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Kowalczyk OS, Medina S, Tsivaka D, McMahon SB, Williams SCR, Brooks JCW, Lythgoe DJ, Howard MA. Spinal fMRI demonstrates segmental organisation of functionally connected networks in the cervical spinal cord: A test-retest reliability study. Hum Brain Mapp 2024; 45:e26600. [PMID: 38339896 PMCID: PMC10831202 DOI: 10.1002/hbm.26600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
Resting functional magnetic resonance imaging (fMRI) studies have identified intrinsic spinal cord activity, which forms organised motor (ventral) and sensory (dorsal) resting-state networks. However, to facilitate the use of spinal fMRI in, for example, clinical studies, it is crucial to first assess the reliability of the method, particularly given the unique anatomical, physiological, and methodological challenges associated with acquiring the data. Here, we characterise functional connectivity relationships in the cervical cord and assess their between-session test-retest reliability in 23 young healthy volunteers. Resting-state networks were estimated in two ways (1) by estimating seed-to-voxel connectivity maps and (2) by calculating seed-to-seed correlations. Seed regions corresponded to the four grey matter horns (ventral/dorsal and left/right) of C5-C8 segmental levels. Test-retest reliability was assessed using the intraclass correlation coefficient. Spatial overlap of clusters derived from seed-to-voxel analysis between sessions was examined using Dice coefficients. Following seed-to-voxel analysis, we observed distinct unilateral dorsal and ventral organisation of cervical spinal resting-state networks that was largely confined in the rostro-caudal extent to each spinal segmental level, with more sparse connections observed between segments. Additionally, strongest correlations were observed between within-segment ipsilateral dorsal-ventral connections, followed by within-segment dorso-dorsal and ventro-ventral connections. Test-retest reliability of these networks was mixed. Reliability was poor when assessed on a voxelwise level, with more promising indications of reliability when examining the average signal within clusters. Reliability of correlation strength between seeds was highly variable, with the highest reliability achieved in ipsilateral dorsal-ventral and dorso-dorsal/ventro-ventral connectivity. However, the spatial overlap of networks between sessions was excellent. We demonstrate that while test-retest reliability of cervical spinal resting-state networks is mixed, their spatial extent is similar across sessions, suggesting that these networks are characterised by a consistent spatial representation over time.
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Affiliation(s)
- Olivia S. Kowalczyk
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
- The Wellcome Centre for Human Neuroimaging, Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | - Sonia Medina
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
| | - Dimitra Tsivaka
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
- Medical Physics Department, Medical SchoolUniversity of ThessalyLarisaGreece
| | | | - Steven C. R. Williams
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
| | | | - David J. Lythgoe
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
| | - Matthew A. Howard
- Department of Neuroimaging, Institute of Psychology, Psychiatry & NeuroscienceKing's College LondonLondonUK
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Kowalczyk OS, Cubillo AI, Criaud M, Giampietro V, O'Daly OG, Mehta MA, Rubia K. Single-dose effects of methylphenidate and atomoxetine on functional connectivity during an n-back task in boys with ADHD. Psychopharmacology (Berl) 2023; 240:2045-2060. [PMID: 37500785 PMCID: PMC10506949 DOI: 10.1007/s00213-023-06422-7] [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] [Received: 02/09/2022] [Accepted: 07/08/2023] [Indexed: 07/29/2023]
Abstract
RATIONALE Working memory deficits and associated neurofunctional abnormalities are frequently reported in attention-deficit/hyperactivity disorder (ADHD). Methylphenidate and atomoxetine improve working memory performance and increase activation of regions under-functioning in ADHD. Additionally, methylphenidate has been observed to modulate functional networks involved in working memory. No research, however, has examined the effects of atomoxetine or compared the two drugs. OBJECTIVES This study aimed to test methylphenidate and atomoxetine effects on functional connectivity during working memory in boys with ADHD. METHODS We tested comparative effects of methylphenidate and atomoxetine on functional connectivity during the n-back task in 19 medication-naïve boys with ADHD (10-15 years old) relative to placebo and assessed potential normalisation effects of brain dysfunctions under placebo relative to 20 age-matched neurotypical boys. Patients were scanned in a randomised, double-blind, cross-over design under single doses of methylphenidate, atomoxetine, and placebo. Controls were scanned once, unmedicated. RESULTS Patients under placebo showed abnormally increased connectivity between right superior parietal gyrus (rSPG) and left central operculum/insula. This hyperconnectivity was not observed when patients were under methylphenidate or atomoxetine. Furthermore, under methylphenidate, patients showed increased connectivity relative to controls between right middle frontal gyrus (rMFG) and cingulo-temporo-parietal and striato-thalamic regions, and between rSPG and cingulo-parietal areas. Interrogating these networks within patients revealed increased connectivity between both rMFG and rSPG and right supramarginal gyrus under methylphenidate relative to placebo. Nonetheless, no differences across drug conditions were observed within patients at whole brain level. No drug effects on performance were observed. CONCLUSIONS This study shows shared modulating effects of methylphenidate and atomoxetine on parieto-insular connectivity but exclusive effects of methylphenidate on connectivity increases in fronto-temporo-parietal and fronto-striato-thalamic networks in ADHD.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Ana I Cubillo
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Jacobs Center for Productive Youth Development, Zurich Center for Neuroeconomics, University of Zürich, Zürich, Switzerland
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Owen G O'Daly
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Howard MA, Lawn T, Kowalczyk OS. Harnessing the power of endogenous pain control mechanisms for novel therapeutics: how might innovations in neuroimaging help? Curr Opin Support Palliat Care 2023; 17:150-155. [PMID: 37352611 PMCID: PMC10371061 DOI: 10.1097/spc.0000000000000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
PURPOSE OF REVIEW This review explores the potential of using novel imaging approaches to deepen our understanding of descending modulatory mechanisms in pain, focussing on functional magnetic resonance imaging (fMRI) of the spinal cord and novel approaches to combining molecular and fMRI data. This review sheds light on the neural processes involved in pain modulation, paving the way for the development of targeted treatments. RECENT FINDINGS The reviewed literature demonstrates significant advancements in pain research. Recent studies show the potential of using fMRI to investigate the spinal cord's role in pain modulation. Furthermore, novel analytical approaches integrating molecular and fMRI data show promise in elucidating the complex neurobiological processes underlying pain regulation. The main themes explored here include the identification of neurochemical markers associated with pain modulation and the characterisation of neural circuits involved in descending pain control. SUMMARY A comprehensive understanding of descending modulatory mechanisms in pain can inform the development of novel treatments, targeting dysfunction of these key pathways. By leveraging spinal fMRI and integrating molecular data into brain fMRI, researchers can identify potential therapeutic targets throughout the neuraxis. These advances may contribute to the development of personalised medicine approaches, allowing for tailored interventions based on individual pain profiles.
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Affiliation(s)
- Matthew A. Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
| | - Timothy Lawn
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
| | - Olivia S. Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
- The Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, UK
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Tsivaka D, Williams SCR, Medina S, Kowalczyk OS, Brooks JCW, Howard MA, Lythgoe DJ, Tsougos I. A second-order and slice-specific linear shimming technique to improve spinal cord fMRI. Magn Reson Imaging 2023:S0730-725X(23)00108-X. [PMID: 37353180 DOI: 10.1016/j.mri.2023.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/20/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
PURPOSE To develop a second-order and slice-specific linear shimming technique and investigate its efficiency in the mitigation of signal loss and distortions, and the increase of temporal signal-to-noise ratio (tSNR) within the spinal cord during functional Magnetic Resonance Imaging (fMRI) of the human cervical spinal cord. METHODS All scans were performed on a General Electric Discovery MR750 3 T scanner, using a head, neck and spine coil and a neurovascular array. To improve B0 homogeneity, a field map was acquired, and second-order shims (SOS) were optimized over manually defined regions of interest (ROIs). Signal loss from dephasing by susceptibility-induced gradients was reduced by optimizing slice-specific x-, y- and z-shims to maximize signal within the spinal cord. Spectral-spatial excitation pulses were used in both the slice-specific linear shimming calibration scan and fMRI acquisitions. The shimming technique's efficiency was initially tested on eight healthy volunteers by comparing tSNR between images acquired with the manufacturer's standard linear shimming and with our SOS and xyz-shimming technique. Subsequently, using an increased spatial resolution as needed for fMRI of the spinal cord, tSNR measurements were performed on resting-state fMRI images from 14 healthy participants. RESULTS Spinal fMRI images acquired with only the standard linear shimming suffered from severe signal loss below the C5 vertebral level. The developed shimming technique compensated for this loss especially at levels C6 and C7, while tSNR was significantly higher at all vertebral levels with SOS and xyz-shimming than without it. CONCLUSION A comprehensive shimming approach which includes the use of spectral-spatial excitation pulses along with both second-order and slice-specific linear shim optimization reduces regional signal loss and increases tSNR along the c-spine (C3-C7), improving the ability to record functional signals from the human spinal cord.
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Affiliation(s)
- D Tsivaka
- Medical Physics Department, Medical School, University of Thessaly, Larisa, Greece; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S Medina
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - O S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - J C W Brooks
- School of Psychology, University of East Anglia, Norwich, UK
| | - M A Howard
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - D J Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - I Tsougos
- Medical Physics Department, Medical School, University of Thessaly, Larisa, Greece; Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Westwood SJ, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Agbedjro D, Wexler BE, Cohen Kadosh R, Asherson P, Rubia K. Transcranial direct current stimulation (tDCS) combined with cognitive training in adolescent boys with ADHD: a double-blind, randomised, sham-controlled trial. Psychol Med 2023; 53:497-512. [PMID: 34225830 PMCID: PMC9899574 DOI: 10.1017/s0033291721001859] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/19/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) could be a side-effect-free alternative to psychostimulants in attention-deficit/hyperactivity disorder (ADHD). Although there is limited evidence for clinical and cognitive effects, most studies were small, single-session and stimulated left dorsolateral prefrontal cortex (dlPFC). No sham-controlled study has stimulated the right inferior frontal cortex (rIFC), which is the most consistently under-functioning region in ADHD, with multiple anodal-tDCS sessions combined with cognitive training (CT) to enhance effects. Thus, we investigated the clinical and cognitive effects of multi-session anodal-tDCS over rIFC combined with CT in double-blind, randomised, sham-controlled trial (RCT, ISRCTN48265228). METHODS Fifty boys with ADHD (10-18 years) received 15 weekday sessions of anodal- or sham-tDCS over rIFC combined with CT (20 min, 1 mA). ANCOVA, adjusting for baseline measures, age and medication status, tested group differences in clinical and ADHD-relevant executive functions at posttreatment and after 6 months. RESULTS ADHD-Rating Scale, Conners ADHD Index and adverse effects were significantly lower at post-treatment after sham relative to anodal tDCS. No other effects were significant. CONCLUSIONS This rigorous and largest RCT of tDCS in adolescent boys with ADHD found no evidence of improved ADHD symptoms or cognitive performance following multi-session anodal tDCS over rIFC combined with CT. These findings extend limited meta-analytic evidence of cognitive and clinical effects in ADHD after 1-5 tDCS sessions over mainly left dlPFC. Given that tDCS is commercially and clinically available, the findings are important as they suggest that rIFC stimulation may not be indicated as a neurotherapy for cognitive or clinical remediation for ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
- Department of Neuroimaging, King's College London, London, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Bruce E. Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Roi Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, King's College London, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
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Lam SL, Criaud M, Lukito S, Westwood SJ, Agbedjro D, Kowalczyk OS, Curran S, Barret N, Abbott C, Liang H, Simonoff E, Barker GJ, Giampietro V, Rubia K. Double-Blind, Sham-Controlled Randomized Trial Testing the Efficacy of fMRI Neurofeedback on Clinical and Cognitive Measures in Children With ADHD. Am J Psychiatry 2022; 179:947-958. [PMID: 36349428 PMCID: PMC7614456 DOI: 10.1176/appi.ajp.21100999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/11/2022]
Abstract
OBJECTIVE Functional MRI neurofeedback (fMRI-NF) could potentially be a novel, safe nonpharmacological treatment for attention deficit hyperactivity disorder (ADHD). A proof-of-concept randomized controlled trial of fMRI-NF of the right inferior frontal cortex (rIFC), compared to an active control condition, showed promising improvement of ADHD symptoms (albeit in both groups) and in brain function. However, comparison with a placebo condition in a larger trial is required to test efficacy. METHODS This double-blind, sham-controlled randomized controlled trial tested the effectiveness and efficacy of fMRI-NF of the rIFC on symptoms and executive functions in 88 boys with ADHD (44 each in the active and sham arms). To investigate treatment-related changes, groups were compared at the posttreatment and 6-month follow-up assessments, controlling for baseline scores, age, and medication status. The primary outcome measure was posttreatment score on the ADHD Rating Scale (ADHD-RS). RESULTS No significant group differences were found on the ADHD-RS. Both groups showed similar decreases in other clinical and cognitive measures, except for a significantly greater decrease in irritability and improvement in motor inhibition in sham relative to active fMRI-NF at the posttreatment assessment, covarying for baseline. There were no significant side effects or adverse events. The active relative to the sham fMRI-NF group showed enhanced activation in rIFC and other frontal and temporo-occipital-cerebellar self-regulation areas. However, there was no progressive rIFC upregulation, correlation with ADHD-RS scores, or transfer of learning. CONCLUSIONS Contrary to the hypothesis, the study findings do not suggest that fMRI-NF of the rIFC is effective in improving clinical symptoms or cognition in boys with ADHD.
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Affiliation(s)
- Sheut-Ling Lam
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Marion Criaud
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Steve Lukito
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Samuel J Westwood
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Deborah Agbedjro
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Olivia S Kowalczyk
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Sarah Curran
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Nadia Barret
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Chris Abbott
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Holan Liang
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Gareth J Barker
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Vincent Giampietro
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
| | - Katya Rubia
- Department of Child and Adolescent Psychiatry (Lam, Criaud, Lukito, Westwood, Simonoff, Rubia), Department of Neuroimaging (Kowalczyk, Barker, Giampietro), and Department of Biostatistics (Agbedjro), King's College London; Institute for Globally Distributed Open Research and Education (Criaud); Institute of Human Sciences, University of Wolverhampton, Wolverhampton, U.K. (Westwood); Department of Psychology, School of Social Science, University of Westminster, London (Westwood); Southwest London and St George's Mental Health NHS Trust, London (Curran); South London and Maudsley NHS Foundation Trust, London (Barret, Abbott); Great Ormond Street Hospital for Children NHS Foundation Trust, London (Liang); Department of Child and Adolescent Psychiatry, Technical University Dresden, Germany (Rubia)
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Westwood SJ, Bozhilova N, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Wexler BE, Kadosh RC, Asherson P, Rubia K. The effect of transcranial direct current stimulation (tDCS) combined with cognitive training on EEG spectral power in adolescent boys with ADHD: A double-blind, randomized, sham-controlled trial. IBRO Neurosci Rep 2022; 12:55-64. [PMID: 35746969 PMCID: PMC9210460 DOI: 10.1016/j.ibneur.2021.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/19/2021] [Indexed: 12/19/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a possible alternative to psychostimulants in Attention-Deficit/Hyperactivity Disorder (ADHD), but its mechanisms of action in children and adolescents with ADHD are poorly understood. We conducted the first 15-session, sham-controlled study of anodal tDCS over right inferior frontal cortex (rIFC) combined with cognitive training (CT) in 50 children/adolescents with ADHD. We investigated the mechanisms of action on resting and Go/No-Go Task-based QEEG measures in a subgroup of 23 participants with ADHD (n, sham = 10; anodal tDCS = 13). We failed to find a significant sham versus anodal tDCS group differences in QEEG spectral power during rest and Go/No-Go Task performance, a correlation between QEEG and Go/No-Go Task performance, and changes in clinical and cognitive measures. These findings extend the non-significant clinical and cognitive effects in our sample of 50 children/adolescents with ADHD. Given that the subgroup of 23 participants would have been underpowered, the interpretation of our findings is limited and should be used as a foundation for future investigations. Larger, adequately powered randomized controlled trials should explore different protocols titrated to the individual and using comprehensive measures to assess cognitive, clinical, and neural effects of tDCS and its underlying mechanisms of action in ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Wolverhampton, Wolverhampton WV1 1LY UK
- Department of Psychology, School of Social Science, University of Westminster, London W1W 6UW, UK
- Correspondence to: Department of Child and Adolescent Psychiatry - PO85 Institute of Psychiatry, Psychology and Neuroscience King’s College London, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Natali Bozhilova
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
- Correspondence to: School of Psychology Elizabeth Fry Building, University of Surrey, Guildford GU2 7XH, UK.
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sophie Wallace-Hanlon
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Bruce E. Wexler
- Department of Psychiatry, Yale University School of Medicine, 06520–8096, USA
| | - Roi Cohen Kadosh
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
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Kowalczyk OS, Lautarescu A, Blok E, Dall'Aglio L, Westwood SJ. What senior academics can do to support reproducible and open research: a short, three-step guide. BMC Res Notes 2022; 15:116. [PMID: 35317865 PMCID: PMC8938725 DOI: 10.1186/s13104-022-05999-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/09/2022] [Indexed: 01/31/2023] Open
Abstract
Increasingly, policies are being introduced to reward and recognise open research practices, while the adoption of such practices into research routines is being facilitated by many grassroots initiatives. However, despite this widespread endorsement and support, as well as various efforts led by early career researchers, open research is yet to be widely adopted. For open research to become the norm, initiatives should engage academics from all career stages, particularly senior academics (namely senior lecturers, readers, professors) given their routine involvement in determining the quality of research. Senior academics, however, face unique challenges in implementing policy changes and supporting grassroots initiatives. Given that—like all researchers—senior academics are motivated by self-interest, this paper lays out three feasible steps that senior academics can take to improve the quality and productivity of their research, that also serve to engender open research. These steps include changing (a) hiring criteria, (b) how scholarly outputs are credited, and (c) how we fund and publish in line with open research principles. The guidance we provide is accompanied by material for further reading.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra Lautarescu
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology, Neuroscience, King's College London, London, UK.,Department of Perinatal Imaging and Health, Centre for the Developing Brain, School of Biomedical Imaging and Medical Sciences, King's College London, London, UK
| | - Elisabet Blok
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Lorenza Dall'Aglio
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Samuel J Westwood
- Institute of Psychiatry, Psychology, Neuroscience, King's College London, London, UK. .,Department of Psychology, School of Social Science, University of Westminster, 115 New Cavendish Street, London, W1W 6UW, UK.
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Kowalczyk OS, Mehta MA, O’Daly OG, Criaud M. Task-based functional connectivity in attention-deficit/hyperactivity disorder: A systematic review. Biological Psychiatry Global Open Science 2021; 2:350-367. [DOI: 10.1016/j.bpsgos.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/30/2022] Open
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Kowalczyk OS, Pauls AM, Fusté M, Williams SCR, Hazelgrove K, Vecchio C, Seneviratne G, Pariante CM, Dazzan P, Mehta MA. Neurocognitive correlates of working memory and emotional processing in postpartum psychosis: an fMRI study. Psychol Med 2021; 51:1724-1732. [PMID: 32174288 DOI: 10.1017/s0033291720000471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Postpartum psychosis (PP) is a severe postpartum disorder. While working memory and emotional processing-related brain function are consistently impaired in psychoses unrelated to the puerperium, no studies have investigated them in PP. METHODS Twenty-four women at risk of developing PP (11 developed an episode - PE; 13 remained well - NPE) and 20 healthy postpartum women completed two functional magnetic resonance imaging tasks within a year of delivery: working memory (n-back) and emotional face recognition (fearful faces). We compared women at-risk of PP to controls, as well as NPE, PE, and controls to test for potential effects of a PP episode occurrence. RESULTS Women at-risk of PP and PE showed hyperactivation of lateral visual areas, precuneus, and posterior cingulate during the n-back task. The at-risk group as a whole, as well as the PE and NPE groups, showed hyperconnectivity of the right dorsolateral prefrontal cortex (DLPFC) with various parieto-occipito-temporo-cerebellar regions compared to controls during several n-back conditions. Increases in connectivity between the right DLPFC and ipsilateral middle temporal gyrus were observed in the PE group compared to NPE during 2-back. During the fearful faces task, at-risk women as a group showed hyperactivation of fronto-cingulo-subcortical regions, and hypoconnectivity between the left amygdala and ipsilateral occipito-parietal regions compared to controls. No significant performance differences were observed. CONCLUSIONS These results present preliminary evidence of a differential nature of functional brain abnormalities in PP compared to the typically observed reduced connectivity with the DLPFC in psychoses unrelated to puerperium, such as bipolar disorder.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Astrid M Pauls
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Montserrat Fusté
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Steven C R Williams
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Katie Hazelgrove
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Costanza Vecchio
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Gertrude Seneviratne
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Carmine M Pariante
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Section of Stress, Psychiatry and Immunology and Perinatal Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, King's College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mitul A Mehta
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Kowalczyk OS, Cubillo AI, Smith A, Barrett N, Giampietro V, Brammer M, Simmons A, Rubia K. Methylphenidate and atomoxetine normalise fronto-parietal underactivation during sustained attention in ADHD adolescents. Eur Neuropsychopharmacol 2019; 29:1102-1116. [PMID: 31358436 DOI: 10.1016/j.euroneuro.2019.07.139] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 02/02/2023]
Abstract
Problems with sustained attention are a key clinical feature of Attention Deficit/Hyperactivity Disorder (ADHD) which also manifests in poor performance and abnormal fronto-striato-parietal activation during sustained attention. Methylphenidate and atomoxetine improve attention functions and upregulate abnormal fronto-cortical activation during executive function tasks in ADHD patients. Despite this, no functional Magnetic Resonance Imaging (fMRI) study has compared the effects of methylphenidate and atomoxetine on the neurofunctional substrates of sustained attention in ADHD. This randomised, double-blind, placebo-controlled, cross-over study investigated the comparative normalisation effects of methylphenidate and atomoxetine on fMRI correlates and performance in 14 ADHD adolescents relative to 27 age-matched healthy controls during a parametric sustained attention/vigilance task with progressively increasing load of sustained attention. ADHD patients were scanned three times under a single clinical dose of either methylphenidate, atomoxetine, or placebo in pseudo-randomised order. Healthy controls were scanned once and compared to patients under each drug condition to test for potential drug-normalisation effects. Relative to controls, ADHD boys under placebo were impaired in performance and had underactivation in predominantly right-hemispheric fronto-parietal, and striato-thalamic regions. Both drugs normalised all underactivations, while only methylphenidate improved performance deficits. Within patients, methylphenidate had a drug-specific effect of upregulating left ventrolateral prefrontal/superior temporal activation relative to placebo and atomoxetine, while both drugs increased activation of right middle/superior temporal cortex, posterior cingulate, and precuneus relative to placebo. The study shows shared normalisation effects of methylphenidate and atomoxetine on fronto-striato-thalamo-parietal dysfunction in ADHD during sustained attention but a drug-specific upregulation effects of methylphenidate on ventral fronto-temporal regions.
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Affiliation(s)
- Olivia S Kowalczyk
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, De Crespigny Park, London SE5 8AF, UK.
| | - Ana I Cubillo
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, De Crespigny Park, London SE5 8AF, UK; Jacobs Center for Productive Youth Development, Zurich Center for Neuroeconomics, University of Zürich, Switzerland
| | - Anna Smith
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, De Crespigny Park, London SE5 8AF, UK
| | - Nadia Barrett
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, De Crespigny Park, London SE5 8AF, UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, UK
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, UK
| | - Andrew Simmons
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, UK; Centre for Neurodegeneration Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King´s College London, De Crespigny Park, London SE5 8AF, UK
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