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Silver A, Bentley H, Darras KE, Vertinsky AT. MI-RADS: An Innovative Mentorship Initiative to Improve Gender Disparity in Application to Diagnostic Radiology. Can Assoc Radiol J 2023; 74:766-767. [PMID: 36898694 DOI: 10.1177/08465371231160999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Affiliation(s)
- Alexandra Silver
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Helena Bentley
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kathryn E Darras
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
| | - Alexandra T Vertinsky
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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2
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Gicas KM, Benitah K, Thornton AE, Petersson AM, Jones PW, Stubbs JL, Jones AA, Panenka WJ, Lang DJ, Leonova O, Vila-Rodriguez F, Barr AM, Buchanan T, Su W, Vertinsky AT, Rauscher A, MacEwan GW, Honer WG. Using serial position effects to investigate memory dysfunction in homeless and precariously housed persons. Clin Neuropsychol 2023; 37:1710-1727. [PMID: 36790121 DOI: 10.1080/13854046.2023.2178513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
Background: Homeless and precariously housed persons exhibit significant memory impairment, but the component processes underlying memory dysfunction have not been explored. We examined the serial position profile (i.e., primacy and recency effects) of verbal memory and its neuroanatomical correlates to identify the nature of memory difficulties in a large cohort of homeless and precariously housed adults. Method: The sample included 227 community-dwelling homeless and precariously housed adults. Serial position scores (primacy, middle, recency) were computed using the Hopkins Verbal Learning Test-Revised. Paired sample t-tests were used to compare percent recall from each word list region. Age-adjusted correlations assessed associations between serial position scores and other cognitive domains (attention, processing speed, executive functioning). Regression analyses were conducted to examine regional brain volumes of interest (hippocampus, entorhinal cortex, dorsolateral prefrontal cortex [DLPFC]) and their differential associations with serial position scores. Results: The serial position profile was characterized by a diminished recency effect in relation to the primacy effect. Serial position scores positively correlated with sustained attention and cognitive control. Larger hippocampal volume was associated with better primacy item recall. DLPFC volume was not associated with serial position recall after adjustment for false discovery rate. There were no associations between regional brain volumes and recency item recall. Conclusion: Our results suggest that commonly reported memory difficulties in homeless and precariously housed adults are likely secondary to a core deficit in executive control due to compromised frontal lobe functioning. These findings have implications for cognitive rehabilitation in this complex and vulnerable group.
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Affiliation(s)
| | - Katie Benitah
- Department of Psychology, York University, Toronto, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Anna M Petersson
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Paul W Jones
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Jacob L Stubbs
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Andrea A Jones
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Alexander Rauscher
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, Canada
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3
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Stubbs JL, Jones AA, Wolfman D, Chan RCY, Vila-Rodriguez F, Vertinsky AT, Heran MK, Su W, Lang DJ, Field TS, Gicas KM, Woodward ML, Thornton AE, Barr AM, Leonova O, MacEwan W, Rauscher A, Honer WG, Panenka WJ. Differential age-associated brain atrophy and white matter changes among homeless and precariously housed individuals compared with the general population. BMJ Neurol Open 2023; 5:e000349. [PMID: 36660541 PMCID: PMC9843194 DOI: 10.1136/bmjno-2022-000349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
Background Homeless or precariously housed individuals live with poor health and experience premature mortality compared with the general population, yet little is known about age-related brain changes among these individuals. We evaluated whether MRI measures of brain structure are differentially associated with age and selected risk factors among individuals who are homeless or precariously housed compared with a general population sample. Methods We compared T1-weighted and diffusion tensor imaging measures of brain macrostructure and white matter microstructure in a well-characterised sample of 312 precariously housed participants with a publicly available dataset of 382 participants recruited from the general population. We used piecewise and multiple linear regression to examine differential associations between MRI measures and between the samples, and to explore associations with risk factors in the precariously housed sample. Results Compared with the general population sample, older age in the precariously housed sample was associated with more whole-brain atrophy (β=-0.20, p=0.0029), lower whole-brain fractional anisotropy (β=-0.32, p<0.0001) and higher whole-brain mean diffusivity (β=0.69, p<0.0001). Several MRI measures had non-linear associations with age, with further adverse changes after age 35-40 in the precariously housed sample. History of traumatic brain injury, stimulant dependence and heroin dependence was associated with more atrophy or alterations in white matter diffusivity in the precariously housed sample. Conclusions Older age is associated with adverse MRI measures of brain structure among homeless and precariously housed individuals compared with the general population. Education, improvements in care provision and policy may help to reduce the health disparities experienced by these individuals.
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Affiliation(s)
- Jacob L Stubbs
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Andrea A Jones
- Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Daniel Wolfman
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Ryan C Y Chan
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Fidel Vila-Rodriguez
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,Non-Invasive Neurostimulation Therapies Laboratory, University of British Columbia, Vancouver, BC, Canada
| | | | - Manraj K Heran
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Wayne Su
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Donna J Lang
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Thalia S Field
- Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | | | - Melissa L Woodward
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Allen E Thornton
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada,Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Olga Leonova
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada
| | - William MacEwan
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Rauscher
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - William G Honer
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - William J Panenka
- Department of Psychaitry, University of British Columbia, Vancouver, BC, Canada,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada,British Columbia Neuropsychiatry Program, University of British Columbia, Vancouver, BC, Canada
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4
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Stubbs JL, Thornton AE, Gicas KM, O'Connor TA, Livingston EM, Lu HY, Mehta AK, Lang DJ, Vertinsky AT, Field TS, Heran MK, Leonova O, Sahota CS, Buchanan T, Barr AM, MacEwan GW, Rauscher A, Honer WG, Panenka WJ. Characterizing Traumatic Brain Injury and Its Association with Losing Stable Housing in a Community-based Sample. Can J Psychiatry 2022; 67:207-215. [PMID: 33719613 PMCID: PMC8935598 DOI: 10.1177/07067437211000665] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is increasingly recognized as a common and impactful health determinant in homeless and precariously housed populations. We sought to describe the history of TBI in a precariously housed sample and evaluate how TBI was associated with the initial loss and lifetime duration of homelessness and precarious housing. METHOD We characterized the prevalence, mechanisms, and sex difference of lifetime TBI in a precariously housed sample. We also examined the impact of TBI severity and timing on becoming and staying homeless or precariously housed; 285 precariously housed participants completed the Brain Injury Screening Questionnaire in addition to other health assessments. RESULTS A history of TBI was reported in 82.1% of the sample, with 64.6% reporting > 1 TBI, and 21.4% reporting a moderate or severe TBI. Assault was the most common mechanism of injury overall, and females reported significantly more traumatic brain injuries due to physical abuse than males (adjusted OR = 1.26, 95% CI = 1.14 to 1.39, P < 0.0001). The first moderate or severe TBI was significantly closer to the first experience of homelessness (b = 2.79, P = 0.003) and precarious housing (b = 2.69, P < 0.0001) than was the first mild TBI. In participants who received their first TBI prior to becoming homeless or precariously housed, traumatic brain injuries more proximal to the initial loss of stable housing were associated with a longer lifetime duration of homelessness (RR = 1.04, 95% CI = 1.02 to 1.06, P < 0.0001) and precarious housing (RR = 1.03, 95% CI = 1.01 to 1.04, P < 0.0001). CONCLUSIONS These findings demonstrate the high prevalence of TBI in this vulnerable population, and that aspects of TBI severity and timing are associated with the loss and lifetime duration of stable housing.
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Affiliation(s)
- Jacob L Stubbs
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - Allen E Thornton
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kristina M Gicas
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Psychology, York University, Toronto, Ontario, Canada
| | - Tiffany A O'Connor
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Emily M Livingston
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Henri Y Lu
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Amiti K Mehta
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - Donna J Lang
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexandra T Vertinsky
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thalia S Field
- Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Manraj K Heran
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charanveer S Sahota
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - Alasdair M Barr
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alexander Rauscher
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada.,British Columbia Neuropsychiatry Program, University of British Columbia, Vancouver, British Columbia, Canada
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5
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O'Connor TA, Panenka WJ, Livingston EM, Stubbs JL, Askew J, Sahota CS, Feldman SJ, Buchanan T, Xu L, Hu XJ, Lang DJ, Woodward ML, Thornton WL, Gicas KM, Vertinsky AT, Heran MK, Su W, MacEwan GW, Barr AM, Honer WG, Thornton AE. Traumatic brain injury in precariously housed persons: Incidence and risks. EClinicalMedicine 2022; 44:101277. [PMID: 35252825 PMCID: PMC8888336 DOI: 10.1016/j.eclinm.2022.101277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/19/2021] [Accepted: 01/10/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Homeless and precarious housed persons are particularly prone to traumatic brain injuries (TBIs), but existent incidence rates are hampered by poor case acquisition. We rigorously documented TBIs in precariously housed persons transitioning in and out of homelessness. METHODS Between December 2016 and May 2018, 326 precariously housed participants enrolled in a longitudinal study in Vancouver, Canada were assessed monthly for TBI occurrences after education on sequelae. Over one participant-year, 2433 TBI screenings were acquired for 326 person-years and variables associated with odds of incident TBI were evaluated. FINDINGS One hundred participants acquired 175 TBIs, yielding an observed incidence proportion of 30·7% and event proportion of 53·7%. Of the injured, 61% reported one TBI and 39% reported multiple injuries. Acute intoxication was present for more than half of the TBI events assessed. Additionally, 9·7% of TBI events occurred in the context of a drug overdose. Common injury mechanisms were falls (45·1%), assaults (25·1%), and hitting one's head on an object (13·1%). In this community-based but non-randomly recruited sample, exploratory analyses identified factors associated with odds of an incident TBI over one year of follow-up, including: schizophrenia disorders (odds ratio (OR) = 0·43, 95% confidence interval (CI) 0·19, 0·94), role functioning (OR = 0·69, 95% CI 0·52, 0·91), opioid dependence (OR = 2·17, 95% CI 1·27, 3·72) and those reporting past TBIs (OR = 1·99, 95% CI 1·13, 3·52). INTERPRETATION Given the ubiquity of TBIs revealed in this precariously housed sample, we identify an underappreciated and urgent healthcare priority. Several factors modified the odds of incident TBI, which can facilitate investigations into targeted prevention efforts. FUNDING Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, William and Ada Isabelle Steel Research Fund, Simon Fraser University Vice-President Research Undergraduate Student Research Award and Simon Fraser University Psychology Department Research Grant.
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Affiliation(s)
- Tiffany A. O'Connor
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute
| | - William J. Panenka
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Emily M. Livingston
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute
| | - Jacob L. Stubbs
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Julia Askew
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Charanveer S. Sahota
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute
| | | | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Linwan Xu
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada
| | - X. Joan Hu
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada
| | - Donna J. Lang
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Melissa L. Woodward
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Kristina M. Gicas
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Department of Psychology, York University, Toronto, ON, Canada
| | | | - Manraj K. Heran
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Wayne Su
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - G. William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alasdair M. Barr
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - William G. Honer
- British Columbia Mental Health and Substance Use Services Research Institute
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Allen E. Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute
- Correspondence to: Allen E. Thornton, Human Neuropsychology Laboratory, Department of Psychology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.
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6
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Gicas KM, Cheng A, Panenka WJ, Kim DD, Yau JC, Procyshyn RM, Stubbs JL, Jones AA, Bains S, Thornton AE, Lang DJ, Vertinsky AT, Rauscher A, Honer WG, Barr AM. Differential effects of cannabis exposure during early versus later adolescence on the expression of psychosis in homeless and precariously housed adults. Prog Neuropsychopharmacol Biol Psychiatry 2021; 106:110084. [PMID: 32890696 DOI: 10.1016/j.pnpbp.2020.110084] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/16/2020] [Accepted: 08/26/2020] [Indexed: 12/20/2022]
Abstract
Longitudinal studies of cannabis exposure during early adolescence in the general population frequently report an increased risk of subsequently developing psychotic symptoms or a psychotic illness. However, there is a dearth of knowledge about the effects of early cannabis exposure on psychosis in homeless and precariously housed adults, who represent a population afflicted with high rates of psychosis. The aim of the present study was to examine how early cannabis exposure (by age 15) compared to later first use (after age 15) affected the expression of adult psychosis in this population. Secondary measures of psychopathology, drug use, cognition and brain structure were also collected. 437 subjects were recruited from single room occupancy hotels in the urban setting of the Downtown Eastside of Vancouver, Canada. Psychiatric diagnoses were determined, and psychotic symptom severity was measured with the 5-factor PANSS. Participants completed a battery of neurocognitive tests, and brain structure was assessed using structural and diffusion tensor imaging MRI scans. Results indicated that early cannabis exposure was associated with an increased risk (OR = 1.09, p < .05) of developing substance induced psychosis, whereas later first use increased risk (OR = 2.19, p < .01) of developing schizophrenia or schizoaffective disorder. There was no group difference in neurocognitive function, although differences were observed in the lateral orbitofrontal cortex and white matter tract diffusivity. These findings indicate that early cannabis exposure in this population may increase the risk of developing drug associated psychoses, which could potentially be mediated in part through altered neurodevelopmental brain changes.
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Affiliation(s)
| | - Alex Cheng
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - David D Kim
- Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Jade C Yau
- Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Jacob L Stubbs
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Simran Bains
- Department of Medicine, Imperial College London, United Kingdom
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Alexandra T Vertinsky
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Alex Rauscher
- Department of Radiology, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology & Therapeutics, 2176 Health Sciences Mall, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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7
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Gicas KM, Thornton AE, Waclawik K, Wang N, Jones AA, Panenka WJ, Lang DJ, Smith GN, Vila-Rodriguez F, Leonova O, Barr AM, Procyshyn RM, Buchanan T, Su W, Vertinsky AT, Rauscher A, MacEwan GW, Honer WG. Volumes of the Hippocampal Formation Differentiate Component Processes of Memory in a Community Sample of Homeless and Marginally Housed Persons. Arch Clin Neuropsychol 2019; 34:548-562. [PMID: 30407496 DOI: 10.1093/arclin/acy066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Persons who are homeless or marginally housed exhibit significant cognitive dysfunction, with memory being the most impaired domain. Hippocampal subfield volumes have been found to differentially relate to component processes of memory. The neural correlates of memory have not been previously examined in marginalized persons who are understudied and underserved. We examined whether hippocampal subfields and entorhinal cortex volumes are uniquely related to indices of verbal episodic memory using the Hopkins Verbal Learning Test - Revised. METHOD Data was used from a large sample of community dwelling homeless and marginally housed adults (N = 227). Regression analyses were conducted to examine hippocampal subfield volumes (CA1, CA3, CA4, dentate gyrus, subiculum) and entorhinal cortex, and their associations with measures of verbal immediate recall, learning slope, and verbal delayed recall. RESULTS Greater CA3 subfield volume was associated with better performance on an index of encoding (immediate recall), but only in older individuals. Greater CA1 and subiculum volumes were associated with better performance on immediate and delayed recall (measures that tap into retrieval processes), but not with learning slope (a more pure index of encoding). Entorhinal cortex volume was related to all components of memory beyond total hippocampal volume. CONCLUSIONS Our results suggest common neuroanatomical correlates of memory dysfunction in large sample of marginalized persons, and these are uniquely related to different components of memory. These findings have clinical relevance for marginalized populations and theoretical relevance to the growing literature on functional specialization of the hippocampal subfields.
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Affiliation(s)
- Kristina M Gicas
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | | | - Nena Wang
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancouver, Canada
| | - Geoff N Smith
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Alexander Rauscher
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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8
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Gicas KM, Cheng A, Rawtaer I, Willi TS, Panenka WJ, Lang DJ, Smith GN, Vila-Rodriguez F, Leonova O, Giesbrecht CJ, Jones AA, Barr AM, Procyshyn RM, Buchanan T, MacEwan GW, Su W, Vertinsky AT, Rauscher A, O'Rourke N, Loken Thornton W, Thornton AE, Honer WG. Diffusion tensor imaging of neurocognitive profiles in a community cohort living in marginal housing. Brain Behav 2019; 9:e01233. [PMID: 30724486 PMCID: PMC6422717 DOI: 10.1002/brb3.1233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 11/13/2018] [Accepted: 01/09/2019] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE We investigated white matter differences associated with distinct neurocognitive profiles derived from a large cohort of marginally housed persons with comorbid physical and mental illnesses. Our prior work identified three profile cluster groups: a high functioning group (Cluster 1), a low functioning group with relative strength in decision-making (Cluster 3), and an intermediary group with a relative decision-making weakness (Cluster 2). This study extends previous findings of cortical gray matter differences between these groups with evidence for putative neurodevelopmental abnormalities in the low cognitive functioning group (i.e., Cluster 3). We hypothesized that altered white matter diffusion would be associated with the lowest functioning neurocognitive profile and would be associated with previously observed gray matter differences. METHOD Participants from a socially impoverished neighborhood in Vancouver, Canada underwent neurocognitive evaluation and neuroimaging. We performed Tract-Based Spatial Statistics using diffusion tensor imaging data from 184 participants to examine whole-brain differences in white matter microstructure between cluster analytically derived neurocognitive profiles, as well as unitary neurocognitive measures. Correlations between frontal gray and white matter were also examined. RESULTS Cluster 3 showed increased diffusion in predominately bilateral frontal and interhemisphere tracts (vs. Clusters 1 and 2), with relatively greater diffusion in the left hemisphere (vs. Cluster 1). Differences in radial diffusivity were more prominent compared with axial diffusivity. A weak association between regional frontal fractional anisotropy and previously defined abnormalities in gyrification was observed. CONCLUSIONS In a socially marginalized sample, we established several patterns in the covariation of white matter diffusion and neurocognitive functioning. These patterns elucidate the neurobiological substrates and vulnerabilities that are apt to underlie functional impairments inherent to this complex and heterogeneous population.
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Affiliation(s)
- Kristina M Gicas
- Department of Psychology, Simon Fraser University, Burnaby, Canada.,Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Alex Cheng
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Iris Rawtaer
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Taylor S Willi
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - William J Panenka
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Donna J Lang
- Department of Radiology, University of British Columbia, Vancover, Canada
| | - Geoff N Smith
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | | | - Olga Leonova
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | | | - Andrea A Jones
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancover, Canada
| | - Ric M Procyshyn
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Tari Buchanan
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - G William MacEwan
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | - Wayne Su
- Department of Psychiatry, University of British Columbia, Vancover, Canada
| | | | - Alexander Rauscher
- Department of Paediatrics, University of British Columbia, Vancover, Canada
| | - Norm O'Rourke
- Department of Public Health and Centre for Multidisciplinary Research in Aging, University of the Negev, Be'er Sheva, Israel
| | | | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancover, Canada
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9
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Woodward ML, Gicas KM, Warburton DE, White RF, Rauscher A, Leonova O, Su W, Smith GN, Thornton AE, Vertinsky AT, Phillips AA, Goghari VM, Honer WG, Lang DJ. Hippocampal volume and vasculature before and after exercise in treatment-resistant schizophrenia. Schizophr Res 2018; 202:158-165. [PMID: 30539767 DOI: 10.1016/j.schres.2018.06.054] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/11/2018] [Accepted: 06/20/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Schizophrenia is associated with poor cognitive function and elevated cardiometabolic disease risk. These health concerns may exacerbate neurocognitive dysfunction associated with hippocampal abnormalities, particularly hippocampal volume reductions. Regular exercise is thought to improve symptom severity, reduce depression, and improve cognition in schizophrenia, and may trigger exercise-mediated hippocampal growth. The potential for the benefits of exercise for treatment-resistant schizophrenia patients has not been clearly assessed. This study aims to assess the effect of exercise on hippocampal plasticity and clinical outcomes in chronic schizophrenia. METHODS Seventeen DSM-IV criteria schizophrenia or schizoaffective disorder patients completed a customized moderate intensity 12-week aerobic or weight-bearing exercise program. Adherence rates were 83% ± 9.4%) with 70% of participants completing the entire exercise program. Concomitant neuroimaging, clinical and cognitive assessments were obtained at baseline and 12-weeks. RESULTS At follow-up, symptom severity scores (t(16) = -16.8, p. ≤ 0.0001) and social functioning (t(16) = 4.4, p. = 0.0004) improved. A trend for improved depression scores (t(16) = -2.0, p. = 0.06) with no change in anxiety, or extrapyramidal symptoms were seen. Hippocampal volume increased (t(16) = -2.54, p. = 0.02), specifically in the left CA-1 field (F(16) = -2.33, p. = 0.03). Hippocampal vascular volume was unchanged. Change in hippocampal volume and vascular volume was not significantly correlated with change in symptom severity or affect scores. CONCLUSIONS Adjunct exercise may accelerate symptom improvement in treatment-resistant psychosis patients. While the underlying mechanism remains unclear, these results indicate that chronic schizophrenia patients experience hippocampal plasticity in response to exercise. STUDY REGISTRATION Clinical Trials.govNCT01392885.
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Affiliation(s)
- M L Woodward
- Department of Radiology, University of British Columbia, Canada
| | - K M Gicas
- Department of Psychology, Simon Fraser University, Canada
| | - D E Warburton
- School of Kinesiology, University of British Columbia, Canada; Experimental Medicine Program, University of British Columbia, Canada
| | - R F White
- Department of Psychiatry, University of British Columbia, Canada
| | - A Rauscher
- Department of Pediatrics, University of British Columbia, Canada
| | - O Leonova
- Department of Psychiatry, University of British Columbia, Canada
| | - W Su
- Department of Psychiatry, University of British Columbia, Canada
| | - G N Smith
- Department of Psychiatry, University of British Columbia, Canada
| | - A E Thornton
- Department of Pediatrics, University of British Columbia, Canada
| | - A T Vertinsky
- Department of Radiology, University of British Columbia, Canada
| | - A A Phillips
- School of Kinesiology, University of British Columbia, Canada
| | - V M Goghari
- Department of Psychology & Graduate Department of Psychological Clinical Science, University of Toronto, Canada
| | - W G Honer
- Department of Psychiatry, University of British Columbia, Canada
| | - D J Lang
- Department of Radiology, University of British Columbia, Canada.
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10
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Vertinsky AT, Li DK, Vavasour IM, Miropolsky V, Zhao G, Zhao Y, Riddehough A, Moore GW, Traboulsee A, Laule C. Diffusely Abnormal White Matter, T2
Burden of Disease, and Brain Volume in Relapsing-Remitting Multiple Sclerosis. J Neuroimaging 2018; 29:151-159. [DOI: 10.1111/jon.12574] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/09/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Alexandra T. Vertinsky
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - David K.B. Li
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Irene M. Vavasour
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - Vladislav Miropolsky
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
| | - Guojun Zhao
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
| | - Yinshan Zhao
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Andrew Riddehough
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
| | - G.R. Wayne Moore
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver British Columbia Canada
| | - Anthony Traboulsee
- UBC MS/MRI Research Group; University of British Columbia; Vancouver British Columbia Canada
- Department of Medicine (Neurology); University of British Columbia; Vancouver British Columbia Canada
| | - Cornelia Laule
- Department of Radiology; University of British Columbia; Vancouver British Columbia Canada
- Department of Pathology and Laboratory Medicine; University of British Columbia; Vancouver British Columbia Canada
- International Collaboration on Repair Discoveries (ICORD); University of British Columbia; Vancouver British Columbia Canada
- Department of Physics and Astronomy; University of British Columbia; Vancouver British Columbia Canada
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11
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Barbic SP, Jones AA, Woodward M, Piercy M, Mathias S, Vila-Rodriguez F, Leonova O, Smith GN, Buchanan T, Vertinsky AT, Gillingham S, Panenka WJ, Rauscher A, Barr AM, Procyshyn RM, MacEwan GW, Lang DJ, Thornton AE, Heran MK, Leon AM, Krausz M, Honer WG. Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study. Can J Public Health 2018; 109:204-214. [PMID: 29981045 PMCID: PMC6964603 DOI: 10.17269/s41997-018-0087-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 01/10/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Young adults living in single room occupancy (SRO) hotels, a form of low-income housing, are known to have complex health and substance problems compared to their peers in the general population. The objective of this study is to comprehensively describe the mental, physical, and social health profile of young adults living in SROs. METHODS This study reports baseline data from young adults aged 18-29 years, as part of a prospective cohort study of adults living in SROs in Vancouver, British Columbia, Canada. Baseline and follow-up data were collected from 101 young adults (median follow-up period 1.9 years [IQR 1.0-3.1]). The comprehensive assessment included laboratory tests, neuroimaging, and clinician- and patient-reported measures of mental, physical, and social health and functioning. RESULTS Three youth died during the preliminary follow-up period, translating into a higher than average mortality rate (18.6, 95% CI 6.0, 57.2) compared to age- and sex-matched Canadians. High prevalence of interactions with the health, social, and justice systems was reported. Participants were living with median two co-occurring illnesses, including mental, neurological, and infectious diseases. Greater number of multimorbid illnesses was associated with poorer real-world functioning (ρ = - 0.373, p < 0.001). All participants reported lifetime alcohol and cannabis use, with pervasive use of stimulants and opioids. CONCLUSION This study reports high mortality rates, multimorbid illnesses, poor functioning, poverty, and ongoing unmet mental health needs among young adults living in SROs. Frequent interactions with the health, social, and justice systems suggest important points of intervention to improve health and functional trajectories of this vulnerable population.
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Affiliation(s)
- Skye P Barbic
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- Department of Occupational Science and Occupational Therapy, UBC, Vancouver, BC, Canada.
- Department of Psychiatry, UBC, Vancouver, BC, Canada.
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada.
- Foundry, Vancouver, BC, Canada.
- Faculty of Medicine, Department of Occupational Science and Occupational Therapy, The University of British Columbia St. Paul's Hospital, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
| | - Andrea A Jones
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Melissa Woodward
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, UBC, Vancouver, BC, Canada
| | | | - Steve Mathias
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
- Foundry, Vancouver, BC, Canada
- St. Paul's Hospital, Vancouver, BC, Canada
| | - Fidel Vila-Rodriguez
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Olga Leonova
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Geoffrey N Smith
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Tari Buchanan
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | | | | | - William J Panenka
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - Alexander Rauscher
- Foundry, Vancouver, BC, Canada
- Department of Pediatrics, UBC, Vancouver, BC, Canada
| | - Alasdair M Barr
- Department of Anesthesiology, Pharmacology & Therapeutics, UBC, Vancouver, BC, Canada
| | - Ric M Procyshyn
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
| | - G William MacEwan
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- St. Paul's Hospital, Vancouver, BC, Canada
| | - Donna J Lang
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Radiology, UBC, Vancouver, BC, Canada
| | - Allen E Thornton
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
| | - Manraj K Heran
- Foundry, Vancouver, BC, Canada
- Vancouver General Hospital, Vancouver, BC, Canada
| | - Adelena M Leon
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, UBC, Vancouver, BC, Canada
| | - Michael Krausz
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - William G Honer
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Psychiatry, UBC, Vancouver, BC, Canada
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12
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Ni Mhurchu E, Ospina J, Janjua AS, Shewchuk JR, Vertinsky AT. Fungal Rhinosinusitis: A Radiological Review with Intraoperative Correlation. Can Assoc Radiol J 2017; 68:178-186. [DOI: 10.1016/j.carj.2016.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/30/2016] [Indexed: 10/19/2022] Open
Abstract
The interaction between fungi and the sinonasal tract results in a range of clinical presentations with a broad spectrum of clinical severity. The most commonly accepted classification system divides fungal rhinosinusitis into invasive and noninvasive subtypes based on histopathological evidence of tissue invasion by fungi. Invasive fungal rhinosinusitis is subdivided into acute invasive and chronic invasive categories. The chronic invasive category includes a subcategory of chronic granulomatous disease. Noninvasive fungal disease includes localized fungal colonization, fungal ball, and allergic fungal rhinosinusitis. Noninvasive disease is simply fungal material (or the products of the inflammatory reaction of the sinus mucosa) that fills the sinuses but does not invade tissue. Bone loss is related to expansion of the sinus(es). Invasive disease causes tissue destruction, such that it expands past the bony confines of the sinuses. It can rapidly spread, causing acute necrosis. Alternatively, there may be slow tissue invasion characterized by symptoms confused with normal sinusitis, but destruction of normal nasal and paranasal structures.
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Affiliation(s)
- Elaine Ni Mhurchu
- Neuroradiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Javier Ospina
- Otolaryngology - Head & Neck Surgery, University of British Columbia, Vancouver General Hospital and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Arif S. Janjua
- Otolaryngology - Head & Neck Surgery, University of British Columbia, Vancouver General Hospital and St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Jason R. Shewchuk
- Neuroradiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Alexandra T. Vertinsky
- Neuroradiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
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13
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Lee DY, Smith GN, Su W, Honer WG, Macewan GW, Lapointe JS, Vertinsky AT, Vila-Rodriguez F, Kopala LC, Lang DJ. White matter tract abnormalities in first-episode psychosis. Schizophr Res 2012; 141:29-34. [PMID: 22863549 DOI: 10.1016/j.schres.2012.06.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 06/23/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
Abstract
Fibers connecting fronto-temporal and fronto-medial structures that pass through the anterior limb of the internal capsule (ALIC) subserve executive and psychomotor functioning. Both of these functions are adversely affected in schizophrenia, and may be abnormal at illness onset. In a study of first-episode psychosis, we used diffusion tensor imaging (DTI) and cognitive testing to examine ALIC integrity. Fourteen early psychosis patients and 29 healthy volunteers were included. Symptoms were assessed with the Positive and Negative Syndromes Scale (PANSS). All structural and diffusion scans were acquired on a GE Signa 1.5T scanner. A T1-weighted 3D FSPGR Inversion Recovery imaging series was acquired for manual seeding in structural space. Diffusion tensor imaging (DTI) was performed, and all DTI images were co-registered to structural space. Seeds were manually drawn bilaterally on the coronal plane at a specified location. Diffusion images were post-processed for subsequent Tract-based Spatial Statistics (TBSS) analysis. First-episode psychosis patients had significantly smaller fronto-medial and fronto-temporal AIC tract volumes compared to healthy volunteers on the left and the right (p-values<0.04). No differences in mean fractional anisotropy (FA) were seen within either left or right tracts (p-values>0.05), nor did TBSS reveal any other differences in FA values between groups in other regions. Relationships between tract volumes and symptom severity were not observed in this study.
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Affiliation(s)
- D Y Lee
- Department of Radiology, Royal Columbian Hospital, New Westminster, BC, Canada
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14
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Vertinsky AT, Coenen VA, Lang DJ, Kolind S, Honey CR, Li D, Rauscher A. Localization of the subthalamic nucleus: optimization with susceptibility-weighted phase MR imaging. AJNR Am J Neuroradiol 2009; 30:1717-24. [PMID: 19509077 DOI: 10.3174/ajnr.a1669] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE On clinical MR images, the subthalamic nuclei (STN) are poorly delineated from adjacent structures, impeding safe direct targeting for placement of electrodes in the treatment of Parkinson disease. Susceptibility-weighted MR phase imaging offers improved contrast and spatial resolution at reduced imaging times relative to clinically used T2-weighted spin-echo imaging for STN visualization. Our purpose was to assess STN visibility by using phase imaging, comparing phase and magnitude images obtained concurrently by using susceptibility-weighted imaging (SWI). The goal was to identify an efficient scanning protocol for high-quality phase images of STN. MATERIALS AND METHODS Seventy-eight SWI scans were acquired at 3T by using different TEs and acceleration factors. STN visibility and delimitation from adjacent structures were scored from 0 (not interpretable) to 5 (excellent). Regression analyses assessed the relationship of STN visibility to scanning parameters RESULTS STN were identified at all studied TEs on phase images. Visibility and delimitation of STN were consistently superior on phase images compared with magnitude images. Good visualization (score of >or=4) of STN on phase imaging occurred at a mean TE of 20.0 ms and a sensitivity encoding (SENSE) of 1.40. Scores of STN visualization on phase images were dependent on SENSE (P < .002) and TE (P < .031). Good delimitation of the STN on phase imaging occurred at a mean TE of 21.6 ms and a SENSE of 1.36. CONCLUSIONS Visualization and delimitation of STN was superior on phase images and was achieved at 3T in <2.5 minutes. A TE of 20 ms and an acceleration factor of <or=1.5 are recommended to visualize STN by using this method.
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Affiliation(s)
- A T Vertinsky
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada
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15
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Vertinsky AT, Schwartz NE, Fischbein NJ, Rosenberg J, Albers GW, Zaharchuk G. Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol 2008; 29:1753-60. [PMID: 18635617 DOI: 10.3174/ajnr.a1189] [Citation(s) in RCA: 213] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Conventional angiography has been historically considered the gold standard for the diagnosis of cervical artery dissection, but MR imaging/MR angiography (MRA) and CT/CT angiography (CTA) are commonly used noninvasive alternatives. The goal of this study was to compare the ability of multidetector CT/CTA and MR imaging/MRA to detect common imaging findings of dissection. MATERIALS AND METHODS Patients in the data base of our Stroke Center between 2003 and 2007 with dissections who had CT/CTA and MR imaging/MRA on initial work-up were reviewed retrospectively. Two neuroradiologists evaluated the images for associated findings of dissection, including acute ischemic stroke, luminal narrowing, vessel irregularity, wall thickening/hematoma, pseudoaneurysm, and intimal flap. The readers also subjectively rated each vessel on the basis of whether the imaging findings were more clearly displayed with CT/CTA or MR imaging/MRA or were equally apparent. RESULTS Eighteen patients with 25 dissected vessels (15 internal carotid arteries [ICA] and 10 vertebral arteries [VA]) met the inclusion criteria. CT/CTA identified more intimal flaps, pseudoaneurysms, and high-grade stenoses than MR imaging/MRA. CT/CTA was preferred for diagnosis in 13 vessels (5 ICA, 8 VA), whereas MR imaging/MRA was preferred in 1 vessel (ICA). The 2 techniques were deemed equal in the remaining 11 vessels (9 ICA, 2 VA). A significant preference for CT/CTA was noted for VA dissections (P < .05), but not for ICA dissections. CONCLUSION Multidetector CT/CTA visualized more features of cervical artery dissection than MR imaging/MRA. CT/CTA was subjectively favored for vertebral dissection, whereas there was no technique preference for ICA dissection. In many cases, MR imaging/MRA provided complementary or confirmatory information, particularly given its better depiction of ischemic complications.
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Affiliation(s)
- A T Vertinsky
- Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Abstract
Macrocephaly, increased intracranial pressure, and hydrocephalus are common related conditions that lead to cross-sectional imaging of the infant and young child. Imaging plays a central role in establishing the diagnosis and guiding disposition and treatment of these patients. In this review, a general overview is provided, and the more common causes of hydrocephalus are presented, including posthemorrhage, postinfection, developmental malformations, and masses. Imaging guidelines are also outlined for initial evaluation and follow-up, along with a discussion of the imaging features of shunt malfunction.
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