correlated functional connectivity remained essentially unchanged across these perianaesthetic states, anticorrelated functional connectivity decreased globally by 35% 1 h after emergence from general anaesthesia compared with baseline, as seen by the region-of-interest analysis. This decrease corresponded to a consistent reduction in expression of canonical resting-state networks, as seen by independent component analysis. All measures returned to baseline 1 day later. CONCLUSIONS: The normal perianaesthesia trajectory of resting-state connectivity in healthy adults is characterised by a transient global reduction in anticorrelated activity shortly after emergence from anaesthesia that returns to baseline by the following day. CLINICAL TRIAL REGISTRATION: NCT02275026.


Asunto(s)
Periodo de Recuperación de la Anestesia , Anestesia General , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Encéfalo/diagnóstico por imagen , Trastornos del Conocimiento/etiología , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Oxígeno/sangre , Sevoflurano/farmacología
10.
Neurorehabil Neural Repair ; 34(9): 795-803, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32684069

RESUMEN

Background. Nigrostriatal dopaminergic loss is a hallmark of Parkinson's disease (PD) pathophysiology, leading to motor Parkinsonism. Different intervention protocols have shown that motor and cognitive functions improvement in PD occur via the modulation of distinct motor and cognitive pathways. Objective. To investigate the effects of two motor training programs on the brains' functional networks in PD patients. Methods. Thirty-seven PD patients were prospectively studied. All enrolled patients underwent either treadmill training (TT) (n = 19) or treadmill with virtual reality (TT + VR) (n = 18) for 6 weeks. Magnetic resonance imaging (MRI) scans (3 T) acquiring 3-dimensional T1-weighted and resting-state functional MRI (rs-fMRI) data sets were performed at baseline and after 6 weeks. Independent component analysis (ICA) was conducted, and functional connectivity (FC) changes within large-scale functional brain networks were examined. Results. In both groups, significant post-training FC decrease in striatal, limbic, and parietal regions within the basal ganglia network, executive control network, and frontal-striatal network, and significant FC increase in the caudate, and cingulate within the sensorimotor network (SMN) were observed. Moreover, a significant time × group interaction was detected where TT + VR training had greater effects on FC levels in the supplementary motor area (SMA) and right precentral gyrus within the SMN, and in the right middle frontal gyrus (MFG) within the cerebellar network. These FC alterations were associated with improved usual and dual-task walking performance. Conclusions. These results suggest that TT with-and-without the addition of a VR component affects distinct neural pathways, highlighting the potential for beneficial neural plasticity in PD. Such distinctive task-specific pathways may foster the facilitation of interventions tailored to the individual needs of PD patients. Registered at Clinicaltrials.gov number: NCT01732653.


Asunto(s)
Conectoma , Terapia por Ejercicio , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/rehabilitación , Red Nerviosa/fisiopatología , Rehabilitación Neurológica , Enfermedad de Parkinson/fisiopatología , Enfermedad de Parkinson/rehabilitación , Anciano , Anciano de 80 o más Años , Terapia por Ejercicio/métodos , Femenino , Trastornos Neurológicos de la Marcha/diagnóstico por imagen , Trastornos Neurológicos de la Marcha/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Red Nerviosa/diagnóstico por imagen , Vías Nerviosas/fisiopatología , Rehabilitación Neurológica/métodos , Evaluación de Resultado en la Atención de Salud , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Estudios Prospectivos , Realidad Virtual
11.
Gait Posture ; 80: 56-61, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32485425

RESUMEN

INTRODUCTION: Falls are associated with numerous risk factors, such as motor and cognitive impairments. However, the neural correlates of falls are poorly understood. OBJECTIVES: Here, we aimed to assess patterns of structural, and resting-state functional connectivity (FC) alterations related to falls in a group of older adults with a history of falls compared to non-fallers. METHODS: Fourteen elderly fallers (mean age = 78.1 ± 1.5 yrs, >2 falls previous six months), and 20 healthy controls (mean age = 69.6 ± 1.3 yrs) were examined. All participants underwent a 3T MRI scan obtaining 3D T1-weighted images, and eyes-open resting-state (rs)-fMRI. Voxel-based morphometry was conducted to detect grey matter differences between the groups. Independent component analysis was conducted based on rs-fMRI and number of attention-and-motor related functional networks was identified and compared between groups using an independent-sample T-test. RESULTS: No differences were observed in grey matter between the groups after correcting for age and gender (p > 0.01, FWEc). Compared with non-fallers, the fallers had lower FC in cerebellar, frontal and parietal cortical nodes within the sensorimotor network (SMN), lateral motor network (M1), Cerebellar network (CBL), frontal-striatal network (FSN), executive control network (ECN), and dorsal attention network (DAN). Moreover, fallers had increased FC in the basal ganglia network (BGN), Left paracentral in M1 and SMN, and right hippocampus in DAN (p < 0.01, FWEc). CONCLUSIONS: Among fallers, reduced connectivity was observed in areas that relate to integration of information, while increased connectivity was found in areas associated with motor and sensory information processing. Together, these results provide evidence to the complex multidimensionality of the neural underpinnings of falls. Furthermore, these findings may help emphasize the importance of interventions that target both motor and cognitive aspects.


Asunto(s)
Accidentes por Caídas , Encéfalo/diagnóstico por imagen , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/fisiopatología , Anciano , Atención , Ganglios Basales , Mapeo Encefálico/métodos , Cerebelo , Cognición , Función Ejecutiva , Femenino , Hipocampo , Humanos , Imagen por Resonancia Magnética , Masculino
12.
Neuroimage Clin ; 25: 102142, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31901654

RESUMEN

Patients with major depressive disorder (MDD) exhibit higher levels of rumination, i.e., repetitive thinking patterns and exaggerated focus on negative states. Rumination is known to be associated with the cortical midline structures / default mode network (DMN) region activity, although the brain network topological organization underlying rumination remains unclear. Implementing a graph theoretical analysis based on ultra-high field 7-Tesla functional MRI data, we tested whether whole brain network connectivity hierarchies during resting state are associated with rumination in a dimensional manner across 20 patients with MDD and 20 healthy controls. Applying this data-driven approach we found a significant correlation between rumination tendency and connectivity strength degree of the right precuneus, a key node of the DMN. In order to interrogate this region further, we then applied the Dependency Network Analysis (DEPNA), a recently developed method used to quantify the connectivity influence of network nodes. This revealed that rumination was associated with lower connectivity influence of the left medial orbito-frontal cortex (MOFC) cortex on the right precuneus. Lastly, we used an information theory entropy measure that quantifies the cohesion of a network's correlation matrix. We show that subjects with higher rumination scores exhibit higher entropy levels within the DMN i.e. decreased overall connectivity within the DMN. These results emphasize the general DMN involvement during self-reflective processing related to maladaptive rumination in MDD. This work specifically highlights the impact of the MOFC on the precuneus, which might serve as a target for clinical neuromodulation treatment.


Asunto(s)
Conectoma/métodos , Trastorno Depresivo Mayor/fisiopatología , Red Nerviosa/fisiopatología , Lóbulo Parietal/fisiopatología , Corteza Prefrontal/fisiopatología , Rumiación Cognitiva/fisiología , Adulto , Conectoma/instrumentación , Trastorno Depresivo Mayor/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Red Nerviosa/diagnóstico por imagen , Lóbulo Parietal/diagnóstico por imagen , Corteza Prefrontal/diagnóstico por imagen
13.
Parkinsonism Relat Disord ; 63: 77-82, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30827838

RESUMEN

INTRODUCTION: Deficits in executive function and attention have been associated with freezing of gait (FOG) in patients with Parkinson's disease (PD). However, the exact changes in the ventral and dorsal attentional networks that may contribute to FOG are unknown. Our aim was to examine the changes in connectivity of the attentional networks in patients with PD and their role in FOG. METHODS: Resting-state fMRI was obtained in 20 healthy controls (age: 69.7 ±â€¯1.3yrs), 11 patients without FOG (age: 74.1 ±â€¯1.2yrs), and 26 patients with FOG (age: 72.3 ±â€¯1.3yrs). Graph theory analysis was used to examine differences in previously defined attention networks between groups. RESULTS: We found differences between the groups in the dorsal attentional network (Global Efficiency: p = 0.007, Local Efficiency: p = 0.017, Between Centrality: p = 0.010). Global efficiency was lower in patients with FOG compared to healthy controls (p = 0.003) and patients without FOG (p = 0.025). Local efficiency was higher in patients with FOG compared to healthy controls (p = 0.014) but not compared to patients without FOG (p = 0.109). In contrast, no differences were found in the ventral attentional network between the groups (Global Efficiency: p = 0.258, Local Efficiency: p = 0.114, Between Centrality: p = 0.130). CONCLUSIONS: Altered organization of the dorsal attention network in patients with FOG may explain the higher risk for FOG during complex walking situations. In contrast, the lack of changes in the ventral attention network may partially explain the effectiveness of external cues on gait in patients with PD. Our findings support the idea that attentional networks play an important role in FOG.


Asunto(s)
Atención/fisiología , Encéfalo/fisiopatología , Trastornos Neurológicos de la Marcha/fisiopatología , Enfermedad de Parkinson/fisiopatología , Anciano , Femenino , Trastornos Neurológicos de la Marcha/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Modelos Neurológicos , Vías Nerviosas/fisiopatología , Enfermedad de Parkinson/complicaciones
14.
Hum Brain Mapp ; 40(8): 2546-2555, 2019 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-30793410

RESUMEN

Non-manifesting carriers (NMC) of the G2019S mutation in the LRRK2 gene represent an "at risk" group for future development of Parkinson's disease (PD) and have demonstrated task related fMRI changes. However, resting-state networks have received less research focus, thus this study aimed to assess the integrity of the motor, default mode (DMN), salience (SAL), and dorsal attention (DAN) networks among this unique population by using two different connectivity measures: interregional functional connectivity analysis and Dependency network analysis (DEP NA). Machine learning classification methods were used to distinguish connectivity between the two groups of participants. Forty-four NMC and 41 non-manifesting non-carriers (NMNC) participated in this study; while no behavioral differences on standard questionnaires could be detected, NMC demonstrated lower connectivity measures in the DMN, SAL, and DAN compared to NMNC but not in the motor network. Significant correlations between NMC connectivity measures in the SAL and attention were identified. Machine learning classification separated NMC from NMNC with an accuracy rate above 0.8. Reduced integrity of non-motor networks was detected among NMC of the G2019S mutation in the LRRK2 gene prior to identifiable changes in connectivity of the motor network, indicating significant non-motor cerebral changes among populations "at risk" for future development of PD.


Asunto(s)
Cerebro/fisiopatología , Conectoma , Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina/genética , Aprendizaje Automático , Red Nerviosa/fisiopatología , Enfermedad de Parkinson/genética , Enfermedad de Parkinson/fisiopatología , Adulto , Cerebro/diagnóstico por imagen , Femenino , Heterocigoto , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Red Nerviosa/diagnóstico por imagen , Enfermedad de Parkinson/diagnóstico por imagen
15.
Front Behav Neurosci ; 12: 60, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29681803

RESUMEN

Emotion regulation is hypothesized to be mediated by the interactions between emotional reactivity and regulation networks during the dynamic unfolding of the emotional episode. Yet, it remains unclear how to delineate the effective relationships between these networks. In this study, we examined the aforementioned networks' information flow hierarchy during viewing of an anger provoking movie excerpt. Anger regulation is particularly essential for averting individuals from aggression and violence, thus improving prosocial behavior. Using subjective ratings of anger intensity we differentiated between low and high anger periods of the film. We then applied the Dependency Network Analysis (DEPNA), a newly developed graph theory method to quantify networks' node importance during the two anger periods. The DEPNA analysis revealed that the impact of the ventromedial prefrontal cortex (vmPFC) was higher in the high anger condition, particularly within the regulation network and on the connections between the reactivity and regulation networks. We further showed that higher levels of vmPFC impact on the regulation network were associated with lower subjective anger intensity during the high-anger cinematic period, and lower trait anger levels. Supporting and replicating previous findings, these results emphasize the previously acknowledged central role of vmPFC in modulating negative affect. We further show that the impact of the vmPFC relies on its correlational influence on the connectivity between reactivity and regulation networks. More importantly, the hierarchy network analysis revealed a link between connectivity patterns of the vmPFC and individual differences in anger reactivity and trait, suggesting its potential therapeutic role.

16.
Transl Psychiatry ; 8(1): 29, 2018 01 31.
Artículo en Inglés | MEDLINE | ID: mdl-29382814

RESUMEN

Impairments in social cognition and interactions are core psychopathologies in schizophrenia, often manifesting as an inability to appropriately relate to the intentions and feelings of others. Neuroimaging has helped to demarcate the dynamics of two distinct functional connectivity circuits underlying the social-affective processes related to mentalization (known as Theory of Mind, ToM) and somatic-affiliation (known as Embodied Simulation, ES). While evidence points to abnormal activation patterns within these networks among those suffering from schizophrenia, it is yet unclear however, if these patients exhibit this abnormal functional connectivity in the context of social-affective experiences. The current fMRI study, investigated functional connectivity dynamics within ToM and ES networks as subjects experienced evolving cinematic portrayals of fear. During scanning, schizophrenia patients and healthy controls passively watched a cinematic scene in which a mother and her son face various threatening events. Participants then provided a continuous and retrospective report of their fear intensity during a second viewing outside the scanner. Using network cohesion index (NCI) analysis, we examined modulations of ES-related and ToM-related functional connectivity dynamics and their relation to symptom severity and the continuous emotional ratings of the induced cinematic fear. Compared to patients, healthy controls showed higher ES-NCI and marginally lower ToM-NCI during emotional peaks. Cross-correlation analysis revealed an intriguing dynamic between NCI and the inter-group difference of reported fear. Schizophrenia patients rated their fear as lower relative to healthy controls, shortly after exhibiting lower ES connectivity. This increased difference in rating was also followed by higher ToM connectivity among schizophrenia patients. The clinical relevance of these findings is further highlighted by the following two results: (a) ToM-NCI was found to have a strong correlation with the severity of general symptoms during one of the two main emotional peaks (Spearman R = 0.77); and (b) k-mean clustering demonstrated that the networks' NCI dynamic during the social-affective context reliably differentiated between patients and controls. Together, these findings point to a possible neural marker for abnormal social-affective processing in schizophrenia, manifested as the disturbed balance between two functional networks involved in social-affective affiliation. This in turn suggests that exaggerated mentalization over somatic-affiliative processing, in response to another's' distress may underlie social-affective deficits in schizophrenia.


Asunto(s)
Afecto , Encéfalo/fisiopatología , Esquizofrenia/fisiopatología , Conducta Social , Adolescente , Adulto , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Emociones/fisiología , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Esquizofrenia/diagnóstico por imagen , Teoría de la Mente , Adulto Joven
17.
Neurology ; 89(17): 1804-1810, 2017 Oct 24.
Artículo en Inglés | MEDLINE | ID: mdl-28954877

RESUMEN

OBJECTIVE: To compare the effects of 2 forms of exercise, i.e., a 6-week trial of treadmill training with virtual reality (TT + VR) that targets motor and cognitive aspects of safe ambulation and a 6-week trial of treadmill training alone (TT), on brain activation in patients with Parkinson disease (PD). METHODS: As part of a randomized controlled trial, patients were randomly assigned to 6 weeks of TT (n = 17, mean age 71.5 ± 1.5 years, disease duration 11.6 ± 1.6 years; 70% men) or TT + VR (n = 17, mean age 71.2 ± 1.7 years, disease duration 7.9 ± 1.4 years; 65% men). A previously validated fMRI imagery paradigm assessed changes in neural activation pretraining and post-training. Participants imagined themselves walking in 2 virtual scenes projected in the fMRI: (1) a clear path and (2) a path with virtual obstacles. Whole brain and region of interest analyses were performed. RESULTS: Brain activation patterns were similar between training arms before the interventions. After training, participants in the TT + VR arm had lower activation than the TT arm in Brodmann area 10 and the inferior frontal gyrus (cluster level familywise error-corrected [FWEcorr] p < 0.012), while the TT arm had lower activation than TT + VR in the cerebellum and middle temporal gyrus (cluster level FWEcorr p < 0.001). Changes in fall frequency and brain activation were correlated in the TT + VR arm. CONCLUSIONS: Exercise modifies brain activation patterns in patients with PD in a mode-specific manner. Motor-cognitive training decreased the reliance on frontal regions, which apparently resulted in improved function, perhaps reflecting increased brain efficiency.


Asunto(s)
Encéfalo/diagnóstico por imagen , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/rehabilitación , Terapia de Exposición Mediante Realidad Virtual/métodos , Anciano , Trastornos del Conocimiento/etiología , Prueba de Esfuerzo , Femenino , Estudios de Seguimiento , Marcha/fisiología , Humanos , Procesamiento de Imagen Asistido por Computador , Imágenes en Psicoterapia/métodos , Imagen por Resonancia Magnética , Masculino , Escala del Estado Mental , Oxígeno/sangre , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Encuestas y Cuestionarios
18.
Neuropsychopharmacology ; 42(12): 2301-2313, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28401924

RESUMEN

Alloparental care, the cooperative care of offspring by group members other than the biological mother, has been widely practiced since early hominin evolution to increase infant survival and thriving. The coparental bond-a relationship of solidarity and commitment between two adults who join their effort to care for children-is a central contributor to children's well-being and sociality; yet, the neural basis of coparenting has not been studied in humans. Here, we followed 84 first-time co-parents (42 couples) across the first 6 years of family formation, including opposite-sex and same-sex couples, measured brain response to coparental stimuli, observed collaborative and undermining coparental behaviors in infancy and preschool, assayed oxytocin (OT) and vasopressin (AVP), and measured coparenting and child behavior problems at 6 years. Across family types, coparental stimuli activated the striatum, specifically the ventral striatum and caudate, striatal nodes implicated in motivational goal-directed social behavior. Psychophysiological interaction analysis indicated that both nodes were functionally coupled with the vmPFC in support of the human coparental bond and this connectivity was stronger as collaborative coparental behavior increased. Furthermore, caudate functional connectivity patterns differentiated distinct corticostriatal pathways associated with two stable coparental behavioral styles; stronger caudate-vmPFC connectivity was associated with more collaborative coparenting and was linked to OT, whereas a stronger caudate-dACC connectivity was associated with increase in undermining coparenting and was related to AVP. Finally, dyadic path-analysis model indicated that the parental caudate-vmPFC connectivity in infancy predicted lower child externalizing symptoms at 6 years as mediated by collaborative coparenting in preschool. Findings indicate that the coparental bond is underpinned by striatal activations and corticostriatal connectivity similar to other human affiliative bonds; highlight specific corticostriatal pathways as defining distinct coparental orientations that underpin family life; chart brain-hormone-behavior constellations for the mature, child-orientated coparental bond; and demonstrate the flexibility of this bond across family constellations and its unique contribution to child well-being.


Asunto(s)
Corteza Cerebral/diagnóstico por imagen , Protección a la Infancia/psicología , Cuerpo Estriado/diagnóstico por imagen , Familia/psicología , Apego a Objetos , Responsabilidad Parental/psicología , Adulto , Niño , Protección a la Infancia/tendencias , Preescolar , Femenino , Humanos , Lactante , Estudios Longitudinales , Imagen por Resonancia Magnética/tendencias , Masculino , Vías Nerviosas/diagnóstico por imagen , Relaciones Padres-Hijo , Responsabilidad Parental/tendencias , Esposos/psicología
19.
Hum Brain Mapp ; 37(12): 4654-4672, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27477592

RESUMEN

We introduce a novel method for delineating context-dependent functional brain networks whose connectivity dynamics are synchronized with the occurrence of a specific psychophysiological process of interest. In this method of context-related network dynamics analysis (CRNDA), a continuous psychophysiological index serves as a reference for clustering the whole-brain into functional networks. We applied CRNDA to fMRI data recorded during the viewing of a sadness-inducing film clip. The method reliably demarcated networks in which temporal patterns of connectivity related to the time series of reported emotional intensity. Our work successfully replicated the link between network connectivity and emotion rating in an independent sample group for seven of the networks. The demarcated networks have clear common functional denominators. Three of these networks overlap with distinct empathy-related networks, previously identified in distinct sets of studies. The other networks are related to sensorimotor processing, language, attention, and working memory. The results indicate that CRNDA, a data-driven method for network clustering that is sensitive to transient connectivity patterns, can productively and reliably demarcate networks that follow psychologically meaningful processes. Hum Brain Mapp 37:4654-4672, 2016. © 2016 Wiley Periodicals, Inc.


Asunto(s)
Mapeo Encefálico/métodos , Encéfalo/diagnóstico por imagen , Encéfalo/fisiología , Emociones/fisiología , Imagen por Resonancia Magnética , Percepción Visual/fisiología , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Películas Cinematográficas , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/fisiología , Psicofisiología , Autoinforme
20.
Cortex ; 82: 277-286, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27453508

RESUMEN

Patients with Parkinson's disease (PD) have difficulties in executive functions including conflict monitoring. The neural mechanisms underlying these difficulties are not yet fully understood. In order to examine the neural mechanisms related to conflict monitoring in PD, we evaluated 35 patients with PD and 20 healthy older adults while they performed a word-color Stroop paradigm in the MRI. Specifically, we focused on changes between the groups in task-related functional connectivity using psycho-physiological interaction (PPI) analysis. The anterior cingulate cortex (ACC), which is a brain node previously associated with the Stroop paradigm, was selected as the seed region for this analysis. Patients with PD, as compared to healthy controls, had reduced task-related functional connectivity between the ACC and parietal regions including the precuneus and inferior parietal lobe. This was seen only in the incongruent Stroop condition. A higher level of connectivity between the ACC and precuneus was correlated with a lower error rate in the conflicting, incongruent Stroop condition in the healthy controls, but not in the patients with PD. Furthermore, the patients also had reduced functional connectivity between the ACC and the superior frontal gyrus which was present in both the incongruent and congruent task condition. The present findings shed light on brain mechanisms that are apparently associated with specific cognitive difficulties in patients with PD. Among patients with PD, impaired conflict monitoring processing within the ACC-based fronto-parietal network may contribute to difficulties under increased executive demands.


Asunto(s)
Encéfalo/fisiopatología , Conflicto Psicológico , Función Ejecutiva/fisiología , Red Nerviosa/fisiopatología , Enfermedad de Parkinson/fisiopatología , Anciano , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Red Nerviosa/diagnóstico por imagen , Vías Nerviosas/diagnóstico por imagen , Vías Nerviosas/fisiopatología , Pruebas Neuropsicológicas , Enfermedad de Parkinson/diagnóstico por imagen , Test de Stroop
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