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Deschwanden PF, Hotz I, Mérillat S, Jäncke L. Functional connectivity-based compensation in the brains of non-demented older adults and the influence of lifestyle: A longitudinal 7-year study. Neuroimage 2025; 308:121075. [PMID: 39914511 DOI: 10.1016/j.neuroimage.2025.121075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2024] [Revised: 01/16/2025] [Accepted: 02/03/2025] [Indexed: 02/09/2025] Open
Abstract
INTRODUCTION The aging brain is characterized by structural decline and functional connectivity changes towards dedifferentiation, leading to cognitive decline. To some degree, the brain can compensate for structural deterioration. In this study, we aim to answer two questions: Where can we detect longitudinal functional connectivity-based compensation in the brains of cognitively healthy older adults? Can lifestyle predict the strength of this functional compensation? METHODS Using longitudinal data from 228 cognitively healthy older adults, we analyzed five measurement points over 7 years. Network-based statistics and latent growth modeling were employed to examine changes in structural and functional connectivity, as well as potential functional compensation for declines in processing speed and memory. Random forest and linear regression were used to predict the amplitude of compensation based on demographic, biological, and lifestyle factors. RESULTS Both functional and structural connectivity showed increases and decreases over time, depending on the specific connection and measure. Increased functional connectivity of 27 connections was linked to smaller declines in cognition. Five of those connections showed simultaneous decreases in fractional anisotropy, indicating direct compensation. The degree of compensation depended on the type of compensation and the cognitive ability, with demographic, biological, and lifestyle factors explaining 3.4-8.9% of the variance. CONCLUSIONS There are widespread changes in structural and functional connectivity in older adults. Despite the trend of dedifferentiation in functional connectivity, we detected both direct and indirect compensatory subnetworks that mitigated the decline in cognitive performance. The degree of compensation was influenced by demographic, biological, and lifestyle factors.
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Affiliation(s)
- Pascal Frédéric Deschwanden
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland.
| | - Isabel Hotz
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
| | - Susan Mérillat
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland; Healthy Longevity Center, University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
| | - Lutz Jäncke
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Stampfenbachstrasse 73, Zurich CH-8006, Switzerland
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Nardelli VMF, Okazaki VHA, Guimarães AN, Nascimento VB, Dascal JB. Effects on older adult Women's precision, strength and flexibility from resistance training and handicrafts practice. J Bodyw Mov Ther 2024; 40:1356-1362. [PMID: 39593457 DOI: 10.1016/j.jbmt.2024.07.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 06/05/2024] [Accepted: 07/07/2024] [Indexed: 11/28/2024]
Abstract
INTRODUCTION As individuals age, they experience a gradual decline in strength, flexibility, and precision control. While resistance training has shown positive effects on aging, little is known about how beneficial handicrafts could be in effectively promoting motor improvements in aging. This study aimed to compare manual precision, manual grip strength, and upper limb flexibility among three groups of older adult women: (a) regular practitioners of resistance training, (b) regular practitioners of handicrafts, and (c) insufficiently active participants who did not engage in either regular resistance training or handicraft practice. METHODS A total of 30 women (mean age = 67.86, SD = 7.01) were divided equally into the three groups (n = 10 per group). The participants were asked to perform a manual manipulative precision test, a manual grip strength test, and an upper limb flexibility test. RESULTS The participants in the resistance training group exhibited superior precision and strength compared to those in the handicraft group, as well as better precision, strength, and flexibility compared to the control group participants. The handicraft group demonstrated better precision and upper limb flexibility compared to the control group. CONCLUSION Therefore, while resistance training was particularly beneficial for improving these motor skills, engaging in handicrafts also proved to be an effective means of maintaining and/or enhancing certain important motor abilities.
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Affiliation(s)
| | - Victor Hugo Alves Okazaki
- Physical Education Department, State University of Londrina, Brazil, Celso Garcia Cid Roadway, Pr 445 Km 380, University Campus, 86.057-970, Londrina, Brazil.
| | - Anderson Nascimento Guimarães
- Physical Education Department, State University of Londrina, Brazil, Celso Garcia Cid Roadway, Pr 445 Km 380, University Campus, 86.057-970, Londrina, Brazil.
| | | | - Juliana Bayeux Dascal
- Physical Education Department, State University of Londrina, Brazil, Celso Garcia Cid Roadway, Pr 445 Km 380, University Campus, 86.057-970, Londrina, Brazil.
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Boyd MC, Burdette JH, Miller ME, Lyday RG, Hugenschmidt CE, Jack Rejeski W, Simpson SL, Baker LD, Tomlinson CE, Kritchevsky SB, Laurienti PJ. Association of physical function with connectivity in the sensorimotor and dorsal attention networks: why examining specific components of physical function matters. GeroScience 2024; 46:4987-5002. [PMID: 38967698 PMCID: PMC11336134 DOI: 10.1007/s11357-024-01251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 06/07/2024] [Indexed: 07/06/2024] Open
Abstract
Declining physical function with aging is associated with structural and functional brain network organization. Gaining a greater understanding of network associations may be useful for targeting interventions that are designed to slow or prevent such decline. Our previous work demonstrated that the Short Physical Performance Battery (eSPPB) score and body mass index (BMI) exhibited a statistical interaction in their associations with connectivity in the sensorimotor cortex (SMN) and the dorsal attention network (DAN). The current study examined if components of the eSPPB have unique associations with these brain networks. Functional magnetic resonance imaging was performed on 192 participants in the BNET study, a longitudinal and observational trial of community-dwelling adults aged 70 or older. Functional brain networks were generated for resting state and during a motor imagery task. Regression analyses were performed between eSPPB component scores (gait speed, complex gait speed, static balance, and lower extremity strength) and BMI with SMN and DAN connectivity. Gait speed, complex gait speed, and lower extremity strength significantly interacted with BMI in their association with SMN at rest. Gait speed and complex gait speed were interacted with BMI in the DAN at rest while complex gait speed, static balance, and lower extremity strength interacted with BMI in the DAN during motor imagery. Results demonstrate that different components of physical function, such as balance or gait speed and BMI, are associated with unique aspects of brain network organization. Gaining a greater mechanistic understanding of the associations between low physical function, body mass, and brain physiology may lead to the development of treatments that not only target specific physical function limitations but also specific brain networks.
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Affiliation(s)
- Madeline C Boyd
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Jonathan H Burdette
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Robert G Lyday
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Sean L Simpson
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Laura D Baker
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Chal E Tomlinson
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Janssen R&D of Johnson & Johnson, Raritan, NJ, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine Section On Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
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Tanase AD, Chen H, Miller ME, Hugenschmidt CE, Williamson JD, Kritchevsky SB, Laurienti PJ, Thompson AC. Visual contrast sensitivity is associated with community structure integrity in cognitively unimpaired older adults: the Brain Networks and Mobility (B-NET) Study. AGING BRAIN 2024; 6:100122. [PMID: 39148934 PMCID: PMC11325069 DOI: 10.1016/j.nbas.2024.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 05/28/2024] [Accepted: 07/04/2024] [Indexed: 08/17/2024] Open
Abstract
Older adults with impairment in contrast sensitivity (CS), the ability to visually perceive differences in light and dark, are more likely to demonstrate limitations in mobility function, but the mechanisms underlying this relationship are poorly understood. We sought to determine if functional brain networks important to visual processing and mobility may help elucidate possible neural correlates of this relationship. This cross-sectional analysis utilized functional MRI both at rest and during a motor imagery (MI) task in 192 community-dwelling, cognitively-unimpaired older adults ≥ 70 years of age from the Brain Networks and Mobility study (B-NET). Brain networks were partitioned into network communities, groups of regions that are more interconnected with each other than the rest of the brain, the spatial consistency of the communities for multiple brain subnetworks was assessed. Lower baseline binocular CS was significantly associated with degraded sensorimotor network (SMN) community structure at rest. During the MI task, lower binocular CS was significantly associated with degraded community structure in both the visual (VN) and default mode network (DMN). These findings may suggest shared neural pathways for visual and mobility dysfunction that could be targeted in future studies.
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Affiliation(s)
- Alexis D Tanase
- Wake Forest University School of Medicine, Department of Radiology, Winston-Salem, NC, USA
| | - Haiying Chen
- Wake Forest University School of Medicine, Department of Biostatistics, Winston-Salem, NC, USA
| | - Michael E Miller
- Wake Forest University School of Medicine, Division of Public Health Sciences, Winston-Salem, NC, USA
- Wake Forest University School of Medicine, Department of Gerontology and Geriatric Medicine, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Wake Forest University School of Medicine, Department of Gerontology and Geriatric Medicine, Winston-Salem, NC, USA
| | - Jeff D Williamson
- Wake Forest University School of Medicine, Department of Gerontology and Geriatric Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Wake Forest University School of Medicine, Department of Gerontology and Geriatric Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Wake Forest University School of Medicine, Department of Radiology, Winston-Salem, NC, USA
| | - Atalie C Thompson
- Wake Forest University School of Medicine, Department of Gerontology and Geriatric Medicine, Winston-Salem, NC, USA
- Wake Forest University School of Medicine, Department of Surgical Ophthalmology, Winston-Salem, NC, USA
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Zukowski LA, Fino PC, Levin I, Hsieh KL, Lockhart SN, Miller ME, Laurienti PJ, Kritchevsky SB, Hugenschmidt CE. Age and beta amyloid deposition impact gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface in older adults. Hum Mov Sci 2024; 93:103175. [PMID: 38198920 PMCID: PMC11195422 DOI: 10.1016/j.humov.2023.103175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/13/2023] [Accepted: 12/23/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Capturing a measure of movement quality during a complex walking task may indicate the earliest signs of detrimental changes to the brain due to beta amyloid (Aβ) deposition and be a potential differentiator of older adults at elevated and low risk of developing Alzheimer's disease. This study aimed to determine: 1) age-related differences in gait speed, stride length, and gait smoothness while transitioning from an even to an uneven walking surface, by comparing young adults (YA) and older adults (OA), and 2) if gait speed, stride length, and gait smoothness in OA while transitioning from an even to an uneven walking surface is influenced by the amount of Aβ deposition present in an OA's brain. METHODS Participants included 56 OA (>70 years of age) and 29 YA (25-35 years of age). In OA, Aβ deposition in the brain was quantified by PET imaging. All participants completed a series of cognitive assessments, a functional mobility assessment, and self-report questionnaires. Then participants performed two sets of walking trials on a custom-built walkway containing a mixture of even and uneven surface sections, including three trials with a grass uneven surface and three trials with a rocks uneven surface. Gait data were recorded using a wireless inertial measurement unit system. Stride length, gait speed, and gait smoothness (i.e., log dimensionless lumbar jerk) in the anteroposterior (AP), mediolateral (ML), and vertical (VT) directions were calculated for each stride. Outcomes were retained for five stride locations immediately surrounding the surface transition. RESULTS OA exhibited slower gait (Grass: p < 0.001; Rocks: p = 0.006), shorter strides (Grass: p < 0.001; Rocks: p = 0.008), and smoother gait (Grass AP: p < 0.001; Rocks AP: p = 0.002; Rocks ML: p = 0.02) than YA, but they also exhibited greater reductions in gait speed and stride length than YA while transitioning to the uneven grass and rocks surfaces. Within the OA group, those with greater Aβ deposition exhibited decreases in smoothness with age (Grass AP: p = 0.02; Rocks AP: p = 0.03; Grass ML: p = 0.04; Rocks ML: p = 0.03), while those with lower Aβ deposition exhibited increasing smoothness with age (Grass AP: p = 0.01; Rocks AP: p = 0.02; Grass ML: p = 0.08; Rocks ML: p = 0.07). Better functional mobility was associated with less smooth gait (Grass ML: p = 0.02; Rocks ML: p = 0.05) and with less variable gait smoothness (Grass and Rocks AP: both p = 0.04) in the OA group. CONCLUSION These results suggest that, relative to YA, OA may be adopting more cautious, compensatory gait strategies to maintain smoothness when approaching surface transitions. However, OA with greater Aβ deposition may have limited ability to adopt compensatory gait strategies to increase the smoothness of their walking as they get older because of neuropathological changes altering the sensory integration process and causing worse dynamic balance (i.e., jerkier gait). Functional mobility, in addition to age and Aβ deposition, may be an important factor of whether or not an OA chooses to employ compensatory strategies to prioritize smoothness while walking and what type of compensatory strategy an OA chooses.
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Affiliation(s)
- Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, United States of America.
| | - Peter C Fino
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States of America
| | - Ilana Levin
- Department of Physical Therapy, High Point University, High Point, NC, United States of America
| | - Katherine L Hsieh
- Department of Physical Therapy, Georgia State University, Atlanta, GA, United States of America
| | - Samuel N Lockhart
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Zukowski LA, Brinkerhoff SA, Levin I, Herter TM, Hetrick L, Lockhart SN, Miller ME, Laurienti PJ, Kritchevsky SB, Hugenschmidt CE. Amyloid-β Deposition Predicts Grocery Shopping Performance in Older Adults Without Cognitive Impairment. J Alzheimers Dis 2024; 100:53-75. [PMID: 38820016 DOI: 10.3233/jad-231108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Background A screening tool sensitive to Alzheimer's disease (AD) risk factors, such as amyloid-β (Aβ) deposition, and subtle cognitive changes, best elicited by complex everyday tasks, is needed. Objective To determine if grocery shopping performance could differentiate older adults at elevated risk of developing AD (OAer), older adults at low risk of developing AD (OAlr), and young adults (YA), and if amount of Aβ deposition could predict grocery shopping performance in older adults (OA). Methods Twenty-one OAer (78±5 years), 33 OAlr (78±5 years), and 28 YA (31±3 years) performed four grocery shopping trials, with the best and worst performances analyzed. Measures included trial time, number of correct items, number of grocery note fixations, and number of fixations and percentage of time fixating on the correct shelving unit, correct brand, and correct shelf. Linear mixed effects models compared measures by performance rank (best, worst) and group (OAer, OAlr, YA), and estimated the effect of Aβ deposition on measures in OA. Results Relative to their best performance, OAer and OAlr exhibited more correct shelving unit fixations and correct brand fixations during their worst performance, while YA did not. Within OA's worst performance, greater Aβ deposition was associated with a smaller percentage of time fixating on the correct shelving unit, correct shelf, and correct brand. Within OA, greater Aβ deposition was associated with more grocery note fixations. Conclusions OA with elevated Aβ deposition may exhibit subtle working memory impairments and less efficient visual search strategies while performing a cognitively demanding everyday task.
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Affiliation(s)
- Lisa A Zukowski
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Sarah A Brinkerhoff
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ilana Levin
- Department of Physical Therapy, High Point University, High Point, NC, USA
| | - Troy M Herter
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Lena Hetrick
- Department of Neuroscience, High Point University, High Point, NC, USA
| | - Samuel N Lockhart
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Michael E Miller
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Paul J Laurienti
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Kirse HA, Bahrami M, Lyday RG, Simpson SL, Peterson-Sockwell H, Burdette JH, Laurienti PJ. Differences in Brain Network Topology Based on Alcohol Use History in Adolescents. Brain Sci 2023; 13:1676. [PMID: 38137124 PMCID: PMC10741456 DOI: 10.3390/brainsci13121676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/10/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Approximately 6 million youth aged 12 to 20 consume alcohol monthly in the United States. The effect of alcohol consumption in adolescence on behavior and cognition is heavily researched; however, little is known about how alcohol consumption in adolescence may alter brain function, leading to long-term developmental detriments. In order to investigate differences in brain connectivity associated with alcohol use in adolescents, brain networks were constructed using resting-state functional magnetic resonance imaging data collected by the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) from 698 youth (12-21 years; 117 hazardous drinkers and 581 no/low drinkers). Analyses assessed differences in brain network topology based on alcohol consumption in eight predefined brain networks, as well as in whole-brain connectivity. Within the central executive network (CEN), basal ganglia network (BGN), and sensorimotor network (SMN), no/low drinkers demonstrated stronger and more frequent connections between highly globally efficient nodes, with fewer and weaker connections between highly clustered nodes. Inverse results were observed within the dorsal attention network (DAN), visual network (VN), and frontotemporal network (FTN), with no/low drinkers demonstrating weaker connections between nodes with high efficiency and increased frequency of clustered nodes compared to hazardous drinkers. Cross-sectional results from this study show clear organizational differences between adolescents with no/low or hazardous alcohol use, suggesting that aberrant connectivity in these brain networks is associated with risky drinking behaviors.
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Affiliation(s)
- Haley A. Kirse
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Graduate Program, Wake Forest Graduate School of Arts and Sciences, Integrative Physiology and Pharmacology, Winston-Salem, NC 27101, USA
| | - Mohsen Bahrami
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Robert G. Lyday
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Sean L. Simpson
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Hope Peterson-Sockwell
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
| | - Jonathan H. Burdette
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Paul J. Laurienti
- Laboratory for Complex Brain Networks, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (H.A.K.); (M.B.); (R.G.L.); (S.L.S.); (H.P.-S.); (J.H.B.)
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
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