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Anderson JA, Rashidi-Ranjbar N, Nazeri A, Chad JA, Zhukovsky P, Mulsant BH, Herrmann N, Mah L, Flint AJ, Fischer CE, Pollock BG, Rajji TK, Voineskos AN. Age-Related Alterations in Gray Matter Microstructure in Older People With Remitted Major Depression at Risk for Dementia. Biol Psychiatry Glob Open Sci 2024; 4:374-384. [PMID: 38298786 PMCID: PMC10829634 DOI: 10.1016/j.bpsgos.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/15/2023] [Accepted: 08/27/2023] [Indexed: 02/02/2024] Open
Abstract
Background Major depressive disorder (MDD) in late life is a risk factor for mild cognitive impairment (MCI) and Alzheimer's disease. However, studies of gray matter changes have produced varied estimates of which structures are implicated in MDD and dementia. Changes in gray matter volume and cortical thickness are macrostructural measures for the microstructural processes of free water accumulation and dendritic spine loss. Methods We conducted multishell diffusion imaging to assess gray matter microstructure in 244 older adults with remitted MDD (n = 44), MCI (n = 115), remitted MDD+MCI (n = 61), or without psychiatric disorders or cognitive impairment (healthy control participants; n = 24). We estimated measures related to neurite density, orientation dispersion, and free water (isotropic volume fraction) using a biophysically plausible model (neurite orientation dispersion and density imaging). Results Results showed that increasing age was correlated with an increase in isotropic volume fraction and a decrease in orientation dispersion index, which is consistent with neuropathology dendritic loss. In addition, this relationship between age and increased isotropic volume fraction was more disrupted in the MCI group than in the remitted MDD or healthy control groups. However, the association between age and orientation dispersion index was similar for all 3 groups. Conclusions The findings suggest that the neurite orientation dispersion and density imaging measures could be used to identify biological risk factors for Alzheimer's disease, signifying both conventional neurodegeneration observed with MCI and dendritic loss seen in MDD.
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Affiliation(s)
- John A.E. Anderson
- Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Neda Rashidi-Ranjbar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Arash Nazeri
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri (AN)
| | - Jordan A. Chad
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Peter Zhukovsky
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Benoit H. Mulsant
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nathan Herrmann
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Linda Mah
- Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alastair J. Flint
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bruce G. Pollock
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tarek K. Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - Aristotle N. Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - PACt-MD Study Group
- Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Keenan Research Centre for Biomedical Science, St. Michael’s Hospital, Toronto, Ontario, Canada
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri (AN)
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
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9
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Ottoy J, Ozzoude M, Zukotynski K, Kang MS, Adamo S, Scott C, Ramirez J, Swardfager W, Lam B, Bhan A, Mojiri P, Kiss A, Strother S, Bocti C, Borrie M, Chertkow H, Frayne R, Hsiung R, Laforce RJ, Noseworthy MD, Prato FS, Sahlas DJ, Smith EE, Kuo PH, Chad JA, Pasternak O, Sossi V, Thiel A, Soucy JP, Tardif JC, Black SE, Goubran M. Amyloid-PET of the white matter: Relationship to free water, fiber integrity, and cognition in patients with dementia and small vessel disease. J Cereb Blood Flow Metab 2023; 43:921-936. [PMID: 36695071 DOI: 10.1177/0271678x231152001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
White matter (WM) injury is frequently observed along with dementia. Positron emission tomography with amyloid-ligands (Aβ-PET) recently gained interest for detecting WM injury. Yet, little is understood about the origin of the altered Aβ-PET signal in WM regions. Here, we investigated the relative contributions of diffusion MRI-based microstructural alterations, including free water and tissue-specific properties, to Aβ-PET in WM and to cognition. We included a unique cohort of 115 participants covering the spectrum of low-to-severe white matter hyperintensity (WMH) burden and cognitively normal to dementia. We applied a bi-tensor diffusion-MRI model that differentiates between (i) the extracellular WM compartment (represented via free water), and (ii) the fiber-specific compartment (via free water-adjusted fractional anisotropy [FA]). We observed that, in regions of WMH, a decrease in Aβ-PET related most closely to higher free water and higher WMH volume. In contrast, in normal-appearing WM, an increase in Aβ-PET related more closely to higher cortical Aβ (together with lower free water-adjusted FA). In relation to cognitive impairment, we observed a closer relationship with higher free water than with either free water-adjusted FA or WM PET. Our findings support free water and Aβ-PET as markers of WM abnormalities in patients with mixed dementia, and contribute to a better understanding of processes giving rise to the WM PET signal.
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Affiliation(s)
- Julie Ottoy
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Miracle Ozzoude
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Katherine Zukotynski
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Departments of Medicine and Radiology, McMaster University, Hamilton, ON, Canada.,Department of Medical Imaging, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Min Su Kang
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Sabrina Adamo
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Christopher Scott
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Joel Ramirez
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Walter Swardfager
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
| | - Benjamin Lam
- Department of Medicine (Division of Neurology), Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Aparna Bhan
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Parisa Mojiri
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Alex Kiss
- Department of Research Design and Biostatistics, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Stephen Strother
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,The Rotman Research Institute Baycrest, University of Toronto, Toronto, ON, Canada
| | - Christian Bocti
- Service de Neurologie, Département de Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michael Borrie
- Lawson Health Research Institute, Western University, London, ON, Canada
| | - Howard Chertkow
- Jewish General Hospital and Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Richard Frayne
- Departments of Radiology and Clinical Neuroscience, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Robin Hsiung
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Robert Jr Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, Université Laval, Québec, QC, Canada
| | - Michael D Noseworthy
- Departments of Medicine and Radiology, McMaster University, Hamilton, ON, Canada.,Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - Frank S Prato
- Lawson Health Research Institute, Western University, London, ON, Canada
| | | | - Eric E Smith
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Phillip H Kuo
- Department of Medical Imaging, Medicine, and Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Jordan A Chad
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,The Rotman Research Institute Baycrest, University of Toronto, Toronto, ON, Canada
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Vesna Sossi
- Physics and Astronomy Department and DM Center for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Alexander Thiel
- Jewish General Hospital and Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Jean-Paul Soucy
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - Sandra E Black
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medicine (Division of Neurology), Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Maged Goubran
- LC Campbell Cognitive Neurology Unit, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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11
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MacIntosh BJ, Ji X, Chen JJ, Gilboa A, Roudaia E, Sekuler AB, Gao F, Chad JA, Jegatheesan A, Masellis M, Goubran M, Rabin J, Lam B, Cheng I, Fowler R, Heyn C, Black SE, Graham SJ. Brain structure and function in people recovering from COVID-19 after hospital discharge or self-isolation: a longitudinal observational study protocol. CMAJ Open 2021; 9:E1114-E1119. [PMID: 34848552 PMCID: PMC8648350 DOI: 10.9778/cmajo.20210023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The detailed extent of neuroinvasion or deleterious brain changes resulting from COVID-19 and their time courses remain to be determined in relation to "long-haul" COVID-19 symptoms. Our objective is to determine whether there are alterations in functional brain imaging measures among people with COVID-19 after hospital discharge or self-isolation. METHODS This paper describes a protocol for NeuroCOVID-19, a longitudinal observational study of adults aged 20-75 years at Sunnybrook Health Sciences Centre in Toronto, Ontario, that began in April 2020. We aim to recruit 240 adults, 60 per group: people who contracted COVID-19 and were admitted to hospital (group 1), people who contracted COVID-19 and self-isolated (group 2), people who experienced influenza-like symptoms at acute presentation but tested negative for COVID-19 and self-isolated (group 3, control) and healthy people (group 4, control). Participants are excluded based on premorbid neurologic or severe psychiatric illness, unstable cardiovascular disease, and magnetic resonance imaging (MRI) contraindications. Initial and 3-month follow-up assessments include multiparametric brain MRI and electroencephalography. Sensation and cognition are assessed alongside neuropsychiatric assessments and symptom self-reports. We will test the data from the initial and follow-up assessments for group differences based on 3 outcome measures: MRI cerebral blood flow, MRI resting state fractional amplitude of low-frequency fluctuation and electroencephalography spectral power. INTERPRETATION If neurophysiologic alterations are detected in the COVID-19 groups in our NeuroCOVID-19 study, this information could inform future research regarding interventions for long-haul COVID-19. The study results will be disseminated to scientists, clinicians and COVID-19 survivors, as well as the public and private sectors to provide context on how brain measures relate to lingering symptoms.
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Affiliation(s)
- Bradley J MacIntosh
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont.
| | - Xiang Ji
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - J Jean Chen
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Asaf Gilboa
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Eugenie Roudaia
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Allison B Sekuler
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Fuqiang Gao
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Jordan A Chad
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Aravinthan Jegatheesan
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Mario Masellis
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Maged Goubran
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Jennifer Rabin
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Benjamin Lam
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Ivy Cheng
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Robert Fowler
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Chris Heyn
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Sandra E Black
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
| | - Simon J Graham
- Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont
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