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Papazova I, Wunderlich S, Papazov B, Vogelmann U, Keeser D, Karali T, Falkai P, Rospleszcz S, Maurus I, Schmitt A, Hasan A, Malchow B, Stöcklein S. Characterizing cognitive subtypes in schizophrenia using cortical curvature. J Psychiatr Res 2024; 173:131-138. [PMID: 38531143 DOI: 10.1016/j.jpsychires.2024.03.019] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
Cognitive deficits are a core symptom of schizophrenia, but research on their neural underpinnings has been challenged by the heterogeneity in deficits' severity among patients. Here, we address this issue by combining logistic regression and random forest to classify two neuropsychological profiles of patients with high (HighCog) and low (LowCog) cognitive performance in two independent samples. We based our analysis on the cortical features grey matter volume (VOL), cortical thickness (CT), and mean curvature (MC) of N = 57 patients (discovery sample) and validated the classification in an independent sample (N = 52). We investigated which cortical feature would yield the best classification results and expected that the 10 most important features would include frontal and temporal brain regions. The model based on MC had the best performance with area under the curve (AUC) values of 76% and 73%, and identified fronto-temporal and occipital brain regions as the most important features for the classification. Moreover, subsequent comparison analyses could reveal significant differences in MC of single brain regions between the two cognitive profiles. The present study suggests MC as a promising neuroanatomical parameter for characterizing schizophrenia cognitive subtypes.
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Affiliation(s)
- Irina Papazova
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Geschwister-Schönert-Straße 1, 86156, Augsburg, Germany; Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; DZPG (German Center for Mental Health), partner site München, Augsburg, Germany.
| | - Stephan Wunderlich
- Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Department of Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Ulrike Vogelmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Temmuz Karali
- Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Susanne Rospleszcz
- Institute of Epidemiology, Helmholtz Zentrum Munich, German Research Center for Environmental Health, Munich, Germany; Department of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Alkomiet Hasan
- Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Geschwister-Schönert-Straße 1, 86156, Augsburg, Germany; DZPG (German Center for Mental Health), partner site München, Augsburg, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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Roell L, Keeser D, Papazov B, Lembeck M, Papazova I, Greska D, Muenz S, Schneider-Axmann T, Sykorova EB, Thieme CE, Vogel BO, Mohnke S, Huppertz C, Roeh A, Keller-Varady K, Malchow B, Stoecklein S, Ertl-Wagner B, Henkel K, Wolfarth B, Tantchik W, Walter H, Hirjak D, Schmitt A, Hasan A, Meyer-Lindenberg A, Falkai P, Maurus I. Effects of Exercise on Structural and Functional Brain Patterns in Schizophrenia-Data From a Multicenter Randomized-Controlled Study. Schizophr Bull 2024; 50:145-156. [PMID: 37597507 PMCID: PMC10754172 DOI: 10.1093/schbul/sbad113] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
BACKGROUND AND HYPOTHESIS Aerobic exercise interventions in people with schizophrenia have been demonstrated to improve clinical outcomes, but findings regarding the underlying neural mechanisms are limited and mainly focus on the hippocampal formation. Therefore, we conducted a global exploratory analysis of structural and functional neural adaptations after exercise and explored their clinical implications. STUDY DESIGN In this randomized controlled trial, structural and functional MRI data were available for 91 patients with schizophrenia who performed either aerobic exercise on a bicycle ergometer or underwent a flexibility, strengthening, and balance training as control group. We analyzed clinical and neuroimaging data before and after 6 months of regular exercise. Bayesian linear mixed models and Bayesian logistic regressions were calculated to evaluate effects of exercise on multiple neural outcomes and their potential clinical relevance. STUDY RESULTS Our results indicated that aerobic exercise in people with schizophrenia led to structural and functional adaptations mainly within the default-mode network, the cortico-striato-pallido-thalamo-cortical loop, and the cerebello-thalamo-cortical pathway. We further observed that volume increases in the right posterior cingulate gyrus as a central node of the default-mode network were linked to improvements in disorder severity. CONCLUSIONS These exploratory findings suggest a positive impact of aerobic exercise on 3 cerebral networks that are involved in the pathophysiology of schizophrenia. CLINICAL TRIALS REGISTRATION The underlying study of this manuscript was registered in the International Clinical Trials Database, ClinicalTrials.gov (NCT number: NCT03466112, https://clinicaltrials.gov/ct2/show/NCT03466112?term=NCT03466112&draw=2&rank=1) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).
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Affiliation(s)
- Lukas Roell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Neuroimaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Moritz Lembeck
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - David Greska
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Muenz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Eliska B Sykorova
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christina E Thieme
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Bob O Vogel
- Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany
| | - Sebastian Mohnke
- Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany
| | - Charlotte Huppertz
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Astrid Roeh
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Katriona Keller-Varady
- Hannover Medical School, Department of Rehabilitation and Sports Medicine, Hannover, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany
| | - Sophia Stoecklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Karsten Henkel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Bernd Wolfarth
- Department of Sports Medicine, University Hospital Charité Berlin, Berlin, Germany
| | - Wladimir Tantchik
- Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, University Hospital Charité Berlin, Berlin, Germany
| | - Dusan Hirjak
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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3
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Finze A, Biechele G, Rauchmann BS, Franzmeier N, Palleis C, Katzdobler S, Weidinger E, Guersel S, Schuster S, Harris S, Schmitt J, Beyer L, Gnörich J, Lindner S, Albert NL, Wetzel CH, Rupprecht R, Rominger A, Danek A, Burow L, Kurz C, Tato M, Utecht J, Papazov B, Zaganjori M, Trappmann LK, Goldhardt O, Grimmer T, Haeckert J, Janowitz D, Buerger K, Keeser D, Stoecklein S, Dietrich O, Morenas-Rodriguez E, Barthel H, Sabri O, Bartenstein P, Simons M, Haass C, Höglinger GU, Levin J, Perneczky R, Brendel M. Individual regional associations between Aβ-, tau- and neurodegeneration (ATN) with microglial activation in patients with primary and secondary tauopathies. Mol Psychiatry 2023; 28:4438-4450. [PMID: 37495886 PMCID: PMC10827660 DOI: 10.1038/s41380-023-02188-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 06/27/2023] [Accepted: 07/10/2023] [Indexed: 07/28/2023]
Abstract
β-amyloid (Aβ) and tau aggregation as well as neuronal injury and atrophy (ATN) are the major hallmarks of Alzheimer's disease (AD), and biomarkers for these hallmarks have been linked to neuroinflammation. However, the detailed regional associations of these biomarkers with microglial activation in individual patients remain to be elucidated. We investigated a cohort of 55 patients with AD and primary tauopathies and 10 healthy controls that underwent TSPO-, Aβ-, tau-, and perfusion-surrogate-PET, as well as structural MRI. Z-score deviations for 246 brain regions were calculated and biomarker contributions of Aβ (A), tau (T), perfusion (N1), and gray matter atrophy (N2) to microglial activation (TSPO, I) were calculated for each individual subject. Individual ATN-related microglial activation was correlated with clinical performance and CSF soluble TREM2 (sTREM2) concentrations. In typical and atypical AD, regional tau was stronger and more frequently associated with microglial activation when compared to regional Aβ (AD: βT = 0.412 ± 0.196 vs. βA = 0.142 ± 0.123, p < 0.001; AD-CBS: βT = 0.385 ± 0.176 vs. βA = 0.131 ± 0.186, p = 0.031). The strong association between regional tau and microglia reproduced well in primary tauopathies (βT = 0.418 ± 0.154). Stronger individual associations between tau and microglial activation were associated with poorer clinical performance. In patients with 4RT, sTREM2 levels showed a positive association with tau-related microglial activation. Tau pathology has strong regional associations with microglial activation in primary and secondary tauopathies. Tau and Aβ related microglial response indices may serve as a two-dimensional in vivo assessment of neuroinflammation in neurodegenerative diseases.
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Grants
- EXC 2145 SyNergy - ID 390857198 Deutsche Forschungsgemeinschaft (German Research Foundation)
- EXC 2155 - project number 39087428 Deutsche Forschungsgemeinschaft (German Research Foundation)
- HO2402/18-1 Deutsche Forschungsgemeinschaft (German Research Foundation)
- FOR-2858 project numbers 403161218, 421887978 and 422188432 Deutsche Forschungsgemeinschaft (German Research Foundation)
- 19063p Alzheimer Forschung Initiative (Alzheimer Forschung Initiative e.V.)
- GUH was additionally funded by the German Federal Ministry of Education and Research (BMBF, 01KU1403A EpiPD; 01EK1605A HitTau; 01DH18025 TauTherapy); European Joint Programme on Rare Diseases (Improve-PSP); VolkswagenStiftung (Niedersächsisches Vorab); Petermax-Müller Foundation (Etiology and Therapy of Synucleinopathies and Tauopathies). The Lüneburg Heritage and Friedrich-Baur-Stiftung have supported the work of CP. The Hirnliga e.V. supported recruitment and imaging of the ActiGliA cohort (Manfred-Strohscheer-Stiftung) by a grant to BSR and MB.
- TG received consulting fees from AbbVie, Alector, Anavex, Biogen, Eli Lilly, Functional Neuromodulation, Grifols, Iqvia, Noselab, Novo Nordisk, NuiCare, Orphanzyme, Roche Diagnostics, Roche Pharma, UCB, and Vivoryon; lecture fees from Grifols, Medical Tribune, Novo Nordisk, Roche Pharma, and Schwabe; and has received grants to his institution from Roche Diagnostics.
- CH collaborates with Denali Therapeutics. CH is chief advisor of ISAR Bioscience and a member of the advisory board of AviadoBio.
- Günter Höglinger participated in industry-sponsored research projects from Abbvie, Biogen, Biohaven, Novartis, Roche, Sanofi, UCB; serves as a consultant for Abbvie, Alzprotect, Aprineua, Asceneuron, Bial, Biogen, Biohaven, Kyowa Kirin, Lundbeck, Novartis, Retrotope, Roche, Sanofi, UCB; received honoraria for scientific presentations from Abbvie, Bayer Vital, Bial, Biogen, Bristol Myers Squibb, Kyowa Kirin, Roche, Teva, UCB, Zambon; holds a patent on Treatment of Synucleinopathies. United States Patent No.: US 10,918,628 B2: EP 17 787 904.6-1109 / 3 525 788; received publication royalties from Academic Press, Kohlhammer, and Thieme.
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Affiliation(s)
- Anika Finze
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Gloria Biechele
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Carla Palleis
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Katzdobler
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Endy Weidinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stefanie Harris
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Schmitt
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Leonie Beyer
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Johannes Gnörich
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Simon Lindner
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christian H Wetzel
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Axel Rominger
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Nuclear Medicine, University Hospital, Inselspital Bern, Bern, Switzerland
| | - Adrian Danek
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Maia Tato
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
| | - Mirlind Zaganjori
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lena-Katharina Trappmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Jan Haeckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | | | | | - Daniel Keeser
- NeuroImaging Core Unit Munich (NICUM), LMU University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stoecklein
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Olaf Dietrich
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
| | | | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mikael Simons
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Institute of Neuronal Cell Biology, Technical University of Munich, Munich, Germany
| | - Christian Haass
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich, Munich, Germany
| | - Günter U Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Robert Perneczky
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
- Sheffield Institute for Translational Neurosciences (SITraN), University of Sheffield, Sheffield, UK
| | - Matthias Brendel
- Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
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Stoecklein VM, Wunderlich S, Papazov B, Thon N, Schmutzer M, Schinner R, Zimmermann H, Liebig T, Ricke J, Liu H, Tonn JC, Schichor C, Stoecklein S. Perifocal Edema in Patients with Meningioma is Associated with Impaired Whole-Brain Connectivity as Detected by Resting-State fMRI. AJNR Am J Neuroradiol 2023:ajnr.A7915. [PMID: 37385680 PMCID: PMC10337612 DOI: 10.3174/ajnr.a7915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/28/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND AND PURPOSE Meningiomas are intracranial tumors that usually carry a benign prognosis. Some meningiomas cause perifocal edema. Resting-state fMRI can be used to assess whole-brain functional connectivity, which can serve as a marker for disease severity. Here, we investigated whether the presence of perifocal edema in preoperative patients with meningiomas leads to impaired functional connectivity and if these changes are associated with cognitive function. MATERIALS AND METHODS Patients with suspected meningiomas were prospectively included, and resting-state fMRI scans were obtained. Impairment of functional connectivity was quantified on a whole-brain level using our recently published resting-state fMRI-based marker, called the dysconnectivity index. Using uni- and multivariate regression models, we investigated the association of the dysconnectivity index with edema and tumor volume as well as cognitive test scores. RESULTS Twenty-nine patients were included. In a multivariate regression analysis, there was a highly significant association of dysconnectivity index values and edema volume in the total sample and in a subsample of 14 patients with edema, when accounting for potential confounders like age and temporal SNR. There was no statistically significant association with tumor volume. Better neurocognitive performance was strongly associated with lower dysconnectivity index values. CONCLUSIONS Resting-state fMRI showed a significant association between impaired functional connectivity and perifocal edema, but not tumor volume, in patients with meningiomas. We demonstrated that better neurocognitive function was associated with less impairment of functional connectivity. This result shows that our resting-state fMRI marker indicates a detrimental influence of peritumoral brain edema on global functional connectivity in patients with meningiomas.
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Affiliation(s)
- V M Stoecklein
- From the Department of Neurosurgery (V.M.S., N.T., M.S., J.-C.T., C.S.)
- German Cancer Consortium (V.M.S., N.T., J.-C.T., C.S.)
| | - S Wunderlich
- Department of Radiology (S.W., B.P., R.S., J.R., S.S.)
| | - B Papazov
- Department of Radiology (S.W., B.P., R.S., J.R., S.S.)
| | - N Thon
- From the Department of Neurosurgery (V.M.S., N.T., M.S., J.-C.T., C.S.)
- German Cancer Consortium (V.M.S., N.T., J.-C.T., C.S.)
| | - M Schmutzer
- From the Department of Neurosurgery (V.M.S., N.T., M.S., J.-C.T., C.S.)
| | - R Schinner
- Department of Radiology (S.W., B.P., R.S., J.R., S.S.)
| | - H Zimmermann
- Department of Neuroradiology (H.Z., T.L.), Ludwig-Maximilians-University Munich, Munich, Germany
| | - T Liebig
- Department of Neuroradiology (H.Z., T.L.), Ludwig-Maximilians-University Munich, Munich, Germany
| | - J Ricke
- Department of Radiology (S.W., B.P., R.S., J.R., S.S.)
| | - H Liu
- Department of Radiology (H.L.), Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
- Department of Neuroscience (H.L.), Medical University of South Carolina, Charleston, South Carolina
| | - J-C Tonn
- From the Department of Neurosurgery (V.M.S., N.T., M.S., J.-C.T., C.S.)
- German Cancer Consortium (V.M.S., N.T., J.-C.T., C.S.)
| | - C Schichor
- From the Department of Neurosurgery (V.M.S., N.T., M.S., J.-C.T., C.S.)
- German Cancer Consortium (V.M.S., N.T., J.-C.T., C.S.)
| | - S Stoecklein
- Department of Radiology (S.W., B.P., R.S., J.R., S.S.)
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5
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Krčmář L, Jäger I, Boudriot E, Hanken K, Gabriel V, Melcher J, Klimas N, Dengl F, Schmoelz S, Pingen P, Campana M, Moussiopoulou J, Yakimov V, Ioannou G, Wichert S, DeJonge S, Zill P, Papazov B, de Almeida V, Galinski S, Gabellini N, Hasanaj G, Mortazavi M, Karali T, Hisch A, Kallweit MS, Meisinger VJ, Löhrs L, Neumeier K, Behrens S, Karch S, Schworm B, Kern C, Priglinger S, Malchow B, Steiner J, Hasan A, Padberg F, Pogarell O, Falkai P, Schmitt A, Wagner E, Keeser D, Raabe FJ. The multimodal Munich Clinical Deep Phenotyping study to bridge the translational gap in severe mental illness treatment research. Front Psychiatry 2023; 14:1179811. [PMID: 37215661 PMCID: PMC10196006 DOI: 10.3389/fpsyt.2023.1179811] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Treatment of severe mental illness (SMI) symptoms, especially negative symptoms and cognitive dysfunction in schizophrenia, remains a major unmet need. There is good evidence that SMIs have a strong genetic background and are characterized by multiple biological alterations, including disturbed brain circuits and connectivity, dysregulated neuronal excitation-inhibition, disturbed dopaminergic and glutamatergic pathways, and partially dysregulated inflammatory processes. The ways in which the dysregulated signaling pathways are interconnected remains largely unknown, in part because well-characterized clinical studies on comprehensive biomaterial are lacking. Furthermore, the development of drugs to treat SMIs such as schizophrenia is limited by the use of operationalized symptom-based clusters for diagnosis. Methods In line with the Research Domain Criteria initiative, the Clinical Deep Phenotyping (CDP) study is using a multimodal approach to reveal the neurobiological underpinnings of clinically relevant schizophrenia subgroups by performing broad transdiagnostic clinical characterization with standardized neurocognitive assessments, multimodal neuroimaging, electrophysiological assessments, retinal investigations, and omics-based analyzes of blood and cerebrospinal fluid. Moreover, to bridge the translational gap in biological psychiatry the study includes in vitro investigations on human-induced pluripotent stem cells, which are available from a subset of participants. Results Here, we report on the feasibility of this multimodal approach, which has been successfully initiated in the first participants in the CDP cohort; to date, the cohort comprises over 194 individuals with SMI and 187 age and gender matched healthy controls. In addition, we describe the applied research modalities and study objectives. Discussion The identification of cross-diagnostic and diagnosis-specific biotype-informed subgroups of patients and the translational dissection of those subgroups may help to pave the way toward precision medicine with artificial intelligence-supported tailored interventions and treatment. This aim is particularly important in psychiatry, a field where innovation is urgently needed because specific symptom domains, such as negative symptoms and cognitive dysfunction, and treatment-resistant symptoms in general are still difficult to treat.
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Affiliation(s)
- Lenka Krčmář
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Iris Jäger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Emanuel Boudriot
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Hanken
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Vanessa Gabriel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Julian Melcher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nicole Klimas
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Dengl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Schmoelz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Pauline Pingen
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Mattia Campana
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Vladislav Yakimov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Georgios Ioannou
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sven Wichert
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Silvia DeJonge
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Zill
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Valéria de Almeida
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sabrina Galinski
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Gabellini
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Genc Hasanaj
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Matin Mortazavi
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra Hisch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Marcel S Kallweit
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Verena J. Meisinger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Löhrs
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Karin Neumeier
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Stephanie Behrens
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schworm
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | - Christoph Kern
- Department of Ophthalmology, University Hospital, LMU Munich, Munich, Germany
| | | | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Johann Steiner
- Department of Psychiatry and Psychotherapy, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Center for Health and Medical Prevention, Magdeburg, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich, University Hospital, LMU Munich, Munich, Germany
- Munich Center for Neurosciences, LMU Munich, Munich, Germany
| | - Florian J. Raabe
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
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6
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Ersoezlue E, Perneczky R, Tato M, Utecht J, Kurz C, Häckert J, Guersel S, Burow L, Koller G, Stoecklein S, Keeser D, Papazov B, Totzke M, Ballarini T, Brosseron F, Buerger K, Dechent P, Dobisch L, Ewers M, Fliessbach K, Glanz W, Haynes JD, Heneka MT, Janowitz D, Kilimann I, Kleineidam L, Laske C, Maier F, Munk MH, Peters O, Priller J, Ramirez A, Roeske S, Roy N, Scheffler K, Schneider A, Schott BH, Spottke A, Spruth EJ, Teipel S, Unterfeld C, Wagner M, Wang X, Wiltfang J, Wolfsgruber S, Yakupov R, Duezel E, Jessen F, Rauchmann BS. A Residual Marker of Cognitive Reserve Is Associated with Resting-State Intrinsic Functional Connectivity Along the Alzheimer's Disease Continuum. J Alzheimers Dis 2023; 92:925-940. [PMID: 36806502 DOI: 10.3233/jad-220464] [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] [Indexed: 02/19/2023]
Abstract
BACKGROUND Cognitive reserve (CR) explains inter-individual differences in the impact of the neurodegenerative burden on cognitive functioning. A residual model was proposed to estimate CR more accurately than previous measures. However, associations between residual CR markers (CRM) and functional connectivity (FC) remain unexplored. OBJECTIVE To explore the associations between the CRM and intrinsic network connectivity (INC) in resting-state networks along the neuropathological-continuum of Alzheimer's disease (ADN). METHODS Three hundred eighteen participants from the DELCODE cohort were stratified using cerebrospinal fluid biomarkers according to the A(myloid-β)/T(au)/N(eurodegeneration) classification. CRM was calculated utilizing residuals obtained from a multilinear regression model predicting cognition from markers of disease burden. Using an independent component analysis in resting-state fMRI data, we measured INC of resting-state networks, i.e., default mode network (DMN), frontoparietal network (FPN), salience network (SAL), and dorsal attention network. The associations of INC with a composite memory score and CRM and the associations of CRM with the seed-to-voxel functional connectivity of memory-related were tested in general linear models. RESULTS CRM was positively associated with INC in the DMN in the entire cohort. The A+T+N+ group revealed an anti-correlation between the SAL and the DMN. Furthermore, CRM was positively associated with anti-correlation between memory-related regions in FPN and DMN in ADN and A+T/N+. CONCLUSION Our results provide evidence that INC is associated with CRM in ADN defined as participants with amyloid pathology with or without cognitive symptoms, suggesting that the neural correlates of CR are mirrored in network FC in resting-state.
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Affiliation(s)
- Ersin Ersoezlue
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany.,Department of Gerontopsychiatry and Developmental Disorders, kbo-Isar-Amper-Klinikum Haar, University Teaching Hospital of LMU Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE) Munich, Germany.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Maia Tato
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Jan Häckert
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Sophia Stoecklein
- Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany.,Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Boris Papazov
- Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Marie Totzke
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | | | | | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE Munich), Munich, Germany.,Institute for Stroke and Dementia Research (ISD), University Hospital LMU Munich, Germany
| | - Peter Dechent
- MR-Research in Neurosciences Department of Cognitive Neurology, Georg-August-University Goettingen, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE Munich), Munich, Germany.,Institute for Stroke and Dementia Research (ISD), University Hospital LMU Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Germany
| | - John Dylan Haynes
- Bernstein Center for Computational Neuroscience Charité - Universitätsmedizin Berlin, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital LMU Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE) Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luca Kleineidam
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE) Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Franziska Maier
- Department of Psychiatry, Medical Faculty of University of Cologne, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE) Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Oliver Peters
- Department of Psychiatry, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE) Berlin, Germany
| | - Josef Priller
- Department of Psychiatry and Psychotherapy, Charité Berlin, Germany.,Department of Psychiatry and Psychotherapy, School of Medicine Technical University of Munich, Germany.,University of Edinburgh and UK DRI Edinburgh, UK
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany.,Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, Germany.,Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany
| | - Björn H Schott
- German Center for Neurodegenerative Diseases (DZNE) Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Department of Neurology, University of Bonn, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE) Rostock, Germany.,Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Chantal Unterfeld
- Department of Psychiatry, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany
| | - Xiao Wang
- Department of Psychiatry, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE) Goettingen, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Germany.,Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Portugal
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Medical Center of Neurodegenerative Disease and Geriatric Psychiatry, University of Bonn, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Germany.,Department of Psychiatry, Medical Faculty of University of Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD) University of Cologne, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE) Munich, Germany.,Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK.,Department of Neuroradiology, University Hospital, LMU Munich, Germany
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7
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Ersoezlue E, Rauchmann BS, Schneider-Axmann T, Wagner M, Ballarini T, Tato M, Utecht J, Kurz C, Papazov B, Guersel S, Burow L, Koller G, Stöcklein S, Keeser D, Bartels C, Brosseron F, Buerger K, Cetindag AC, Dechent P, Dobisch L, Ewers M, Fliessbach K, Frommann I, Haynes JD, Heneka MT, Janowitz D, Kilimann I, Kleinedam L, Laske C, Maier F, Metzger CD, Munk MH, Peters O, Preis L, Priller J, Ramirez A, Roeske S, Roy N, Scheffler K, Schneider A, Spottke A, Spruth EJ, Teipel S, Wiltfang J, Wolfsgruber S, Yakupov R, Duezel E, Jessen F, Perneczky R. Lifelong experiences as a proxy of cognitive reserve moderate the association between connectivity and cognition in Alzheimer's disease. Neurobiol Aging 2023; 122:33-44. [PMID: 36476760 DOI: 10.1016/j.neurobiolaging.2022.05.015] [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: 10/10/2021] [Revised: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/05/2022]
Abstract
Alzheimer's disease (AD) is associated with alterations in functional connectivity (FC) of the brain. The FC underpinnings of CR, that is, lifelong experiences, are largely unknown. Resting-state FC and structural MRI were performed in 76 CSF amyloid-β (Aβ) negative healthy controls and 152 Aβ positive individuals as an AD spectrum cohort (ADS; 55 with subjective cognitive decline, SCD; 52 with mild cognitive impairment; 45 with AD dementia). Following a region-of-interest (ROI) FC analysis, intrinsic network connectivity within the default-mode network (INC-DMN) and anti-correlation in INC between the DMN and dorsal attention network (DMN:DAN) were obtained as composite scores. CR was estimated by education and Lifetime Experiences Questionnaire (LEQ). The association between INC-DMN and MEM was attenuated by higher LEQ scores in the entire ADS group, particularly in SCD. In ROI analyses, higher LEQ scores were associated with higher FC within the DMN in ADS group. INC-DMN remains relatively intact despite memory decline in individuals with higher lifetime activity estimates, supporting a role for functional networks in maintaining cognitive function in AD.
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Affiliation(s)
- Ersin Ersoezlue
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Tommaso Ballarini
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Maia Tato
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Frederic Brosseron
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Arda C Cetindag
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurology and Psychiatry, Georg-August-University Göttingen, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Ingo Frommann
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - John D Haynes
- Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin, Berlin, Germany
| | - Michael T Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Daniel Janowitz
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Luca Kleinedam
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Franziska Maier
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Coraline D Metzger
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Matthias H Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- Charité - Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Lukas Preis
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany; Department of Psychiatry and Psychotherapy, Technical University Munich, Munich, Germany
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany; Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Sandra Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike J Spruth
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany; Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Köln, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany; Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK; Sheffield Institute for Translational Neurology (SITraN), University of Sheffield, Sheffield, UK.
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8
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Stoecklein S, Wunderlich S, Papazov B, Winkelmann M, Kunz WG, Mueller K, Ernst K, Stoecklein VM, Blumenberg V, Karschnia P, Bücklein VL, Rejeski K, Schmidt C, von Bergwelt-Baildon M, Tonn JC, Ricke J, Liu H, Remi J, Subklewe M, von Baumgarten L, Schoeberl F. Functional connectivity MRI provides an imaging correlate for chimeric antigen receptor T-cell-associated neurotoxicity. Neurooncol Adv 2023; 5:vdad135. [PMID: 38024243 PMCID: PMC10673700 DOI: 10.1093/noajnl/vdad135] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Treatment of hematological malignancies with chimeric antigen receptor modified T cells (CART) is highly efficient, but often limited by an immune effector cell-associated neurotoxicity syndrome (ICANS). As conventional MRI is often unremarkable during ICANS, we aimed to examine whether resting-state functional MRI (rsfMRI) is suitable to depict and quantify brain network alterations underlying ICANS in the individual patient. Methods The dysconnectivity index (DCI) based on rsfMRI was longitudinally assessed in systemic lymphoma patients and 1 melanoma patient during ICANS and before or after clinical resolution of ICANS. Results Seven lymphoma patients and 1 melanoma patient (19-77 years; 2 female) were included. DCI was significantly increased during ICANS with normalization after recovery (P = .0039). Higher ICANS grades were significantly correlated with increased DCI scores (r = 0.7807; P = .0222). DCI increase was most prominent in the inferior frontal gyrus and the frontal operculum (ie, Broca's area) and in the posterior parts of the superior temporal gyrus and the temporoparietal junction (ie, Wernicke's area) of the language-dominant hemisphere, thus reflecting the major clinical symptoms of nonfluent dysphasia and dyspraxia. Conclusions RsfMRI-based DCI might be suitable to directly quantify the severity of ICANS in individual patients undergoing CAR T-transfusion. Besides ICANS, DCI seems a promising diagnostic tool to quantify functional brain network alterations during encephalopathies of different etiologies, in general.
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Affiliation(s)
- Sophia Stoecklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Stephan Wunderlich
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Michael Winkelmann
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Wolfgang G Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Mueller
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Ernst
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Veit M Stoecklein
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Viktoria Blumenberg
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center, LMU Munich, Munich, Germany
| | - Philipp Karschnia
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Veit L Bücklein
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Kai Rejeski
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Laboratory for Translational Cancer Immunology, Gene Center, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Christian Schmidt
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Joerg-Christian Tonn
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Hesheng Liu
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA
| | - Jan Remi
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Marion Subklewe
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Louisa von Baumgarten
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Bavarian Cancer Research Center (BZKF), Erlangen, Germany
| | - Florian Schoeberl
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders, University Hospital, LMU Munich, Munich, Germany
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9
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Maywald M, Pogarell O, Levai S, Paolini M, Tschentscher N, Rauchmann BS, Krause D, Stöcklein S, Goerigk S, Röll L, Ertl-Wagner B, Papazov B, Keeser D, Karch S, Chrobok A. Neurofunctional differences and similarities between persistent postural-perceptual dizziness and anxiety disorder. Neuroimage Clin 2023; 37:103330. [PMID: 36696807 PMCID: PMC9879992 DOI: 10.1016/j.nicl.2023.103330] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Persistent postural-perceptual dizziness (PPPD) (ICD-11) and anxiety disorders (ANX) share behavioural symptoms like anxiety, avoidance, social withdrawal, hyperarousal, or palpitation as well as neurological symptoms like vertigo, stance and gait disorders. Furthermore, previous studies have shown a bidirectional link between vestibulo-spatial and anxiety neural networks. So far, there have been no neuroimaging-studies comparing these groups. OBJECTIVES The aim of this explorative study was to investigate differences and similarities of neural correlates between these two patient groups and to compare their findings with a healthy control group. METHODS 63 participants, divided in two patient groups (ANX = 20 and PPPD = 14) and two sex and age matched healthy control groups (HC-A = 16, HC-P = 13) were included. Anxiety and dizziness related pictures were shown during fMRI-measurements in a block-design in order to induce emotional responses. All subjects filled in questionnaires regarding vertigo (VSS, VHQ), anxiety (STAI), depression (BDI-II), alexithymia (TAS), and illness-perception (IPQ). After modelling the BOLD response with a standard canonical HRF, voxel-wise t-tests between conditions (emotional-negative vs neutral stimuli) were used to generate statistical contrast maps and identify relevant brain areas (pFDR < 0.05, cluster size >30 voxels). ROI-analyses were performed for amygdala, cingulate gyrus, hippocampus, inferior frontal gyrus, insula, supramarginal gyrus and thalamus (p ≤ 0.05). RESULTS Patient groups differed from both HC groups regarding anxiety, dizziness, depression and alexithymia scores; ratings of the PPPD group and the ANX group did differ significantly only in the VSS subscale 'vertigo and related symptoms' (VSS-VER). The PPPD group showed increased neural responses in the vestibulo-spatial network, especially in the supramarginal gyrus (SMG), and superior temporal gyrus (STG), compared to ANX and HC-P group. The PPPD group showed increased neural responses compared to the HC-P group in the anxiety network including amygdala, insula, lentiform gyrus, hippocampus, inferior frontal gyrus (IFG) and brainstem. Neuronal responses were enhanced in visual structures, e.g. fusiform gyrus, middle occipital gyrus, and in the medial orbitofrontal cortex (mOFC) in healthy controls compared to patients with ANX and PPPD, and in the ANX group compared to the PPPD group. CONCLUSIONS These findings indicate that neuronal responses to emotional information in the PPPD and the ANX group are comparable in anxiety networks but not in vestibulo-spatial networks. Patients with PPPD revealed a stronger neuronal response especially in SMG and STG compared to the ANX and the HC group. These results might suggest higher sensitivity and poorer adaptation processes in the PPPD group to anxiety and dizziness related pictures. Stronger activation in visual processing areas in HC subjects might be due to less emotional and more visual processing strategies.
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Affiliation(s)
- Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Levai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Nadja Tschentscher
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sophia Stöcklein
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lukas Röll
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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10
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Behnke L, Mizutani-Tiebel Y, Chang KY, Thielscher A, Bulubas L, Karali T, Papazov B, Kumpf U, Stöcklein S, Campana M, Soldini A, Luisa Dechantsreiter EM, Tagnin L, Burkhardt G, Takahashi S, Padberg F, Keeser D. Good news for data sharing: Defacing of MR scans using SimNIBS 4.0. Brain Stimul 2023. [DOI: 10.1016/j.brs.2023.01.773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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11
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Rauchmann B, Brendel M, Franzmeier N, Trappmann L, Zaganjori M, Ersoezlue E, Morenas‐Rodriguez E, Guersel S, Burow L, Kurz C, Haeckert J, Tatò M, Utecht J, Papazov B, Pogarell O, Janowitz D, Buerger K, Ewers M, Palleis C, Weidinger E, Biechele G, Schuster S, Finze A, Eckenweber F, Rupprecht R, Rominger A, Goldhardt O, Grimmer T, Keeser D, Stoecklein S, Dietrich O, Bartenstein P, Levin J, Höglinger G, Perneczky R. Microglial activation and connectivity in Alzheimer's disease and aging. Ann Neurol 2022; 92:768-781. [DOI: 10.1002/ana.26465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Boris‐Stephan Rauchmann
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield Sheffield UK
- Department of Neuroradiology University Hospital LMU Munich Germany
| | - Matthias Brendel
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Lena Trappmann
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Mirlind Zaganjori
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Ersin Ersoezlue
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Estrella Morenas‐Rodriguez
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Chair of Metabolic Biochemistry, Biomedical Center (BMC), Faculty of Medicine, LMU Munich Munich Germany
| | - Selim Guersel
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Carolin Kurz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Jan Haeckert
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics University of Augsburg, Bezirkskrankenhaus Augsburg Augsburg Germany
| | - Maia Tatò
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Julia Utecht
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Boris Papazov
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Katharina Buerger
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
| | - Michael Ewers
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich Munich Germany
| | - Carla Palleis
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Endy Weidinger
- Department of Neurology University Hospital, LMU Munich Munich Germany
| | - Gloria Biechele
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Sebastian Schuster
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Anika Finze
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Florian Eckenweber
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany
| | - Axel Rominger
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Department of Nuclear Medicine University of Bern, Inselspital Bern Switzerland
| | - Oliver Goldhardt
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar Technical University Munich Munich Germany
| | - Daniel Keeser
- Department of Radiology University Hospital, LMU Munich Munich Germany
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Department of Neuroradiology University Hospital LMU Munich Germany
| | - Sophia Stoecklein
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Olaf Dietrich
- Department of Radiology University Hospital, LMU Munich Munich Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology University Hospital, LMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Department of Neurology Hannover Medical School Hannover Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Munich Germany
- Ageing Epidemiology (AGE) Research Unit, School of Public Health Imperial College London London UK
- Munich Cluster for Systems Neurology (SyNergy), Munich Germany
- Sheffield Institute for Translational Neuroscience (SITraN) University of Sheffield Sheffield UK
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12
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Mizutani-Tiebel Y, Takahashi S, Karali T, Mezger E, Bulubas L, Papazova I, Dechantsreiter E, Stoecklein S, Papazov B, Thielscher A, Padberg F, Keeser D. Differences in electric field strength between clinical and non-clinical populations induced by prefrontal tDCS: A cross-diagnostic, individual MRI-based modeling study. Neuroimage Clin 2022; 34:103011. [PMID: 35487132 PMCID: PMC9125784 DOI: 10.1016/j.nicl.2022.103011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 12/22/2021] [Revised: 03/17/2022] [Accepted: 04/13/2022] [Indexed: 01/25/2023]
Abstract
MDD and SCZ showed lower prefrontal tDCS-induced e-field strengths compared to HC. Average e-field strengths did not significantly differ between MDD and SCZ patients. Inter-individual variability of e-field intensities and distribution was prominent. Inter-rater variability emphasizes the importance of standardized positioning.
Introduction Prefrontal cortex (PFC) regions are promising targets for therapeutic applications of non-invasive brain stimulation, e.g. transcranial direct current stimulation (tDCS), which has been proposed as a novel intervention for major depressive disorder (MDD) and negative symptoms of schizophrenia (SCZ). However, the effects of tDCS vary inter-individually, and dose–response relationships have not been established. Stimulation parameters are often tested in healthy subjects and transferred to clinical populations. The current study investigates the variability of individual MRI-based electric fields (e-fields) of standard bifrontal tDCS across individual subjects and diagnoses. Method The study included 74 subjects, i.e. 25 patients with MDD, 24 patients with SCZ, and 25 healthy controls (HC). Individual e-fields of a common tDCS protocol (i.e. 2 mA stimulation intensity, bifrontal anode-F3/cathode-F4 montage) were modeled by two investigators using SimNIBS (2.0.1) based on structural MRI scans. Result On a whole-brain level, the average e-field strength was significantly reduced in MDD and SCZ compared to HC, but MDD and SCZ did not differ significantly. Regions of interest (ROI) analysis for PFC subregions showed reduced e-fields in Sallet areas 8B and 9 for MDD and SCZ compared to HC, whereas there was again no difference between MDD and SCZ. Within groups, we generally observed high inter-individual variability of e-field intensities at a higher percentile of voxels. Conclusion MRI-based e-field modeling revealed significant differences in e-field strengths between clinical and non-clinical populations in addition to a general inter-individual variability. These findings support the notion that dose–response relationships for tDCS cannot be simply transferred from healthy to clinical cohorts and need to be individually established for clinical groups. In this respect, MRI-based e-field modeling may serve as a proxy for individualized dosing.
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Affiliation(s)
- Yuki Mizutani-Tiebel
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; NeuroImaging Core Unit Munich (NICUM), Munich, Germany.
| | - Shun Takahashi
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan; Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan; Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan; Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Temmuz Karali
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany
| | - Eva Mezger
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Lucia Bulubas
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; Department of Psychiatry and Psychotherapy, University of Augsburg, Germany
| | - Esther Dechantsreiter
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | | | - Boris Papazov
- NeuroImaging Core Unit Munich (NICUM), Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU, Munich, Germany; NeuroImaging Core Unit Munich (NICUM), Munich, Germany; Department of Radiology, University Hospital LMU, Munich, Germany; Munich Center for Neurosciences (MCN) - Brain & Mind, 82152 Planegg-Martinsried, Germany.
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13
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Yamada S, Takahashi S, Malchow B, Papazova I, Stöcklein S, Ertl-Wagner B, Papazov B, Kumpf U, Wobrock T, Keller-Varady K, Hasan A, Falkai P, Wagner E, Raabe FJ, Keeser D. Cognitive and functional deficits are associated with white matter abnormalities in two independent cohorts of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:957-969. [PMID: 34935072 PMCID: PMC9388472 DOI: 10.1007/s00406-021-01363-8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/24/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Significant evidence links white matter (WM) microstructural abnormalities to cognitive impairment in schizophrenia (SZ), but the relationship of these abnormalities with functional outcome remains unclear. METHODS In two independent cohorts (C1, C2), patients with SZ were divided into two subgroups: patients with higher cognitive performance (SZ-HCP-C1, n = 25; SZ-HCP-C2, n = 24) and patients with lower cognitive performance (SZ-LCP-C1, n = 25; SZ-LCP-C2, n = 24). Healthy controls (HC) were included in both cohorts (HC-C1, n = 52; HC-C2, n = 27). We compared fractional anisotropy (FA) of the whole-brain WM skeleton between the three groups (SZ-LCP, SZ-HCP, HC) by a whole-brain exploratory approach and an atlas-defined WM regions-of-interest approach via tract-based spatial statistics. In addition, we explored whether FA values were associated with Global Assessment of Functioning (GAF) scores in the SZ groups. RESULTS In both cohorts, mean FA values of whole-brain WM skeleton were significantly lower in the SCZ-LCP group than in the SCZ-HCP group. Whereas in C1 the FA of the frontal part of the left inferior fronto-occipital fasciculus (IFOF) was positively correlated with GAF score, in C2 the FA of the temporal part of the left IFOF was positively correlated with GAF score. CONCLUSIONS We provide robust evidence for WM microstructural abnormalities in SZ. These abnormalities are more prominent in patients with low cognitive performance and are associated with the level of functioning.
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Affiliation(s)
- Shinichi Yamada
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.412857.d0000 0004 1763 1087Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shun Takahashi
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.412857.d0000 0004 1763 1087Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan ,Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan
| | - Berend Malchow
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Irina Papazova
- grid.7307.30000 0001 2108 9006Department of Psychiatry Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Sophia Stöcklein
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- grid.42327.300000 0004 0473 9646Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Boris Papazov
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Ulrike Kumpf
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Wobrock
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany ,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Gross-Umstadt, Germany
| | - Katriona Keller-Varady
- grid.10423.340000 0000 9529 9877Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Alkomiet Hasan
- grid.7307.30000 0001 2108 9006Department of Psychiatry Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Peter Falkai
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Elias Wagner
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Florian J. Raabe
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. .,Department of Radiology, University Hospital, LMU Munich, Munich, Germany. .,NeuroImaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany.
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Roell L, Maurus I, Keeser D, Karali T, Papazov B, Hasan A, Schmitt A, Papazova I, Lembeck M, Hirjak D, Sykorova E, Thieme CE, Muenz S, Seitz V, Greska D, Campana M, Wagner E, Loehrs L, Stoecklein S, Ertl-Wagner B, Poemsl J, Roeh A, Malchow B, Keller-Varady K, Meyer-Lindenberg A, Falkai P. Association between aerobic fitness and the functional connectome in patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:1253-1272. [PMID: 35488054 PMCID: PMC9508005 DOI: 10.1007/s00406-022-01411-x] [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: 12/28/2021] [Accepted: 04/05/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Schizophrenia is accompanied by widespread alterations in static functional connectivity associated with symptom severity and cognitive deficits. Improvements in aerobic fitness have been demonstrated to ameliorate symptomatology and cognition in people with schizophrenia, but the intermediary role of macroscale connectivity patterns remains unknown. OBJECTIVE Therefore, we aim to explore the relation between aerobic fitness and the functional connectome in individuals with schizophrenia. Further, we investigate clinical and cognitive relevance of the identified fitness-connectivity links. METHODS Patients diagnosed with schizophrenia were included in this cross-sectional resting-state fMRI analysis. Multilevel Bayesian partial correlations between aerobic fitness and functional connections across the whole brain as well as between static functional connectivity patterns and clinical and cognitive outcome were performed. Preliminary causal inferences were enabled based on mediation analyses. RESULTS Static functional connectivity between the subcortical nuclei and the cerebellum as well as between temporal seeds mediated the attenuating relation between aerobic fitness and total symptom severity. Functional connections between cerebellar seeds affected the positive link between aerobic fitness and global cognition, while the functional interplay between central and limbic seeds drove the beneficial association between aerobic fitness and emotion recognition. CONCLUSION The current study provides first insights into the interactions between aerobic fitness, the functional connectome and clinical and cognitive outcome in people with schizophrenia, but causal interpretations are preliminary. Further interventional aerobic exercise studies are needed to replicate the current findings and to enable conclusive causal inferences. TRIAL REGISTRATION The study which the manuscript is based on is registered in the International Clinical Trials Database (ClinicalTrials.gov identifier [NCT number]: NCT03466112) and in the German Clinical Trials Register (DRKS-ID: DRKS00009804).
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Affiliation(s)
- Lukas Roell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336, Munich, Germany. .,NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany.
| | - Isabel Maurus
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Daniel Keeser
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.411095.80000 0004 0477 2585NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
| | - Temmuz Karali
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.411095.80000 0004 0477 2585NeuroImaging Core Unit Munich (NICUM), University Hospital LMU, Munich, Germany
| | - Boris Papazov
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Alkomiet Hasan
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Andrea Schmitt
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany ,grid.11899.380000 0004 1937 0722Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Irina Papazova
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Moritz Lembeck
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Dusan Hirjak
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Eliska Sykorova
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Cristina E. Thieme
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Susanne Muenz
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Valentina Seitz
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - David Greska
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Mattia Campana
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Elias Wagner
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Lisa Loehrs
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
| | - Sophia Stoecklein
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany ,grid.42327.300000 0004 0473 9646Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Johannes Poemsl
- grid.15474.330000 0004 0477 2438Department of Psychiatry and Psychotherapy, Medical Faculty, Technical University of Munich, University Hospital ‘Klinikum Rechts Der Isar’, Munich, Germany
| | - Astrid Roeh
- grid.7307.30000 0001 2108 9006Department of Psychiatry and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, University of Augsburg, Augsburg, Germany
| | - Berend Malchow
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Hospital Göttingen, Göttingen, Germany
| | - Katriona Keller-Varady
- grid.492118.70000 0004 0619 212XHannover Medical School, Institute of Sports Medicine, Hannover, Germany
| | - Andreas Meyer-Lindenberg
- grid.7700.00000 0001 2190 4373Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Peter Falkai
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 7, 80336 Munich, Germany
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Beller E, Keeser D, Wehn A, Malchow B, Karali T, Schmitt A, Papazova I, Papazov B, Schoeppe F, de Figueiredo GN, Ertl-Wagner B, Stoecklein S. T1-MPRAGE and T2-FLAIR segmentation of cortical and subcortical brain regions-an MRI evaluation study. Neuroradiology 2018; 61:129-136. [PMID: 30402744 DOI: 10.1007/s00234-018-2121-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 08/26/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Development of a warp-based automated brain segmentation approach of 3D fluid-attenuated inversion recovery (FLAIR) images and comparison to 3D T1-based segmentation. METHODS 3D FLAIR and 3D T1-weighted sequences of 30 healthy subjects (mean age 29.9 ± 8.3 years, 8 female) were acquired on the same 3T MR scanner. Warp-based segmentation was applied for volumetry of total gray matter (GM), white matter (WM), and 116 atlas regions. Segmentation results of both sequences were compared using Pearson correlation (r). RESULTS Correlation of GM segmentation results based on FLAIR and T1 was overall good for cortical structures (mean r across all cortical structures = 0.76). Comparatively weaker results were found in the occipital lobe (r = 0.77), central region (mean r = 0.58), basal ganglia (mean r = 0.59), thalamus (r = 0.30), and cerebellum (r = 0.73). FLAIR segmentation underestimated volume of the central region compared to T1, but showed a better anatomic concordance with the occipital lobe on visual review and subcortical structures, when also compared to manual segmentation. Visual analysis of FLAIR-based WM segmentation revealed frequent misclassification of regions of high signal intensity as GM. CONCLUSION Warp-based FLAIR segmentation yields comparable results to T1 segmentation for most cortical GM structures and may provide anatomically more congruent segmentation of subcortical GM structures. Selected cortical regions, especially the central region and total WM, seem to be underestimated on FLAIR segmentation.
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Affiliation(s)
- Ebba Beller
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany. .,Institut für Diagnostische und Interventionelle Radiologie, Kinder- und Neuroradiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
| | - Daniel Keeser
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Antonia Wehn
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Temmuz Karali
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, São Paulo, SP, 05453-010, Brazil
| | - Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris Papazov
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Franziska Schoeppe
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany
| | | | - Birgit Ertl-Wagner
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany.,Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Sophia Stoecklein
- Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany
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