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Aggarwal N, Tromp DP, Blackford JU, Pine DS, Roseboom PH, Williams LE, Kalin NH. Sex-Specific Distributed White Matter Microarchitectural Alterations in Preadolescent Youths With Anxiety Disorders: A Mega-Analytic Study. Am J Psychiatry 2024; 181:299-309. [PMID: 38476042 PMCID: PMC11129321 DOI: 10.1176/appi.ajp.20221048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE Anxiety disorders are among the most common psychiatric disorders in youths and emerge during childhood. This is also a period of rapid white matter (WM) development, which is critical for efficient neuronal communication. Previous work in preadolescent children with anxiety disorders demonstrated anxiety disorder-related reductions in WM microstructural integrity (fractional anisotropy [FA]) in the uncinate fasciculus (UF), the major WM tract facilitating prefrontal cortical-limbic structural connectivity. Importantly, this association was found only in boys with anxiety disorders. To confirm this finding and more comprehensively understand WM changes in childhood anxiety, this mega-analytic study characterizes WM alterations related to anxiety disorders and sex in the largest sample of preadolescent children to date. METHODS Diffusion tensor imaging data from published studies of preadolescent children with anxiety disorders and healthy volunteers (ages 8-12) (N=198) were combined with a new data set (N=97) for a total sample of 165 children with anxiety disorders and 132 healthy volunteers. Children with anxiety disorders met DSM-5 criteria for current generalized, separation, and/or social anxiety disorder. Analyses of tractography and voxel-wise data assessed between-group differences (anxiety disorder vs. healthy volunteer), effects of sex, and their interaction. RESULTS Tract-based and voxel-wise analyses confirmed a significant reduction in UF FA in boys but not girls with anxiety disorders. Results also demonstrated other significant widespread anxiety disorder-related WM alterations specifically in boys, including in multiple commissural, association, projection, and brainstem regions. CONCLUSIONS In addition to confirming male-specific anxiety disorder-related reductions in UF FA, the results demonstrate that anxiety disorders in boys and not girls are associated with broadly distributed WM alterations across the brain. These findings support further studies focused on understanding the extent to which WM alterations in boys with anxiety disorders are involved in pathophysiological processes that mediate anxiety disorders. The findings also suggest the possibility that WM microarchitecture could serve as a novel treatment target for childhood anxiety disorders.
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Affiliation(s)
- Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Do P.M. Tromp
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Jennifer U. Blackford
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68198, United States
| | - Daniel S. Pine
- Section on Developmental and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD 20814, United States
| | - Patrick H. Roseboom
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Lisa E. Williams
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
| | - Ned H. Kalin
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI 53719, United States
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Kim J, Barcus R, Lipford ME, Yuan H, Ririe DG, Jung Y, Vlasova RM, Styner M, Nader MA, Whitlow CT. Effects of multiple anesthetic exposures on rhesus macaque brain development: a longitudinal structural MRI analysis. Cereb Cortex 2024; 34:bhad463. [PMID: 38142289 PMCID: PMC10793576 DOI: 10.1093/cercor/bhad463] [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: 03/06/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 12/25/2023] Open
Abstract
Concerns about the potential neurotoxic effects of anesthetics on developing brain exist. When making clinical decisions, the timing and dosage of anesthetic exposure are critical factors to consider due to their associated risks. In our study, we investigated the impact of repeated anesthetic exposures on the brain development trajectory of a cohort of rhesus monkeys (n = 26) over their first 2 yr of life, utilizing longitudinal magnetic resonance imaging data. We hypothesized that early or high-dose anesthesia exposure could negatively influence structural brain development. By employing the generalized additive mixed model, we traced the longitudinal trajectories of brain volume, cortical thickness, and white matter integrity. The interaction analysis revealed that age and cumulative anesthetic dose were variably linked to white matter integrity but not to morphometric measures. Early high-dose exposure was associated with increased mean, axial, and radial diffusivities across all white matter regions, compared to late-low-dose exposure. Our findings indicate that early or high-dose anesthesia exposure during infancy disrupts structural brain development in rhesus monkeys. Consequently, the timing of elective surgeries and procedures that require anesthesia for children and pregnant women should be strategically planned to account for the cumulative dose of volatile anesthetics, aiming to minimize the potential risks to brain development.
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Affiliation(s)
- Jeongchul Kim
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
- School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Winston-Salem, NC, United States
| | - Richard Barcus
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Megan E Lipford
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
- School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Winston-Salem, NC, United States
| | - Hongyu Yuan
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Douglas G Ririe
- Pain Mechanisms Lab, Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Youngkyoo Jung
- Department of Biomedical Engineering, University of California Davis, Davis, CA, United States
| | - Roza M Vlasova
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Martin Styner
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Michael A Nader
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Center for Research on Substance Use and Addiction, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Christopher T Whitlow
- Radiology Informatics and Image Processing Laboratory (RIIPL), Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States
- School of Biomedical Engineering and Sciences, Virginia Tech-Wake Forest University, Winston-Salem, NC, United States
- Center for Research on Substance Use and Addiction, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Clinical and Translational Science Institute, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States
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Aggarwal N, Oler JA, Tromp DPM, Roseboom PH, Riedel MK, Elam VR, Brotman MA, Kalin NH. A preliminary study of the effects of an antimuscarinic agent on anxious behaviors and white matter microarchitecture in nonhuman primates. Neuropsychopharmacology 2024; 49:405-413. [PMID: 37516801 PMCID: PMC10724160 DOI: 10.1038/s41386-023-01686-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
Myelination subserves efficient neuronal communication, and alterations in white matter (WM) microstructure have been implicated in numerous psychiatric disorders, including pathological anxiety. Recent work in rodents suggests that muscarinic antagonists may enhance myelination with behavioral benefits; however, the neural and behavioral effects of muscarinic antagonists have yet to be explored in non-human primates (NHP). Here, as a potentially translatable therapeutic strategy for human pathological anxiety, we present data from a first-in-primate study exploring the effects of the muscarinic receptor antagonist solifenacin on anxious behaviors and WM microstructure. 12 preadolescent rhesus macaques (6 vehicle control, 6 experimental; 8F, 4M) were included in a pre-test/post-test between-group study design. The experimental group received solifenacin succinate for ~60 days. Subjects underwent pre- and post-assessments of: 1) anxious temperament (AT)-related behaviors in the potentially threatening no-eye-contact (NEC) paradigm (30-min); and 2) WM and regional brain metabolism imaging metrics, including diffusion tensor imaging (DTI), quantitative relaxometry (QR), and FDG-PET. In relation to anxiety-related behaviors expressed during the NEC, significant Group (vehicle control vs. solifenacin) by Session (pre vs. post) interactions were found for freezing, cooing, and locomotion. Compared to vehicle controls, solifenacin-treated subjects exhibited effects consistent with reduced anxiety, specifically decreased freezing duration, increased locomotion duration, and increased cooing frequency. Furthermore, the Group-by-Session-by-Sex interaction indicated that these effects occurred predominantly in the males. Exploratory whole-brain voxelwise analyses of post-minus-pre differences in DTI, QR, and FDG-PET metrics revealed some solifenacin-related changes in WM microstructure and brain metabolism. These findings in NHPs support the further investigation of the utility of antimuscarinic agents in targeting WM microstructure as a means to treat pathological anxiety.
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Affiliation(s)
- Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA.
| | - Jonathan A Oler
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Do P M Tromp
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Patrick H Roseboom
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Marissa K Riedel
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Victoria R Elam
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Melissa A Brotman
- Neuroscience and Novel Therapeutics Unit, National Institute of Mental Health, Bethesda, MD, 20892, USA
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, 53719, USA
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Moody JF, Aggarwal N, Dean DC, Tromp DPM, Kecskemeti SR, Oler JA, Kalin NH, Alexander AL. Longitudinal assessment of early-life white matter development with quantitative relaxometry in nonhuman primates. Neuroimage 2022; 251:118989. [PMID: 35151851 PMCID: PMC8940652 DOI: 10.1016/j.neuroimage.2022.118989] [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: 11/03/2021] [Revised: 01/13/2022] [Accepted: 02/09/2022] [Indexed: 12/01/2022] Open
Abstract
Alterations in white matter (WM) development are associated with many neuropsychiatric and neurodevelopmental disorders. Most MRI studies examining WM development employ diffusion tensor imaging (DTI), which relies on estimating diffusion patterns of water molecules as a reflection of WM microstructure. Quantitative relaxometry, an alternative method for characterizing WM microstructural changes, is based on molecular interactions associated with the magnetic relaxation of protons. In a longitudinal study of 34 infant non-human primates (NHP) (Macaca mulatta) across the first year of life, we implement a novel, high-resolution, T1-weighted MPnRAGE sequence to examine WM trajectories of the longitudinal relaxation rate (qR1) in relation to DTI metrics and gestational age at scan. To the best of our knowledge, this is the first study to assess developmental WM trajectories in NHPs using quantitative relaxometry and the first to directly compare DTI and relaxometry metrics during infancy. We demonstrate that qR1 exhibits robust logarithmic growth, unfolding in a posterior-anterior and medial-lateral fashion, similar to DTI metrics. On a within-subject level, DTI metrics and qR1 are highly correlated, but are largely unrelated on a between-subject level. Unlike DTI metrics, gestational age at birth (time in utero) is a strong predictor of early postnatal qR1 levels. Whereas individual differences in DTI metrics are maintained across the first year of life, this is not the case for qR1. These results point to the similarities and differences in using quantitative relaxometry and DTI in developmental studies, providing a basis for future studies to characterize the unique processes that these measures reflect at the cellular and molecular level.
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Affiliation(s)
- Jason F Moody
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, United States.
| | - Nakul Aggarwal
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, United States
| | - Douglas C Dean
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, United States; Department of Pediatrics, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, United States; Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, United States
| | - Do P M Tromp
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, United States
| | - Steve R Kecskemeti
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, United States
| | - Jonathan A Oler
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, United States
| | - Ned H Kalin
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, United States
| | - Andrew L Alexander
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, United States; Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, WI 53719, United States; Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705, United States
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