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van der Horn HJ, Vakhtin AA, Julio K, Nitschke S, Shaff N, Dodd AB, Erhardt E, Phillips JP, Pirio Richardson S, Deligtisch A, Stewart M, Suarez Cedeno G, Meles SK, Mayer AR, Ryman SG. Parkinson's disease cerebrovascular reactivity pattern: A feasibility study. J Cereb Blood Flow Metab 2024:271678X241241895. [PMID: 38578669 DOI: 10.1177/0271678x241241895] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
A mounting body of research points to cerebrovascular dysfunction as a fundamental element in the pathophysiology of Parkinson's disease (PD). In the current feasibility study, blood-oxygen-level-dependent (BOLD) MRI was used to measure cerebrovascular reactivity (CVR) in response to hypercapnia in 26 PD patients and 16 healthy controls (HC), and aimed to find a multivariate pattern specific to PD. Whole-brain maps of CVR amplitude (i.e., magnitude of response to CO2) and latency (i.e., time to reach maximum amplitude) were computed, which were further analyzed using scaled sub-profile model principal component analysis (SSM-PCA) with leave-one-out cross-validation. A meaningful pattern based on CVR latency was identified, which was named the PD CVR pattern (PD-CVRP). This pattern was characterized by relatively increased latency in basal ganglia, sensorimotor cortex, supplementary motor area, thalamus and visual cortex, as well as decreased latency in the cerebral white matter, relative to HC. There were no significant associations with clinical measures, though sample size may have limited our ability to detect significant associations. In summary, the PD-CVRP highlights the importance of cerebrovascular dysfunction in PD, and may be a potential biomarker for future clinical research and practice.
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Affiliation(s)
- Harm Jan van der Horn
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Andrei A Vakhtin
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Kayla Julio
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Stephanie Nitschke
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Nicholas Shaff
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Andrew B Dodd
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA
| | - John P Phillips
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Sarah Pirio Richardson
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - Amanda Deligtisch
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Melanie Stewart
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Gerson Suarez Cedeno
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
| | - Sanne K Meles
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Andrew R Mayer
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
| | - Sephira G Ryman
- Department of Translational Neuroscience, The Mind Research Network, Albuquerque, NM, USA
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, USA
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van der Horn HJ, Ling JM, Wick TV, Dodd AB, Robertson-Benta CR, McQuaid JR, Zotev V, Vakhtin AA, Ryman SG, Cabral J, Phillips JP, Campbell RA, Sapien RE, Mayer AR. Dynamic Functional Connectivity in Pediatric Mild Traumatic Brain Injury. Neuroimage 2024; 285:120470. [PMID: 38016527 PMCID: PMC10815936 DOI: 10.1016/j.neuroimage.2023.120470] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
Resting-state fMRI can be used to identify recurrent oscillatory patterns of functional connectivity within the human brain, also known as dynamic brain states. Alterations in dynamic brain states are highly likely to occur following pediatric mild traumatic brain injury (pmTBI) due to the active developmental changes. The current study used resting-state fMRI to investigate dynamic brain states in 200 patients with pmTBI (ages 8-18 years, median = 14 years) at the subacute (∼1-week post-injury) and early chronic (∼ 4 months post-injury) stages, and in 179 age- and sex-matched healthy controls (HC). A k-means clustering analysis was applied to the dominant time-varying phase coherence patterns to obtain dynamic brain states. In addition, correlations between brain signals were computed as measures of static functional connectivity. Dynamic connectivity analyses showed that patients with pmTBI spend less time in a frontotemporal default mode/limbic brain state, with no evidence of change as a function of recovery post-injury. Consistent with models showing traumatic strain convergence in deep grey matter and midline regions, static interhemispheric connectivity was affected between the left and right precuneus and thalamus, and between the right supplementary motor area and contralateral cerebellum. Changes in static or dynamic connectivity were not related to symptom burden or injury severity measures, such as loss of consciousness and post-traumatic amnesia. In aggregate, our study shows that brain dynamics are altered up to 4 months after pmTBI, in brain areas that are known to be vulnerable to TBI. Future longitudinal studies are warranted to examine the significance of our findings in terms of long-term neurodevelopment.
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Affiliation(s)
| | - Josef M Ling
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | - Tracey V Wick
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | - Andrew B Dodd
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | | | | | - Vadim Zotev
- The Mind Research Network/LBERI, Albuquerque, NM 87106
| | | | | | - Joana Cabral
- Life and Health Sciences Research Institute, University of Minho, Braga, Portugal
| | | | - Richard A Campbell
- Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131
| | - Robert E Sapien
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131
| | - Andrew R Mayer
- The Mind Research Network/LBERI, Albuquerque, NM 87106; Department of Psychiatry & Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131; Department of Psychology, University of New Mexico, Albuquerque, NM 87131; Department of Neurology, University of New Mexico, Albuquerque, NM 87131
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Plummer AM, Matos YL, Lin HC, Ryman SG, Birg A, Quinn DK, Parada AN, Vakhtin AA. Gut-brain pathogenesis of post-acute COVID-19 neurocognitive symptoms. Front Neurosci 2023; 17:1232480. [PMID: 37841680 PMCID: PMC10568482 DOI: 10.3389/fnins.2023.1232480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Approximately one third of non-hospitalized coronavirus disease of 2019 (COVID-19) patients report chronic symptoms after recovering from the acute stage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Some of the most persistent and common complaints of this post-acute COVID-19 syndrome (PACS) are cognitive in nature, described subjectively as "brain fog" and also objectively measured as deficits in executive function, working memory, attention, and processing speed. The mechanisms of these chronic cognitive sequelae are currently not understood. SARS-CoV-2 inflicts damage to cerebral blood vessels and the intestinal wall by binding to angiotensin-converting enzyme 2 (ACE2) receptors and also by evoking production of high levels of systemic cytokines, compromising the brain's neurovascular unit, degrading the intestinal barrier, and potentially increasing the permeability of both to harmful substances. Such substances are hypothesized to be produced in the gut by pathogenic microbiota that, given the profound effects COVID-19 has on the gastrointestinal system, may fourish as a result of intestinal post-COVID-19 dysbiosis. COVID-19 may therefore create a scenario in which neurotoxic and neuroinflammatory substances readily proliferate from the gut lumen and encounter a weakened neurovascular unit, gaining access to the brain and subsequently producing cognitive deficits. Here, we review this proposed PACS pathogenesis along the gut-brain axis, while also identifying specific methodologies that are currently available to experimentally measure each individual component of the model.
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Affiliation(s)
- Allison M. Plummer
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States
| | - Yvette L. Matos
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
| | - Henry C. Lin
- Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, NM, United States
- Section of Gastroenterology, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, United States
| | - Sephira G. Ryman
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, University of New Mexico, Albuquerque, NM, United States
| | - Aleksandr Birg
- Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, NM, United States
- Section of Gastroenterology, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, United States
| | - Davin K. Quinn
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Alisha N. Parada
- Division of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, United States
| | - Andrei A. Vakhtin
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States
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Quinn DK, Upston J, Jones TR, Gibson BC, Olmstead TA, Yang J, Price AM, Bowers-Wu DH, Durham E, Hazlewood S, Farrar DC, Miller J, Lloyd MO, Garcia CA, Ojeda CJ, Hager BW, Vakhtin AA, Abbott CC. Electric field distribution predicts efficacy of accelerated intermittent theta burst stimulation for late-life depression. Front Psychiatry 2023; 14:1215093. [PMID: 37593449 PMCID: PMC10427506 DOI: 10.3389/fpsyt.2023.1215093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/13/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Repetitive transcranial magnetic stimulation (rTMS) is a promising intervention for late-life depression (LLD) but may have lower rates of response and remission owing to age-related brain changes. In particular, rTMS induced electric field strength may be attenuated by cortical atrophy in the prefrontal cortex. To identify clinical characteristics and treatment parameters associated with response, we undertook a pilot study of accelerated fMRI-guided intermittent theta burst stimulation (iTBS) to the right dorsolateral prefrontal cortex in 25 adults aged 50 or greater diagnosed with LLD and qualifying to receive clinical rTMS. Methods Participants underwent baseline behavioral assessment, cognitive testing, and structural and functional MRI to generate individualized targets and perform electric field modeling. Forty-five sessions of iTBS were delivered over 9 days (1800 pulses per session, 50-min inter-session interval). Assessments and testing were repeated after 15 sessions (Visit 2) and 45 sessions (Visit 3). Primary outcome measure was the change in depressive symptoms on the Inventory of Depressive Symptomatology-30-Clinician (IDS-C-30) from Visit 1 to Visit 3. Results Overall there was a significant improvement in IDS score with the treatment (Visit 1: 38.6; Visit 2: 31.0; Visit 3: 21.3; mean improvement 45.5%) with 13/25 (52%) achieving response and 5/25 (20%) achieving remission (IDS-C-30 < 12). Electric field strength and antidepressant effect were positively correlated in a subregion of the ventrolateral prefrontal cortex (VLPFC) (Brodmann area 47) and negatively correlated in the posterior dorsolateral prefrontal cortex (DLPFC). Conclusion Response and remission rates were lower than in recently published trials of accelerated fMRI-guided iTBS to the left DLPFC. These results suggest that sufficient electric field strength in VLPFC may be a contributor to effective rTMS, and that modeling to optimize electric field strength in this area may improve response and remission rates. Further studies are needed to clarify the relationship of induced electric field strength with antidepressant effects of rTMS for LLD.
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Affiliation(s)
- Davin K. Quinn
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Thomas R. Jones
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Benjamin C. Gibson
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Tessa A. Olmstead
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Justine Yang
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | | | - Dorothy H. Bowers-Wu
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Erick Durham
- Department of Psychiatry, Texas Tech University, El Paso, TX, United States
| | - Shawn Hazlewood
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Danielle C. Farrar
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Jeremy Miller
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Megan O. Lloyd
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Crystal A. Garcia
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Cesar J. Ojeda
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | - Brant W. Hager
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
| | | | - Christopher C. Abbott
- Department of Psychiatry and Behavioral Sciences, UNM, Albuquerque, NM, United States
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Ryman S, Vakhtin AA, Richardson SP, Lin HC. Microbiome-gut-brain dysfunction in prodromal and symptomatic Lewy body diseases. J Neurol 2023; 270:746-758. [PMID: 36355185 PMCID: PMC9886597 DOI: 10.1007/s00415-022-11461-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
Lewy body diseases, such as Parkinson's disease and dementia with Lewy bodies, vary in their clinical phenotype but exhibit the same defining pathological feature, α-synuclein aggregation. Microbiome-gut-brain dysfunction may play a role in the initiation or progression of disease processes, though there are multiple potential mechanisms. We discuss the need to evaluate gastrointestinal mechanisms of pathogenesis across Lewy body diseases, as disease mechanisms likely span across diagnostic categories and a 'body first' clinical syndrome may better account for the heterogeneity of clinical presentations across the disorders. We discuss two primary hypotheses that suggest that either α-synuclein aggregation occurs in the gut and spreads in a prion-like fashion to the brain or systemic inflammatory processes driven by gastrointestinal dysfunction contribute to the pathophysiology of Lewy body diseases. Both of these hypotheses posit that dysbiosis and intestinal permeability are key mechanisms and potential treatment targets. Ultimately, this work can identify early interventions targeting initial disease pathogenic processes before the development of overt motor and cognitive symptoms.
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Affiliation(s)
- Sephira Ryman
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA.
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, The University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Andrei A Vakhtin
- The Mind Research Network, 1101 Yale Blvd. NE, Albuquerque, NM, 87106, USA
| | - Sarah Pirio Richardson
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of Neurology, The University of New Mexico, Albuquerque, NM, 87131, USA
| | - Henry C Lin
- Department of Medicine, The University of New Mexico, Albuquerque, NM, 87131, USA
- Section of Gastroenterology, New Mexico VA Health Care System, Albuquerque, NM, 87108, USA
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Mayer AR, Meier TB, Dodd AB, Stephenson DD, Robertson-Benta CR, Ling JM, Pabbathi Reddy S, Zotev V, Vakamudi K, Campbell RA, Sapien RE, Erhardt EB, Phillips JP, Vakhtin AA. Prospective Study of Gray Matter Atrophy Following Pediatric Mild Traumatic Brain Injury. Neurology 2023; 100:e516-e527. [PMID: 36522161 PMCID: PMC9931084 DOI: 10.1212/wnl.0000000000201470] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The clinical and physiologic time course for recovery following pediatric mild traumatic brain injury (pmTBI) remains actively debated. The primary objective of the current study was to prospectively examine structural brain changes (cortical thickness and subcortical volumes) and age-at-injury effects. A priori study hypotheses predicted reduced cortical thickness and hippocampal volumes up to 4 months postinjury, which would be inversely associated with age at injury. METHODS Prospective cohort study design with consecutive recruitment. Study inclusion adapted from American Congress of Rehabilitation Medicine (upper threshold) and Zurich Concussion in Sport Group (minimal threshold) and diagnosed by Emergency Department and Urgent Care clinicians. Major neurologic, psychiatric, or developmental disorders were exclusionary. Clinical (Common Data Element) and structural (3 T MRI) evaluations within 11 days (subacute visit [SA]) and at 4 months (early chronic visit [EC]) postinjury. Age- and sex-matched healthy controls (HC) to control for repeat testing/neurodevelopment. Clinical outcomes based on self-report and cognitive testing. Structural images quantified with FreeSurfer (version 7.1.1). RESULTS A total of 208 patients with pmTBI (age = 14.4 ± 2.9; 40.4% female) and 176 HC (age = 14.2 ± 2.9; 42.0% female) were included in the final analyses (>80% retention). Reduced cortical thickness (right rostral middle frontal gyrus; d = -0.49) and hippocampal volumes (d = -0.24) observed for pmTBI, but not associated with age at injury. Hippocampal volume recovery was mediated by loss of consciousness/posttraumatic amnesia. Significantly greater postconcussive symptoms and cognitive deficits were observed at SA and EC visits, but were not associated with the structural abnormalities. Structural abnormalities slightly improved balanced classification accuracy above and beyond clinical gold standards (∆+3.9%), with a greater increase in specificity (∆+7.5%) relative to sensitivity (∆+0.3%). DISCUSSION Current findings indicate that structural brain abnormalities may persist up to 4 months post-pmTBI and are partially mediated by initial markers of injury severity. These results contribute to a growing body of evidence suggesting prolonged physiologic recovery post-pmTBI. In contrast, there was no evidence for age-at-injury effects or physiologic correlates of persistent symptoms in our sample.
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Affiliation(s)
- Andrew R Mayer
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque.
| | - Timothy B Meier
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Andrew B Dodd
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - David D Stephenson
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Cidney R Robertson-Benta
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Josef M Ling
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Sharvani Pabbathi Reddy
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Vadim Zotev
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Kishore Vakamudi
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Richard A Campbell
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Robert E Sapien
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Erik B Erhardt
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - John P Phillips
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
| | - Andrei A Vakhtin
- From the The Mind Research Network/Lovelace Biomedical Research Institute (A.R.M., A.B.D., D.D.S., C.R.R.-B., J.M.L., S.P.R., V.Z., K.V., J.P.P., A.A.V.); Department of Psychology (A.R.M.), Department of Neurology (A.R.M., J.P.P.), and Department of Psychiatry & Behavioral Sciences (A.R.M., R.A.C.), University of New Mexico, Albuquerque; Department of Neurosurgery (T.B.M.), Department of Cell Biology, Neurobiology and Anatomy (T.B.M.), and Department of Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; and Department of Emergency Medicine (R.E.S.), and Department of Mathematics and Statistics (E.B.E.), University of New Mexico, Albuquerque
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7
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Mayer AR, Ling JM, Dodd AB, Stephenson DD, Pabbathi Reddy S, Robertson-Benta CR, Erhardt EB, Harms RL, Meier TB, Vakhtin AA, Campbell RA, Sapien RE, Phillips JP. Multicompartmental models and diffusion abnormalities in paediatric mild traumatic brain injury. Brain 2022; 145:4124-4137. [PMID: 35727944 DOI: 10.1093/brain/awac221] [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: 11/23/2021] [Revised: 04/29/2022] [Accepted: 06/09/2022] [Indexed: 01/23/2023] Open
Abstract
The underlying pathophysiology of paediatric mild traumatic brain injury and the time-course for biological recovery remains widely debated, with clinical care principally informed by subjective self-report. Similarly, clinical evidence indicates that adolescence is a risk factor for prolonged recovery, but the impact of age-at-injury on biomarkers has not been determined in large, homogeneous samples. The current study collected diffusion MRI data in consecutively recruited patients (n = 203; 8-18 years old) and age and sex-matched healthy controls (n = 170) in a prospective cohort design. Patients were evaluated subacutely (1-11 days post-injury) as well as at 4 months post-injury (early chronic phase). Healthy participants were evaluated at similar times to control for neurodevelopment and practice effects. Clinical findings indicated persistent symptoms at 4 months for a significant minority of patients (22%), along with residual executive dysfunction and verbal memory deficits. Results indicated increased fractional anisotropy and reduced mean diffusivity for patients, with abnormalities persisting up to 4 months post-injury. Multicompartmental geometric models indicated that estimates of intracellular volume fractions were increased in patients, whereas estimates of free water fractions were decreased. Critically, unique areas of white matter pathology (increased free water fractions or increased neurite dispersion) were observed when standard assumptions regarding parallel diffusivity were altered in multicompartmental models to be more biologically plausible. Cross-validation analyses indicated that some diffusion findings were more reproducible when ∼70% of the total sample (142 patients, 119 controls) were used in analyses, highlighting the need for large-sample sizes to detect abnormalities. Supervised machine learning approaches (random forests) indicated that diffusion abnormalities increased overall diagnostic accuracy (patients versus controls) by ∼10% after controlling for current clinical gold standards, with each diffusion metric accounting for only a few unique percentage points. In summary, current results suggest that novel multicompartmental models are more sensitive to paediatric mild traumatic brain injury pathology, and that this sensitivity is increased when using parameters that more accurately reflect diffusion in healthy tissue. Results also indicate that diffusion data may be insufficient to achieve a high degree of objective diagnostic accuracy in patients when used in isolation, which is to be expected given known heterogeneities in pathophysiology, mechanism of injury and even criteria for diagnoses. Finally, current results indicate ongoing clinical and physiological recovery at 4 months post-injury.
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Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/LBERI, Albuquerque, NM 87106, USA.,Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA.,Department of Neurology, University of New Mexico, Albuquerque, NM 87131, USA.,Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Josef M Ling
- The Mind Research Network/LBERI, Albuquerque, NM 87106, USA
| | - Andrew B Dodd
- The Mind Research Network/LBERI, Albuquerque, NM 87106, USA
| | | | | | | | - Erik B Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM 87131, USA
| | | | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA.,Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | | | - Richard A Campbell
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - Robert E Sapien
- Department of Emergency Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - John P Phillips
- The Mind Research Network/LBERI, Albuquerque, NM 87106, USA.,Department of Neurology, University of New Mexico, Albuquerque, NM 87131, USA
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8
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Stone DB, Ryman SG, Hartman AP, Wertz CJ, Vakhtin AA. Specific White Matter Tracts and Diffusion Properties Predict Conversion From Mild Cognitive Impairment to Alzheimer's Disease. Front Aging Neurosci 2021; 13:711579. [PMID: 34366830 PMCID: PMC8343075 DOI: 10.3389/fnagi.2021.711579] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Identifying biomarkers that can assess the risk of developing Alzheimer's Disease (AD) remains a significant challenge. In this study, we investigated the integrity levels of brain white matter in 34 patients with mild cognitive impairment (MCI) who later converted to AD and 53 stable MCI patients. We used diffusion tensor imaging (DTI) and automated fiber quantification to obtain the diffusion properties of 20 major white matter tracts. To identify which tracts and diffusion measures are most relevant to AD conversion, we used support vector machines (SVMs) to classify the AD conversion and non-conversion MCI patients based on the diffusion properties of each tract individually. We found that diffusivity measures from seven white matter tracts were predictive of AD conversion with axial diffusivity being the most predictive diffusion measure. Additional analyses revealed that white matter changes in the central and parahippocampal terminal regions of the right cingulate hippocampal bundle, central regions of the right inferior frontal occipital fasciculus, and posterior and anterior regions of the left inferior longitudinal fasciculus were the best predictors of conversion from MCI to AD. An SVM based on these white matter tract regions achieved an accuracy of 0.75. These findings provide additional potential biomarkers of AD risk in MCI patients.
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9
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Vakhtin AA, Zhang Y, Wintermark M, Ashford JW, Furst AJ. Distant histories of mild traumatic brain injury exacerbate age-related differences in white matter properties. Neurobiol Aging 2021; 107:30-41. [PMID: 34371285 DOI: 10.1016/j.neurobiolaging.2021.07.002] [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: 03/02/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
We examined associations of distant histories of mild traumatic brain injury (mTBI) with non-linear and linear trajectories of white matter (WM) properties across a wide age range (23-77). Diffusion tensor imaging (DTI) data obtained from 171 Veterans with histories of clinically diagnosed mTBIs and 115 controls were subjected to tractography, isolating 20 major WM tracts. Non-linear and linear effects of age on each tract's diffusion properties were examined in terms of their interactions with group (mTBI and control). The non-linear model revealed 7 tracts in which the mTBI group's DTI metrics rapidly deviated from control trajectories in middle and late adulthoods, despite the injuries having occurred in the late 20s, on average. In contrast, no interactions between prior injuries and age were detected when examining linear trajectories. Distant mTBIs may thus accelerate normal age-related trajectories of WM degeneration much later in life. As such, life-long histories of head trauma should be assessed in all patients in their mid-to-late adulthoods, whether neurologically healthy or presenting with seemingly unrelated neuropathology.
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Affiliation(s)
- Andrei A Vakhtin
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.
| | - Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA
| | - Max Wintermark
- Neuroradiology, Stanford University School of Medicine, Stanford, CA, USA
| | - John W Ashford
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Ansgar J Furst
- War Related Illness and Injury Study Center (WRIISC), Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA; Polytrauma System of Care, Palo Alto Veterans Affairs Hospital, Palo Alto, CA, USA
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10
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Zhang Y, Vakhtin AA, Dietch J, Jennings JS, Yesavage JA, Clark JD, Bayley PJ, Ashford JW, Furst AJ. Brainstem damage is associated with poorer sleep quality and increased pain in gulf war illness veterans. Life Sci 2021; 280:119724. [PMID: 34144059 DOI: 10.1016/j.lfs.2021.119724] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/01/2021] [Accepted: 06/07/2021] [Indexed: 11/19/2022]
Abstract
AIMS Gulf War Illness (GWI) is manifested as multiple chronic symptoms, including chronic pain, chronic fatigue, sleep problems, neuropsychiatric disorders, respiratory, gastrointestinal, and skin problems. No single target tissue or unifying pathogenic process has been identified that accounts for this variety of symptoms. The brainstem has been suspected to contribute to this multiple symptomatology. The aim of this study was to assess the role of the brainstem in chronic sleep problems and pain in GWI veterans. MATERIALS AND METHODS We enrolled 90 veterans (Age = 50 ± 5, 87% Male) who were deployed to the 1990-91 Gulf War and presented with GWI symptoms. Sleep quality was evaluated using the global Pittsburgh Sleep Quality Index. Pain intensities were obtained with the Brief Pain Inventory sum score. Volumes in cortical, subcortical, brainstem, and brainstem subregions and diffusion tensor metrics in 10 bilateral brainstem tracts were tested for correlations with symptom measures. KEY FINDINGS Poorer sleep quality was significantly correlated with atrophy of the whole brainstem and brainstem subregions (including midbrain, pons, medulla). Poorer sleep quality also significantly correlated with lower fractional anisotropy in the nigrostriatal tract, medial forebrain tract, and the dorsal longitudinal fasciculus. There was a significant correlation between increased pain intensity and decreased fractional anisotropy in the dorsal longitudinal fasciculus. These correlations were not altered after controlling for age, sex, total intracranial volumes, or additional factors, e.g., depression and neurological conditions. SIGNIFICANCE These findings suggest that the brainstem plays an important role in the aberrant neuromodulation of sleep and pain symptoms in GWI.
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Affiliation(s)
- Yu Zhang
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States.
| | | | - Jessica Dietch
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
| | - Jennifer S Jennings
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Jerome A Yesavage
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
| | - J David Clark
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
| | - Peter J Bayley
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
| | - J Wesson Ashford
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
| | - Ansgar J Furst
- War Related Illness & Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University, Stanford, CA, United States
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11
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Quinn DK, Jones TR, Upston J, Huff M, Ryman SG, Vakhtin AA, Abbott CC. Right prefrontal intermittent theta-burst stimulation for major depressive disorder: A case series. Brain Stimul 2020; 14:97-99. [PMID: 33242610 DOI: 10.1016/j.brs.2020.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Davin K Quinn
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA.
| | - Thomas R Jones
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Joel Upston
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Michael Huff
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
| | - Sephira G Ryman
- Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Andrei A Vakhtin
- Mind Research Network, 1101 Yale Boulevard NE, Albuquerque, NM, 87106, USA
| | - Christopher C Abbott
- Department of Psychiatry and Behavioral Sciences, 2600 Marble Avenue NE, University of New Mexico, Albuquerque, NM, 87106, USA
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12
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Zhang Y, Vakhtin AA, Jennings JS, Massaband P, Wintermark M, Craig PL, Ashford JW, Clark JD, Furst AJ. Diffusion tensor tractography of brainstem fibers and its application in pain. PLoS One 2020; 15:e0213952. [PMID: 32069284 PMCID: PMC7028272 DOI: 10.1371/journal.pone.0213952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/02/2020] [Indexed: 12/13/2022] Open
Abstract
Evaluation of brainstem pathways with diffusion tensor imaging (DTI) and tractography may provide insights into pathophysiologies associated with dysfunction of key brainstem circuits. However, identification of these tracts has been elusive, with relatively few in vivo human studies to date. In this paper we proposed an automated approach for reconstructing nine brainstem fiber trajectories of pathways that might be involved in pain modulation. We first performed native-space manual tractography of these fiber tracts in a small normative cohort of participants and confirmed the anatomical precision of the results using existing anatomical literature. Second, region-of-interest pairs were manually defined at each extracted fiber’s termini and nonlinearly warped to a standard anatomical brain template to create an atlas of the region-of-interest pairs. The resulting atlas was then transformed non-linearly into the native space of 17 veteran patients’ brains for automated brainstem tractography. Lastly, we assessed the relationships between the integrity levels of the obtained fiber bundles and pain severity levels. Fractional anisotropy (FA) measures derived using automated tractography reflected the respective tracts’ FA levels obtained via manual tractography. A significant inverse relationship between FA and pain levels was detected within the automatically derived dorsal and medial longitudinal fasciculi of the brainstem. This study demonstrates the feasibility of DTI in exploring brainstem circuitries involved in pain processing. In this context, the described automated approach is a viable alternative to the time-consuming manual tractography. The physiological and functional relevance of the measures derived from automated tractography is evidenced by their relationships with individual pain severities.
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Affiliation(s)
- Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- * E-mail:
| | - Andrei A. Vakhtin
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Jennifer S. Jennings
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Payam Massaband
- Radiology, VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Max Wintermark
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
- Neuroradiology at Stanford University, Stanford, California, United States of America
| | - Patricia L. Craig
- Radiology, VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - J. Wesson Ashford
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - J. David Clark
- Pain Clinic, VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, United States of America
| | - Ansgar J. Furst
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
- Neurology and Neurological Sciences, Stanford University, Stanford, California, United States of America
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13
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Zhang Y, Avery T, Vakhtin AA, Mathersul DC, Tranvinh E, Wintermark M, Massaband P, Ashford JW, Bayley PJ, Furst AJ. Brainstem atrophy in Gulf War Illness. Neurotoxicology 2020; 78:71-79. [PMID: 32081703 DOI: 10.1016/j.neuro.2020.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 10/05/2019] [Revised: 01/30/2020] [Accepted: 02/16/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Gulf War Illness (GWI) is a condition that affects about 30 % of veterans who served in the 1990-91 Persian Gulf War. Given its broad symptomatic manifestation, including chronic pain, fatigue, neurological, gastrointestinal, respiratory, and skin problems, it is of interest to examine whether GWI is associated with changes in the brain. Existing neuroimaging studies, however, have been limited by small sample sizes, inconsistent GWI diagnosis criteria, and potential comorbidity confounds. OBJECTIVES Using a large cohort of US veterans with GWI, we assessed regional brain volumes for their associations with GWI, and quantified the relationships between any regional volumetric changes and GWI symptoms. METHODS Structural magnetic resonance imaging (MRI) scans from 111 veterans with GWI (Age = 49 ± 6, 88 % Male) and 59 healthy controls (age = 51 ± 9, 78 % male) were collected at the California War Related Illness and Injury Study Center (WRIISC-CA) and from a multicenter study of the Parkinson's Progression Marker Initiative (PPMI), respectively. Individual MRI volumes were segmented and parcellated using FreeSurfer. Regional volumes of 19 subcortical, 68 cortical, and 3 brainstem structures were evaluated in the GWI cohort relative to healthy controls. The relationships between regional volumes and GWI symptoms were also assessed. RESULTS We found significant subcortical atrophy, but no cortical differences, in the GWI group relative to controls, with the largest effect detected in the brainstem, followed by the ventral diencephalon and the thalamus. In a subsample of 58 veterans with GWI who completed the Chronic Fatigue Scale (CFS) inventory of Centers for Disease Control and Prevention (CDC), smaller brainstem volumes were significantly correlated with increased severities of fatigue and depressive symptoms. CONCLUSION The findings suggest that brainstem volume may be selectively affected by GWI, and that the resulting atrophy could in turn mediate or moderate GWI-related symptoms such as fatigue and depression. Consequently, the brain stem should be carefully considered in future research focusing on GWI pathology.
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Affiliation(s)
- Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA.
| | - Timothy Avery
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Andrei A Vakhtin
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Danielle C Mathersul
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Eric Tranvinh
- Neuroradiology, Stanford University School of Medicine, USA
| | - Max Wintermark
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Neuroradiology, Stanford University School of Medicine, USA
| | - Payam Massaband
- Radiology, VA Palo Alto Health Care System, USA; Radiology, Stanford University School of Medicine, USA
| | - J Wesson Ashford
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA
| | - Ansgar J Furst
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, USA; Psychiatry and Behavioral Sciences, Stanford University School of Medicine, USA; Neurology and Neurological Sciences, Stanford University, USA; Polytrauma System of Care (PSC), VA Palo Alto Health Care System, USA
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14
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Vakhtin AA, Zhang Y, Wintermark M, Massaband P, Robinson MT, Ashford JW, Furst AJ. White Matter Asymmetry: A Reflection of Pathology in Traumatic Brain Injury. J Neurotrauma 2020; 37:373-381. [DOI: 10.1089/neu.2019.6487] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Andrei A. Vakhtin
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Yu Zhang
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
| | - Max Wintermark
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
- Department of Neuroradiology, Stanford University School of Medicine, Stanford, California
| | - Payam Massaband
- Department of Radiology, Stanford University School of Medicine, Stanford, California
- Departments of Radiology, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
| | - Miguel T. Robinson
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
| | - John W. Ashford
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Ansgar J. Furst
- War Related Illness and Injury Study Center, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
- Polytrauma, System of Care, Veterans Affairs Palo Alto, Palo Alto, California
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15
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Ryman SG, Yeo RA, Witkiewitz K, Vakhtin AA, van den Heuvel M, de Reus M, Flores RA, Wertz CR, Jung RE. Fronto-Parietal gray matter and white matter efficiency differentially predict intelligence in males and females. Hum Brain Mapp 2018; 37:4006-4016. [PMID: 27329671 DOI: 10.1002/hbm.23291] [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] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 05/03/2016] [Accepted: 06/08/2016] [Indexed: 11/10/2022] Open
Abstract
While there are minimal sex differences in overall intelligence, males, on average, have larger total brain volume and corresponding regional brain volumes compared to females, measures that are consistently related to intelligence. Limited research has examined which other brain characteristics may differentially contribute to intelligence in females to facilitate equal performance on intelligence measures. Recent reports of sex differences in the neural characteristics of the brain further highlight the need to differentiate how the structural neural characteristics relate to intellectual ability in males and females. The current study utilized a graph network approach in conjunction with structural equation modeling to examine potential sex differences in the relationship between white matter efficiency, fronto-parietal gray matter volume, and general cognitive ability (GCA). Participants were healthy adults (n = 244) who completed a battery of cognitive testing and underwent structural neuroimaging. Results indicated that in males, a latent factor of fronto-parietal gray matter was significantly related to GCA when controlling for total gray matter volume. In females, white matter efficiency and total gray matter volume were significantly related to GCA, with no specificity of the fronto-parietal gray matter factor over and above total gray matter volume. This work highlights that different neural characteristics across males and females may contribute to performance on intelligence measures. Hum Brain Mapp 37:4006-4016, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sephira G Ryman
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico.
| | - Ronald A Yeo
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Andrei A Vakhtin
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | - Martijn van den Heuvel
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel de Reus
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ranee A Flores
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
| | | | - Rex E Jung
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico
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Vakhtin AA, Kodituwakku PW, Garcia CM, Tesche CD. Aberrant development of post-movement beta rebound in adolescents and young adults with fetal alcohol spectrum disorders. Neuroimage Clin 2015; 9:392-400. [PMID: 26594621 PMCID: PMC4589820 DOI: 10.1016/j.nicl.2015.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 08/24/2015] [Accepted: 09/09/2015] [Indexed: 12/14/2022]
Abstract
Dependent on maternal (e.g. genetic, age) and exposure (frequency, quantity, and timing) variables, the effects of prenatal alcohol exposure on the developing fetus are known to vary widely, producing a broad range of morphological anomalies and neurocognitive deficits in offspring, referred to as fetal alcohol spectrum disorders (FASD). Maternal drinking during pregnancy remains a leading risk factor for the development of intellectual disabilities in the US. While few functional findings exist today that shed light on the mechanisms responsible for the observed impairments in individuals with FASD, animal models consistently report deleterious effects of early alcohol exposure on GABA-ergic inhibitory pathways. The post-motor beta rebound (PMBR), a transient increase of 15-30 Hz beta power in the motor cortex that follows the termination of movement, has been implicated as a neural signature of GABA-ergic inhibitory activity. Further, PMBR has been shown to be a reliable predictor of age in adolescents. The present study sought to investigate any differences in the development of PMBR between FASD and control groups. Beta event-related de-synchronization (ERD) and movement-related gamma synchronization (MRGS), although not clearly linked to brain maturation, were also examined. Twenty-two participants with FASD and 22 age and sex-matched controls (12-22 years old) underwent magnetoencephalography scans while performing an auditory oddball task, which required a button press in response to select target stimuli. The data surrounding the button presses were localized to the participants' motor cortices, and the time courses from the locations of the maximally evoked PMBR were subjected to wavelet analyses. The subsequent analysis of PMBR, ERD, and MRGS revealed a significant interaction between group and age in their effects on PMBR. While age had a significant effect on PMBR in the controls, no simple effects of age were detected in the FASD group. The FASD group additionally displayed decreased overall ERD levels. No group or age effects on MRGS were detected. The described findings provide further evidence for broad impairments in inhibitory processes in adolescents with FASD, possibly related to aberrant development of GABA-ergic pathways.
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Affiliation(s)
- Andrei A Vakhtin
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Piyadasa W Kodituwakku
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM 87131, USA
| | | | - Claudia D Tesche
- Department of Psychology, University of New Mexico, Albuquerque, NM 87131, USA
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17
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Jung RE, Wertz CJ, Meadows CA, Ryman SG, Vakhtin AA, Flores RA. Quantity yields quality when it comes to creativity: a brain and behavioral test of the equal-odds rule. Front Psychol 2015; 6:864. [PMID: 26161075 PMCID: PMC4479710 DOI: 10.3389/fpsyg.2015.00864] [Citation(s) in RCA: 29] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/12/2015] [Indexed: 11/18/2022] Open
Abstract
The creativity research community is in search of a viable cognitive measure providing support for behavioral observations that higher ideational output is often associated with higher creativity (known as the equal-odds rule). One such measure has included divergent thinking: the production of many examples or uses for a common or single object or image. We sought to test the equal-odds rule using a measure of divergent thinking, and applied the consensual assessment technique to determine creative responses as opposed to merely original responses. We also sought to determine structural brain correlates of both ideational fluency and ideational creativity. Two-hundred forty-six subjects were subjected to a broad battery of behavioral measures, including a core measure of divergent thinking (Foresight), and measures of intelligence, creative achievement, and personality (i.e., Openness to Experience). Cortical thickness and subcortical volumes (e.g., thalamus) were measured using automated techniques (FreeSurfer). We found that higher number of responses on the divergent thinking task was significantly associated with higher creativity (r = 0.73) as independently assessed by three judges. Moreover, we found that creativity was predicted by cortical thickness in regions including the left frontal pole and left parahippocampal gyrus. These results support the equal-odds rule, and provide neuronal evidence implicating brain regions involved with “thinking about the future” and “extracting future prospects.”
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Affiliation(s)
- Rex E Jung
- Department of Psychology, University of New Mexico Albuquerque, NM, USA ; Department of Neurosurgery, University of New Mexico Albuquerque, NM, USA
| | | | | | - Sephira G Ryman
- Department of Psychology, University of New Mexico Albuquerque, NM, USA
| | - Andrei A Vakhtin
- Department of Psychology, University of New Mexico Albuquerque, NM, USA
| | - Ranee A Flores
- Department of Neurosurgery, University of New Mexico Albuquerque, NM, USA
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Ryman SG, van den Heuvel MP, Yeo RA, Caprihan A, Carrasco J, Vakhtin AA, Flores RA, Wertz C, Jung RE. Sex differences in the relationship between white matter connectivity and creativity. Neuroimage 2014; 101:380-9. [PMID: 25064665 DOI: 10.1016/j.neuroimage.2014.07.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 07/10/2014] [Accepted: 07/16/2014] [Indexed: 11/20/2022] Open
Abstract
Creative cognition emerges from a complex network of interacting brain regions. This study investigated the relationship between the structural organization of the human brain and aspects of creative cognition tapped by divergent thinking tasks. Diffusion weighted imaging (DWI) was used to obtain fiber tracts from 83 segmented cortical regions. This information was represented as a network and metrics of connectivity organization, including connectivity strength, clustering and communication efficiency were computed, and their relationship to individual levels of creativity was examined. Permutation testing identified significant sex differences in the relationship between global connectivity and creativity as measured by divergent thinking tests. Females demonstrated significant inverse relationships between global connectivity and creative cognition, whereas there were no significant relationships observed in males. Node specific analyses revealed inverse relationships across measures of connectivity, efficiency, clustering and creative cognition in widespread regions in females. Our findings suggest that females involve more regions of the brain in processing to produce novel ideas to solutions, perhaps at the expense of efficiency (greater path lengths). Males, in contrast, exhibited few, relatively weak positive relationships across these measures. Extending recent observations of sex differences in connectome structure, our findings of sexually dimorphic relationships suggest a unique topological organization of connectivity underlying the generation of novel ideas in males and females.
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Affiliation(s)
- Sephira G Ryman
- University of New Mexico Department of Neurosurgery, USA; University of New Mexico Department of Psychology, USA
| | | | - Ronald A Yeo
- University of New Mexico Department of Psychology, USA
| | | | - Jessica Carrasco
- University of New Mexico Department of Neurosurgery, USA; University of New Mexico Department of Psychology, USA
| | - Andrei A Vakhtin
- University of New Mexico Department of Neurosurgery, USA; University of New Mexico Department of Psychology, USA
| | - Ranee A Flores
- University of New Mexico Department of Neurosurgery, USA
| | | | - Rex E Jung
- University of New Mexico Department of Neurosurgery, USA; University of New Mexico Department of Psychology, USA.
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Vakhtin AA, Calhoun VD, Jung RE, Prestopnik JL, Taylor PA, Ford CC. Changes in intrinsic functional brain networks following blast-induced mild traumatic brain injury. Brain Inj 2014; 27:1304-10. [PMID: 24020442 DOI: 10.3109/02699052.2013.823561] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Blast-induced mild traumatic brain injuries (mTBI) commonly go undetected by computed tomography and conventional magnetic resonance imaging (MRI). This study was used to investigate functional brain network abnormalities in a group of blast-induced mTBI subjects using independent component analysis (ICA) of resting state functional MRI (fMRI) data. METHODS Twenty-eight resting state networks of 13 veterans who sustained blast-induced mTBI were compared with healthy controls across three fMRI domains: blood oxygenation level-dependent spatial maps, time course spectra and functional connectivity. RESULTS The mTBI group exhibited hyperactivity in the temporo-parietal junctions and hypoactivity in the left inferior temporal gyrus. Abnormal frequencies in default-mode (DMN), sensorimotor, attentional and frontal networks were detected. In addition, functional connectivity was disrupted in six network pairs: DMN-basal ganglia, attention-sensorimotor, frontal-DMN, attention-sensorimotor, attention-frontal and sensorimotor-sensorimotor. CONCLUSIONS The results suggest white matter disruption across certain attentional networks. Additionally, given their elevated activity relative to controls', the temporo-parietal junctions of blast mTBI subjects may be compensating for diffuse axonal injury in other cortical regions.
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Affiliation(s)
- Andrei A Vakhtin
- Department of Neurology, Health Sciences Center, University of New Mexico , Albuquerque, NM , USA
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Jung RE, Ryman SG, Vakhtin AA, Carrasco J, Wertz C, Flores RA. Subcortical correlates of individual differences in aptitude. PLoS One 2014; 9:e89425. [PMID: 24586770 PMCID: PMC3934897 DOI: 10.1371/journal.pone.0089425] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 01/21/2014] [Indexed: 11/19/2022] Open
Abstract
The study of individual differences encompasses broad constructs including intelligence, creativity, and personality. However, substantially less research is devoted to the study of specific aptitudes in spite of their importance to educational, occupational, and avocational success. We sought to determine subcortical brain structural correlates of several broad aptitudes including Math, Vocabulary, Foresight, Paper Folding, and Inductive Reasoning in a large (N = 107), healthy, young (age range = 16-29) cohort. Subcortical volumes were measured using an automated technique (FreeSurfer) across structures including bilateral caudate, putamen, globus pallidus, thalamus, nucleus accumbens, hippocampus, amygdala, and five equal regions of the corpus callosum. We found that performance on measures of each aptitude was predicted by different subcortical structures: Math--higher right nucleus accumbens volume; Vocabulary--higher left hippocampus volume; Paper Folding--higher right thalamus volume; Foresight--lower right thalamus and higher mid anterior corpus callosum volume; Inductive Reasoning--higher mid anterior corpus callosum volume. Our results support general findings, within the cognitive neurosciences, showing lateralization of structure-function relationships, as well as more specific relationships between individual structures (e.g., left hippocampus) and functions relevant to particular aptitudes (e.g., Vocabulary).
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Affiliation(s)
- Rex E. Jung
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, United States of America
- * E-mail:
| | - Sephira G. Ryman
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Andrei A. Vakhtin
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Jessica Carrasco
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Chris Wertz
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Ranee A. Flores
- Department of Neurosurgery, University of New Mexico, Albuquerque, New Mexico, United States of America
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