Test-retest reliability of a functional MRI working memory paradigm in normal and schizophrenic subjects

Striatal Response to Reward Anticipation as a Biomarker for Schizophrenia and Negative Symptoms: Effects, Test-Retest Reliability, and Stability Across Sites

BACKGROUND

Ventral striatal hypoactivation during reward anticipation has consistently been observed in patients with schizophrenia. In addition, that hypoactivation has been shown to correlate negatively with negative symptoms, and in particular with apathy. However, little is known about the stability of these results over time and their reliability across different centers.

METHODS

In total, 67 patients with schizophrenia (15 females) and 55 healthy controls (13 females) were recruited in 2 centers in Switzerland and Germany. To assess the neural bases of reward anticipation, all participants performed a variant of the Monetary Incentive Delay task while undergoing event-related functional magnetic resonance imaging at baseline and after 3 months. Stability over time was measured using intra-class correlation (ICC(A,1)) and stability between centers was measured with mixed models.

RESULTS

Results showed the expected ventral striatal hypoactivation in patients compared to controls during reward anticipation. We showed that these results were stable across centers. The primary analysis did not reveal an effect of time. Test-retest reliability was moderate for controls, and poor for patients. We did not find an association between ventral striatal hypoactivation and negative symptoms in patients.

CONCLUSIONS

Our results align with the hypothesis that ventral striatal activation is related to modulation of motivational saliency during reward anticipation. They also confirm that patients with schizophrenia show impaired reward anticipation. However, the poor test-retest reliability and the absence of an association with symptoms suggests that further research is needed before ventral striatal activity can be used as a biomarker on the individual patient level.

Test-Retest Reliability of Functional Connectivity in Adolescents With Depression

BACKGROUND

The test-retest reliability of functional magnetic resonance imaging is critical to identifying reproducible biomarkers for psychiatric illness. Recent work has shown how reliability limits the observable effect size of brain-behavior associations, hindering detection of these effects. However, while a fast-growing literature has explored both univariate and multivariate reliability in healthy individuals, relatively few studies have explored reliability in populations with psychiatric illnesses or how this interacts with age.

METHODS

Here, we investigated functional connectivity reliability over the course of 1 year in a longitudinal cohort of 88 adolescents (age at baseline = 15.63 ± 1.29 years; 64 female) with major depressive disorder (MDD) and without MDD (healthy volunteers [HVs]). We compared a univariate metric, intraclass correlation coefficient, and 2 multivariate metrics, fingerprinting and discriminability.

RESULTS

Adolescents with MDD had marginally higher mean intraclass correlation coefficient (μMDD = 0.34, 95% CI, 0.12-0.54; μHV = 0.27, 95% CI, 0.05-0.52), but both groups had poor average intraclass correlation coefficients (<0.4). Fingerprinting index was greater than chance and did not differ between groups (fingerprinting indexMDD = 0.75; fingerprinting indexHV = 0.91; Poisson tests p < .001). Discriminability indicated high multivariate reliability in both groups (discriminabilityMDD = 0.80; discriminabilityHV = 0.82; permutation tests p < .01). Neither univariate nor multivariate reliability was associated with symptom severity or edge-level effect size of group differences.

CONCLUSIONS

Overall, we found little evidence for a relationship between depression and reliability of functional connectivity during adolescence. These findings suggest that biomarker identification in depression is not limited due to reliability compared with healthy samples and support the shift toward multivariate analysis for improved power and reliability.

Reliability and stability challenges in ABCD task fMRI data

Trait stability of measures is an essential requirement for individual differences research. Functional MRI has been increasingly used in studies that rely on the assumption of trait stability, such as attempts to relate task related brain activation to individual differences in behavior and psychopathology. However, recent research using adult samples has questioned the trait stability of task-fMRI measures, as assessed by test-retest correlations. To date, little is known about trait stability of task fMRI in children. Here, we examined within-session reliability and long-term stability of individual differences in task-fMRI measures using fMRI measures of brain activation provided by the adolescent brain cognitive development (ABCD) Study Release v4.0 as an individual's average regional activity, using its tasks focused on reward processing, response inhibition, and working memory. We also evaluated the effects of factors potentially affecting reliability and stability. Reliability and stability (quantified as the ratio of non-scanner related stable variance to all variances) was poor in virtually all brain regions, with an average value of 0.088 and 0.072 for short term (within-session) reliability and long-term (between-session) stability, respectively, in regions of interest (ROIs) historically-recruited by the tasks. Only one reliability or stability value in ROIs exceeded the 'poor' cut-off of 0.4, and in fact rarely exceeded 0.2 (only 4.9%). Motion had a pronounced effect on estimated reliability/stability, with the lowest motion quartile of participants having a mean reliability/stability 2.5 times higher (albeit still 'poor') than the highest motion quartile. Poor reliability and stability of task-fMRI, particularly in children, diminishes potential utility of fMRI data due to a drastic reduction of effect sizes and, consequently, statistical power for the detection of brain-behavior associations. This essential issue urgently needs to be addressed through optimization of task design, scanning parameters, data acquisition protocols, preprocessing pipelines, and data denoising methods.

Test-retest stability of spontaneous brain activity and functional connectivity in the core resting-state networks assessed with ultrahigh field 7-Tesla resting-state functional magnetic resonance imaging

The growing demand for precise and reliable biomarkers in psychiatry is fueling research interest in the hope that identifying quantifiable indicators will improve diagnoses and treatment planning across a range of mental health conditions. The individual properties of brain networks at rest have been highlighted as a possible source for such biomarkers, with the added advantage that they are relatively straightforward to obtain. However, an important prerequisite for their consideration is their reproducibility. While the reliability of resting‐state (RS) measurements has often been studied at standard field strengths, they have rarely been investigated using ultrahigh‐field (UHF) magnetic resonance imaging (MRI) systems. We investigated the intersession stability of four functional MRI RS parameters—amplitude of low‐frequency fluctuations (ALFF) and fractional ALFF (fALFF; representing the spontaneous brain activity), regional homogeneity (ReHo; measure of local connectivity), and degree centrality (DC; measure of long‐range connectivity)—in three RS networks, previously shown to play an important role in several psychiatric diseases—the default mode network (DMN), the central executive network (CEN), and the salience network (SN). Our investigation at individual subject space revealed a strong stability for ALFF, ReHo, and DC in all three networks, and a moderate level of stability in fALFF. Furthermore, the internetwork connectivity between each network pair was strongly stable between CEN/SN and moderately stable between DMN/SN and DMN/SN. The high degree of reliability and reproducibility in capturing the properties of the three major RS networks by means of UHF‐MRI points to its applicability as a potentially useful tool in the search for disease‐relevant biomarkers.

A guide to the measurement and interpretation of fMRI test-retest reliability

The test-retest reliability of functional neuroimaging data has recently been a topic of much discussion. Despite early conflicting reports, converging reports now suggest that test-retest reliability is poor for standard univariate measures-namely, voxel- and region-level task-based activation and edge-level functional connectivity. To better understand the implications of these recent studies requires understanding the nuances of test-retest reliability as commonly measured by the intraclass correlation coefficient (ICC). Here we provide a guide to the measurement and interpretation of test-retest reliability in functional neuroimaging and review major findings in the literature. We highlight the importance of making choices that improve reliability so long as they do not diminish validity, pointing to the potential of multivariate approaches that improve both. Finally, we discuss the implications of recent reports of low test-retest reliability in the context of ongoing work in the field.

Lessons learned from using fMRI in the early clinical development of a mu-opioid receptor antagonist for disorders of compulsive consumption

Functional magnetic resonance imaging (fMRI) has been widely used to gain a greater understanding of brain circuitry abnormalities in CNS disorders. fMRI has also been used to examine pharmacological modulation of brain circuity and is increasingly being used in early clinical drug development as functional pharmacodynamic index of target engagement, and to provide early indication of clinical efficacy. In this short review, we summarize data from experimental medicine and early clinical development studies of a mu-opioid receptor antagonist, GSK1521498 developed for disorders of compulsive consumption including binge eating in obesity. We demonstrate how fMRI can be used to answer important questions of early clinical drug development relating to; (1) target engagement, (2) dose response relationships, (3) differential efficacy and (4) prediction of behavioural and clinically relevant outcomes. We also highlight important methodological factors that need to be considered when conducting fMRI studies in drug development given the challenges faced with small sample sizes in Phase 1 and early proof of mechanism studies. While these data highlight the value of fMRI as a biomarker in drug development, its use for making Go/No-go decisions is still faced with challenges given the variability of responses, interpretation of brain activation changes and the limited data linking drug induced changes in brain activity to clinical or behavioural outcome. These challenges need to be addressed to fulfil the promise of fMRI as a tool in clinical drug development.

Scanning Conditions in Functional Connectivity Magnetic Resonance Imaging: How to Standardise Resting-State for Optimal Data Acquisition and Visualisation?

Functional connectivity magnetic resonance imaging (fcMRI), performed during resting wakefulness without tasks or stimulation, is a non-invasive technique to assess and visualise functional brain networks in vivo. Acquisition of resting-state imaging data has become increasingly common in longitudinal studies to investigate brain health and disease. However, the scanning protocols vary considerably across different institutions creating challenges for comparability especially for the interpretation of findings in patient cohorts and establishment of diagnostic or prognostic imaging biomarkers. The aim of this chapter is to discuss the effect of two experimental conditions (i.e. a low cognitive demand paradigm and a pure resting-state fcMRI) on the reproducibility of brain networks between a baseline and a follow-up session, 30 (±5) days later, acquired from 12 right-handed volunteers (29 ± 5 yrs). A novel method was developed and used for a direct statistical comparison of the test-retest reliability using 28 well-established functional brain networks. Overall, both scanning conditions produced good levels of test-retest reliability. While the pure resting-state condition showed higher test-retest reliability for 18 of the 28 analysed networks, the low cognitive demand paradigm produced higher test-retest reliability for 8 of the 28 brain networks (i.e. visual, sensorimotor and frontal areas); in 2 of the 28 brain networks no significant changes could be detected. These results are relevant to planning of longitudinal studies, as higher test-retest reliability generally increases statistical power. This work also makes an important contribution to neuroimaging where optimising fcMRI experimental scanning conditions, and hence data visualisation of brain function, remains an on-going topic of interest. In this chapter, we provide a full methodological explanation of the two paradigms and our analysis so that readers can apply them to their own scanning protocols.

Clinical Strategies and Technical Challenges in Psychoradiology

Psychoradiology is an emerging discipline at the intersection between radiology and psychiatry. It holds promise for playing a role in clinical diagnosis, evaluation of treatment response and prognosis, and illness risk prediction for patients with psychiatric disorders. Addressing complex issues, such as the biological heterogeneity of psychiatric syndromes and unclear neurobiological mechanisms underpinning radiological abnormalities, is a challenge that needs to be resolved. With the advance of multimodal imaging and more efforts in standardization of image acquisition and analysis, psychoradiology is becoming a promising tool for the future of clinical care for patients with psychiatric disorders.

Test-retest reliability of task-based and resting-state blood oxygen level dependence and cerebral blood flow measures

Despite their wide-spread use, only limited information is available on the comparative test-retest reliability of task-based functional and resting state magnetic resonance imaging measures of blood oxygen level dependence (tb-fMRI and rs-fMRI) and cerebral blood flow (CBF) using arterial spin labeling. This information is critical to designing properly powered longitudinal studies. Here we comprehensively quantified and compared the test-retest reliability and reproducibility performance of 8 commonly applied fMRI tasks, 6 rs-fMRI metrics and CBF in 30 healthy volunteers. We find large variability in test-retest reliability performance across the different tb-fMRI paradigms and rs-fMRI metrics, ranging from poor to excellent. A larger extent of activation in tb-fMRI is linked to higher between-subject reliability of the respective task suggesting that differences in the amount of activation may be used as a first reliability estimate of novel tb-fMRI paradigms. For rs-fMRI, a good reliability of local activity estimates is paralleled by poor performance of global connectivity metrics. Evaluated CBF measures provide in general a good to excellent test-reliability matching or surpassing the best performing tb-fMRI and rs-fMRI metrics. This comprehensive effort allows for direct comparisons of test-retest reliability between the evaluated MRI domains and measures to aid the design of future tb-fMRI, rs-fMRI and CBF studies.

Threat distractor and perceptual load modulate test-retest reliability of anterior cingulate cortex response

Accumulating data from fMRI studies implicate the rostral anterior cingulate cortex (rACC) in inhibition of attention to threat distractors that compete with task-relevant goals for processing resources. However, little data is available on the reliability of rACC activation. Our aim in the current study was to examine test-retest reliability of rACC activation over a 12-week period, in the context of a validated emotional interference paradigm that varied in perceptual load. During functional MRI, 23 healthy volunteers completed a task involving a target letter in a string of identical letters (low load) or in a string of mixed letters (high load) superimposed on angry, fearful, and neutral face distractors. Intraclass correlation coefficients (ICCs) indicated that under low, but not high perceptual load, rACC activation to fearful vs. neutral distractors was moderately reliable. Conversely, regardless of perceptual load, rACC activation to angry vs. neutral distractors was not reliable. Regarding behavioral performance, ICCs indicated that accuracy was not reliable regardless of distractor type or perceptual load. Although reaction time (RT) was similarly not reliable regardless of distractor type under low perceptual load, RT to angry vs. neutral distractors and to fearful vs. neutral distractors was reliable under high perceptual load. Together, results indicate the test-retest reliability of rACC activation and corresponding behavioral performance are context dependent; reliability of the former varies as a function of distractor type and level of cognitive demand, whereas reliability of the latter depends on behavioral index (accuracy vs. RT) and level of cognitive demand but not distractor type.

Unreliability of putative fMRI biomarkers during emotional face processing

There is considerable need to develop tailored approaches to psychiatric treatment. Numerous researchers have proposed using functional magnetic resonance imaging (fMRI) biomarkers to predict therapeutic response, in particular by measuring task-evoked subgenual anterior cingulate (sgACC) and amygdala activation in mood and anxiety disorders. Translating this to the clinic relies on the assumption that blood-oxygen-level dependent (BOLD) responses in these regions are stable within individuals. To test this assumption, we scanned a group of 29 volunteers twice (mean test-retest interval=14.3 days) and calculated the within-subject reliability of the amplitude of the amygdalae and sgACC BOLD responses to emotional faces using three paradigms: emotion identification; emotion matching; and gender classification. We also calculated the reliability of activation in a control region, the right fusiform face area (FFA). All three tasks elicited robust group activations in the amygdalae and sgACC (which changed little on average over scanning sessions), but within-subject reliability was surprisingly low, despite excellent reliability in the control right FFA region. Our findings demonstrate low statistical reliability of two important putative treatment biomarkers in mood and anxiety disorders.

Speech-evoked activation in adult temporal cortex measured using functional near-infrared spectroscopy (fNIRS): Are the measurements reliable?

Functional near-infrared spectroscopy (fNIRS) is a silent, non-invasive neuroimaging technique that is potentially well suited to auditory research. However, the reliability of auditory-evoked activation measured using fNIRS is largely unknown. The present study investigated the test-retest reliability of speech-evoked fNIRS responses in normally-hearing adults. Seventeen participants underwent fNIRS imaging in two sessions separated by three months. In a block design, participants were presented with auditory speech, visual speech (silent speechreading), and audiovisual speech conditions. Optode arrays were placed bilaterally over the temporal lobes, targeting auditory brain regions. A range of established metrics was used to quantify the reproducibility of cortical activation patterns, as well as the amplitude and time course of the haemodynamic response within predefined regions of interest. The use of a signal processing algorithm designed to reduce the influence of systemic physiological signals was found to be crucial to achieving reliable detection of significant activation at the group level. For auditory speech (with or without visual cues), reliability was good to excellent at the group level, but highly variable among individuals. Temporal-lobe activation in response to visual speech was less reliable, especially in the right hemisphere. Consistent with previous reports, fNIRS reliability was improved by averaging across a small number of channels overlying a cortical region of interest. Overall, the present results confirm that fNIRS can measure speech-evoked auditory responses in adults that are highly reliable at the group level, and indicate that signal processing to reduce physiological noise may substantially improve the reliability of fNIRS measurements.

Improving fMRI reliability in presurgical mapping for brain tumours

PURPOSE

Functional MRI (fMRI) is becoming increasingly integrated into clinical practice for presurgical mapping. Current efforts are focused on validating data quality, with reliability being a major factor. In this paper, we demonstrate the utility of a recently developed approach that uses receiver operating characteristic-reliability (ROC-r) to: (1) identify reliable versus unreliable data sets; (2) automatically select processing options to enhance data quality; and (3) automatically select individualised thresholds for activation maps.

METHODS

Presurgical fMRI was conducted in 16 patients undergoing surgical treatment for brain tumours. Within-session test-retest fMRI was conducted, and ROC-reliability of the patient group was compared to a previous healthy control cohort. Individually optimised preprocessing pipelines were determined to improve reliability. Spatial correspondence was assessed by comparing the fMRI results to intraoperative cortical stimulation mapping, in terms of the distance to the nearest active fMRI voxel.

RESULTS

The average ROC-r reliability for the patients was 0.58±0.03, as compared to 0.72±0.02 in healthy controls. For the patient group, this increased significantly to 0.65±0.02 by adopting optimised preprocessing pipelines. Co-localisation of the fMRI maps with cortical stimulation was significantly better for more reliable versus less reliable data sets (8.3±0.9 vs 29±3 mm, respectively).

CONCLUSIONS

We demonstrated ROC-r analysis for identifying reliable fMRI data sets, choosing optimal postprocessing pipelines, and selecting patient-specific thresholds. Data sets with higher reliability also showed closer spatial correspondence to cortical stimulation. ROC-r can thus identify poor fMRI data at time of scanning, allowing for repeat scans when necessary. ROC-r analysis provides optimised and automated fMRI processing for improved presurgical mapping.

Test-retest reliability of graph metrics of resting state MRI functional brain networks: A review

The employment of graph theory to analyze spontaneous fluctuations in resting state BOLD fMRI data has become a dominant theme in brain imaging studies and neuroscience. Analysis of resting state functional brain networks based on graph theory has proven to be a powerful tool to quantitatively characterize functional architecture of the brain and it has provided a new platform to explore the overall structure of local and global functional connectivity in the brain. Due to its increased use and possible expansion to clinical use, it is essential that the reliability of such a technique is very strongly assessed. In this review, we explore the outcome of recent studies in network reliability which apply graph theory to analyze connectome resting state networks. Therefore, we investigate which preprocessing steps may affect reproducibility the most. In order to investigate network reliability, we compared the test-retest (TRT) reliability of functional data of published neuroimaging studies with different preprocessing steps. In particular we tested influence of global signal regression, correlation metric choice, binary versus weighted link definition, frequency band selection and length of time-series. Statistical analysis shows that only frequency band selection and length of time-series seem to affect TRT reliability. Our results highlight the importance of the choice of the preprocessing steps to achieve more reproducible measurements.

Tutorial on use of intraclass correlation coefficients for assessing intertest reliability and its application in functional near-infrared spectroscopy-based brain imaging

Test-retest reliability of neuroimaging measurements is an important concern in the investigation of cognitive functions in the human brain. To date, intraclass correlation coefficients (ICCs), originally used in interrater reliability studies in behavioral sciences, have become commonly used metrics in reliability studies on neuroimaging and functional near-infrared spectroscopy (fNIRS). However, as there are six popular forms of ICC, the adequateness of the comprehensive understanding of ICCs will affect how one may appropriately select, use, and interpret ICCs toward a reliability study. We first offer a brief review and tutorial on the statistical rationale of ICCs, including their underlying analysis of variance models and technical definitions, in the context of assessment on intertest reliability. Second, we provide general guidelines on the selection and interpretation of ICCs. Third, we illustrate the proposed approach by using an actual research study to assess interest reliability of fNIRS-based, volumetric diffuse optical tomography of brain activities stimulated by a risk decision-making protocol. Last, special issues that may arise in reliability assessment using ICCs are discussed and solutions are suggested.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback

STUDY OBJECTIVES

To better understand the sometimes catastrophic effects of sleep loss on naturalistic decision making, we investigated effects of sleep deprivation on decision making in a reversal learning paradigm requiring acquisition and updating of information based on outcome feedback.

DESIGN

Subjects were randomized to a sleep deprivation or control condition, with performance testing at baseline, after 2 nights of total sleep deprivation (or rested control), and following 2 nights of recovery sleep. Subjects performed a decision task involving initial learning of go and no go response sets followed by unannounced reversal of contingencies, requiring use of outcome feedback for decisions. A working memory scanning task and psychomotor vigilance test were also administered.

SETTING

Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring.

SUBJECTS

Twenty-six subjects (22-40 y of age; 10 women).

INTERVENTIONS

Thirteen subjects were randomized to a 62-h total sleep deprivation condition; the others were controls.

MEASUREMENTS AND RESULTS

Unlike controls, sleep deprived subjects had difficulty with initial learning of go and no go stimuli sets and had profound impairment adapting to reversal. Skin conductance responses to outcome feedback were diminished, indicating blunted affective reactions to feedback accompanying sleep deprivation. Working memory scanning performance was not significantly affected by sleep deprivation. And although sleep deprived subjects showed expected attentional lapses, these could not account for impairments in reversal learning decision making.

CONCLUSIONS

Sleep deprivation is particularly problematic for decision making involving uncertainty and unexpected change. Blunted reactions to feedback while sleep deprived underlie failures to adapt to uncertainty and changing contingencies. Thus, an error may register, but with diminished effect because of reduced affective valence of the feedback or because the feedback is not cognitively bound with the choice. This has important implications for understanding and managing sleep loss-induced cognitive impairment in emergency response, disaster management, military operations, and other dynamic real-world settings with uncertain outcomes and imperfect information.

Bringing memory fMRI to the clinic: comparison of seven memory fMRI protocols in temporal lobe epilepsy

fMRI is increasingly implemented in the clinic to assess memory function. There are multiple approaches to memory fMRI, but limited data on advantages and reliability of different methods. Here, we compared effect size, activation lateralisation, and between‐sessions reliability of seven memory fMRI protocols: Hometown Walking (block design), Scene encoding (block design and event‐related design), Picture encoding (block and event‐related), and Word encoding (block and event‐related). All protocols were performed on three occasions in 16 patients with temporal lobe epilepsy (TLE). Group T‐maps showed activity bilaterally in medial temporal lobe for all protocols. Using ANOVA, there was an interaction between hemisphere and seizure‐onset lateralisation (P = 0.009) and between hemisphere, protocol and seizure‐onset lateralisation (P = 0.002), showing that the distribution of memory‐related activity between left and right temporal lobes differed between protocols and between patients with left‐onset and right‐onset seizures. Using voxelwise intraclass Correlation Coefficient, between‐sessions reliability was best for Hometown and Scenes (block and event). The between‐sessions spatial overlap of activated voxels was also greatest for Hometown and Scenes. Lateralisation of activity between hemispheres was most reliable for Scenes (block and event) and Words (event). Using receiver operating characteristic analysis to explore the ability of each fMRI protocol to classify patients as left‐onset or right‐onset TLE, only the Words (event) protocol achieved a significantly above‐chance classification of patients at all three sessions. We conclude that Words (event) protocol shows the best combination of between‐sessions reliability of the distribution of activity between hemispheres and reliable ability to distinguish between left‐onset and right‐onset patients. Hum Brain Mapp 36:1595–1608, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Test-retest reliability of functional near infrared spectroscopy in infants

There has been a rapid rise in the number of publications using functional near infrared spectroscopy (fNIRS) for human developmental research over the past decade. However test-retest reliability of this measure of brain activation in infants remains unknown. To assess this, we utilized data from a longitudinal cohort who participated in an fNIRS study on social perception at two age points. Thirteen infants had valid data from two sessions held 8.5 months apart (4 to 8 months and 12 to 16 months). Inter- and intrasession fNIRS test-retest reliability was assessed at the individual and group levels using the oxyhemoglobin ([Formula: see text]) signal. Infant compliance with the study was similar in both sessions (assessed by the proportion of time infants looked to the stimuli), and there was minimal discrepancy in sensor placement over the targeted area between sessions. At the group level, good spatial overlap of significant responses and signal reliability was seen (spatial overlap was 0.941 and average signal change within an region of interest was [Formula: see text]). At participant level, spatial overlap was acceptable ([Formula: see text] on average across infants) although signal reliability varied between participants. This first study of test-retest reliability of fNIRS in infants shows encouraging results, particularly for group-based analysis.

Test-retest reliability of N400 event-related brain potential measures in a word-pair semantic priming paradigm in patients with schizophrenia

The N400 event-related brain potential (ERP), a negative voltage deflection occurring approximately 400ms after onset of any meaningful stimulus, is reduced in amplitude when the stimulus is preceded by related context. Previous work has found this N400 semantic priming effect to be decreased in schizophrenia, suggesting impairment in using meaningful context to activate related concepts in semantic memory. Thus, N400 amplitude may be a useful biomarker of abnormal semantic processing and its response to treatment in schizophrenia. To help assess the validity of N400 amplitude as a longitudinal measure in schizophrenia, we evaluated its test-retest reliability. ERPs were recorded in sixteen schizophrenia patients who viewed prime words, each followed at 300- or 750-ms stimulus-onset asynchrony (SOA) by a target that was either a related or unrelated word, or nonword. Participants' task was to indicate whether or not the target was a real word. They were retested on the same procedure one week later. Test-retest reliability was assessed by calculating Pearson's r and intraclass correlation coefficients (ICCs) across timepoints for N400 amplitudes for related and unrelated targets, at each SOA. Consistent with previous results, there were no significant differences between patients' N400 amplitudes for related and unrelated targets, at any SOA/timepoint combination. Pearson's r and ICCs for N400 amplitudes at Fz across timepoints were significant for both target types at each SOA (ranges: r 0.52-0.64, ICC 0.52-0.63; all p<.04). The results suggest potential utility of N400 amplitude as a longitudinal neurophysiological biomarker of semantic processing abnormalities in schizophrenia.

Temporal stability and moderating effects of age and sex on CNTRaCS task performance

Research in schizophrenia has increasingly focused on incorporating measures from cognitive neuroscience, but little is known about their psychometric characteristics. Here, we extend prior research by reporting on temporal stability, as well as age and sex effects, for cognitive neuroscience paradigms optimized as part of the Cognitive Neuroscience Test Reliability and Clinical applications for Schizophrenia consortium. Ninety-nine outpatients with schizophrenia and 131 healthy controls performed 5 tasks assessing 4 constructs at 3 sessions. The constructs were (1) Goal maintenance (Dot Probe Expectancy [DPX] and AX continuous performance tasks [AX-CPT]); (2) Episodic memory (Relational and Item-Specific Encoding and Retrieval task [RiSE]); (3) Visual integration (Jittered Orientation Visual Integration task [JOVI]); and (4) Perceptual gain control (Contrast-Contrast Effect Task [CCE]). Patients performed worse than controls on all but the CCE, and the magnitude of these group differences was stable across sessions, with no sex differences observed. Improvements over sessions were seen for the AX-CPT, the DPX, and the JOVI though practice effects for the AX-CPT and the DPX were primarily present in older participants. For the AX-CPT and the JOVI, practice effects were larger for T1 to T2 than for T2 to T3. Age was associated with poor associative recognition on the RiSE and accuracy on the JOVI. Test-rest reliability ranged from poor for the JOVI threshold score to adequate to good for the DPX, AX-CPT, and JOVI accuracy measures, with RiSE and CCE measures in the moderate range. These results suggest that group differences in DPX, AX-CPT, RiSE, and JOVI are robust and consistent across repeated testing.

Mapping small-world properties through development in the human brain: disruption in schizophrenia

Evidence from imaging studies suggests that the human brain has a small-world network topology that might be disrupted in certain brain disorders. However, current methodology is based on global graph theory measures, such as clustering, C, characteristic path length, L, and small-worldness, S, that lack spatial specificity and are insufficient to identify regional brain abnormalities. Here we propose novel ultra-fast methodology for mapping local properties of brain network topology such as local C, L and S (lC, lL and lS) in the human brain at 3-mm isotropic resolution from ‘resting-state’ magnetic resonance imaging data. Test-retest datasets from 40 healthy children/adolescents were used to demonstrate the overall good reliability of the measures across sessions and computational parameters (intraclass correlation > 0.5 for lC and lL) and their low variability across subjects (< 29%). Whereas regions with high local functional connectivity density (lFCD; local degree) in posterior parietal and occipital cortices demonstrated high lC and short lL, subcortical regions (globus pallidus, thalamus, hippocampus and amygdala), cerebellum (lobes and vermis), cingulum and temporal cortex also had high, lS, demonstrating stronger small-world topology than other hubs. Children/adolescents had stronger lFCD, higher lC and longer lL in most cortical regions and thalamus than 74 healthy adults, consistent with pruning of functional connectivity during maturation. In contrast, lFCD, lC and lL were weaker in thalamus and midbrain, and lL was shorter in frontal cortical regions and cerebellum for 69 schizophrenia patients than for 74 healthy controls, suggesting exaggerated pruning of connectivity in schizophrenia. Follow up correlation analyses for seeds in thalamus and midbrain uncovered lower positive connectivity of these regions in thalamus, putamen, cerebellum and frontal cortex (cingulum, orbitofrontal, inferior frontal) and lower negative connectivity in auditory, visual, motor, premotor and somatosensory cortices for schizophrenia patients than for controls, consistent with prior findings of thalamic disconnection in schizophrenia.

Reliability measures of functional magnetic resonance imaging in a longitudinal evaluation of mild cognitive impairment

As the aging population grows, it has become increasingly important to carefully characterize amnestic mild cognitive impairment (aMCI), a preclinical stage of Alzheimer's disease (AD). Functional magnetic resonance imaging (fMRI) is a valuable tool for monitoring disease progression in selectively vulnerable brain regions associated with AD neuropathology. However, the reliability of fMRI data in longitudinal studies of older adults with aMCI is largely unexplored. To address this, aMCI participants completed two visual working tasks, a Delayed-Recognition task and a One-Back task, on three separate scanning sessions over a three-month period. Test-retest reliability of the fMRI blood oxygen level dependent (BOLD) activity was assessed using an intraclass correlation (ICC) analysis approach. Results indicated that brain regions engaged during the task displayed greater reliability across sessions compared to regions that were not utilized by the task. During task-engagement, differential reliability scores were observed across the brain such that the frontal lobe, medial temporal lobe, and subcortical structures exhibited fair to moderate reliability (ICC=0.3-0.6), while temporal, parietal, and occipital regions exhibited moderate to good reliability (ICC=0.4-0.7). Additionally, reliability across brain regions was more stable when three fMRI sessions were used in the ICC calculation relative to two fMRI sessions. In conclusion, the fMRI BOLD signal is reliable across scanning sessions in this population and thus a useful tool for tracking longitudinal change in observational and interventional studies in aMCI.

The impact of genome-wide supported schizophrenia risk variants in the neurogranin gene on brain structure and function

The neural mechanisms underlying genetic risk for schizophrenia, a highly heritable psychiatric condition, are still under investigation. New schizophrenia risk genes discovered through genome-wide association studies (GWAS), such as neurogranin (NRGN), can be used to identify these mechanisms. In this study we examined the association of two common NRGN risk single nucleotide polymorphisms (SNPs) with functional and structural brain-based intermediate phenotypes for schizophrenia. We obtained structural, functional MRI and genotype data of 92 schizophrenia patients and 114 healthy volunteers from the multisite Mind Clinical Imaging Consortium study. Two schizophrenia-associated NRGN SNPs (rs12807809 and rs12541) were tested for association with working memory-elicited dorsolateral prefrontal cortex (DLPFC) activity and surface-wide cortical thickness. NRGN rs12541 risk allele homozygotes (TT) displayed increased working memory-related activity in several brain regions, including the left DLPFC, left insula, left somatosensory cortex and the cingulate cortex, when compared to non-risk allele carriers. NRGN rs12807809 non-risk allele (C) carriers showed reduced cortical gray matter thickness compared to risk allele homozygotes (TT) in an area comprising the right pericalcarine gyrus, the right cuneus, and the right lingual gyrus. Our study highlights the effects of schizophrenia risk variants in the NRGN gene on functional and structural brain-based intermediate phenotypes for schizophrenia. These results support recent GWAS findings and further implicate NRGN in the pathophysiology of schizophrenia by suggesting that genetic NRGN risk variants contribute to subtle changes in neural functioning and anatomy that can be quantified with neuroimaging methods.

Neuroimaging as a potential biomarker to optimize psychiatric research and treatment

Complex, polygenic phenotypes in psychiatry hamper our understanding of the underlying molecular pathways and mechanisms of many diseases. The unknown aetiology, together with symptoms which often show a large variability both across individuals and over time and also tend to respond comparatively slowly to medication, can be a problem for patient treatment and drug development. We argue that neuroimaging has the potential to improve psychiatric treatment in two ways. First, by reducing phenotypic complexity, neuroimaging intermediate phenotypes can help to identify disease-related genes and can shed light into the biological mechanisms of known risk genes. Second, quantitative neuroimaging markers - reflecting the spectrum of impairment on a brain-based level - can be used as a more sensitive, reliable and immediate treatment response biomarker. In the end, enhancing both our understanding of the pathophysiology of psychiatric disorders and the prediction of treatment success could eventually optimise current therapy plans.

High-order interactions observed in multi-task intrinsic networks are dominant indicators of aberrant brain function in schizophrenia

Identifying the complex activity relationships present in rich, modern neuroimaging data sets remains a key challenge for neuroscience. The problem is hard because (a) the underlying spatial and temporal networks may be nonlinear and multivariate and (b) the observed data may be driven by numerous latent factors. Further, modern experiments often produce data sets containing multiple stimulus contexts or tasks processed by the same subjects. Fusing such multi-session data sets may reveal additional structure, but raises further statistical challenges. We present a novel analysis method for extracting complex activity networks from such multifaceted imaging data sets. Compared to previous methods, we choose a new point in the trade-off space, sacrificing detailed generative probability models and explicit latent variable inference in order to achieve robust estimation of multivariate, nonlinear group factors ("network clusters"). We apply our method to identify relationships of task-specific intrinsic networks in schizophrenia patients and control subjects from a large fMRI study. After identifying network-clusters characterized by within- and between-task interactions, we find significant differences between patient and control groups in interaction strength among networks. Our results are consistent with known findings of brain regions exhibiting deviations in schizophrenic patients. However, we also find high-order, nonlinear interactions that discriminate groups but that are not detected by linear, pairwise methods. We additionally identify high-order relationships that provide new insights into schizophrenia but that have not been found by traditional univariate or second-order methods. Overall, our approach can identify key relationships that are missed by existing analysis methods, without losing the ability to find relationships that are known to be important.

Relationships among cognition, emotion, and motivation: implications for intervention and neuroplasticity in psychopathology

Emotion-cognition and motivation-cognition relationships and related brain mechanisms are receiving increasing attention in the clinical research literature as a means of understanding diverse types of psychopathology and improving biological and psychological treatments. This paper reviews and integrates some of the growing evidence for cognitive biases and deficits in depression and anxiety, how these disruptions interact with emotional and motivational processes, and what brain mechanisms appear to be involved. This integration sets the stage for understanding the role of neuroplasticity in implementing change in cognitive, emotional, and motivational processes in psychopathology as a function of intervention.

Reproducibility of brain activation during auditory verbal hallucinations

Previous studies investigated fMRI-guided repetitive Transcranial Magnetic Stimulation (rTMS) as an alternative treatment for auditory verbal hallucinations (AVH). This tailor-made treatment focuses at directing the rTMS coil to the location where hallucinatory activation is maximal, as identified with fMRI scans of individual patients. For the effective use of such treatment it is important to determine whether brain activation during AVH can be reliably detected using fMRI. Thirty-three psychotic patients indicated the presence of AVH during two subsequent scans. Reproducibility was measured by calculating 1) the distance between local maxima of significantly activated clusters and 2) percentage overlap of activation patterns over the two scans. These measurements were obtained both in single subjects and on group-level in five regions of interest (ROIs). ROIs consisted of the areas that were most frequently activated during AVH. Scans were considered reproducible if the distance between local maxima was smaller than 2 cm, as rTMS-treatment may target an area of approximately 2-4 cm. The median distance between local maxima was smaller than 2 cm for all ROIs on single-subject level, as well as on group-level. In addition, on single-subject level median percentage overlap varied between 14 and 38% for the different ROIs. On group-level, this was substantially higher with percentages overlap varying between 34 and 98%. Based on these results, AVH-scans may be considered sufficiently reproducible to be suitable for fMRI-guided rTMS treatment.

Are reaction times obtained during fMRI scanning reliable and valid measures of behavior?

Assuming that behavior observed during functional magnetic resonance imaging (fMRI) is comparable with behavior outside the scanner appears to be a basic tenet in cognitive neuroscience. Nevertheless, this assumption has rarely been tested directly. Here, we examined the reliability and validity of speeded performance during fMRI scanning by having the same 30 participants perform a battery of five reaction time (RT) tasks in two separate fMRI sessions and a standard laboratory (i.e., outside-scanner) session. Medium-to-high intra-class correlations between the three sessions showed that individual RT differences were conserved across sessions. Thus, for the range of tasks used, test-retest reliability and criterion validity of performance during scanning were satisfactory. Further, the pattern of between-task relations did not change within the scanner, attesting to the construct validity of performance measurements during scanning. In some tasks, however, RTs obtained from fMRI conditions were significantly shorter than those observed under normal laboratory conditions. In summary, RTs obtained during fMRI scanning appear to be largely reliable and valid measures of behavior. The observed RT speed-up during scanning might reflect task-specific interactions with a slightly different neuro-cognitive state, indicating some limits to generalizing brain-behavior relations observed with fMRI. These findings encourage further efforts in fMRI research to establish the external validity of within-scanner task performance.

Altered cerebral response during cognitive control: a potential indicator of genetic liability for schizophrenia

Aberrant activity in brain regions underlying various aspects of executive cognition has been reported in patients with schizophrenia and in their healthy relatives, suggesting an association with genetic liability. The aim of this study was to investigate brain responses to selective aspects of cognitive control in unaffected siblings who are at increased genetic risk of schizophrenia. Altogether, 65 non-affected siblings, 70 patients with schizophrenia spectrum disorders, and 235 normal controls participated in this study. Blood-oxygen-level-dependent functional magnetic resonance imaging was conducted while participants performed a cognitive control task ('flanker task') to identify brain activity and connectivity associated with response inhibition and conflict monitoring, and suppression. Behaviorally, similar to patients with schizophrenia, siblings were less accurate when inhibiting prepotent responses relative to normal controls. During response inhibition, again similar to patients with schizophrenia, siblings showed decreased activity in the anterior cingulate (ACC), along with increased functional coupling with the dorsolateral prefrontal cortex (PFC) when compared to normal controls. Our findings show altered ACC activity and PFC connectivity in unaffected siblings and patients with schizophrenia during response inhibition. These results suggest that such changes in the neural activity underlying aspects of cognitive control may represent a potential intermediate phenotype for the investigation of the genetic basis of schizophrenia.

Variability of clinical functional MR imaging results: a multicenter study

PURPOSE

To investigate intersite variability of clinical functional magnetic resonance (MR) imaging, including influence of task standardization on variability and use of various parameters to inform the clinician whether the reliability of a given functional localization is high or low.

MATERIALS AND METHODS

Local ethics committees approved the study; all participants gave written informed consent. Eight women and seven men (mean age, 40 years) were prospectively investigated at three experienced functional MR sites with 1.5- (two sites) or 3-T (one site) MR. Nonstandardized motor and highly standardized somatosensory versions of a frequently requested clinical task (localization of the primary sensorimotor cortex) were used. Perirolandic functional MR variability was assessed (peak activation variability, center of mass [COM] variability, intraclass correlation values, overlap ratio [OR], activation size ratio). Data quality measures for functional MR images included percentage signal change (PSC), contrast-to-noise ratio (CNR), and head motion parameters. Data were analyzed with analysis of variance and a correlation analysis.

RESULTS

Localization of perirolandic functional MR activity differed by 8 mm (peak activity) and 6 mm (COM activity) among sites. Peak activation varied up to 16.5 mm (COM range, 0.4-16.5 mm) and 45.5 mm (peak activity range, 1.8-45.5 mm). Signal strength (PSC, CNR) was significantly lower for the somatosensory task (mean PSC, 1.0% ± 0.5 [standard deviation]; mean CNR, 1.2 ± 0.4) than for the motor task (mean PSC, 2.4% ± 0.8; mean CNR, 2.9 ± 0.9) (P < .001, both). Intersite variability was larger with low signal strength (negative correlations between signal strength and peak activation variability) even if the task was highly standardized (mean OR, 22.0% ± 18.9 [somatosensory task] and 50.1% ± 18.8 [motor task]).

CONCLUSION

Clinical practice and clinical functional MR biomarker studies should consider that the center of task-specific brain activation may vary up to 16.5 mm, with the investigating site, and should maximize functional MR signal strength and evaluate reliability of local results with PSC and CNR.

Neurometrics of intrinsic connectivity networks at rest using fMRI: retest reliability and cross-validation using a meta-level method

Functional images of the resting brain can be empirically parsed into intrinsic connectivity networks (ICNs) which closely resemble patterns of evoked task-based brain activity and which have a biological and genetic basis. Recently, ICNs have become popular for investigating brain functioning and brain-behavior relationships. However, the replicability and neurometrics of these networks are only beginning to be reported. Using a meta-level independent component analysis (ICA), we produced ICNs from three data sets collected from two samples of healthy adults. The ICNs from our data sets demonstrated robust and independent replication of 12 intrinsic networks that reflected 17 canonical, task-based, brain networks. We found within-subject reliability of ICNs was modest overall, but ranged from poor to good, and that voxels with the highest measured connectivity rarely had the highest reliability. Networks associated with executive functions, visuospatial reasoning, motor coordination, speech and audition, default mode, vision, and interoception showed moderate to high group-level reproducibility and replicability. However, only the first four of these networks also showed fair or better within-subject reliability over time. Our findings highlight the replicability of ICNs across data sets, the range of within-subject neurometrics across different networks, and the shared characteristics between resting and task-based networks.

Pilot fMRI investigation of representational plasticity associated with motor skill learning and its functional consequences

Complex skill learning at a joint initiates competition between its representation in the primary motor cortex (M1) and that of the neighboring untrained joint. This process of representational plasticity has been mapped by cortically-evoking simple movements. We investigated, following skill learning at a joint, 1) whether comparable processes of representational plasticity are observed when mapping is based on volitionally produced complex movements and 2) the consequence on the skill of the adjacent untrained joint. Twenty-four healthy subjects were assigned to either finger- or elbow-skill training or no-training control group. At pretest and posttest, subjects performed complex skill movements at finger, elbow and ankle concurrent with functional magnetic resonance imaging (fMRI) to define learning and allow mapping of corresponding activation-based representations in M1. Skill following both finger- and elbow- training transferred to the ankle (remote joint) (p = 0.05 and 0.05); however, finger training did not transfer to the elbow and elbow training did not transfer to the finger. Following finger training, location of the trained finger representation showed a trend (p = 0.08) for medial shift towards the representation of adjacent untrained elbow joint; the change in intensity of the latter representation was associated with elbow skill (Spearman's ρ = -0.71, p = 0.07). Following elbow training, the trained elbow representation and the adjacent untrained finger representation increased their overlap (p = 0.02), which was associated with finger skill (Spearman's ρ = -0.83, p = 0.04). Thus, our pilot study reveals comparable processes of representational plasticity with fMRI mapping of complex skill movements as have been demonstrated with cortically-evoked methods. Importantly, these processes may limit the degree of transfer of skill between trained and adjacent untrained joints. These pilot findings that await confirmation in large-scale studies have significant implications for neuro-rehabilitation. For instance, techniques, such as motor cortical stimulation, that can potentially modulate processes of representational plasticity between trained and adjacent untrained representations, may optimize transfer of skill.

Task and task-free FMRI reproducibility comparison for motor network identification

Test-retest reliability of individual functional magnetic resonance imaging (fMRI) results is of importance in clinical practice and longitudinal experiments. While several studies have investigated reliability of task-induced motor network activation, less is known about the reliability of the task-free motor network. Here, we investigate the reproducibility of task-free fMRI, and compare it to motor task activity. Sixteen healthy subjects participated in this study with a test-retest interval of seven weeks. The task-free motor network was assessed with a univariate, seed-voxel-based correlation analysis. Reproducibility was tested by means of intraclass correlation (ICC) values and ratio of overlap. Higher ICC values and a better overlap were found for task fMRI as compared to task-free fMRI. Furthermore, ratio of overlap improved for task fMRI at higher thresholds, while it decreased for task-free fMRI, suggesting a less focal spatial pattern of the motor network during resting state. However, for both techniques the most active voxels were located in the primary motor cortex. This indicates that, just like task fMRI, task-free fMRI can properly identify critical brain areas for motor task performance. Although both fMRI techniques are able to detect the motor network, resting-state fMRI is less reliable than task fMRI.

[Schizophrenia, cognition and neuroimaging]

Schizophrenia is a complex illness whose mechanisms are still largely unknown. Functional brain imaging, by making the link between psyche and brain, has recently become an indispensable tool to study in vivo the neural bases underlying cognitive dysfunction in this disease. But despite the proliferation of data coming from this approach, the exact impact of functional imaging on our understanding of the disease remains blurry. In general, studies of the brain functioning of patients with schizophrenia found activation abnormalities which vary in nature and localization depending of the cognitive paradigm used. However, it appears that neurofunctional abnormalities observed in patients cannot be reduced to a simple well-localized deficit. It would be rather an alteration of the dynamics of the interactions between different brain regions that underlie the cognitive disturbances encountered in the disease. Functional brain imaging now offers new perspectives to clarify the dynamics of the brain networks, and particularly those involved in high-level cognitive functions, such as cognitive control or social cognition which seem to play a crucial role in the disease. The characterization of these features is an important issue not only to develop new hypotheses on the pathophysiology of the disorder, but also more pragmatically to identify potential therapeutic targets.

Advances in longitudinal MRI diagnostic tests

INTRODUCTION

The past decade has seen an explosion of functional magnetic resonance imaging (MRI) studies in neuroscience. As the technology progresses, it is now possible to carry out longitudinal studies using functional MRI. Such studies can be used to understand the progression of mental and neurological disorders and the effectiveness of different treatments by obtaining direct measures of brain activity as well as markers of tissue health and connectivity.

AREAS COVERED

We review six popular neuroimaging tools that can be used for longitudinal studies: blood oxygen level-dependent (BOLD)-weighted imaging, BOLD-based functional connectivity, arterial spin labeling, dynamic R2* imaging, voxel-based morphometry, and diffusion tensor imaging.

EXPERT OPINION

Each of these techniques is targeted to probe a specific feature of brain function or brain structure and can reveal important information about the progression of a pathological condition. We anticipate that in the near future, the MRI techniques discussed here may become standard tools in clinical use and will not be used for research purposes only.

Functional neuroimaging of treatment effects in psychiatry: methodological challenges and recommendations

Functional magnetic resonance imaging (fMRI) has helped to elucidate the neurobiological bases of psychiatric and neurodevelopmental disorders by localizing etiologically-relevant aberrations in brain function. Functional MRI also has shown great promise to help understand potential mechanisms of action of effective treatments for a range of psychiatric and neurodevelopmental disorders, including mood and anxiety disorders, schizophrenia, and autism. However, the use of fMRI to probe intervention effects in psychiatry is associated with unique methodological considerations, including the psychometric properties of repeated fMRI scans, how to assess potential relations between the effects of an intervention on symptoms and on specific brain activation patterns, and how to best make causal inferences about intervention effects on brain function. Additionally, the study of treatment effects in neurodevelopmental disorders presents additional unique challenges related to brain maturation, analysis methods, and the potential for motion artifacts. We review these methodological considerations and provide recommendations for best practices for each of these topics.

Potential utility of resting-state magnetoencephalography as a biomarker of CNS abnormality in HIV disease

There is a lack of a neuroimaging biomarker for HIV-Associated Neurocognitive Disorder. We report magnetoencephalography (MEG) data from patients with HIV disease and risk-group appropriate controls that were collected to determine the MEG frequency profile during the resting state, and the stability of the profile over 24 weeks. 17 individuals (10 HIV+, 7 HIV-) completed detailed neurobehavioral evaluations and 10min of resting-state MEG acquisition with a 306-channel whole-head system. The entire evaluation and MEG measurement were repeated 24 weeks later. Relative MEG power in the delta (0-4Hz), theta (4-7Hz), alpha (8-12Hz), beta (12-30Hz) and low gamma (30-50Hz) bands was computed for 8 predefined sensor groups. The median stability of resting-state relative power over 24 weeks of follow-up was .80 with eyes closed, and .72 with eyes open. The relative gamma power in the right occipital (t(15)=1.99, p<.06, r=-.46) and right frontal (t(15)=2.15, p<.05, r=-.48) regions was associated with serostatus. The effect of age on delta power was greater in the seropositive subjects (r(2)=.51) than in the seronegative subjects (r(2)=.11). Individuals with high theta-to-gamma ratios tended to have lower cognitive test performance, regardless of serostatus. The stability of the wide-band MEG frequency profiles over 24 weeks supports the utility of MEG as a biomarker. The links between the MEG profile, serostatus, and cognition suggest further research on its potential in HAND is needed.

Test-retest reliability of evoked BOLD signals from a cognitive-emotive fMRI test battery

Even more than in cognitive research applications, moving fMRI to the clinic and the drug development process requires the generation of stable and reliable signal changes. The performance characteristics of the fMRI paradigm constrain experimental power and may require different study designs (e.g., crossover vs. parallel groups), yet fMRI reliability characteristics can be strongly dependent on the nature of the fMRI task. The present study investigated both within-subject and group-level reliability of a combined three-task fMRI battery targeting three systems of wide applicability in clinical and cognitive neuroscience: an emotional (face matching), a motivational (monetary reward anticipation) and a cognitive (n-back working memory) task. A group of 25 young, healthy volunteers were scanned twice on a 3T MRI scanner with a mean test-retest interval of 14.6 days. FMRI reliability was quantified using the intraclass correlation coefficient (ICC) applied at three different levels ranging from a global to a localized and fine spatial scale: (1) reliability of group-level activation maps over the whole brain and within targeted regions of interest (ROIs); (2) within-subject reliability of ROI-mean amplitudes and (3) within-subject reliability of individual voxels in the target ROIs. Results showed robust evoked activation of all three tasks in their respective target regions (emotional task=amygdala; motivational task=ventral striatum; cognitive task=right dorsolateral prefrontal cortex and parietal cortices) with high effect sizes (ES) of ROI-mean summary values (ES=1.11-1.44 for the faces task, 0.96-1.43 for the reward task, 0.83-2.58 for the n-back task). Reliability of group level activation was excellent for all three tasks with ICCs of 0.89-0.98 at the whole brain level and 0.66-0.97 within target ROIs. Within-subject reliability of ROI-mean amplitudes across sessions was fair to good for the reward task (ICCs=0.56-0.62) and, dependent on the particular ROI, also fair-to-good for the n-back task (ICCs=0.44-0.57) but lower for the faces task (ICC=-0.02-0.16). In conclusion, all three tasks are well suited to between-subject designs, including imaging genetics. When specific recommendations are followed, the n-back and reward task are also suited for within-subject designs, including pharmaco-fMRI. The present study provides task-specific fMRI reliability performance measures that will inform the optimal use, powering and design of fMRI studies using comparable tasks.

Striatal function in relation to negative symptoms in schizophrenia

BACKGROUND

Previous studies have suggested that motivational aspects of executive functioning, which may be disrupted in schizophrenia patients with negative symptoms, are mediated in part by the striatum. Negative symptoms have been linked to impaired recruitment of both the striatum and the dorsolateral prefrontal cortex (DLPFC). Here we tested the hypothesis that negative symptoms are associated primarily with striatal dysfunction, using functional magnetic resonance imaging (fMRI).

METHOD

Working-memory load-dependent activation and gray matter volumes of the striatum and DLPFC were measured using a region-of-interest (ROI) approach, in 147 schizophrenia patients and 160 healthy controls. In addition to testing for a linear relationships between striatal function and negative symptoms, we chose a second, categorical analytic strategy in which we compared three demographically and behaviorally matched subgroups: patients with a high burden of negative symptoms, patients with minimal negative symptoms, and healthy subjects.

RESULTS

There were no differences in striatal response magnitudes between schizophrenia patients and healthy controls, but right DLPFC activity was higher in patients than in controls. Negative symptoms were inversely associated with striatal, but not DLPFC, activity. In addition, patients with a high burden of negative symptoms exhibited significantly lower bilateral striatal, but not DLPFC, activation than schizophrenia patients with minimal negative symptoms. Working memory performance, antipsychotic exposure and changes in gray matter volumes did not account for these differences.

CONCLUSIONS

These data provide further evidence for a robust association between negative symptoms and diminished striatal activity. Future work will determine whether low striatal activity in schizophrenia patients could serve as a reliable biomarker for negative symptoms.

CNTRICS imaging biomarkers selection: Working memory

The sixth meeting of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) consortium was focused on selecting promising imaging biomarker measures for each of the cognitive constructs selected in the first CNTRICS meeting. In the domain of working memory (WM), the 2 constructs of interest were "goal maintenance" and "interference control." CNTRICS received 7 task nominations for goal maintenance and 3 task nominations for interference control. For goal maintenance, the breakout group for WM recommended the AX Continuous Performance Test/Dot Pattern Expectancy (DPX) and the Switching Stroop task for translation and further development for use in clinical trial contexts in schizophrenia research. Notably, these same 2 paradigms were recommended for "rule generation and selection" in executive control, a highly related construct. For interference control, the breakout group recommended the Suppress Task and the Sternberg Item Recognition Paradigm for translation for use in clinical trials. This manuscript describes the ways in which each of these tasks met the criteria used by the breakout group to recommend tasks for further development. In addition, the group revisited the construct of WM capacity. Since the initial CNTRICS meeting, a growing body of work has emerged on the neurobiological substrates of WM capacity, making measure of this construct ready for translation. The group suggested a promising imaging biomarker measure for capacity, a version of the change detection task that measures delay activity over posterior parietal and occipital cortex.

The effects of exercise on the neuronal response to food cues

Increased physical activity is associated with successful long-term weight loss maintenance due to mechanisms likely more complex than simply increased energy expenditure. The impact of physical activity on the central regulation of food intake may be an important mechanism of this effect. The objective of this study was to examine the effects of exercise training and acute exercise on the neuronal response to food cues as well as eating behaviors. fMRI was performed in the fasted state at baseline and again after a 6 month progressive exercise intervention (supervised, 5 days/wk) both with and without an acute exercise bout in 12 overweight/obese (5 women, 7 men; BMI 33 ± 4 kg/m(2)) healthy adults. fMRI data were acquired while subjects were presented with visual stimuli of foods of high hedonic value as compared to neutral control objects. Questionnaires on eating behaviors, ratings of appeal and desire for foods, and ratings of appetite (hunger, satiety, prospective intake) using visual analog scales were also performed at baseline and again after the 6-month exercise intervention. While only a trend was observed for a reduction in body weight (102 ± 5 to 99 ± 6 kg, p=0.09), a significant reduction in fat mass was observed (36.4 ± 2.8 to 33.7 ± 3.2 kg, p=0.04), although as expected changes in fat mass were variable (-10.0 to +3.7 kg). Chronic exercise was associated with a reduction in the neuronal response to food, primarily in the posterior attention network and insula. A significant positive correlation between the change in fat/body mass and the change in insula response to food cues with chronic exercise was observed. An acute exercise bout attenuated the effects of chronic exercise. The exercise intervention, however, did not impact any of the measures of appetitive behavior. In summary, despite no effects on behavioral measures of appetite, chronic exercise training was associated with attenuation in the response to visual food cues in brain regions known to be important in food intake regulation. The insula, in particular, appears to play an important role in the potential exercise-induced weight loss and weight loss maintenance.

Using brain imaging measures in studies of procognitive pharmacologic agents in schizophrenia: psychometric and quality assurance considerations

The first phase of the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICs) initiative focused on the identification of cognitive constructs from human and animal neuroscience that were relevant to understanding cognitive deficits in schizophrenia, as well as promising task paradigms that could be used to assess these constructs behaviorally. The current phase of CNTRICs has the goal of expanding this initial work by including measures of brain function that can augment these behavioral tasks as biomarkers to be used in drug development processing. Here we review many of the psychometric issues that need to be addressed regarding the development and inclusion of such methods in the drug development process. In addition, we review quality assurance concerns, issues associated with multicenter trials, concerns associated with potential pharmacologic confounds on imaging measures, as well as power and analysis considerations. Although review is couched in the context of the use of biomarkers for treatment studies in schizophrenia, we believe the issues and suggestions included are relevant to the entire range of neuropsychiatric disorders as well as to a wide range of imaging modalities (i.e., functional magnetic resonance imaging, positron emission tomography, event-related potentials, electroencephalography, transcranial magnetic stimulation, near infrared spectroscopy, etc.) and are relevant to both pharmacologic and psychological intervention approaches.

An fMRI study of prefrontal dysfunction and symptomatic recovery in schizophrenia

OBJECTIVE

Prefrontal cortical dysfunction has been implicated in the pathophysiology of schizophrenia but it is unclear to what extent these are related to changes in symptomatology as well as task demand.

METHOD

We examined the neural correlates of symptom change and task demand during a longitudinal functional magnetic resonance imaging (fMRI) study using a verbal fluency task with differential task demands in patients with schizophrenia and matched healthy control subjects. The fMRI data were acquired using clustered acquisition technique, enabling ongoing monitoring of behavioural responses, in the patient group on two occasions separated by 6-8 weeks, and the control group at baseline.

RESULTS

Positive psychotic symptoms were significantly reduced over the 6-8-week duration of the study. This change was associated with increased activation within the left middle frontal gyrus and decreased activation of the left precuneus. An interaction between symptom change and task demand was evident in the activation of the left middle frontal gyrus. The decrease in positive symptoms was associated with normalisation of activation in the dorsolateral prefrontal cortex and a decrease in parietal activation during the verbal fluency task.

CONCLUSION

The data supports the role of dysfunctional prefronto-parietal relationships in the genesis of positive psychotic symptoms.

Reproducibility of fMRI activations during a story listening task in patients with schizophrenia

A prerequisite to longitudinal fMRI studies in schizophrenia is the knowledge on fMRI signal reliability in schizophrenia patients. We assessed the reproducibility of activations elicited by two fMRI sessions, which were 21 months apart, of a story listening paradigm in 10 schizophrenia patients and 10 healthy subjects. In both groups, we observed a high degree of spatial overlap of activation maps as well as a good reproducibility of signal variations assessed on a voxel-wise basis in temporal areas underlying early stages of language processing. Task performance, assessed through a comprehension questionnaire, had no impact on the activation reproducibility.