Evaluation of Glymphatic System Development in Neonatal Brain via Diffusion Analysis along the Perivascular Space Index.

OBJECTIVE: Glymphatic system is a recently discovered macroscopic waste clearance system associated with numerous neurological diseases. However, little is known about glymphatic system development in neonates. We sought to evaluate diffusion along the perivascular space (ALPS) index, a proxy for glymphatic system function, in neonates and investigate its potential associations with maturation, sex, and preterm birth. METHODS: Diffusion magnetic resonance imaging (MRI) data in 418 neonates, including 92 preterm neonates (57 males) and 326 term neonates (175 males), from the Developing Human Connectome Project were used for evaluating ALPS index. Linear regression modeling was performed to assess group differences in the ALPS index according to preterm birth and sex. Pearson's and partial correlation analysis were performed to assess the association between the ALPS index and gestational age (GA) as well as postmenstrual age (PMA) at MRI. Moderation analysis was performed to assess the moderation effect of preterm birth on the relationship between the ALPS index and PMA. RESULTS: Compared to term neonates, preterm neonates exhibited lower ALPS indices (p < 0.001). The ALPS index positively correlated with PMA (p = 0.004) and GA (p < 0.001). Preterm birth (p = 0.013) had a significant moderation effect on the relationship between the ALPS index and PMA. Sex had no significant direct effect (p = 0.639) or moderation effect (p = 0.333) on ALPS index. INTERPRETATION: Glymphatic system development is a dynamic process in neonates, which can be moderated by preterm birth, the ALPS index could serve as a sensitive biomarker for monitoring this process. ANN NEUROL 2024;96:970-980.

Association of MRI Indexes of the Perivascular Space Network and Cognitive Impairment in Patients with Obstructive Sleep Apnea.

Background The role of perivascular space (PVS) dysfunction in obstructive sleep apnea (OSA) requires further study. Purpose To compare MRI indexes of PVS across patients with differing severities of OSA and relate them with disease characteristics and treatment. Materials and Methods This single-center prospective study included healthy controls (HCs) and patients with complaints of snoring who underwent MRI and cognitive evaluation between June 2021 and December 2022. Participants with complaints of snoring were classified into four groups (snoring, mild OSA, moderate OSA, and severe OSA). PVS networks were assessed at MRI using PVS volume fraction, extracellular free water (FW), and diffusion tensor imaging analysis along the PVS (DTI-ALPS). One-way analysis of variance and Pearson correlation were used for analysis. Alterations in PVS indexes and cognitive performance after treatment were assessed in 15 participants with moderate OSA. Results A total of 105 participants (mean age, 33.4 years ± 8.9 [SD]; 80 males) and 50 HCs (mean age, 37.0 years ± 8.6; 33 males) were included. Higher mean PVS volume fraction was observed in participants with severe OSA (n = 23) than in patients with mild OSA (n = 36) (0.11 vs 0.10; P = .03). Participants with severe OSA exhibited higher mean FW index (0.11) than both HCs (0.10; P < .001) and patients with mild OSA (0.10; P = .003). All patient groups had lower DTI-ALPS than HCs (range, 1.5-1.9 vs 2.1; all P < .001). DTI-ALPS correlated with cognitive performance on the Stroop Color and Word Test (r range, -0.23 to -0.24; P value range, .003-.005). After treatment, PVS indexes changed (P value range, <.001 to .01) and cognitive performance improved (P value range, <.001 to .03). Conclusion Differences in PVS indexes were observed among participants with differing severities of OSA and HCs. Indexes correlated with measures of cognitive function, and changes in indexes and improvement in cognitive performance were observed after treatment in participants with moderate OSA. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Port in this issue.

Glymphatic System in Preterm Neonates: Developmental Insights Following Birth Asphyxia.

BACKGROUND: Birth asphyxia (BA) and germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) are common clinical events in preterm neonates. However, their effects on the glymphatic system (GS) development in preterm neonates remain arcane. PURPOSE: To evaluate the developmental trajectory of the GS, and to investigate the effects of BA and GMH-IVH on GS function in preterm neonates. STUDY TYPE: Prospective. POPULATION: Two independent datasets, prospectively acquired internal dataset (including 99 preterm neonates, 40 female, mean [standard deviation] gestational age (GA) at birth, 29.95 [2.63] weeks) and the developing Human Connectome Project (dHCP) dataset (including 81 preterm neonates, 29 female, median [interquartile range] GA at birth, 32.71 [4.28] weeks). FIELD STRENGTH/SEQUENCE: 3.0 T MRI and diffusion-weighted spin-echo planar imaging sequence. ASSESSMENT: The diffusion-weighted images were preprocessed in volumetric space using the FMRIB Software Library and diffusion along the perivascular space (DTI-ALPS) index was accessed to evaluate GS function. STATISTICAL TESTS: Two sample t tests, one-way analysis of variance followed by least-significant difference (LSD) post hoc analysis, chi-squared tests, and Pearson's correlation analysis. Significance level: P < 0.05. RESULTS: In prospectively acquired internal dataset, preterm neonates with BA exhibited a significant lower DTI-ALPS index than those without BA (0.98 ± 0.08 vs. 1.08 ± 0.07, T = -5.89); however, GMH-IVH did not exert significant influences on the DTI-ALPS index (P = 0.83 and 0.27). The DTI-ALPS index increased significantly at postmenstrual age ranging from 25 to 34 weeks (r = 0.38) and then plateaued after 34 weeks (P = 0.35), which we also observed in the dHCP dataset. DATA CONCLUSION: BA rather than GMH-IVH serves as the major influencing factor in the development of GS in preterm neonates. Moreover, as GS development follows a nonlinear trajectory, we recommend close monitoring of GS development in preterm neonates with a GA less than 34 weeks. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

Representation of the inferred relationships in a map-like space.

A cognitive map is an internal representation of the external world that guides flexible behavior in a complex environment. Cognitive map theory assumes that relationships between entities can be organized using Euclidean-based coordinates. Previous studies revealed that cognitive map theory can also be generalized to inferences about abstract spaces, such as social spaces. However, it is still unclear whether humans can construct a cognitive map by combining relational knowledge between discrete entities with multiple abstract dimensions in nonsocial spaces. Here we asked subjects to learn to navigate a novel object space defined by two feature dimensions, price and abstraction. The subjects first learned the rank relationships between objects in each feature dimension and then completed a transitive inferences task. We recorded brain activity using functional magnetic resonance imaging (fMRI) while they performed the transitive inference task. By analyzing the behavioral data, we found that the Euclidean distance between objects had a significant effect on response time (RT). The longer the one-dimensional rank distance and two-dimensional (2D) Euclidean distance between objects the shorter the RT. The task-fMRI data were analyzed using both univariate analysis and representational similarity analysis. We found that the hippocampus, entorhinal cortex, and medial orbitofrontal cortex were able to represent the Euclidean distance between objects in 2D space. Our findings suggest that relationship inferences between discrete objects can be made in a 2D nonsocial space and that the neural basis of this inference is related to cognitive maps.

The role of the parahippocampal cortex in landmark-based distance estimation based on the contextual hypothesis.

Parahippocampal cortex (PHC) is a vital neural bases in spatial navigation. However, its functional role is still unclear. "Contextual hypothesis," which assumes that the PHC participates in processing the spatial association between the landmark and destination, provides a potential answer to the question. Nevertheless, the hypothesis was previously tested using the picture categorization task, which is indirectly related to spatial navigation. By now, study is still needed for testing the hypothesis with a navigation-related paradigm. In the current study, we tested the hypothesis by an fMRI experiment in which participants performed a distance estimation task in a virtual environment under three different conditions: landmark free (LF), stable landmark (SL), and ambiguous landmark (AL). By analyzing the behavioral data, we found that the presence of an SL improved the participants' performance in distance estimation. Comparing the brain activity in SL-versus-LF contrast as well as AL-versus-LF contrast, we found that the PHC was activated by the SL rather than by AL when encoding the distance. This indicates that the PHC is elicited by strongly associated context and encodes the landmark reference for distance perception. Furthermore, accessing the representational similarity with the activity of the PHC across conditions, we observed a high similarity within the same condition but low similarity between conditions. This result indicated that the PHC sustains the contextual information for discriminating between scenes. Our findings provided insights into the neural correlates of the landmark information processing from the perspective of contextual hypothesis.

Dynamic Causal Modelling of Hierarchical Planning.

Hierarchical planning (HP) is a strategy that optimizes the planning by storing the steps towards the goal (lower-level planning) into subgoals (higher-level planning). In the framework of model-based reinforcement learning, HP requires the computation through the transition value between higher-level hierarchies. Previous study identified the dmPFC, PMC and SPL were involved in the computation process of HP respectively. However, it is still unclear about how these regions interaction with each other to support the computation in HP, which could deepen our understanding about the implementation of plan algorithm in hierarchical environment. To address this question, we conducted an fMRI experiment using a virtual subway navigation task. We identified the activity of the dmPFC, premotor cortex (PMC) and superior parietal lobe (SPL) with general linear model (GLM) in HP. Then, Dynamic Causal Modelling (DCM) was performed to quantify the influence of the higher- and lower-planning on the connectivity between the brain areas identified by the GLM. The strongest modulation effect of the higher-level planning was found on the dmPFC→right PMC connection. Furthermore, using Parametric Empirical Bayes (PEB), we found the modulation of higher-level planning on the dmPFC→right PMC and right PMC→SPL connections could explain the individual difference of the response time. We conclude that the dmPFC-related connectivity takes the response to the higher-level planning, while the PMC acts as the bridge between the higher-level planning to behavior outcome.

Human spatial navigation: Neural representations of spatial scales and reference frames obtained from an ALE meta-analysis.

Humans use different spatial reference frames (allocentric or egocentric) to navigate successfully toward their destination in different spatial scale spaces (environmental or vista). However, it remains unclear how the brain represents different spatial scales and different spatial reference frames. Thus, we conducted an activation likelihood estimation (ALE) meta-analysis of 47 fMRI articles involving human spatial navigation. We found that both the environmental and vista spaces activated the parahippocampal place area (PPA), retrosplenial complex (RSC), and occipital place area in the right hemisphere. The environmental space showed stronger activation than the vista space in the occipital and frontal regions. No brain region exhibited stronger activation for the vista than the environmental space. The allocentric and egocentric reference frames activated the bilateral PPA and right RSC. The allocentric frame showed more stronger activations than the egocentric frame in the right culmen, left middle frontal gyrus, and precuneus. No brain region displayed stronger activation for the egocentric than the allocentric navigation. Our findings suggest that navigation in different spatial scale spaces can evoke specific and common brain regions, and that the brain regions representing spatial reference frames are not absolutely separated.

Spatiotemporal discoordination of brain spontaneous activity in major depressive disorder.

BACKGROUND: Major depressive disorder (MDD) is a widespread mental health issue, impacting spatial and temporal aspects of brain activity. The neural mechanisms behind MDD remain unclear. To address this gap, we introduce a novel measure, spatiotemporal topology (SPT), capturing both the hierarchy and dynamic attributes of brain activity in depressive disorder patients. METHODS: We analyzed fMRI data from 285 MDD inpatients and 141 healthy controls (HC). SPT was assessed by coupling brain gradient measurement and time delay estimation. A nested machine learning process distinguished between MDD and HC using SPT. Person's correlation tested the link between SPT's and symptom severity, and another machine learning method predicted the gap between patients' chronological and brain age. RESULTS: SPT demonstrated significant differences between patients and healthy controls (F = 2.944, p < 0.001). Machine learning approaches revealed SPT's ability to discriminate between patients and healthy controls (Accuracy = 0.65, Sensitivity = 0.67, Specificity = 0.64). Moreover, SPT correlated with the severity of depression symptom (r = 0.32. pFDR = 0.045) and predicted the gap between patients' chronological age and brain age (r = 0.756, p < 0.001). LIMITATIONS: Evaluation of brain dynamics was constrained by MRI temporal resolution. CONCLUSIONS: Our study introduces SPT as a promising metric to characterize the spatiotemporal signature of brain function, providing insights into deviant brain activity associated with depressive disorders and advancing our understanding of their psychopathological mechanisms.

Reduced coupling between global signal and cerebrospinal fluid inflow in patients with depressive disorder: A resting state functional MRI study.

BACKGROUND: Depressed patients often suffer from sleep disturbance, which has been recognized to be responsible for glymphatic dysfunction. The purpose of this study was to investigate the coupling strength of global blood­oxygen-level-dependent (gBOLD) signals and cerebrospinal fluid (CSF) inflow dynamics, which is a biomarker for glymphatic function, in depressed patients and to explore its potential relationship with sleep disturbance by using resting-state functional MRI. METHODS: A total of 138 depressed patients (112 females, age: 34.70 ± 13.11 years) and 84 healthy controls (29 females, age: 36.6 ± 11.75 years) participated in this study. The gBOLD-CSF coupling strength was calculated to evaluate glymphatic function. Sleep disturbance was evaluated using the insomnia items (item 4 for insomnia-early, item 5 for insomnia-middle, and item 6 for insomnia-late) of The 17-item Hamilton Depression Rating Scale for depressed patients, which was correlated with the gBOLD-CSF coupling strength. RESULTS: The depressed patients exhibited weaker gBOLD-CSF coupling relative to healthy controls (p = 0.022), possibly due to impairment of the glymphatic system. Moreover, the gBOLD-CSF coupling strength correlated with insomnia-middle (r = 0.097, p = 0.008) in depressed patients. Limitations This study is a cross-sectional study. CONCLUSION: Our findings shed light on the pathophysiology of depression, indicating that cerebral waste clearance system deficits are correlated with poor sleep quality in depressed patients.

A specific brain network for a social map in the human brain.

Individuals use social information to guide social interactions and to update relationships along multiple social dimensions. However, it is unclear what neural basis underlies this process of abstract "social navigation". In the current study, we recruited twenty-nine participants who performed a choose-your-own-adventure game in which they interacted with fictional characters during fMRI scanning. Using a whole-brain GLM approach, we found that vectors encoding two-dimensional information about the relationships predicted BOLD responses in the hippocampus and the precuneus, replicating previous work. We also explored whether these geometric representations were related to key brain regions previously identified in physical and abstract spatial navigation studies, but we did not find involvement of the entorhinal cortex, parahippocampal gyrus or the retrosplenial cortex. Finally, we used psychophysiological interaction analysis and identified a network of regions that correlated during participants' decisions, including the left posterior hippocampus, precuneus, dorsolateral prefrontal cortex (dlPFC), and the insula. Our findings suggest a brain network for social navigation in multiple abstract, social dimensions that includes the hippocampus, precuneus, dlPFC, and insula.

Cortical myelin content mediates differences in affective temperaments.

BACKGROUND: Affective temperaments are regarded as subclinical forms and precursors of mental disorders. It may serve as candidates to facilitate the diagnosis and prediction of mental disorders. Cortical myelination likely characterizes the neurodevelopment and the evolution of cognitive functions and reflects brain functional demand. However, little is known about the relationship between affective temperaments and myelin plasticity. This study aims to analyze the association between the affective temperaments and cortical myelin content (CMC) in human brain. METHODS: We measured affective temperaments using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) on 106 healthy adults and used the ratio of T1- and T2-weighted images as the proxy for CMC. Using the unsupervised k-means clustering algorithm, we classified the cortical gray matter into heavily, intermediately, and lightly myelinated regions. The correlation between affective temperaments and CMC was calculated separately for different myelinated regions. RESULTS: Hyperthymic temperament correlated negatively with CMC in the heavily myelinated (right postcentral gyrus and bilateral precentral gyrus) and lightly myelinated (bilateral frontal and lateral temporal) regions. Cyclothymic temperament showed a downward parabola-like correlation with CMC across the heavily, intermediately, and lightly myel0inated areas of the bilateral parietal-temporal regions. LIMITATIONS: The analysis was constrained to cortical regions. The results were obtained from healthy subjects and we did not acquired data from patients of affective disorder, which may compromise the generalizability of the present findings. CONCLUSION: The findings suggest that hyperthymic and cyclothymic temperaments have a CMC basis in extensive brain regions.