Deviations from normative brain white and gray matter structure are associated with psychopathology in youth

Cortical thickness modeling and variability in Alzheimer's disease and frontotemporal dementia

BACKGROUND AND OBJECTIVE

Alzheimer's disease (AD) and frontotemporal dementia (FTD) show different patterns of cortical thickness (CTh) loss compared with healthy controls (HC), even though there is relevant heterogeneity between individuals suffering from each of these diseases. Thus, we developed CTh models to study individual variability in AD, FTD, and HC.

METHODS

We used the baseline CTh measures of 379 participants obtained from the structural MRI processed with FreeSurfer. A total of 169 AD patients (63 ± 9 years, 65 men), 88 FTD patients (64 ± 9 years, 43 men), and 122 HC (62 ± 10 years, 47 men) were studied. We fitted region-wise temporal models of CTh using Support Vector Regression. Then, we studied associations of individual deviations from the model with cerebrospinal fluid levels of neurofilament light chain (NfL) and 14-3-3 protein and Mini-Mental State Examination (MMSE). Furthermore, we used real longitudinal data from 144 participants to test model predictivity.

RESULTS

We defined CTh spatiotemporal models for each group with a reliable fit. Individual deviation correlated with MMSE for AD and with NfL for FTD. AD patients with higher deviations from the trend presented higher MMSE values. In FTD, lower NfL levels were associated with higher deviations from the CTh prediction. For AD and HC, we could predict longitudinal visits with the presented model trained with baseline data. For FTD, the longitudinal visits had more variability.

CONCLUSION

We highlight the value of CTh models for studying AD and FTD longitudinal changes and variability and their relationships with cognitive features and biomarkers.

"Pscore": A Novel Percentile-Based Metric to Accurately Assess Individual Deviations in Non-Gaussian Distributions of Quantitative MRI Metrics

BACKGROUND

Quantitative magnetic resonance imaging (MRI) metrics could be used in personalized medicine to assess individuals against normative distributions. Conventional Zscore analysis is inadequate in the presence of non-Gaussian distributions. Therefore, if quantitative MRI metrics deviate from normality, an alternative is needed.

PURPOSE

To confirm non-Gaussianity of diffusion MRI (dMRI) metrics on a publicly available dataset, and to propose a novel percentile-based method, "Pscore" to address this issue.

STUDY TYPE

Retrospective cohort.

POPULATION

Nine hundred and sixty-one healthy young adults (age: 22-35 years, females: 53%) from the Human Connectome Project.

FIELD STRENGTH/SEQUENCE

3-T, spin-echo diffusion echo-planar imaging, T1-weighted: MPRAGE.

ASSESSMENT

The dMRI data were preprocessed using the TORTOISE pipeline. Forty-eight regions of interest (ROIs) from the JHU atlas were redrawn on a study-specific diffusion tensor (DT) template and average values were computed from various DT and mean apparent propagator (MAP) metrics. For each ROI, percentile ranks across participants were computed to generate "Pscores"-which normalized the difference between the median and a participant's value with the corresponding difference between the median and the 5th/95th percentile values.

STATISTICAL TESTS

ROI-wise distributions were assessed using log transformations, Zscore, and the "Pscore" methods. The percentages of extreme values above-95th and below-5th percentile boundaries (PEV>95 (%), PEV<5 (%)) were also assessed in the overall white matter. Bootstrapping was performed to test the reliability of Pscores in small samples (N = 100) using 100 iterations.

RESULTS

The dMRI metric distributions were systematically non-Gaussian, including positively skewed (eg, mean and radial diffusivity) and negatively skewed (eg, fractional and propagator anisotropy) metrics. This resulted in unbalanced tails in Zscore distributions (PEV>95  ≠ 5%, PEV<5  ≠ 5%) whereas "Pscore" distributions were symmetric and balanced (PEV>95  = PEV<5  = 5%); even for small bootstrapped samples (averagePEV > 95 ¯ = PEV < 5 ¯ = 5 ± 0 % $$ \overline{{\mathrm{PEV}}_{>95}}=\overline{{\mathrm{PEV}}_{<5}}=5\pm 0\% $$ [SD]).

DATA CONCLUSION

The inherent skewness observed for dMRI metrics may preclude the use of conventional Zscore analysis. The proposed "Pscore" method may help estimating individual deviations more accurately in skewed normative data, even from small datasets.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY: Stage 1.

'Pscore' - A Novel Percentile-Based Metric to Accurately Assess Individual Deviations in Non-Gaussian Distributions of Quantitative MRI Metrics

BACKGROUND

Quantitative MRI metrics could be used in personalized medicine to assess individuals against normative distributions. Conventional Zscore analysis is inadequate in the presence of non-Gaussian distributions. Therefore, if quantitative MRI metrics deviate from normality, an alternative is needed.

PURPOSE

To confirm non-Gaussianity of diffusion MRI (dMRI) metrics on a publicly available dataset, and to propose a novel percentile-based method, 'Pscore' to address this issue.

STUDY TYPE

Retrospective cohort.

POPULATION

961 healthy young-adults (age:22-35 years, Females:53%) from the Human Connectome Project.

FIELD STRENGTH/SEQUENCE

3-T, spin-echo diffusion echo-planar imaging, T1-weighted: MPRAGE.

ASSESSMENT

The dMRI data were preprocessed using the TORTOISE pipeline. Forty-eight regions of interest (ROIs) from the JHU-atlas were redrawn on a study-specific diffusion tensor (DT) template and average values were computed from various DT and mean apparent propagator (MAP) metrics. For each ROI, percentile ranks across participants were computed to generate 'Pscores'- which normalized the difference between the median and a participant's value with the corresponding difference between the median and the 5th/95th percentile values.

STATISTICAL TESTS

ROI-wise distributions were assessed using Log transformations, Zscore, and the 'Pscore' methods. The percentages of extreme values above-95th and below-5th percentile boundaries (PEV < 5 ( % ) ,PEV < 5 ( % ) ) were also assessed in the overall white matter. Bootstrapping was performed to test the reliability of Pscores in small samples (n=100) using 100 iterations.

RESULTS

The dMRI metric distributions were systematically non-Gaussian, including positively skewed (e.g., mean and radial distributions P E V > 95 ≠ 5 % , P E V < 5 ≠ 5 % whereas 'Pscore' distributions were symmetric and balanced P E V > 95 = P E V < 5 = 5 % ; even for small bootstrapped samples (average P E V > 95 ¯ = P E V < 5 ¯ = 5 ± 0 % S D ).

DATA CONCLUSION

The inherent skewness observed for dMRI metrics may preclude the use of conventional Zscore analysis. The proposed 'Pscore' method may help estimating individual deviations more accurately in skewed normative data, even from small datasets.

Advancing herbal medicine: enhancing product quality and safety through robust quality control practices

This manuscript provides an in-depth review of the significance of quality control in herbal medication products, focusing on its role in maintaining efficiency and safety. With a historical foundation in traditional medicine systems, herbal remedies have gained widespread popularity as natural alternatives to conventional treatments. However, the increasing demand for these products necessitates stringent quality control measures to ensure consistency and safety. This comprehensive review explores the importance of quality control methods in monitoring various aspects of herbal product development, manufacturing, and distribution. Emphasizing the need for standardized processes, the manuscript delves into the detection and prevention of contaminants, the authentication of herbal ingredients, and the adherence to regulatory standards. Additionally, it highlights the integration of traditional knowledge and modern scientific approaches in achieving optimal quality control outcomes. By emphasizing the role of quality control in herbal medicine, this manuscript contributes to promoting consumer trust, safeguarding public health, and fostering the responsible use of herbal medication products.