Relationship Between Sulcal Characteristics and Brain Aging

The Impact of HIV on Early Brain Aging-A Pathophysiological (Re)View

Background/Objectives: This review aims to provide a comprehensive understanding of how HIV alters normal aging trajectories in the brain, presenting the HIV-related molecular mechanisms and pathophysiological pathways involved in brain aging. The review explores the roles of inflammation, oxidative stress, and viral persistence in the brain, highlighting how these factors contribute to neuronal damage and cognitive impairment and accelerate normal brain aging. Additionally, it also addresses the impact of antiretroviral therapy on brain aging and the biological markers associated with its occurrence. Methods: We extensively searched PubMed for English-language articles published from 2000 to 2024. The following keywords were used in the search: "HIV", "brain", "brain aging", "neuroinflammation", "HAART", and "HAND". This strategy yielded 250 articles for inclusion in our review. Results: A combination of blood-brain barrier dysfunction, with the direct effects of HIV on the central nervous system, chronic neuroinflammation, telomere shortening, neurogenesis impairments, and neurotoxicity associated with antiretroviral treatment (ART), alters and amplifies the mechanisms of normal brain aging. Conclusions: Current evidence suggests that HIV infection accelerates neurodegenerative processes of normal brain aging, leading to cognitive decline and structural brain changes at an earlier age than typically observed in the general population.

Neuro-evolutionary evidence for a universal fractal primate brain shape

The cerebral cortex displays a bewildering diversity of shapes and sizes across and within species. Despite this diversity, we present a universal multi-scale description of primate cortices. We show that all cortical shapes can be described as a set of nested folds of different sizes. As neighbouring folds are gradually merged, the cortices of 11 primate species follow a common scale-free morphometric trajectory, that also overlaps with over 70 other mammalian species. Our results indicate that all cerebral cortices are approximations of the same archetypal fractal shape with a fractal dimension of df = 2.5. Importantly, this new understanding enables a more precise quantification of brain morphology as a function of scale. To demonstrate the importance of this new understanding, we show a scale-dependent effect of ageing on brain morphology. We observe a more than fourfold increase in effect size (from two standard deviations to eight standard deviations) at a spatial scale of approximately 2 mm compared to standard morphological analyses. Our new understanding may, therefore, generate superior biomarkers for a range of conditions in the future.

Defining Overlooked Structures Reveals New Associations between the Cortex and Cognition in Aging and Alzheimer's Disease

Recent work suggests that indentations of the cerebral cortex, or sulci, may be uniquely vulnerable to atrophy in aging and Alzheimer's disease (AD) and that the posteromedial cortex (PMC) is particularly vulnerable to atrophy and pathology accumulation. However, these studies did not consider small, shallow, and variable tertiary sulci that are located in association cortices and are often associated with human-specific aspects of cognition. Here, we manually defined 4,362 PMC sulci in 432 hemispheres in 216 human participants (50.5% female) and found that these smaller putative tertiary sulci showed more age- and AD-related thinning than larger, more consistent sulci, with the strongest effects for two newly uncovered sulci. A model-based approach relating sulcal morphology to cognition identified that a subset of these sulci was most associated with memory and executive function scores in older adults. These findings lend support to the retrogenesis hypothesis linking brain development and aging and provide new neuroanatomical targets for future studies of aging and AD.

Structural brain morphometry differences and similarities between young patients with Crohn's disease in remission and healthy young and old controls

Introduction

Crohn's disease (CD), one of the main phenotypes of inflammatory bowel disease (IBD), can affect any part of the gastrointestinal tract. It can impact the function of gastrointestinal secretions, as well as increasing the intestinal permeability leading to an aberrant immunological response and subsequent intestinal inflammation. Studies have reported anatomical and functional brain changes in Crohn's Disease patients (CDs), possibly due to increased inflammatory markers and microglial cells that play key roles in communicating between the brain, gut, and systemic immune system. To date, no studies have demonstrated similarities between morphological brain changes seen in IBD and brain morphometry observed in older healthy controls..

Methods

For the present study, twelve young CDs in remission (M = 26.08 years, SD = 4.9 years, 7 male) were recruited from an IBD Clinic. Data from 12 young age-matched healthy controls (HCs) (24.5 years, SD = 3.6 years, 8 male) and 12 older HCs (59 years, SD = 8 years, 8 male), previously collected for a different study under a similar MR protocol, were analyzed as controls. T1 weighted images and structural image processing techniques were used to extract surface-based brain measures, to test our hypothesis that young CDs have different brain surface morphometry than their age-matched young HCs and furthermore, appear more similar to older HCs. The phonemic verbal fluency (VF) task (the Controlled Oral Word Association Test, COWAT) (Benton, 1976) was administered to test verbal cognitive ability and executive control.

Results/Discussion

On the whole, CDs had more brain regions with differences in brain morphometry measures when compared to the young HCs as compared to the old HCs, suggesting that CD has an effect on the brain that makes it appear more similar to old HCs. Additionally, our study demonstrates this atypical brain morphometry is associated with function on a cognitive task. These results suggest that even younger CDs may be showing some evidence of structural brain changes that demonstrate increased resemblance to older HC brains rather than their similarly aged healthy counterparts.

Simultaneous High-Frame-Rate Acoustic Plane-Wave and Optical Imaging of Intracranial Cavitation in Polyacrylamide Brain Phantoms during Blunt Force Impact

Blunt and blast impacts occur in civilian and military personnel, resulting in traumatic brain injuries necessitating a complete understanding of damage mechanisms and protective equipment design. However, the inability to monitor in vivo brain deformation and potential harmful cavitation events during collisions limits the investigation of injury mechanisms. To study the cavitation potential, we developed a full-scale human head phantom with features that allow a direct optical and acoustic observation at high frame rates during blunt impacts. The phantom consists of a transparent polyacrylamide material sealed with fluid in a 3D-printed skull where windows are integrated for data acquisition. The model has similar mechanical properties to brain tissue and includes simplified yet key anatomical features. Optical imaging indicated reproducible cavitation events above a threshold impact energy and localized cavitation to the fluid of the central sulcus, which appeared as high-intensity regions in acoustic images. An acoustic spectral analysis detected cavitation as harmonic and broadband signals that were mapped onto a reconstructed acoustic frame. Small bubbles trapped during phantom fabrication resulted in cavitation artifacts, which remain the largest challenge of the study. Ultimately, acoustic imaging demonstrated the potential to be a stand-alone tool, allowing observations at depth, where optical techniques are limited.

Twelve weeks of physical exercise breaks with coordinative exercises at the workplace increase the sulcal depth and decrease gray matter volume in brain structures related to visuomotor processes

Physical exercise can evoke changes in the brain structure. Consequently, these can lead to positive impacts on brain health. However, physical exercise studies including coordinative exercises are rare. Therefore, in this study, we investigated how 12 weeks of physical exercise breaks (PEBs) with coordinative exercises, focusing mainly on juggling tasks, affected the brain structure. The participants were randomly allocated to an intervention group (IG, n = 16; 42.8 ± 10.2 years) and a control group (CG, n = 9; 44.2 ± 12.3 years). The IG performed the PEBs with coordinative exercises twice per week for 15-20 min per session. Before the intervention, after 6 weeks of the intervention, and after 12 weeks of the intervention, participants underwent a high-resolution 3T T1-weighted magnetic resonance imagining scan. Juggling performance was assessed by measuring the time taken to perform a three-ball cascade. A surface-based analysis revealed an increase in vertex-wise cortical depth in a cluster including the inferior parietal lobe after 6 and 12 weeks of training in the IG. After 12 weeks, the IG showed a decrease in gray matter (GM) volume in a cluster primarily involving the right insula and the right operculum. The changes in the GM volume were related to improvements in juggling performance. No significant changes were found for the CG. To conclude, the present study showed that regular engagement in PEBs with coordinative exercises led to changes in brain structures strongly implicated in visuomotor processes involving hand and arm movements.

Changed cortical thickness and sulcal depth in pediatric acute lymphoblastic leukemia survivors treated with chemotherapy only

The purpose of this study is to observe the changes of cortical morphological characteristics and their potential contribution to cognitive function in ALL survivors by using surface-based morphometry (SBM). Using SBM analysis, we calculated and compared group differences in cortical thickness, sulcal depth, gyrification, and fractal dimension of the cerebral cortex between 18 pediatric ALL survivors treated on chemotherapy-only protocols and off treatment within 2 years, and 18 healthy controls (HCs) with two-sample t-tests [P < 0.05, family-wise error (FWE) corrected]. Relationships between abnormal cortical characteristic values and cognitive function parameters were investigated with partial correlation analysis, taking age as a covariate. We found decreased cortical thickness mainly located in the prefrontal and temporal region, and increased sulcal depth in left rostral middle frontal cortex and left pars orbitalis in the ALL survivors compared to HCs. There were no statistically significant differences in the gyrification and fractal dimension between the two groups. In ALL survivors, cortical thickness and sulcal depth of above areas values revealed no significant correlation with the cognitive function parameters. In conclusion, pediatric ALL survivors show decreased cortical thickness in prefrontal and temporal regions, and increased sulcal depth in prefrontal region. These results suggest that SBM-based approach can be used to assess changes of cortical morphological characteristics in pediatric ALL survivors.

Aging and Cerebral Glucose Metabolism: 18F-FDG-PET/CT Reveals Distinct Global and Regional Metabolic Changes in Healthy Patients

Alterations in cerebral glucose metabolism can be indicative of both normal and pathological aging processes. In this retrospective study, we evaluated global and regional neurological glucose metabolism in 73 healthy individuals (mean age: 35.8 ± 13.1 years; 82.5% female) using 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). This population exhibited a low prevalence of comorbidities associated with cerebrovascular risk factors. We utilized 18F-FDG-PET/CT imaging and quantitative regional analysis to assess cerebral glucose metabolism. A statistically significant negative correlation was found between age and the global standardized uptake value mean (SUVmean) of FDG uptake (p = 0.000795), indicating a decrease in whole-brain glucose metabolism with aging. Furthermore, region-specific analysis identified significant correlations in four cerebral regions, with positive correlations in the basis pontis, cerebellar hemisphere, and cerebellum and a negative correlation in the lateral orbital gyrus. These results were further confirmed via linear regression analysis. Our findings reveal a nuanced understanding of how aging affects glucose metabolism in the brain, providing insight into normal neurology. The study underscores the utility of 18F-FDG-PET/CT as a sensitive tool in monitoring these metabolic changes, highlighting its potential for the early detection of neurological diseases and disorders related to aging.

Cortical morphological changes in multiple sclerosis patients: a study of cortical thickness, sulcal depth, and local gyrification index

PURPOSE

Multiple sclerosis (MS) is a disease that progresses not only with demyelination but also with neurodegeneration. One of the goals of drug treatment in MS is to prevent neurodegeneration. Cortical thickness (CT), sulcal depth (SD), and local gyrification index (LGI) are indicators related to neurodegeneration. The aim of this study is to investigate changes in CT, SD, and LGI in patients with relapsing-remitting MS (RRMS).

METHODS

T1 images of 74 RRMS patients and 65 healthy controls were used. T1 hypointense areas in RRMS patients were corrected using fully automated methods. CT, SD, and LGI were calculated for each patient.

RESULTS

RRMS patients showed widespread cortical thinning, especially in bilateral temporoparietal areas, decreased SD in bilateral supramarginal gyrus, superior temporal gyrus, postcentral gyrus, and transverse temporal gyrus, and decreased LGI, especially in the left posterior cingulate gyrus and insula. The decrease in cortical thickness was associated with the number of attacks and lesion volume. EDSS was related to CT in the right lingual, inferior temporal, and fusiform gyrus. The LGI was correlated with T2 lesion volume in bilateral insula, with EDSS in the right insula and transverse and superior temporal gyri, and with the number of attacks in the right paracentral gyrus and pre-cuneus. However, SD did not show any correlation with EDSS, T2 lesion volume, or the number of attacks.

CONCLUSION

Our results demonstrate widespread cortical thinning, decreased sulcal depth in local areas, and decreased gyrification in folds in RRMS patients, which are related to clinical parameters.

Defining overlooked structures reveals new associations between cortex and cognition in aging and Alzheimer's disease

Recent work suggests that indentations of the cerebral cortex, or sulci, may be uniquely vulnerable to atrophy in aging and Alzheimer's disease (AD) and that posteromedial cortex (PMC) is particularly vulnerable to atrophy and pathology accumulation. However, these studies did not consider small, shallow, and variable tertiary sulci that are located in association cortices and are often associated with human-specific aspects of cognition. Here, we first manually defined 4,362 PMC sulci in 432 hemispheres in 216 participants. Tertiary sulci showed more age- and AD-related thinning than non-tertiary sulci, with the strongest effects for two newly uncovered tertiary sulci. A model-based approach relating sulcal morphology to cognition identified that a subset of these sulci were most associated with memory and executive function scores in older adults. These findings support the retrogenesis hypothesis linking brain development and aging, and provide new neuroanatomical targets for future studies of aging and AD.

Development of Human Lateral Prefrontal Sulcal Morphology and Its Relation to Reasoning Performance

Previous findings show that the morphology of folds (sulci) of the human cerebral cortex flatten during postnatal development. However, previous studies did not consider the relationship between sulcal morphology and cognitive development in individual participants. Here, we fill this gap in knowledge by leveraging cross-sectional morphologic neuroimaging data in the lateral PFC (LPFC) from individual human participants (6-36 years old, males and females; N = 108; 3672 sulci), as well as longitudinal morphologic and behavioral data from a subset of child and adolescent participants scanned at two time points (6-18 years old; N = 44; 2992 sulci). Manually defining thousands of sulci revealed that LPFC sulcal morphology (depth, surface area, and gray matter thickness) differed between children (6-11 years old)/adolescents (11-18 years old) and young adults (22-36 years old) cross-sectionally, but only cortical thickness showed differences across childhood and adolescence and presented longitudinal changes during childhood and adolescence. Furthermore, a data-driven approach relating morphology and cognition identified that longitudinal changes in cortical thickness of four left-hemisphere LPFC sulci predicted longitudinal changes in reasoning performance, a higher-level cognitive ability that relies on LPFC. Contrary to previous findings, these results suggest that sulci may flatten either after this time frame or over a longer longitudinal period of time than previously presented. Crucially, these results also suggest that longitudinal changes in the cortex within specific LPFC sulci are behaviorally meaningful, providing targeted structures, and areas of the cortex, for future neuroimaging studies examining the development of cognitive abilities.SIGNIFICANCE STATEMENT Recent work has shown that individual differences in neuroanatomical structures (indentations, or sulci) within the lateral PFC are behaviorally meaningful during childhood and adolescence. Here, we describe how specific lateral PFC sulci develop at the level of individual participants for the first time: from both cross-sectional and longitudinal perspectives. Further, we show, also for the first time, that the longitudinal morphologic changes in these structures are behaviorally relevant. These findings lay the foundation for a future avenue to precisely study the development of the cortex and highlight the importance of studying the development of sulci in other cortical expanses and charting how these changes relate to the cognitive abilities those areas support at the level of individual participants.

Characterization of material properties and deformation in the ANGUS phantom during mild head impacts using MRI

Traumatic brain injury (TBI) is a major health concern affecting both military and civilian populations. Despite notable advances in TBI research in recent years, there remains a significant gap in linking the impulsive loadings from a blast or a blunt impact to the clinical injury patterns observed in TBI. Synthetic head models or phantoms can be used to establish this link as they can be constructed with geometry, anatomy, and material properties that match the human brain, and can be used as an alternative to animal models. This study presents one such phantom called the Anthropomorphic Neurologic Gyrencephalic Unified Standard (ANGUS) phantom, which is an idealized gyrencephalic brain phantom composed of polyacrylamide gel. Here we mechanically characterized the ANGUS phantom using tagged magnetic resonance imaging (MRI) and magnetic resonance elastography (MRE), and then compared the outcomes to data obtained in healthy volunteers. The direct comparison between the phantom's response and the data from a cohort of in vivo human subjects demonstrate that the ANGUS phantom may be an appropriate model for bulk tissue response and gyral dynamics of the human brain under small amplitude linear impulses. However, the phantom's response differs from that of the in vivo human brain under rotational impacts, suggesting avenues for future improvements to the phantom.

Fetal temporal sulcus depth asymmetry has prognostic value for language development

In most humans, the superior temporal sulcus (STS) shows a rightward depth asymmetry. This asymmetry can not only be observed in adults, but is already recognizable in the fetal brain. As the STS lies adjacent to brain areas important for language, STS depth asymmetry may represent an anatomical marker for language abilities. This study investigated the prognostic value of STS depth asymmetry in healthy fetuses for later language abilities, language localization, and language-related white matter tracts. Less right lateralization of the fetal STS depth was significantly associated with better verbal abilities, with fetal STS depth asymmetry explaining more than 40% of variance in verbal skills 6-13 years later. Furthermore, less right fetal STS depth asymmetry correlated with increased left language localization during childhood. We hypothesize that earlier and/or more localized fetal development of the left temporal cortex is accompanied by an earlier development of the left STS and is favorable for early language learning. If the findings of this pilot study hold true in larger samples of healthy children and in different clinical populations, fetal STS asymmetry has the potential to become a diagnostic biomarker of the maturity and integrity of neural correlates of language.

Alterations of gray and white matter volumes and cortical thickness in treated HIV-positive patients

Brain structural changes in HIV identified by voxel-based morphometry (VBM) alone could arise from a variety of causes that are difficult to distinguish without further information, such as cortical thickness (CT), gyrification index (GI) or sulcal depth (SD). Hence, our goal was to assess these additional metrics in HIV using high-resolution 3D T₁-weighted images and investigate if surface-based morphometric (SBM) analysis would reveal significant changes in the gray matter (GM) and white matter (WM) volumes combined with alterations in cortical thickness (CT), gyrification index (GI), sulcal depth (SD). T1-w magnetization-prepared-rapid-acquisition gradient-echo (MP-RAGE) scans were acquired in 27 HIV-infected individuals on antiretroviral therapy (ART) and 15 HIV-uninfected healthy controls using a 3T MRI scanner equipped with a 16-channel head "receive" and a quadrature body "transmit" coil. Voxel-based and surface-based morphometric analyses were performed using the MATLAB based SPM Computational Anatomy Toolbox (CAT12.7(1700)). HIV-infected patients showed significantly altered GM and WM volumes, CT, GI, and SD, in multiple brain regions. This study showed the association of altered GM and WM volumes in local brain regions with the changes in region-wise CT, GI and SD measures of HIV-infected patients, especially in the parahippocampal and middle frontal regions as compared to uninfected healthy controls. The outcome of this study suggests that the findings of VBM may not necessarily indicate the volumetric shrinkage or increase alone, but might also be due to altered CT, GI, or SD. Correlation analysis showed a significantly accelerated gray matter loss with age in HIV-infected individuals compared to uninfected healthy controls.

Surface-Based Cortical Measures in Multimodal Association Brain Regions Predict Chess Expertise

The complex structure of the brain supports high-order cognition, which is crucial for mastering chess. Surface-based measures, including the fractional dimension (FD) and gyrification index (GI), may be more sensitive in detecting cortical changes relative to volumetric indexes. For this reason, structural magnetic resonance imaging data from 29 chess experts and 29 novice participants were analyzed using the CAT12 toolbox. FD and GI for each brain region were compared between the groups. A multivariate model was used to identify surface-based brain measures that can predict chess expertise. In chess experts, FD is increased in the left frontal operculum (p < 0.01), and this change correlates with the starting age of chess practice (ρ = −0.54, p < 0.01). FD is decreased in the right superior parietal lobule (p < 0.01). Chess expertise is predicted by the FD in a network of fronto-parieto-temporal regions and is associated with GI changes in the middle cingulate gyrus (p < 0.01) and the superior temporal sulcus (p < 0.01). Our findings add to the evidence that chess expertise is based on the complex properties of the brain surface of a network of transmodal association areas important for flexible high-level cognitive functions. Interestingly, these changes are associated with long-lasting practice, suggesting that neuroplastic effects develop over time.

Cortical and subcortical grey matter atrophy in Amyotrophic Lateral Sclerosis correlates with measures of disease accumulation independent of disease aggressiveness

There is a growing demand for reliable biomarkers to monitor disease progression in Amyotrophic Lateral Sclerosis (ALS) that also take the heterogeneity of ALS into account. In this study, we explored the association between Magnetic Resonance Imaging (MRI)-derived measures of cortical thickness (CT) and subcortical grey matter (GM) volume with D50 model parameters. T1-weighted MRI images of 72 Healthy Controls (HC) and 100 patients with ALS were analyzed using Surface-based Morphometry for cortical structures and Voxel-based Morphometry for subcortical Region-Of-Interest analyses using the Computational Anatomy Toolbox (CAT12). In Inter-group contrasts, these parameters were compared between patients and HC. Further, the D50 model was used to conduct subgroup-analyses, dividing patients by a) Phase of disease covered at the time of MRI-scan and b) individual overall disease aggressiveness. Finally, correlations between GM and D50 model-derived parameters were examined. Inter-group analyses revealed ALS-related cortical thinning compared to HC located mainly in frontotemporal regions and a decrease in GM volume in the left hippocampus and amygdala. A comparison of patients in different phases showed further cortical and subcortical GM atrophy along with disease progression. Correspondingly, regression analyses identified negative correlations between cortical thickness and individual disease covered. However, there were no differences in CT and subcortical GM between patients with low and high disease aggressiveness. By application of the D50 model, we identified correlations between cortical and subcortical GM atrophy and ALS-related functional disability, but not with disease aggressiveness. This qualifies CT and subcortical GM volume as biomarkers representing individual disease covered to monitor therapeutic interventions in ALS.

Neuroanatomical foundations of delayed reward discounting decision making II: Evaluation of sulcal morphology and fractal dimensionality

Delayed reward discounting (DRD) is a form of decision-making reflecting valuation of smaller immediate rewards versus larger delayed rewards, and high DRD has been linked to several health behaviors, including substance use disorders, attention-deficit/hyperactivity disorder, and obesity. Elucidating the underlying neuroanatomical factors may offer important insights into the etiology of these conditions. We used structural MRI scans of 1038 Human Connectome Project participants (M_age = 28.86, 54.7% female) to explore two novel measures of neuroanatomy related to DRD: 1) sulcal morphology (SM; depth and width) and 2) fractal dimensionality (FD), or cortical morphometric complexity, of parcellated cortical and subcortical regions. To ascertain unique contributions to DRD preferences, indicators that displayed significant partial correlations with DRD after family-wise error correction were entered into iterative mixed-effect models guided by the association magnitude. When considering only SM indicators, the depth of the right inferior and width of the left central sulci were uniquely associated with DRD preferences. When considering only FD indicators, the FD of the left middle temporal gyrus, right lateral orbitofrontal cortex, and left lateral occipital and entorhinal cortices uniquely contributed DRD. When considering SM and FD indicators simultaneously, the right inferior frontal sulcus depth and left central sulcus width; and the FD of the left middle temporal gyrus, lateral occipital cortex and entorhinal cortex were uniquely associated with DRD. These results implicate SM and FD as features of the brain that underlie variation in the DRD decision-making phenotype and as promising candidates for understanding DRD as a biobehavioral disease process.

Connectome-based predictive models using resting-state fMRI for studying brain aging

Changes in the brain with age can provide useful information regarding an individual's chronological age. studies have suggested that functional connectomes identified via resting-state functional magnetic resonance imaging (fMRI) could be a powerful feature for predicting an individual's age. We applied connectome-based predictive modeling (CPM) to investigate individual chronological age predictions via resting-state fMRI using open-source datasets. The significant feature for age prediction was confirmed in 168 subjects from the Southwest University Adult Lifespan Dataset. The higher contributing nodes for age production included a positive connection from the left inferior parietal sulcus and a negative connection from the right middle temporal sulcus. On the network scale, the subcortical-cerebellum network was the dominant network for age prediction. The generalizability of CPM, which was constructed using the identified features, was verified by applying this model to independent datasets that were randomly selected from the Autism Brain Imaging Data Exchange I and the Open Access Series of Imaging Studies 3. CPM via resting-state fMRI is a potential robust predictor for determining an individual's chronological age from changes in the brain.

Towards the Interpretability of Deep Learning Models for Multi-modal Neuroimaging: Finding Structural Changes of the Ageing Brain

Brain-age (BA) estimates based on deep learning are increasingly used as neuroimaging biomarker for brain health; however, the underlying neural features have remained unclear. We combined ensembles of convolutional neural networks with Layer-wise Relevance Propagation (LRP) to detect which brain features contribute to BA. Trained on magnetic resonance imaging (MRI) data of a population-based study (n=2637, 18-82 years), our models estimated age accurately based on single and multiple modalities, regionally restricted and whole-brain images (mean absolute errors 3.37-3.86 years). We find that BA estimates capture aging at both small and large-scale changes, revealing gross enlargements of ventricles and subarachnoid spaces, as well as white matter lesions, and atrophies that appear throughout the brain. Divergence from expected aging reflected cardiovascular risk factors and accelerated aging was more pronounced in the frontal lobe. Applying LRP, our study demonstrates how superior deep learning models detect brain-aging in healthy and at-risk individuals throughout adulthood.

Normal Aging Induces Changes in the Brain and Neurodegeneration Progress: Review of the Structural, Biochemical, Metabolic, Cellular, and Molecular Changes

Aging is accompanied by many changes in brain and contributes to progressive cognitive decline. In contrast to pathological changes in brain, normal aging brain changes have relatively mild but important changes in structural, biochemical and molecular level. Representatively, aging associated brain changes include atrophy of tissues, alteration in neurotransmitters and damage accumulation in cellular environment. These effects have causative link with age associated changes which ultimately results in cognitive decline. Although several evidences were found in normal aging changes of brain, it is not clearly integrated. Figuring out aging related changes in brain is important as aging is the process that everyone goes through, and comprehensive understanding may help to progress further studies. This review clarifies normal aging brain changes in an asymptotic and comprehensive manner, from a gross level to a microscopic and molecular level, and discusses potential approaches to seek the changes with cognitive decline.

Cortical thickness systematically varies with curvature and depth in healthy human brains

Cortical thickness varies throughout the cortex in a systematic way. However, it is challenging to investigate the patterns of cortical thickness due to the intricate geometry of the cortex. The cortex has a folded nature both in radial and tangential directions which forms not only gyri and sulci but also tangential folds and intersections. In this article, cortical curvature and depth are used to characterize the spatial distribution of the cortical thickness with much higher resolution than conventional regional atlases. To do this, a computational pipeline was developed that is capable of calculating a variety of quantitative measures such as surface area, cortical thickness, curvature (mean curvature, Gaussian curvature, shape index, intrinsic curvature index, and folding index), and sulcal depth. By analyzing 501 neurotypical adult human subjects from the ABIDE-I dataset, we show that cortex has a very organized structure and cortical thickness is strongly correlated with local shape. Our results indicate that cortical thickness consistently increases along the gyral-sulcal spectrum from concave to convex shape, encompassing the saddle shape along the way. Additionally, tangential folds influence cortical thickness in a similar way as gyral and sulcal folds; outer folds are consistently thicker than inner.

Fully Automatic Classification of Brain Atrophy on NCCT Images in Cerebral Small Vessel Disease: A Pilot Study Using Deep Learning Models

Objective

Brain atrophy is an important imaging characteristic of cerebral small vascular disease (CSVD). Our study explores the linear measurement application on CT images of CSVD patients and develops a fully automatic brain atrophy classification model. The second aim was to compare it with the end-to-end Convolutional Neural Networks (CNNs) model.

Methods

A total of 385 subjects such as 107 no-atrophy brain, 185 mild atrophy, and 93 severe atrophy were collected and randomly separated into training set (n = 308) and test set (n = 77). Key slices for linear measurement were manually identified and used to annotate nine linear measurements and a binary classification of cerebral sulci widening. A linear-measurement-based pipeline (2D model) was constructed for two-types (existence/non-existence brain atrophy) or three-types classification (no/mild atrophy/severe atrophy). For comparison, an end-to-end CNN model (3D-deep learning model) for brain atrophy classification was also developed. Furthermore, age and gender were integrated to the 2D and 3D models. The sensitivity, specificity, accuracy, average F1 score, receiver operating characteristics (ROC) curves for two-type classification and weighed kappa for three-type classification of the two models were compared.

Results

Automated measurement of linear measurements and cerebral sulci widening achieved moderate to almost perfect agreement with manual annotation. In two-type atrophy classification, area under the curves (AUCs) of the 2D model and 3D model were 0.953 and 0.941 with no significant difference (p = 0.250). The Weighted kappa of the 2D model and 3D model were 0.727 and 0.607 according to standard classification they displayed, mild atrophy and severe atrophy, respectively. Applying patient age and gender information improved classification performances of both 2D and 3D models in two-type and three-type classification of brain atrophy.

Conclusion

We provide a model composed of different modules that can classify CSVD-related brain atrophy on CT images automatically, using linear measurement. It has similar performance and better interpretability than the end-to-end CNNs model and may prove advantageous in the clinical setting.

Differential Relationships Between Brain Structure and Dual Task Walking in Young and Older Adults

Almost 25% of all older adults experience difficulty walking. Mobility difficulties for older adults are more pronounced when they perform a simultaneous cognitive task while walking (i.e., dual task walking). Although it is known that aging results in widespread brain atrophy, few studies have integrated across more than one neuroimaging modality to comprehensively examine the structural neural correlates that may underlie dual task walking in older age. We collected spatiotemporal gait data during single and dual task walking for 37 young (18-34 years) and 23 older adults (66-86 years). We also collected T 1-weighted and diffusion-weighted MRI scans to determine how brain structure differs in older age and relates to dual task walking. We addressed two aims: (1) to characterize age differences in brain structure across a range of metrics including volumetric, surface, and white matter microstructure; and (2) to test for age group differences in the relationship between brain structure and the dual task cost (DTcost) of gait speed and variability. Key findings included widespread brain atrophy for the older adults, with the most pronounced age differences in brain regions related to sensorimotor processing. We also found multiple associations between regional brain atrophy and greater DTcost of gait speed and variability for the older adults. The older adults showed a relationship of both thinner temporal cortex and shallower sulcal depth in the frontal, sensorimotor, and parietal cortices with greater DTcost of gait. Additionally, the older adults showed a relationship of ventricular volume and superior longitudinal fasciculus free-water corrected axial and radial diffusivity with greater DTcost of gait. These relationships were not present for the young adults. Stepwise multiple regression found sulcal depth in the left precentral gyrus, axial diffusivity in the superior longitudinal fasciculus, and sex to best predict DTcost of gait speed, and cortical thickness in the superior temporal gyrus to best predict DTcost of gait variability for older adults. These results contribute to scientific understanding of how individual variations in brain structure are associated with mobility function in aging. This has implications for uncovering mechanisms of brain aging and for identifying target regions for mobility interventions for aging populations.

The genetic architecture of human cortical folding

The folding of the human cerebral cortex is a highly genetically regulated process that allows for a much larger surface area to fit into the cranial vault and optimizes functional organization. Sulcal depth is a robust yet understudied measure of localized folding, previously associated with multiple neurodevelopmental disorders. Here, we report the first genome-wide association study of sulcal depth. Through the multivariate omnibus statistical test (MOSTest) applied to vertex-wise measures from 33,748 U.K. Biobank participants (mean age, 64.3 years; 52.0% female), we identified 856 genome-wide significant loci (P < 5 × 10−8). Comparisons with cortical thickness and surface area indicated that sulcal depth has higher locus yield, heritability, and effective sample size. There was a large amount of genetic overlap between these traits, with gene-based analyses indicating strong associations with neurodevelopmental processes. Our findings demonstrate sulcal depth is a promising neuroimaging phenotype that may enhance our understanding of cortical morphology.

Mesoscale Simulation-based Parametric Study of Damage Potential in Brain Tissue Using Hyperelastic and Internal State Variable Models

Two-dimensional mesoscale finite element analysis (FEA) of a multi-layered brain tissue was performed to calculate the damage related average stress triaxiality and local maximum von Mises strain in the brain. The FEA was integrated with rate dependent hyperelastic and internal state variable (ISV) models respectively describing the behaviors of wet and dry brain tissues. Using the finite element results, a statistical method of design of experiments (DOE) was utilized to independently screen the relative influences of seven parameters related to brain morphology (sulcal width/depth, gray matter (GM) thickness, cerebrospinal fluid (CSF) thickness and brain lobe) and loading/environment conditions (strain rate and humidity) with respect to the potential damage growth/coalescence in the brain tissue. The results of the parametric study illustrated that the GM thickness and humidity were the two most crucial parameters affecting average stress triaxiality. For the local maximum von Mises strain at the depth of brain sulci, the brain lobe/region was the most influential factor. The conclusion of this investigation gives insight for the future development and refinement of a macroscale brain damage model incorporating information from lower length scale.

Brain aging mechanisms with mechanical manifestations

Brain aging is a complex process that affects everything from the subcellular to the organ level, begins early in life, and accelerates with age. Morphologically, brain aging is primarily characterized by brain volume loss, cortical thinning, white matter degradation, loss of gyrification, and ventricular enlargement. Pathophysiologically, brain aging is associated with neuron cell shrinking, dendritic degeneration, demyelination, small vessel disease, metabolic slowing, microglial activation, and the formation of white matter lesions. In recent years, the mechanics community has demonstrated increasing interest in modeling the brain's (bio)mechanical behavior and uses constitutive modeling to predict shape changes of anatomically accurate finite element brain models in health and disease. Here, we pursue two objectives. First, we review existing imaging-based data on white and gray matter atrophy rates and organ-level aging patterns. This data is required to calibrate and validate constitutive brain models. Second, we review the most critical cell- and tissue-level aging mechanisms that drive white and gray matter changes. We focuse on aging mechanisms that ultimately manifest as organ-level shape changes based on the idea that the integration of imaging and mechanical modeling may help identify the tipping point when normal aging ends and pathological neurodegeneration begins.

Brain Shape Changes Associated With Cerebral Atrophy in Healthy Aging and Alzheimer's Disease

Both healthy and pathological brain aging are characterized by various degrees of cognitive decline that strongly correlate with morphological changes referred to as cerebral atrophy. These hallmark morphological changes include cortical thinning, white and gray matter volume loss, ventricular enlargement, and loss of gyrification all caused by a myriad of subcellular and cellular aging processes. While the biology of brain aging has been investigated extensively, the mechanics of brain aging remains vastly understudied. Here, we propose a multiphysics model that couples tissue atrophy and Alzheimer's disease biomarker progression. We adopt the multiplicative split of the deformation gradient into a shrinking and an elastic part. We model atrophy as region-specific isotropic shrinking and differentiate between a constant, tissue-dependent atrophy rate in healthy aging, and an atrophy rate in Alzheimer's disease that is proportional to the local biomarker concentration. Our finite element modeling approach delivers a computational framework to systematically study the spatiotemporal progression of cerebral atrophy and its regional effect on brain shape. We verify our results via comparison with cross-sectional medical imaging studies that reveal persistent age-related atrophy patterns. Our long-term goal is to develop a diagnostic tool able to differentiate between healthy and accelerated aging, typically observed in Alzheimer's disease and related dementias, in order to allow for earlier and more effective interventions.

Sex Differences in Lifespan Trajectories and Variability of Human Sulcal and Gyral Morphology

Sex differences in the development and aging of human sulcal morphology have been understudied. We charted sex differences in trajectories and inter-individual variability of global sulcal depth, width, and length, pial surface area, exposed (hull) gyral surface area, unexposed sulcal surface area, cortical thickness, gyral span, and cortex volume across the lifespan in a longitudinal sample (700 scans, 194 participants 2 scans, 104 three scans, age range: 16-70 years) of neurotypical males and females. After adjusting for brain volume, females had thicker cortex and steeper thickness decline until age 40 years; trajectories converged thereafter. Across sexes, sulcal shortening was faster before age 40, while sulcal shallowing and widening were faster thereafter. Although hull area remained stable, sulcal surface area declined and was more strongly associated with sulcal shortening than with sulcal shallowing and widening. Males showed greater variability for cortex volume and lower variability for sulcal width. Our findings highlight the association between loss of sulcal area, notably through sulcal shortening, with cortex volume loss. Studying sex differences in lifespan trajectories may improve knowledge of individual differences in brain development and the pathophysiology of neuropsychiatric conditions.

Patterns of Sulcal depth and cortical thickness in Parkinson's disease

Previous voxel-based morphometry (VBM) and cortical thickness (CT) studies on Parkinson's disease (PD) have mainly reported the gray matter size reduction, whereas the shape of cortical surface can also change in PD patients. For the first time, we analyzed sulcal depth (SD) patterns in PD patients by using whole brain region of interest (ROI)-based approach. In a cross-sectional study, high-resolution brain structural MRI images were collected from 60 PD patients without dementia and 56 age-and sex-matched healthy controls (HC). SD and CT were estimated using the Computational Anatomy Toolbox (CAT12) and statistically compared between groups on whole brain ROI-based level using statistical parametric mapping 12 (SPM12). Additionally, correlations between regional brain changes and clinical variables were also examined. Compared to HC, PD patients showed lower SD in widespread regions, including temporal (the bilateral transverse temporal, the left inferior temporal, the right middle temporal and the right superior temporal), insular (the left insula), frontal (the left pars triangularis, the left pars opercularis and the left precentral), parietal (the bilateral superior parietal) and occipital (the right cuneus) regions. For CT, only the left pars opercularis showed lower CT in PD patients compared to HC. No regions showed higher SD or CT in PD patients compared to HC. In PD patients, a significant positive correlation was found between SD of the left pars opercularis and MMSE scores, such that lower MMSE scores were related to lower SD of the left pars opercularis. Our results of widespread lower SD, but relatively localized lower CT, indicate that SD seems to be more sensitive to brain changes than CT and may be mainly affected by white matter damage. Hence, SD may be a more promising indicator to investigate the surface shape changes in PD patients. The significant positive correlation between SD of the left pars opercularis and MMSE scores suggests that SD may be prognostic of future cognitive decline.

Surface-based Cortical Morphometry, White Matter Hyperintensity, and Multidomain Cognitive Performance in Asymptomatic Carotid Stenosis

Carotid stenosis is a major contributor to vascular dementia. Recent studies suggest that even clinically "asymptomatic" carotid stenosis is linked with cognitive decline and neuroimaging changes. Here we examined surface-based cortical morphometry, white matter hyperintensity (WMH), and multidomain cognitive performance in unilateral severe (>70% narrowing) asymptomatic carotid stenosis (SACS). We included 24 SACS patients (19 males/5 females; 64.25 ± 7.18 years) and 24 comorbidities-matched controls (19 males/5 females; 67.16 ± 6.10 years), and measured cortical thickness, sulcal depth, gyrification, cortical complexity, and WMH loads with structural MRI images. The SACS patients exhibited: (1) thinner cortex in bilateral somatosensory/motor, bilateral inferior frontal, bilateral fusiform, and left lateral temporal areas; (2) shallower sulci in left lateral temporal, parietal, insular and somatosensory/motor areas; (3) both hyper- and hypo-gyrification in lateral temporal and frontal cortices; (4) lower complexity (fractal dimension) in left insular and right superior temporal areas. Further association analyses showed that the cortical alterations were significantly correlated with verbal memory and WMH burden in SACS. These results suggest that SACS patients present a left-dominated damage tendency, especially in the Perisylvian cortices that span across several large-scale systems of somatosensory/motor and language. Our findings also provide cortical anatomy evidence for cognitive impairment in SACS, suggesting a neuroanatomical predisposition to dementia and cerebrovascular events.

Predicting Progression from Mild Cognitive Impairment to Alzheimer's Disease using MRI-based Cortical Features and a Two-State Markov Model

Magnetic resonance imaging (MRI) has a potential for early diagnosis of individuals at risk for developing Alzheimer's disease (AD). Cognitive performance in healthy elderly people and in those with mild cognitive impairment (MCI) has been associated with measures of cortical gyrification [1] and thickness (CT) [2], yet the extent to which sulcal measures can help to predict AD conversion above and beyond CT measures is not known. Here, we analyzed 721 participants with MCI from phases 1 and 2 of the Alzheimer's Disease Neuroimaging Initiative, applying a two-state Markov model to study the conversion from MCI to AD condition. Our preliminary results suggest that MRI-based cortical features, including sulcal morphometry, may help to predict conversion from MCI to AD.

Neural silences can be localized rapidly using noninvasive scalp EEG

A rapid and cost-effective noninvasive tool to detect and characterize neural silences can be of important benefit in diagnosing and treating many disorders. We propose an algorithm, SilenceMap, for uncovering the absence of electrophysiological signals, or neural silences, using noninvasive scalp electroencephalography (EEG) signals. By accounting for the contributions of different sources to the power of the recorded signals, and using a hemispheric baseline approach and a convex spectral clustering framework, SilenceMap permits rapid detection and localization of regions of silence in the brain using a relatively small amount of EEG data. SilenceMap substantially outperformed existing source localization algorithms in estimating the center-of-mass of the silence for three pediatric cortical resection patients, using fewer than 3 minutes of EEG recordings (13, 2, and 11mm vs. 25, 62, and 53 mm), as well for 100 different simulated regions of silence based on a real human head model (12 ± 0.7 mm vs. 54 ± 2.2 mm). SilenceMap paves the way towards accessible early diagnosis and continuous monitoring of altered physiological properties of human cortical function.

Age dependency and modification of the Subarachnoid Hemorrhage Early Brain Edema Score

OBJECTIVE

The Subarachnoid Hemorrhage Early Brain Edema Score (SEBES) system measures cerebral edema on CT and can be used to predict outcome after subarachnoid hemorrhage (SAH). The authors developed a modified SEBES (SEBES 6c) and assessed whether it could predict outcome after SAH better than the SEBES. Furthermore, they verified the age dependency of these scores.

METHODS

In this retrospective study, all patients with aneurysmal SAH in the period from January 2011 to February 2017 at a single institution were analyzed. The SEBES, which is based on the absence of visible sulci at two defined CT levels (0-4 points), and the SEBES 6c were determined from the initial CT. The SEBES 6c system includes the two levels from the original SEBES and one level located 2 cm below the vertex (0-6 points). The authors investigated whether the various SEBESs are age dependent and if they can predict delayed infarction (DI) and outcome.

RESULTS

Two hundred sixty-one patients met the study inclusion criteria. The SEBES was an independent predictor for DI (OR 1.6 per 1-point increase) and unfavorable outcome (OR 1.36 per 1-point increase), in accordance with findings in the first publication on SEBES. However, here the authors found that the SEBES was age dependent. In the age group younger than 60 years, the patients with high-grade SEBESs (3-4 points) had DIs and unfavorable outcomes significantly more often than the patients with low-grade scores (0-2 points). In the age groups 60-69 years and ≥ 70 years, no significant differences in DI and outcome were identified between high-grade and low-grade scores, although trends toward DI and unfavorable outcomes among the 60-69 age group were noted in patients with high-grade SEBESs.Receiver operating characteristic curve analysis showed that SEBES 6c had a higher prognostic value in predicting outcome than SEBES (p < 0.001). Furthermore, SEBES 6c predicted an unfavorable outcome (OR 1.31 per 1-point increase) and DI (OR 1.36 per 1-point increase) independent of vasospasms. SEBES 6c showed an age dependency similar to that of SEBES.

CONCLUSIONS

SEBES 6c is more suitable for predicting outcome after SAH than SEBES. Furthermore, it predicts outcome and DI independently of vasospasm, so it can be used to differentiate between early brain injury- and vasospasm-dependent infarctions and outcome. However, SEBES and SEBES 6c are both age dependent and can be used for patients aged < 60 years and may have limited suitability for patients aged 60-69 years and no suitability for patients aged ≥ 70 years.

Abnormal Topological Organization of Sulcal Depth-Based Structural Covariance Networks in Parkinson's Disease

Recent research on Parkinson's disease (PD) has demonstrated the topological abnormalities of structural covariance networks (SCNs) using various morphometric features from structural magnetic resonance images (sMRI). However, the sulcal depth (SD)-based SCNs have not been investigated. In this study, we used SD to investigate the topological alterations of SCNs in 60 PD patients and 56 age- and gender-matched healthy controls (HC). SCNs were constructed by thresholding SD correlation matrices of 68 regions and analyzed using graph theoretical approaches. Compared with HC, PD patients showed increased normalized clustering coefficient and normalized path length, as well as a reorganization of degree-based and betweenness-based hubs (i.e., less frontal hubs). Moreover, the degree distribution analysis showed more high-degree nodes in PD patients. In addition, we also found the increased assortativity and reduced robustness under a random attack in PD patients compared to HC. Taken together, these findings indicated an abnormal topological organization of SD-based SCNs in PD patients, which may contribute in understanding the pathophysiology of PD at the network level.

A slower rate of sulcal widening in the brains of the nondemented oldest old

The relationships between aging and brain morphology have been reported in many previous structural brain studies. However, the trajectories of successful brain aging in the extremely old remain underexplored. In the limited research on the oldest old, covering individuals aged 85 years and older, there are very few studies that have focused on the cortical morphology, especially cortical sulcal features. In this paper, we measured sulcal width and depth as well as cortical thickness from T1-weighted scans of 290 nondemented community-dwelling participants aged between 76 and 103 years. We divided the participants into young old (between 76 and 84; mean = 80.35±2.44; male/female = 76/88) and oldest old (between 85 and 103; mean = 91.74±5.11; male/female = 60/66) groups. The results showed that most of the examined sulci significantly widened with increased age and that the rates of sulcal widening were lower in the oldest old. The spatial pattern of the cortical thinning partly corresponded with that of sulcal widening. Compared to females, males had significantly wider sulci, especially in the oldest old. This study builds a foundation for future investigations of neurocognitive disorders and neurodegenerative diseases in the oldest old, including centenarians.

Dynamic changes of region-specific cortical features and scalp-to-cortex distance: implications for transcranial current stimulation modeling

BACKGROUND

Transcranial current stimulation in rehabilitation is a fast-growing field featured with computational and biophysical modeling. Cortical features and scalp-to-cortex distance (SCD) are key variables for determining the strength and distribution of the electric field, yet longitudinal studies able to capture these dynamic changes are missing. We sought to investigate and quantify the ageing effect on the morphometry and SCD of left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in normal ageing adults and mild cognitive impairment (MCI) converters.

METHODS

Baseline, 1-year and 3-year follow-up structural magnetic resonance imaging scans from normal ageing adults (n = 32), and MCI converters (n = 22) were drawn from the Open Access Series of Imaging Studies. We quantified the changes of the cortical features and SCDs of left M1 and DLPFC, including grey matter volume, white matter volume, cortical thickness, and folding. Head model was developed to simulate the impact of SCD on the electric field induced by transcranial current stimulation.

RESULTS

Pronounced ageing effect was found on the SCD of left DLPFC in MCI converters. The SCD change of left DLPFC from baseline to 3-year follow-up demonstrated better performance to discriminate MCI converters from normal ageing adults than the other morphometric measures. The strength of electric field was consequently decreased with SCD in MCI converters.

CONCLUSION

Ageing has a prominent, but differential effect on the region-specific SCD and cortical features in older adults with cognitive impairments. Our findings suggest that SCD, cortical thickness, and folding of the targeted regions could be used as valuable imaging markers when conducting transcranial brain stimulation in individuals with brain atrophy.

Fast uncertainty quantification of tracer distribution in the brain interstitial fluid with multilevel and quasi Monte Carlo

Efficient uncertainty quantification algorithms are key to understand the propagation of uncertainty-from uncertain input parameters to uncertain output quantities-in high resolution mathematical models of brain physiology. Advanced Monte Carlo methods such as quasi Monte Carlo (QMC) and multilevel Monte Carlo (MLMC) have the potential to dramatically improve upon standard Monte Carlo (MC) methods, but their applicability and performance in biomedical applications is underexplored. In this paper, we design and apply QMC and MLMC methods to quantify uncertainty in a convection-diffusion model of tracer transport within the brain. We show that QMC outperforms standard MC simulations when the number of random inputs is small. MLMC considerably outperforms both QMC and standard MC methods and should therefore be preferred for brain transport models.

Age-related decrements in cortical gyrification: Evidence from an accelerated longitudinal dataset

Cortical gyrification has been found to decrease due to aging, but thus far this has only been examined in cross-sectional samples. Interestingly, the topography of these age-related differences in gyrification follows a distinct gradient along the cortex relative to age effects on cortical thickness, likely suggesting a different underlying neurobiological mechanism. Here I examined several aspects of gyrification in an accelerated longitudinal dataset of 280 healthy adults aged 45-92 with an interval between first and last MRI sessions of up to 10 years (total of 815 MRI sessions). Results suggest that age changes in sulcal morphology underlie these changes in gyrification.

Deviant cortical sulcation related to schizophrenia and cognitive deficits in the second trimester

Objectives

Aberrant cortical development, inferred from cortical folding, is linked to the risk of schizophrenia. Cortical folds develop in a time-locked fashion during fetal growth. We leveraged this temporal specificity of sulcation to investigate the timing of the prenatal insult linked to schizophrenia and the cognitive impairment seen in this illness.

Methods

Anatomical MRI scans from 68 patients with schizophrenia and 72 controls were used to evaluate the sulcal depth of five major invariable primary sulci representing lobar development (calcarine sulcus, superior temporal sulcus, superior frontal sulcus, intraparietal sulcus and inferior frontal sulcus) with formation representing the distinct developmental periods.

Results

A repeated-measure ANOVA with five sulci and two hemispheres as the within-subject factors and gender, age and intracranial volume as covariates revealed a significant effect of diagnosis (F[1,134] = 14.8, p = 0.0002). Control subjects had deeper bilateral superior temporal, right inferior frontal and left calcarine sulci. A deeper superior frontal sulcus predicted better cognitive scores among patients.

Conclusion

Our results suggest that the gestational disruption underlying schizophrenia is likely to predate, if not coincide with the appearance of calcarine sulcus (early second trimester). Nevertheless, the burden of cognitive deficits may relate specifically to the aberrant superior frontal development apparent in late second trimester.