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Ringshaw JE, Hendrikse C, Wedderburn CJ, Bradford LE, Williams SR, Nyakonda CN, Subramoney S, Lake MT, Burd T, Hoffman N, Roos A, Narr KL, Joshi SH, Williams SCR, Zar HJ, Stein DJ, Donald KA. Persistent Impact of Antenatal Maternal Anaemia on Child Brain Structure at 6-7 Years of Age: A South African Child Health Study. Res Sq 2024:rs.3.rs-4281448. [PMID: 38746172 PMCID: PMC11092825 DOI: 10.21203/rs.3.rs-4281448/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background The study aim was to determine whether associations of antenatal maternal anaemia with smaller corpus callosum, putamen, and caudate nucleus volumes previously described in children at age 2-3 years persist to age 6-7 years in the Drakenstein Child Health Study (DCHS). Methods This neuroimaging sub-study was nested within the DCHS, a South African population-based birth cohort. Pregnant women were enrolled (2012-2015) and mother-child dyads were followed prospectively. A sub-group of children had magnetic resonance imaging at 6-7 years of age (2018-2022). Mothers had haemoglobin measurements during pregnancy and a proportion of children were tested postnatally. Maternal anaemia (haemoglobin<11g/dL) and child anaemia were classified using WHO and local guidelines. Linear modeling was used to investigate associations between antenatal maternal anaemia status, maternal haemoglobin concentrations, and regional child brain volumes. Models included potential confounders and were conducted with and without child anaemia to assess the relative roles of antenatal versus postnatal anaemia. Results Overall, 157 children ( Mean [ SD ] age of 75.54 [4.77] months; 84 [53.50%] male) were born to mothers with antenatal haemoglobin data. The prevalence of maternal anaemia during pregnancy was 31.85% (50/157). In adjusted models, maternal anaemia status was associated with smaller volumes of the total corpus callosum (adjusted percentage difference, -6.77%; p =0.003), left caudate nucleus (adjusted percentage difference, -5.98%, p =0.005), and right caudate nucleus (adjusted percentage difference, -6.12%; p =0.003). Continuous maternal haemoglobin was positively associated with total corpus callosum ( β =0.239 [CI: 0.10 to 0.38]; p <0.001) and caudate nucleus ( β =0.165 [CI: 0.02 to 0.31]; p =0.027) volumes. In a sub-group ( n =89) with child haemoglobin data ( Mean [ SD ] age of 76.06[4.84]), the prevalence of antenatal maternal anaemia and postnatal child anaemia was 38.20% (34/89) and 47.19% (42/89), respectively. There was no association between maternal and child anaemia (c 2 = 0.799; p =0.372), and child anaemia did not contribute to regional brain volume differences associated with maternal anaemia. Conclusions Associations between maternal anaemia and regional child brain volumes previously reported at 2-3 years of age were consistent and persisted to 6-7 years of age. Findings support the importance of optimizing antenatal maternal health and reinforce these brain regions as a future research focus on intervention outcomes.
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Uban KA, Jonker D, Donald KA, Bodison SC, Brooks SJ, Kan E, Steigelmann B, Roos A, Marshall A, Adise S, Butler-Kruger L, Melly B, Narr KL, Joshi SH, Odendaal HJ, Sowell ER, Stein DJ. Associations between community-level patterns of prenatal alcohol and tobacco exposure on brain structure in a non-clinical sample of 6-year-old children: a South African pilot study. Acta Neuropsychiatr 2024; 36:87-96. [PMID: 36700449 PMCID: PMC10368794 DOI: 10.1017/neu.2022.34] [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: 01/27/2023]
Abstract
The current small study utilised prospective data collection of patterns of prenatal alcohol and tobacco exposure (PAE and PTE) to examine associations with structural brain outcomes in 6-year-olds and served as a pilot to determine the value of prospective data describing community-level patterns of PAE and PTE in a non-clinical sample of children. Participants from the Safe Passage Study in pregnancy were approached when their child was ∼6 years old and completed structural brain magnetic resonance imaging to examine with archived PAE and PTE data (n = 51 children-mother dyads). Linear regression was used to conduct whole-brain structural analyses, with false-discovery rate (FDR) correction, to examine: (a) main effects of PAE, PTE and their interaction; and (b) predictive potential of data that reflect patterns of PAE and PTE (e.g. quantity, frequency and timing (QFT)). Associations between PAE, PTE and their interaction with brain structural measures demonstrated unique profiles of cortical and subcortical alterations that were distinct between PAE only, PTE only and their interactive effects. Analyses examining associations between patterns of PAE and PTE (e.g. QFT) were able to significantly detect brain alterations (that survived FDR correction) in this small non-clinical sample of children. These findings support the hypothesis that considering QFT and co-exposures is important for identifying brain alterations following PAE and/or PTE in a small group of young children. Current results demonstrate that teratogenic outcomes on brain structure differ as a function PAE, PTE or their co-exposures, as well as the pattern (QFT) or exposure.
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Affiliation(s)
- Kristina A Uban
- Public Health, University of California, Irvine, CA, USA
- Center for Neurobiology of Learning and Memory
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Stefanie C Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | | | - Annerine Roos
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Andrew Marshall
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Shana Adise
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Letitia Butler-Kruger
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Brigitte Melly
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Elizabeth R Sowell
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
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Wedderburn CJ, Yeung S, Subramoney S, Fouche JP, Joshi SH, Narr KL, Rehman AM, Roos A, Gibb DM, Zar HJ, Stein DJ, Donald KA. Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study. BMC Med 2024; 22:129. [PMID: 38519887 PMCID: PMC10960435 DOI: 10.1186/s12916-024-03282-6] [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: 08/04/2023] [Accepted: 02/01/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND There is a growing population of children with in utero HIV exposure who are at risk of poor neurodevelopmental outcomes despite avoiding HIV infection. However, the underlying neurobiological pathways are not understood and neuroimaging studies are lacking. We aimed to investigate the cortical brain structure of children who are HIV-exposed and uninfected (HEU) compared to HIV-unexposed (HU) children and to examine the relationship with neurodevelopment. METHODS The Drakenstein Child Health birth cohort study enrolled pregnant women from a high HIV prevalence area in South Africa with longitudinal follow-up of mother-child pairs. High-resolution magnetic resonance imaging scans from 162 children (70 HEU; 92 HU) were acquired at 2-3 years of age. All HEU children were born to mothers taking antiretroviral therapy. Measures of brain structure (cortical thickness and surface area) in the prefrontal cortex regions were extracted from T1-weighted images and compared between groups using multivariate analysis of variance and linear regression. Child development, assessed using the Bayley Scales of Infant and Toddler Development-III, was correlated with cortical structure, and mediation analyses were performed. RESULTS Analyses demonstrated an association between HIV exposure and cortical thickness across the prefrontal cortex (p = 0.035). Children who were HEU had thicker cortices in prefrontal regions, with significantly greater cortical thickness in the medial orbitofrontal cortex (mOFC) bilaterally compared to HU children (3.21 mm versus 3.14 mm, p = 0.009, adjusted effect size 0.44 [95% CI 0.12 to 0.75]). Estimates held across multiple sensitivity analyses. There were no group differences in cortical surface area. Language scores, which were lower in HEU versus HU children (81.82 versus 86.25, p = 0.011, effect size - 0.44 [95% CI - 0.78 to - 0.09]), negatively correlated with prefrontal cortical thickness in both groups. Cortical thickness in the mOFC mediated the relationship between HIV exposure and poor language outcomes (Sobel test p = 0.032). CONCLUSIONS In this cohort study, exposure to HIV during pregnancy was associated with altered cortical structure in early life. Our findings indicate that differences in cortical thickness development in the prefrontal region in children who are HEU may be a pathway leading to language impairment. Longitudinal studies are needed to determine the lasting impact.
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Affiliation(s)
- Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.
- The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - Shunmay Yeung
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Jean-Paul Fouche
- The Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Shantanu H Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Andrea M Rehman
- MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- SA MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Diana M Gibb
- MRC Clinical Trials Unit, University College London, London, UK
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- SA MRC Unit On Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- The Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
- SA MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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Donald KA, Hendrikse CJ, Roos A, Wedderburn CJ, Subramoney S, Ringshaw JE, Bradford L, Hoffman N, Burd T, Narr KL, Woods RP, Zar HJ, Joshi SH, Stein DJ. Prenatal alcohol exposure and white matter microstructural changes across the first 6-7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort. Neuroimage Clin 2024; 41:103572. [PMID: 38309186 PMCID: PMC10847766 DOI: 10.1016/j.nicl.2024.103572] [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] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
Prenatal alcohol exposure (PAE) can affect brain development in early life, but few studies have investigated the effects of PAE on trajectories of white matter tract maturation in young children. Here we used diffusion weighted imaging (DWI) repeated over three time points, to measure the effects of PAE on patterns of white matter microstructural development during the pre-school years. Participants were drawn from the Drakenstein Child Health Study (DCHS), an ongoing birth cohort study conducted in a peri-urban community in the Western Cape, South Africa. A total of 342 scans acquired from 237 children as neonates (N = 82 scans: 30 PAE; 52 controls) and at ages 2-3 (N = 121 scans: 27 PAE; 94 controls) and 6-7 years (N = 139 scans: 45 PAE; 94 controls) were included. Maternal alcohol use during pregnancy and other antenatal covariates were collected from 28 to 32 weeks' gestation. Linear mixed effects models with restricted maxium likelihood to accommodate missing data were implemented to investigate the effects of PAE on fractional anisotropy (FA) and mean diffusivity (MD) in specific white matter tracts over time, while adjusting for child sex and maternal education. We found significant PAE-by-time effects on trajectories of FA development in the left superior cerebellar peduncle (SCP-L: p = 0.001; survived FDR correction) and right superior longitudinal fasciculus (SLF-R: p = 0.046), suggesting altered white matter development among children with PAE. Compared with controls, children with PAE demonstrated a more rapid change in FA in these tracts from the neonatal period to 2-3 years of age, followed by a more tapered trajectory for the period from 2-3 to 6-7 years of age, with these trajectories differing from unexposed control children. Given their supporting roles in various aspects of neurocognitive functioning (i.e., motor regulation, learning, memory, language), altered patterns of maturation in the SCP and SLF may contribute to a spectrum of physical, social, emotional, and cognitive difficulties often experienced by children with PAE. This study highlights the value of repeated early imaging in longitudinal studies of PAE, and focus for early childhood as a critical window of potential susceptibility as well as an opportunity for early intervention.
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Affiliation(s)
- K A Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - C J Hendrikse
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - A Roos
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - C J Wedderburn
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - S Subramoney
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - J E Ringshaw
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - L Bradford
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - N Hoffman
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - T Burd
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - K L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - R P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States; The Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - S H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - D J Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
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Komnenić D, Phillips OR, Joshi SH, Chien C, Schmitz-Hübsch T, Asseyer S, Paul F, Finke C. Superficial white matter integrity in neuromyelitis optica spectrum disorder and multiple sclerosis. Mult Scler J Exp Transl Clin 2024; 10:20552173231226107. [PMID: 38269006 PMCID: PMC10807332 DOI: 10.1177/20552173231226107] [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] [Received: 05/15/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background Superficial white matter (SWM) is a particularly vulnerable area of white matter adjacent to cerebral cortex that was shown to be a sensitive marker of disease severity in several neurological and psychiatric disorders, including multiple sclerosis (MS), but has not been studied in neuromyelitis optica spectrum disorder (NMOSD). Objective To compare the integrity of SWM between MS patients, NMOSD patients and healthy controls, and explore the correlation of SWM integrity with cognitive performance and overall disability. Methods Forty NMOSD patients, 48 MS patients and 52 healthy controls were included in the study. Mean diffusivity (MD) values obtained by diffusion tensor imaging were used as a measure of SWM integrity. Cognitive performance and overall disability were assessed with standardized tests. Results Superficial white matter MD was increased in MS patients compared to healthy controls. Higher MD was associated with poorer spatial memory (most prominently in right temporal and right limbic lobe) and poorer information processing speed in MS patients. After adjusting for age, no significant differences of SWM MD were observed between NMOSD patients and healthy controls. Conclusion Integrity of SWM is compromised in MS, but not in NMOSD, and can serve as a sensitive marker of disease severity.
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Affiliation(s)
- Darko Komnenić
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Humboldt-Universität zu Berlin, Berlin School of Mind and Brain, Berlin, Germany
| | - Owen Robert Phillips
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Shantanu H Joshi
- Department of Neurology, Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Claudia Chien
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin & Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Experimental and Clinical Research Center, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NeuroCure Clinical Research Center, Berlin, Germany
- Department of Psychiatry and Neurosciences, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tanja Schmitz-Hübsch
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin & Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Experimental and Clinical Research Center, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NeuroCure Clinical Research Center, Berlin, Germany
| | - Susanna Asseyer
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin & Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Experimental and Clinical Research Center, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, NeuroCure Clinical Research Center, Berlin, Germany
| | - Friedemann Paul
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin & Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Department of Neurology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carsten Finke
- Humboldt-Universität zu Berlin, Berlin School of Mind and Brain, Berlin, Germany
- Department of Neurology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Williams SR, Robertson FC, Wedderburn CJ, Ringshaw JE, Bradford L, Nyakonda CN, Hoffman N, Joshi SH, Zar HJ, Stein DJ, Donald KA. 1H-MRS neurometabolite profiles and motor development in school-aged children who are HIV-exposed uninfected: a birth cohort study. Front Neurosci 2023; 17:1251575. [PMID: 37901429 PMCID: PMC10600451 DOI: 10.3389/fnins.2023.1251575] [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] [Received: 07/03/2023] [Accepted: 09/14/2023] [Indexed: 10/31/2023] Open
Abstract
Objective Alterations in regional neurometabolite levels as well as impaired neurodevelopmental outcomes have previously been observed in children who are HIV-exposed uninfected (CHEU). However, little is known about how neurometabolite profiles may relate to their developmental impairment. This study aimed to compare neurometabolite concentrations in school-aged CHEU and children who are HIV-unexposed (CHU) and to explore associations of neurometabolite profiles with functional neurodevelopment in the context of perinatal HIV exposure. Methods We used 3 T single voxel proton magnetic resonance spectroscopy (1H-MRS) to quantify absolute and relative neurometabolites in the parietal gray and parietal white matter in school-aged CHEU and aged- and community-matched CHU. Functional neurodevelopmental outcomes were assessed using the early learning outcome measure (ELOM) tool at 6 years of age. Results Our study included 152 school-aged children (50% males), 110 CHEU and 42 CHU, with an average age of 74 months at the neuroimaging visit. In an adjusted multiple linear regression analysis, significantly lower glutamate (Glu) concentrations were found in CHEU as compared to CHU in the parietal gray matter (absolute Glu, p = 0.046; Glu/total creatine (Cr+PCr) ratios, p = 0.035) and lower total choline to creatine ratios (GPC+PCh/Cr+PCr) in the parietal white matter (p = 0.039). Using factor analysis and adjusted logistic regression analysis, a parietal gray matter Glu and myo-inositol (Ins) dominated factor was associated with HIV exposure status in both unadjusted (OR 0.55, 95% CI 0.17-0.45, p = 0.013) and adjusted analyses (OR 0.59, 95% CI 0.35-0.94, p = 0.031). With Ins as one of the dominating metabolites, this neurometabolic factor was similar to that found at the age of two years. Furthermore, this factor was also found to be correlated with ELOM scores of gross motor development in CHEU (Pearson's r = -0.48, p = 0.044). In addition, in CHEU, there was a significant association between Ins/Cr+PCr ratios in the parietal white matter and ELOM scores of fine motor coordination and visual motor integration in CHEU (Pearson's r = 0.51, p = 0.032). Conclusion Reduced Glu concentrations in the parietal gray matter may suggest regional alterations in excitatory glutamatergic transmission pathways in the context of perinatal HIV and/or antiretroviral therapy (ART) exposure, while reduced Cho ratios in the parietal white matter suggest regional myelin loss. Identified associations between neurometabolite profiles and gross and fine motor developmental outcomes in CHEU are suggestive of a neurometabolic mechanism that may underlie impaired motor neurodevelopmental outcomes observed in CHEU.
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Affiliation(s)
- Simone R. Williams
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Frances C. Robertson
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
- Cape Universities Body Imaging Centre (CUBIC), Cape Town, South Africa
| | - Catherine J. Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jessica E. Ringshaw
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Layla Bradford
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Charmaine N. Nyakonda
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Shantanu H. Joshi
- Departments of Neurology and Bioengineering, UCLA, University of California, Los Angeles, Los Angeles, CA, United States
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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7
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Zavaliangos-Petropulu A, McClintock SM, Joshi SH, Taraku B, Al-Sharif NB, Espinoza RT, Narr KL. Hippocampal subfield volumes in treatment resistant depression and serial ketamine treatment. Front Psychiatry 2023; 14:1227879. [PMID: 37876623 PMCID: PMC10590913 DOI: 10.3389/fpsyt.2023.1227879] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/11/2023] [Indexed: 10/26/2023] Open
Abstract
Introduction Subanesthetic ketamine is a rapidly acting antidepressant that has also been found to improve neurocognitive performance in adult patients with treatment resistant depression (TRD). Provisional evidence suggests that ketamine may induce change in hippocampal volume and that larger pre-treatment volumes might be related to positive clinical outcomes. Here, we examine the effects of serial ketamine treatment on hippocampal subfield volumes and relationships between pre-treatment subfield volumes and changes in depressive symptoms and neurocognitive performance. Methods Patients with TRD (N = 66; 31M/35F; age = 39.5 ± 11.1 years) received four ketamine infusions (0.5 mg/kg) over 2 weeks. Structural MRI scans, the National Institutes of Health Toolbox (NIHT) Cognition Battery, and Hamilton Depression Rating Scale (HDRS) were collected at baseline, 24 h after the first and fourth ketamine infusion, and 5 weeks post-treatment. The same data was collected for 32 age and sex matched healthy controls (HC; 17M/15F; age = 35.03 ± 12.2 years) at one timepoint. Subfield (CA1/CA3/CA4/subiculum/molecular layer/GC-ML-DG) volumes corrected for whole hippocampal volume were compared across time, between treatment remitters/non-remitters, and patients and HCs using linear regression models. Relationships between pre-treatment subfield volumes and clinical and cognitive outcomes were also tested. All analyses included Bonferroni correction. Results Patients had smaller pre-treatment left CA4 (p = 0.004) and GC.ML.DG (p = 0.004) volumes compared to HC, but subfield volumes remained stable following ketamine treatment (all p > 0.05). Pre-treatment or change in hippocampal subfield volumes over time showed no variation by remission status nor correlated with depressive symptoms (p > 0.05). Pre-treatment left CA4 was negatively correlated with improved processing speed after single (p = 0.0003) and serial ketamine infusion (p = 0.005). Left GC.ML.DG also negatively correlated with improved processing speed after single infusion (p = 0.001). Right pre-treatment CA3 positively correlated with changes in list sorting working memory at follow-up (p = 0.0007). Discussion These results provide new evidence to suggest that hippocampal subfield volumes at baseline may present a biomarker for neurocognitive improvement following ketamine treatment in TRD. In contrast, pre-treatment subfield volumes and changes in subfield volumes showed negligible relationships with ketamine-related improvements in depressive symptoms.
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Affiliation(s)
- Artemis Zavaliangos-Petropulu
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Shawn M. McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Brandon Taraku
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Noor B. Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Randall T. Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, CA, United States
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8
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Xia Y, Rebello V, Bodison SC, Jonker D, Steigelmann B, Donald KA, Charles W, Stein DJ, Ipser J, Ahmadi H, Kan E, Sowell ER, Narr KL, Joshi SH, Odendaal HJ, Uban KA. Contextualizing the impact of prenatal alcohol and tobacco exposure on neurodevelopment in a South African birth cohort: an analysis from the socioecological perspective. Front Integr Neurosci 2023; 17:1104788. [PMID: 37534335 PMCID: PMC10390790 DOI: 10.3389/fnint.2023.1104788] [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] [Received: 11/22/2022] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
Background Alcohol and tobacco are known teratogens. Historically, more severe prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) have been examined as the principal predictor of neurodevelopmental alterations, with little incorporation of lower doses or ecological contextual factors that can also impact neurodevelopment, such as socioeconomic resources (SER) or adverse childhood experiences (ACEs). Here, a novel analytical approach informed by a socio-ecological perspective was used to examine the associations between SER, PAE and/or PTE, and ACEs, and their effects on neurodevelopment. Methods N = 313 mother-child dyads were recruited from a prospective birth cohort with maternal report of PAE and PTE, and cross-sectional structural brain neuroimaging of child acquired via 3T scanner at ages 8-11 years. In utero SER was measured by maternal education, household income, and home utility availability. The child's ACEs were measured by self-report assisted by the researcher. PAE was grouped into early exposure (<12 weeks), continued exposure (>=12 weeks), and no exposure controls. PTE was grouped into exposed and non-exposed controls. Results Greater access to SER during pregnancy was associated with fewer ACEs (maternal education: β = -0.293,p = 0.01; phone access: β = -0.968,p = 0.05). PTE partially mediated the association between SER and ACEs, where greater SER reduced the likelihood of PTE, which was positively associated with ACEs (β = 1.110,p = 0.01). SER was associated with alterations in superior frontal (β = -1336.036, q = 0.046), lateral orbitofrontal (β = -513.865, q = 0.046), caudal anterior cingulate volumes (β = -222.982, q = 0.046), with access to phone negatively associated with all three brain volumes. Access to water was positively associated with superior frontal volume (β=1569.527, q = 0.013). PTE was associated with smaller volumes of lateral orbitofrontal (β = -331.000, q = 0.033) and nucleus accumbens regions (β = -34.800, q = 0.033). Conclusion Research on neurodevelopment following community-levels of PAE and PTE should more regularly consider the ecological context to accelerate understanding of teratogenic outcomes. Further research is needed to replicate this novel conceptual approach with varying PAE and PTE patterns, to disentangle the interplay between dose, community-level and individual-level risk factors on neurodevelopment.
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Affiliation(s)
- Yingjing Xia
- Public Health, University of California, Irvine, Irvine, CA, United States
| | - Vida Rebello
- Public Health, University of California, Irvine, Irvine, CA, United States
| | - Stefanie C. Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Kirsten A. Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Weslin Charles
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Jonathan Ipser
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Hedyeh Ahmadi
- University Statistical Consulting, LLC, Irvine, CA, United States
| | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, United States
| | - Elizabeth R. Sowell
- Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, United States
| | - Katherine L. Narr
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hein J. Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Kristina A. Uban
- Public Health, University of California, Irvine, Irvine, CA, United States
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Taraku B, Zavaliangos-Petropulu A, Loureiro JR, Al-Sharif NB, Kubicki A, Joshi SH, Woods RP, Espinoza R, Narr KL, Sahib AK. White matter microstructural perturbations after total sleep deprivation in depression. Front Psychiatry 2023; 14:1195763. [PMID: 37457774 PMCID: PMC10345348 DOI: 10.3389/fpsyt.2023.1195763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Background Total sleep deprivation (TSD) transiently reverses depressive symptoms in a majority of patients with depression. How TSD modulates diffusion tensor imaging (DTI) measures of white matter (WM) microstructure, which may be linked with TSD's rapid antidepressant effects, remains uncharacterized. Methods Patients with depression (N = 48, mean age = 33, 26 women) completed diffusion-weighted imaging and Hamilton Depression Rating (HDRS) and rumination scales before and after >24 h of TSD. Healthy controls (HC) (N = 53, 23 women) completed the same assessments at baseline, and after receiving TSD in a subset of HCs (N = 15). Tract based spatial statistics (TBSS) investigated voxelwise changes in fractional anisotropy (FA) across major WM pathways pre-to-post TSD in patients and HCs and between patients and HCs at baseline. Post hoc analyses tested for TSD effects for other diffusion metrics, and the relationships between change in diffusion measures with change in mood and rumination symptoms. Results Significant improvements in mood and rumination occurred in patients with depression (both p < 0.001), but not in HCs following TSD. Patients showed significant (p < 0.05, corrected) decreases in FA values in multiple WM tracts, including the body of the corpus callosum and anterior corona radiata post-TSD. Significant voxel-level changes in FA were not observed in HCs who received TSD (p > 0.05). However, differential effects of TSD between HCs and patients were found in the superior corona radiata, frontal WM and the posterior thalamic radiation (p < 0.05, corrected). A significant (p < 0.05) association between change in FA and axial diffusivity within the right superior corona radiata and improvement in rumination was found post-TSD in patients. Conclusion Total sleep deprivation leads to rapid microstructural changes in WM pathways in patients with depression that are distinct from WM changes associated with TSD observed in HCs. WM tracts including the superior corona radiata and posterior thalamic radiation could be potential biomarkers of the rapid therapeutic effects of TSD. Changes in superior corona radiata FA, in particular, may relate to improvements in maladaptive rumination.
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Affiliation(s)
- Brandon Taraku
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Artemis Zavaliangos-Petropulu
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Joana R. Loureiro
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Noor B. Al-Sharif
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Antoni Kubicki
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H. Joshi
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
| | - Roger P. Woods
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Katherine L. Narr
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ashish K. Sahib
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, United States
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10
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Vuong A, Joshi SH, Staudt LA, Matsumoto JH, Fowler EG. Improved Myelination following Camp Leg Power, a Selective Motor Control Intervention for Children with Spastic Bilateral Cerebral Palsy: A Diffusion Tensor MRI Study. AJNR Am J Neuroradiol 2023; 44:700-706. [PMID: 37142433 PMCID: PMC10249693 DOI: 10.3174/ajnr.a7860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND AND PURPOSE Children with spastic cerebral palsy have motor deficits associated with periventricular leukomalacia indicating WM damage to the corticospinal tracts. We investigated whether practice of skilled lower extremity selective motor control movements would elicit neuroplasticity. MATERIALS AND METHODS Twelve children with spastic bilateral cerebral palsy and periventricular leukomalacia born preterm (mean age, 11.5 years; age range, 7.3-16.6 years) participated in a lower extremity selective motor control intervention, Camp Leg Power. Activities promoted isolated joint movement including isokinetic knee exercises, ankle-controlled gaming, gait training, and sensorimotor activities (3 hours/day, 15 sessions, 1 month). DWI scans were collected pre- and postintervention. Tract-Based Spatial Statistics was used to analyze changes in fractional anisotropy, radial diffusivity, axial diffusivity, and mean diffusivity. RESULTS Significantly reduced radial diffusivity (P < . 05) was found within corticospinal tract ROIs, including 28.4% of the left and 3.6% of the right posterior limb of the internal capsule and 14.1% of the left superior corona radiata. Reduced mean diffusivity was found within the same ROIs (13.3%, 11.6%, and 6.6%, respectively). Additionally, decreased radial diffusivity was observed in the left primary motor cortex. Additional WM tracts had decreased radial diffusivity and mean diffusivity, including the anterior limb of the internal capsule, external capsule, anterior corona radiata, and corpus callosum body and genu. CONCLUSIONS Myelination of the corticospinal tracts improved following Camp Leg Power. Neighboring WM changes suggest recruitment of additional tracts involved in regulating neuroplasticity of the motor regions. Intensive practice of skilled lower extremity selective motor control movements promotes neuroplasticity in children with spastic bilateral cerebral palsy.
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Affiliation(s)
- A Vuong
- From the Departments of Bioengineering (A.V., S.H.J.)
- Orthopaedic Surgery (A.V., L.A.S., E.G.F.)
- Center for Cerebral Palsy (A.V., L.A.S., E.G.F.), University of California Los Angeles/Orthopaedic Institute for Children, Los Angeles, California
| | - S H Joshi
- From the Departments of Bioengineering (A.V., S.H.J.)
- Neurology (S.H.J.), Ahmanson Lovelace Brain Mapping Center
| | - L A Staudt
- Orthopaedic Surgery (A.V., L.A.S., E.G.F.)
- Center for Cerebral Palsy (A.V., L.A.S., E.G.F.), University of California Los Angeles/Orthopaedic Institute for Children, Los Angeles, California
| | - J H Matsumoto
- Pediatrics (J.H.M.), University of California Los Angeles, Los Angeles, California
| | - E G Fowler
- Orthopaedic Surgery (A.V., L.A.S., E.G.F.)
- Center for Cerebral Palsy (A.V., L.A.S., E.G.F.), University of California Los Angeles/Orthopaedic Institute for Children, Los Angeles, California
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11
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Zavaliangos-Petropulu A, McClintock SM, Khalil J, Joshi SH, Taraku B, Al-Sharif NB, Espinoza RT, Narr KL. Neurocognitive effects of subanesthetic serial ketamine infusions in treatment resistant depression. J Affect Disord 2023; 333:161-171. [PMID: 37060953 DOI: 10.1016/j.jad.2023.04.015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION Ketamine treatment prompts a rapid antidepressant response in treatment-resistant depression (TRD). We performed an exploratory investigation of how ketamine treatment in TRD affects different cognitive domains and relates to antidepressant response. METHODS Patients with TRD (N = 66; 30 M/35F; age = 39.5 ± 11.1 years) received four ketamine infusions (0.5 mg/kg). Neurocognitive function and depressive symptoms were assessed at baseline, 24 h after the first and fourth ketamine infusion, and 5 weeks following end of treatment. Mixed effect models tested for changes in seven neurocognitive domains and antidepressant response, with post-hoc pairwise comparisons between timepoints, including follow-up. Relationships between change in neurocognitive function and antidepressant response over the course of treatment were tested with Pearson's correlation and mediation analyses. Associations between baseline neurocognitive performance and antidepressant response were tested with Pearson's correlation. RESULTS Significant improvements in inhibition, working memory, processing speed, and overall fluid cognition were observed after the first and fourth ketamine infusion. Improvements in processing speed and overall fluid cognition persisted through follow-up. Significant improvements in depressive symptoms reverted towards baseline at follow-up. Baseline working memory and change in inhibition were moderately correlated with antidepressant response, however, improvements in neurocognitive performance were statistically independent from antidepressant response. CONCLUSION Antidepressant ketamine leads to improved neurocognitive function, which persist for at least 5 weeks. Neurocognitive improvements observed appear independent of antidepressant response, suggesting ketamine may target overlapping but distinct functional brain systems. Limitations Research investigating repeated serial ketamine treatments is important to determine cognitive safety. This study is a naturalistic design and does not include placebo.
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Affiliation(s)
- Artemis Zavaliangos-Petropulu
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
| | - Shawn M McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jacqueline Khalil
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Brandon Taraku
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Noor B Al-Sharif
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Randall T Espinoza
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine at the University of California, Los Angeles, CA, USA
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12
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Pellowski JA, Wedderburn CJ, Groenewold NA, Roos A, Subramoney S, Hoffman N, Fouche JP, Joshi SH, Woods RP, Narr KL, Zar HJ, Donald KA, Stein DJ. Maternal perinatal depression and child brain structure at 2-3 years in a South African birth cohort study. Transl Psychiatry 2023; 13:96. [PMID: 36941258 PMCID: PMC10027817 DOI: 10.1038/s41398-023-02395-5] [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: 02/07/2023] [Revised: 02/24/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023] Open
Abstract
Maternal perinatal depression is associated with risk of adverse child developmental outcomes and differences in offspring brain structure. Evidence from low- and middle-income countries is lacking as is an investigation of antenatal, postnatal, and persistent depression in the same sample. In a South African birth cohort, we investigated the effect of antenatal and postpartum maternal depressive symptoms on offspring brain structure at 2-3 years of age. Magnetic resonance imaging was performed, extracting cortical thickness and surface areas in frontal cortex regions of interest and subcortical volumes using FreeSurfer software. Maternal depressive symptoms were measured using the Edinburgh Postpartum Depression Scale and the Beck Depression Inventory II antenatally and at 6-10 weeks, 6 months, 12 months, and 18 months postpartum and analyzed dichotomously and continuously. Linear regressions were used controlling for child age, sex, intracranial volume, maternal education, age, smoking, alcohol use and HIV. 146 children were included with 38 (37%) exposed to depressive symptoms antenatally and 44 (35%) exposed postnatally. Of these, 16 (13%) were exposed to both. Postpartum, but not antenatal, depressive symptoms were associated with smaller amygdala volumes in children (B = -74.73, p = 0.01). Persistent maternal depressive symptoms across pregnancy and postpartum were also independently associated with smaller amygdala volumes (B = -78.61, p = 0.047). Differences in amygdala volumes among children exposed to postnatal as well as persistent maternal depressive symptomatology underscore the importance of identifying women at-risk for depression during the entire perinatal period.
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Affiliation(s)
- Jennifer A Pellowski
- Department of Behavioral and Social Sciences and International Health Institute, Brown University School of Public Health, Providence, RI, USA.
- Division of Epidemiology and Biostatistics, University of Cape Town School of Public Health and Family Medicine, Cape Town, SA, South Africa.
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, England
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
| | - Nynke A Groenewold
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, SA, South Africa
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, SA, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, SA, Cape Town, South Africa
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, SA, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, SA, Cape Town, South Africa
| | - Jean-Paul Fouche
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, SA, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, SA, Cape Town, South Africa
| | - Shantanu H Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Roger P Woods
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- South African Medical Research Council (SAMRC) Unit on Child and Adolescent Health, University of Cape Town, Cape Town, SA, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
| | - Dan J Stein
- The Neuroscience Institute, University of Cape Town, SA, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, SA, South Africa
- South African Medical Research Council (SAMRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, SA, Cape Town, South Africa
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13
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Kim Y, Joshi AA, Choi S, Joshi SH, Bhushan C, Varadarajan D, Haldar JP, Leahy RM, Shattuck DW. BrainSuite BIDS App: Containerized Workflows for MRI Analysis. bioRxiv 2023:2023.03.14.532686. [PMID: 36993283 PMCID: PMC10055125 DOI: 10.1101/2023.03.14.532686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
There has been a concerted effort by the neuroimaging community to establish standards for computational methods for data analysis that promote reproducibility and portability. In particular, the Brain Imaging Data Structure (BIDS) specifies a standard for storing imaging data, and the related BIDS App methodology provides a standard for implementing containerized processing environments that include all necessary dependencies to process BIDS datasets using image processing workflows. We present the BrainSuite BIDS App, which encapsulates the core MRI processing functionality of BrainSuite within the BIDS App framework. Specifically, the BrainSuite BIDS App implements a participant-level workflow comprising three pipelines and a corresponding set of group-level analysis workflows for processing the participant-level outputs. The BrainSuite Anatomical Pipeline (BAP) extracts cortical surface models from a T1-weighted (T1w) MRI. It then performs surface-constrained volumetric registration to align the T1w MRI to a labeled anatomical atlas, which is used to delineate anatomical regions of interest in the MRI brain volume and on the cortical surface models. The BrainSuite Diffusion Pipeline (BDP) processes diffusion-weighted imaging (DWI) data, with steps that include coregistering the DWI data to the T1w scan, correcting for geometric image distortion, and fitting diffusion models to the DWI data. The BrainSuite Functional Pipeline (BFP) performs fMRI processing using a combination of FSL, AFNI, and BrainSuite tools. BFP coregisters the fMRI data to the T1w image, then transforms the data to the anatomical atlas space and to the Human Connectome Project's grayordinate space. Each of these outputs can then be processed during group-level analysis. The outputs of BAP and BDP are analyzed using the BrainSuite Statistics in R (bssr) toolbox, which provides functionality for hypothesis testing and statistical modeling. The outputs of BFP can be analyzed using atlas-based or atlas-free statistical methods during group-level processing. These analyses include the application of BrainSync, which synchronizes the time-series data temporally and enables comparison of resting-state or task-based fMRI data across scans. We also present the BrainSuite Dashboard quality control system, which provides a browser-based interface for reviewing the outputs of individual modules of the participant-level pipelines across a study in real-time as they are generated. BrainSuite Dashboard facilitates rapid review of intermediate results, enabling users to identify processing errors and make adjustments to processing parameters if necessary. The comprehensive functionality included in the BrainSuite BIDS App provides a mechanism for rapidly deploying the BrainSuite workflows into new environments to perform large-scale studies. We demonstrate the capabilities of the BrainSuite BIDS App using structural, diffusion, and functional MRI data from the Amsterdam Open MRI Collection's Population Imaging of Psychology dataset.
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Affiliation(s)
- Yeun Kim
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Anand A. Joshi
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
| | - Soyoung Choi
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, USA
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Chitresh Bhushan
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
- GE Research, Schenectady, NY, USA
| | - Divya Varadarajan
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Justin P. Haldar
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
| | - Richard M. Leahy
- Signal and Image Processing Institute, Department of Electrical Engineering – Systems, University of Southern California, Los Angeles, CA, USA
| | - David W. Shattuck
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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14
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Pang B, Doshi S, Roy B, Lai M, Ehlert L, Aysola RS, Kang DW, Anderson A, Joshi SH, Tward D, Scalzo F, Vacas S, Kumar R. Machine learning approach for obstructive sleep apnea screening using brain diffusion tensor imaging. J Sleep Res 2023; 32:e13729. [PMID: 36223645 PMCID: PMC9851969 DOI: 10.1111/jsr.13729] [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: 04/07/2022] [Revised: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 02/03/2023]
Abstract
Patients with obstructive sleep apnea (OSA) show autonomic, mood, cognitive, and breathing dysfunctions that are linked to increased morbidity and mortality, which can be improved with early screening and intervention. The gold standard and other available methods for OSA diagnosis are complex, require whole-night data, and have significant wait periods that potentially delay intervention. Our aim was to examine whether using faster and less complicated machine learning models, including support vector machine (SVM) and random forest (RF), with brain diffusion tensor imaging (DTI) data can classify OSA from healthy controls. We collected two DTI series from 59 patients with OSA [age: 50.2 ± 9.9 years; body mass index (BMI): 31.5 ± 5.6 kg/m2 ; apnea-hypopnea index (AHI): 34.1 ± 21.2 events/h 23 female] and 96 controls (age: 51.8 ± 9.7 years; BMI: 26.2 ± 4.1 kg/m2 ; 51 female) using a 3.0-T magnetic resonance imaging scanner. Using DTI data, mean diffusivity maps were calculated from each series, realigned and averaged, normalised to a common space, and used to conduct cross-validation for model training and selection and to predict OSA. The RF model showed 0.73 OSA and controls classification accuracy and 0.85 area under the curve (AUC) value on the receiver-operator curve. Cross-validation showed the RF model with comparable fitting over SVM for OSA and control data (SVM; accuracy, 0.77; AUC, 0.84). The RF ML model performs similar to SVM, indicating the comparable statistical fitness to DTI data. The findings indicate that RF model has similar AUC and accuracy over SVM, and either model can be used as a faster OSA screening tool for subjects having brain DTI data.
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Affiliation(s)
- Bo Pang
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Statistics, University of California Los Angeles, Los Angeles, CA, USA
| | - Suraj Doshi
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Bhaswati Roy
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Milena Lai
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Luke Ehlert
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ravi S. Aysola
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel W. Kang
- Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ariana Anderson
- Department of Statistics, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Shantanu H. Joshi
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
| | - Daniel Tward
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Computational Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Fabien Scalzo
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Susana Vacas
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
- Brain Research Institute; University of California Los Angeles, Los Angeles, CA, USA
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15
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Wedderburn CJ, Ringshaw JE, Donald KA, Joshi SH, Subramoney S, Fouche JP, Stadler JAM, Barnett W, Rehman AM, Hoffman N, Roos A, Narr KL, Zar HJ, Stein DJ. Association of Maternal and Child Anemia With Brain Structure in Early Life in South Africa. JAMA Netw Open 2022; 5:e2244772. [PMID: 36459137 PMCID: PMC9719049 DOI: 10.1001/jamanetworkopen.2022.44772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/18/2022] [Indexed: 12/03/2022] Open
Abstract
Importance Anemia affects millions of pregnant women and their children worldwide, particularly in low- and middle-income countries. Although anemia in pregnancy is a well-described risk factor for cognitive development, the association with child brain structure is poorly understood. Objective To explore the association of anemia during pregnancy and postnatal child anemia with brain structure in early life. Design, Setting, and Participants This neuroimaging nested cohort study was embedded within the Drakenstein Child Health Study (DCHS), a population-based birth cohort in South Africa. Pregnant individuals were enrolled into the DCHS between 2012 and 2015 from 2 clinics in a periurban setting. Mother-child pairs were assessed prospectively; follow-up is ongoing. A subgroup of children had brain magnetic resonance imaging (MRI) at age 2 to 3 years from 2015 to 2018. This study focused on the 147 pairs with structural neuroimaging and available hemoglobin data. Data analyses were conducted in 2021 and 2022. Exposures Mothers had hemoglobin measurements during pregnancy, and a subgroup of children had hemoglobin measurements during early life. Anemia was classified as hemoglobin levels less than 11 g/dL based on World Health Organization guidelines; children younger than 6 months were classified using local guidelines. Main Outcomes and Measures Child brain volumes of global, subcortical, and corpus callosum structures were quantified using T1-weighted MRI. Linear regression models were used to analyze the associations between maternal and child anemia with child brain volumes, accounting for potential confounders. Results Of 147 children (mean [SD] age at MRI, 34 [2] months; 83 [56.5%] male) with high-resolution MRI scans, prevalence of maternal anemia in pregnancy was 31.3% (46 of 147; median [IQR] gestation of measurement: 13 [9-20] weeks). Maternal anemia during pregnancy was significantly associated with smaller volumes of the child caudate bilaterally (adjusted percentage difference, -5.30% [95% CI, -7.01 to -3.59]), putamen (left hemisphere: -4.33% [95% CI, -5.74 to -2.92]), and corpus callosum (-7.75% [95% CI, -11.24 to -4.26]). Furthermore, antenatal maternal hemoglobin levels were also associated with brain volumes in the caudate (left hemisphere: standardized β = 0.15 [95% CI, 0.02 to 0.28]; right hemisphere: β = 0.15 [95% CI, 0.02 to 0.27]), putamen left hemisphere (β = 0.21 [95% CI, 0.07 to 0.35]), and corpus callosum (β = 0.24 [95% CI, 0.09 to 0.39]). Prevalence of child anemia was 52.5% (42 of 80; median [IQR] age of measurement: 8.0 [2.7 to 14.8] months). Child anemia was not associated with brain volumes, nor did it mediate the association of maternal anemia during pregnancy with brain volumes. Conclusions and Relevance In this cohort study, anemia in pregnancy was associated with altered child brain structural development. Given the high prevalence of antenatal maternal anemia worldwide, these findings suggest that optimizing interventions during pregnancy may improve child brain outcomes.
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Affiliation(s)
- Catherine J. Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jessica E. Ringshaw
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Shantanu H. Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Department of Bioengineering, University of California, Los Angeles
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Jean-Paul Fouche
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jacob A. M. Stadler
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Andrea M. Rehman
- MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nadia Hoffman
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Katherine L. Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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16
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Irimia A, Ngo V, Chaudhari NN, Zhang F, Joshi SH, Penkova AN, O'Donnell LJ, Sheikh-Bahaei N, Zheng X, Chui HC. White matter degradation near cerebral microbleeds is associated with cognitive change after mild traumatic brain injury. Neurobiol Aging 2022; 120:68-80. [PMID: 36116396 PMCID: PMC9759713 DOI: 10.1016/j.neurobiolaging.2022.08.010] [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: 11/17/2021] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 11/28/2022]
Abstract
To explore how cerebral microbleeds (CMBs) accompanying mild traumatic brain injury (mTBI) reflect white matter (WM) degradation and cognitive decline, magnetic resonance images were acquired from 62 mTBI adults (imaged ∼7 days and ∼6 months post-injury) and 203 matched healthy controls. On average, mTBI participants had a count of 2.7 ± 2.6 traumatic CMBs in WM, located 6.1 ± 4.4 mm from cortex. At ∼6-month follow-up, 97% of CMBs were associated with significant reductions (34% ± 11%, q < 0.05) in the fractional anisotropy of WM streamlines within ∼1 cm of CMB locations. Male sex and older age were significant risk factors for larger reductions (q < 0.05). For CMBs in the corpus callosum, cingulum bundle, inferior and middle longitudinal fasciculi, fractional anisotropy changes were significantly and positively associated with changes in cognitive functions mediated by these structures (q < 0.05). Our findings distinguish traumatic from non-traumatic CMBs by virtue of surrounding WM alterations and challenge the assumption that traumatic CMBs are neurocognitively silent. Thus, mTBI with CMB findings can be described as a clinical endophenotype warranting longitudinal cognitive assessment.
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Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA; Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
| | - Van Ngo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Nikhil N Chaudhari
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Fan Zhang
- Laboratory of Mathematics in Imaging, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shantanu H Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Anita N Penkova
- Department of Aerospace and Mechanical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | - Lauren J O'Donnell
- Laboratory of Mathematics in Imaging, Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nasim Sheikh-Bahaei
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Xiaoyu Zheng
- Department of Materials Science & Engineering, University of California, Berkeley, CA, USA
| | - Helena C Chui
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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17
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Marshall AT, Bodison SC, Uban KA, Adise S, Jonker D, Charles W, Donald KA, Kan E, Ipser JC, Butler-Kruger L, Steigelmann B, Narr KL, Joshi SH, Brink LT, Odendaal HJ, Scheffler F, Stein DJ, Sowell ER. The impact of prenatal alcohol and/or tobacco exposure on brain structure in a large sample of children from a South African birth cohort. Alcohol Clin Exp Res 2022; 46:1980-1992. [PMID: 36117382 DOI: 10.1111/acer.14945] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/30/2022] [Accepted: 09/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Neuroimaging studies have emphasized the impact of prenatal alcohol exposure (PAE) on brain development, traditionally in heavily exposed participants. However, less is known about how naturally occurring community patterns of PAE (including light to moderate exposure) affect brain development, particularly in consideration of commonly occurring concurrent impacts of prenatal tobacco exposure (PTE). METHODS Three hundred thirty-two children (ages 8 to 12) living in South Africa's Cape Flats townships underwent structural magnetic resonance imaging. During pregnancy, their mothers reported alcohol and tobacco use, which was used to evaluate PAE and PTE effects on their children's brain structure. Analyses involved the main effects of PAE and PTE (and their interaction) and the effects of PAE and PTE quantity on cortical thickness, surface area, and volume. RESULTS After false-discovery rate (FDR) correction, PAE was associated with thinner left parahippocampal cortices, while PTE was associated with smaller cortical surface area in the bilateral pericalcarine, left lateral orbitofrontal, right posterior cingulate, right rostral anterior cingulate, left caudal middle frontal, and right caudal anterior cingulate gyri. There were no PAE × PTE interactions nor any associations of PAE and PTE exposure on volumetrics that survived FDR correction. CONCLUSION PAE was associated with reduction in the structure of the medial temporal lobe, a brain region critical for learning and memory. PTE had stronger and broader associations, including with regions associated with executive function, reward processing, and emotional regulation, potentially reflecting continued postnatal exposure to tobacco (i.e., second-hand smoke exposure). These differential effects are discussed with respect to reduced PAE quantity in our exposed group versus prior studies within this geographical location, the deep poverty in which participants live, and the consequences of apartheid and racially and economically driven payment practices that contributed to heavy drinking in the region. Longer-term follow-up is needed to determine potential environmental and other moderators of the brain findings here and assess the extent to which they endure over time.
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Affiliation(s)
- Andrew T Marshall
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Stefanie C Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Kristina A Uban
- Department of Public Health, University of California, Irvine, California, USA
| | - Shana Adise
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Weslin Charles
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Jonathan C Ipser
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Letitia Butler-Kruger
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Katherine L Narr
- Department of Neurology, UCLA Brain Mapping Center, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Shantanu H Joshi
- Department of Neurology, UCLA Brain Mapping Center, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Lucy T Brink
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
| | - Elizabeth R Sowell
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
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18
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Sahib AK, Loureiro JR, Vasavada M, Anderson C, Kubicki A, Wade B, Joshi SH, Woods RP, Congdon E, Espinoza R, Narr KL. Modulation of the functional connectome in major depressive disorder by ketamine therapy. Psychol Med 2022; 52:2596-2605. [PMID: 33267926 PMCID: PMC9647551 DOI: 10.1017/s0033291720004560] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 04/30/2020] [Revised: 10/21/2020] [Accepted: 11/09/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subanesthetic ketamine infusion therapy can produce fast-acting antidepressant effects in patients with major depression. How single and repeated ketamine treatment modulates the whole-brain functional connectome to affect clinical outcomes remains uncharacterized. METHODS Data-driven whole brain functional connectivity (FC) analysis was used to identify the functional connections modified by ketamine treatment in patients with major depressive disorder (MDD). MDD patients (N = 61, mean age = 38, 19 women) completed baseline resting-state (RS) functional magnetic resonance imaging and depression symptom scales. Of these patients, n = 48 and n = 51, completed the same assessments 24 h after receiving one and four 0.5 mg/kg intravenous ketamine infusions. Healthy controls (HC) (n = 40, 24 women) completed baseline assessments with no intervention. Analysis of RS FC addressed effects of diagnosis, time, and remitter status. RESULTS Significant differences (p < 0.05, corrected) in RS FC were observed between HC and MDD at baseline in the somatomotor network and between association and default mode networks. These disruptions in FC in MDD patients trended toward control patterns with ketamine treatment. Furthermore, following serial ketamine infusions, significant decreases in FC were observed between the cerebellum and salience network (SN) (p < 0.05, corrected). Patient remitters showed increased FC between the cerebellum and the striatum prior to treatment that decreased following treatment, whereas non-remitters showed the opposite pattern. CONCLUSION Results support that ketamine treatment leads to neurofunctional plasticity between distinct neural networks that are shown as disrupted in MDD patients. Cortico-striatal-cerebellar loops that encompass the SN could be a potential biomarker for ketamine treatment.
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Affiliation(s)
- Ashish K. Sahib
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Joana R. Loureiro
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Megha Vasavada
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Cole Anderson
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Antoni Kubicki
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin Wade
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Shantanu H. Joshi
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Roger P. Woods
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L. Narr
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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19
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Wade BSC, Loureiro J, Sahib A, Kubicki A, Joshi SH, Hellemann G, Espinoza RT, Woods RP, Congdon E, Narr KL. Anterior default mode network and posterior insular connectivity is predictive of depressive symptom reduction following serial ketamine infusion. Psychol Med 2022; 52:2376-2386. [PMID: 35578581 PMCID: PMC9527672 DOI: 10.1017/s0033291722001313] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/20/2021] [Accepted: 04/19/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Ketamine is a rapidly-acting antidepressant treatment with robust response rates. Previous studies have reported that serial ketamine therapy modulates resting state functional connectivity in several large-scale networks, though it remains unknown whether variations in brain structure, function, and connectivity impact subsequent treatment success. We used a data-driven approach to determine whether pretreatment multimodal neuroimaging measures predict changes along symptom dimensions of depression following serial ketamine infusion. METHODS Patients with depression (n = 60) received structural, resting state functional, and diffusion MRI scans before treatment. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HDRS-17), the Inventory of Depressive Symptomatology (IDS-C), and the Rumination Response Scale (RRS) before and 24 h after patients received four (0.5 mg/kg) infusions of racemic ketamine over 2 weeks. Nineteen unaffected controls were assessed at similar timepoints. Random forest regression models predicted symptom changes using pretreatment multimodal neuroimaging and demographic measures. RESULTS Two HDRS-17 subscales, the HDRS-6 and core mood and anhedonia (CMA) symptoms, and the RRS: reflection (RRSR) scale were predicted significantly with 19, 27, and 1% variance explained, respectively. Increased right medial prefrontal cortex/anterior cingulate and posterior insula (PoI) and lower kurtosis of the superior longitudinal fasciculus predicted reduced HDRS-6 and CMA symptoms following treatment. RRSR change was predicted by global connectivity of the left posterior cingulate, left insula, and right superior parietal lobule. CONCLUSIONS Our findings support that connectivity of the anterior default mode network and PoI may serve as potential biomarkers of antidepressant outcomes for core depressive symptoms.
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Affiliation(s)
- Benjamin S. C. Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Joana Loureiro
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Ashish Sahib
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Antoni Kubicki
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Randall T. Espinoza
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Roger P. Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
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20
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Wade BSC, Loureiro J, Sahib A, Kubicki A, Joshi SH, Hellemann G, Espinoza RT, Woods RP, Congdon E, Narr KL. Anterior Default Mode Network and Posterior Insular Connectivity is Predictive of Depressive Symptom Reduction Following Serial Ketamine Infusion - CORRIGENDUM. Psychol Med 2022; 52:2399. [PMID: 35726509 PMCID: PMC9981470 DOI: 10.1017/s0033291722001659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Benjamin S C Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Joana Loureiro
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Ashish Sahib
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Antoni Kubicki
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Randall T Espinoza
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, UCLA, Los Angeles, USA
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21
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Subramoney S, Joshi SH, Wedderburn CJ, Lee D, Roos A, Woods RP, Zar HJ, Narr K, Stein DJ, Donald KA. The impact of prenatal alcohol exposure on gray matter volume and cortical surface area of 2 to 3-year-old children in a South African birth cohort. Alcohol Clin Exp Res 2022; 46:1233-1247. [PMID: 35581528 PMCID: PMC9357164 DOI: 10.1111/acer.14873] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 04/30/2022] [Accepted: 05/07/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a growing literature that demonstrates the effects of prenatal alcohol exposure (PAE) on brain development in school-aged children. Less is known, however, on how PAE impacts the brain early in life. We investigated the effects of PAE and child sex on subcortical gray matter volume, cortical surface area (CSA), cortical volume (CV), and cortical thickness (CT) in children aged 2 to 3 years. METHODS The sample was recruited as a nested cross-sectional substudy of the Drakenstein Child Health Study. Images from T1-weighted magnetic resonance imaging were acquired on 47 alcohol-exposed and 124 control children (i.e., with no or minimal alcohol exposure), aged 2 to 3 years, some of whom were scanned as neonates. Brain images were processed through automated processing pipelines using FreeSurfer version 6.0. Subcortical and a priori selected cortical regions of interest were compared. RESULTS Subcortical volume analyses revealed a PAE by child sex interaction for bilateral putamen volumes (Left: p = 0.02; Right: p = 0.01). There was no PAE by child sex interaction effect on CSA, CV, and CT. Analyses revealed an impact of PAE on CSA (p = 0.04) and CV (p = 0.04), but not CT in this age group. Of note, the inferior parietal gyrus CSA was significantly smaller in children with PAE compared to control children. CONCLUSIONS Findings from this subgroup scanned at age 2 to 3 years build on previously described subcortical volume differences in neonates from this cohort. Findings suggest that PAE persistently affects gray matter development through the critical early years of life. The detectable influence of PAE on brain structure at this early age further highlights the importance of brain imaging studies on the impact of PAE on the young developing brain.
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Affiliation(s)
- Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
| | - Shantanu H. Joshi
- Department of NeurologyUniversity of California Los AngelesLos AngelesCaliforniaUSA
- Department of BioengineeringUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Catherine J. Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
- The Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - David Lee
- Department of BioengineeringUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
- The Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of PsychiatryStellenbosch UniversityStellenboschSouth Africa
| | - Roger P. Woods
- Departments of Neurology, Psychiatry and Biobehavioral SciencesUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
- Unit on Child & Adolescent Health, South African Medical Research Council (SAMRC)University of Cape TownCape TownSouth Africa
| | - Katherine L. Narr
- Departments of Neurology, Psychiatry and Biobehavioral SciencesUniversity of California Los AngelesLos AngelesCaliforniaUSA
| | - Dan J. Stein
- The Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
- SU/UCT MRC Unit on Risk and Resilience in Mental DisordersUniversity of Cape TownCape TownSouth Africa
| | - Kirsten A. Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's HospitalUniversity of Cape TownCape TownSouth Africa
- The Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
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22
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O’Connor MJ, Dillon A, Best KM, O’Neill J, Kilpatrick LA, Joshi SH, Alger JR, Levitt JG. Identification of Seminal Physical Features of Prenatal Alcohol Exposure by Child Psychologists. J Pediatr Neuropsychol 2022. [DOI: 10.1007/s40817-022-00123-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Introduction
Prenatal alcohol exposure (PAE) impacts an estimated 5% or more children born in the USA and is associated with life-long neuropsychological deficits. Early identification is essential but access to diagnostic evaluation is limited. This study reports on the effectiveness of training child psychologists to identify and measure the salient physical features of PAE.
Methods
Children, 8–13 years, were divided into two groups: (1) children meeting criteria for PAE (n = 46) and (2) typically developing controls without PAE (TD; n = 36). Child psychologists were trained to reliability measure height, weight, occipital frontal circumference (OFC), and the characteristic facial features of FASD independent of knowledge of PAE history.
Results
Groups differed significantly on meeting the diagnostic criteria proposed by Hoyme et al. (Pediatrics, 138:e20154256, 2016) on height, OFC, upper vermillion border, philtrum, and palpebral fissure length. They did not differ on weight. All children in the alcohol exposed group could be classified as meeting criteria for an FASD whereas none in the unexposed group met criteria.
Discussion
This study demonstrated that child psychologists, blind to PAE history, could be reliably trained to assess the physical features of children with PAE. Because early diagnosis and intervention is of paramount importance, we propose that inclusive diagnostic criteria for FASD and the use of psychologists and other allied health professionals, trained to screen for the diagnosis, should be expanded in clinical practice.
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23
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Kilpatrick LA, Alger JR, O’Neill J, Joshi SH, Narr KL, Levitt JG, O’Connor MJ. Impact of prenatal alcohol exposure on intracortical myelination and deep white matter in children with attention deficit hyperactivity disorder. Neuroimage Rep 2022; 2:100082. [PMID: 37284413 PMCID: PMC10243188 DOI: 10.1016/j.ynirp.2022.100082] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
White matter alterations have been reported in children with prenatal alcohol exposure (PAE) and in children with attention deficit hyperactivity disorder (ADHD); however, as children with PAE often present with ADHD, covert PAE may have contributed to previous ADHD findings. Additionally, data regarding intracortical myelination in ADHD are lacking. Therefore, we evaluated intracortical myelination (assessed as the T1w/T2w ratio at 4 cortical ribbon levels) and myelin-related deep white matter features in children (aged 8-13 years) with ADHD with PAE (ADHD + PAE), children with familial ADHD without PAE (ADHD-PAE), and typically developing (TD) children. In widespread tracts, ADHD + PAE children showed higher mean and radial diffusivity than TD and ADHD-PAE children and lower fractional anisotropy than ADHD-PAE children; ADHD-PAE and TD children did not differ significantly. Compared to TD children, ADHD + PAE children had lower intracortical myelination only at the deepest cortical level (mainly in right insula and cingulate cortices), while ADHD-PAE children had lower intracortical myelination at multiple cortical levels (mainly in right insula, sensorimotor, and cingulate cortices); ADHD + PAE and ADHD-PAE children did not differ significantly in intracortical myelination. Considering the two ADHD groups jointly (via non-parametric combination) revealed common reductions in intracortical myelination, but no common deep white matter abnormalities. These results suggest the importance of considering PAE in ADHD studies of white matter pathology. ADHD + PAE may be associated with deeper, white matter abnormalities, while familial ADHD without PAE may be associated with more superficial, cortical abnormalities. This may be relevant to the different treatment response observed in these two ADHD etiologies.
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Affiliation(s)
- Lisa A. Kilpatrick
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Jeffry R. Alger
- Department of Neurology, University of California, Los Angeles, CA, USA
- Neurospectroscopics, LLC., Sherman Oaks, CA, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joseph O’Neill
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience, University of California Los Angeles, CA, USA
| | - Shantanu H. Joshi
- Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Bioengineering, University of California, Los Angeles, CA, USA
| | - Katherine L. Narr
- Department of Neurology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jennifer G. Levitt
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience, University of California Los Angeles, CA, USA
| | - Mary J. O’Connor
- Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience, University of California Los Angeles, CA, USA
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24
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Fradi A, Samir C, Braga J, Joshi SH, Loubes JM. Nonparametric Bayesian Regression and Classification on Manifolds, With Applications to 3D Cochlear Shapes. IEEE Trans Image Process 2022; 31:2598-2607. [PMID: 35316178 DOI: 10.1109/tip.2022.3147971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Advanced shape analysis studies such as regression and classification need to be performed on curved manifolds, where often, there is a lack of standard statistical formulations. To overcome these limitations, we introduce a novel machine-learning method on the shape space of curves that avoids direct inference on infinite-dimensional spaces and instead performs Bayesian inference with spherical Gaussian processes decomposition. As an application, we study the shape of the cochlear spiral-shaped cavity within the petrous part of the temporal bone. This problem is particularly challenging due to the relationship between shape and gender, especially in children. Experimental results for both synthetic and real data show improved performance compared to state-of-the-art methods.
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25
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Bertran-Cobo C, Wedderburn CJ, Robertson FC, Subramoney S, Narr KL, Joshi SH, Roos A, Rehman AM, Hoffman N, Zar HJ, Stein DJ, Donald KA. A Neurometabolic Pattern of Elevated Myo-Inositol in Children Who Are HIV-Exposed and Uninfected: A South African Birth Cohort Study. Front Immunol 2022; 13:800273. [PMID: 35419007 PMCID: PMC8995436 DOI: 10.3389/fimmu.2022.800273] [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: 10/22/2021] [Accepted: 02/22/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Exposure to maternal HIV in pregnancy may be a risk factor for impaired child neurodevelopment during the first years of life. Altered neurometabolites have been associated with HIV exposure in older children and may help explain the mechanisms underlying this risk. For the first time, we explored neurometabolic profiles of children who are HIV-exposed and uninfected (CHEU) compared to children who are HIV-unexposed (CHU) at 2-3 years of age. Methods The South African Drakenstein Child Health Study enrolled women during pregnancy and is following mother-child pairs through childhood. MRI scans were acquired on a sub-group of children at 2-3 years. We used single voxel magnetic resonance spectroscopy to measure brain metabolite ratios to total creatine in the parietal grey matter, and left and right parietal white matter of 83 children (36 CHEU; 47 CHU). Using factor analysis, we explored brain metabolite patterns in predefined parietal voxels in these groups using logistic regression models. Differences in relative concentrations of individual metabolites (n-acetyl-aspartate, myo-inositol, total choline, and glutamate) to total creatine between CHEU and CHU groups were also examined. Results Factor analysis revealed four different metabolite patterns, each one characterized by covarying ratios of a single metabolite in parietal grey and white matter. The cross-regional pattern dominated by myo-inositol, a marker for glial reactivity and inflammation, was associated with HIV exposure status (OR 1.63; 95% CI 1.11-2.50) which held after adjusting for child age, sex, and maternal alcohol use during pregnancy (OR 1.59; 95% CI 1.07 -2.47). Additionally, higher relative concentrations of myo-inositol to total creatine were found in left and right parietal white matter of CHEU compared to CHU (p=0.025 and p=0.001 respectively). Discussion Increased ratios of myo-inositol to total creatine in parietal brain regions at age 2-3 years in CHEU are suggestive of early and ongoing neuroinflammatory processes. Altered relative concentrations of neurometabolites were found predominantly in the white matter, which is sensitive to neuroinflammation, and may contribute to developmental risk in this population. Future work on the trajectory of myo-inositol over time in CHEU, alongside markers of neurocognitive development, and the potential for specific neurodevelopmental interventions will be useful.
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Affiliation(s)
- Cesc Bertran-Cobo
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,Research Master Brain and Cognitive Sciences, Faculty of Science, University of Amsterdam, Amsterdam, Netherlands
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Frances C Robertson
- Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Cape Universities Body Imaging Centre (CUBIC), Cape Town, South Africa
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa.,SAMRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Cape Town, South Africa
| | - Andrea M Rehman
- MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nadia Hoffman
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,SAMRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.,SAMRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.,Neuroscience Institute, University of Cape Town, Cape Town, South Africa
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26
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Vuong A, Fowler EG, Matsumoto J, Staudt LA, Yokota H, Joshi SH. Selective Motor Control is a Clinical Correlate of Brain Motor Tract Impairment in Children with Spastic Bilateral Cerebral Palsy. AJNR Am J Neuroradiol 2021; 42:2054-2061. [PMID: 34593378 PMCID: PMC8583266 DOI: 10.3174/ajnr.a7272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/23/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Selective voluntary motor control is an important factor influencing gross motor function, interjoint coordination, and the outcome of hamstring-lengthening surgery in spastic cerebral palsy. Using DTI, we investigated whether selective voluntary motor control would show strong correlations with WM motor tract microstructure and whether selective voluntary motor control is more sensitive to global WM impairment than gross motor function. MATERIALS AND METHODS Children with spastic bilateral cerebral palsy born preterm and typically developing children were recruited. The Selective Control Assessment of the Lower Extremity (SCALE) and Gross Motor Function Measure (GMFM) were assessed in participants with cerebral palsy. Participants underwent brain MR imaging to collect DWI data. Tract-Based Spatial Statistics was used to analyze the WM for between-group differences and correlations with SCALE and GMFM. ROI analyses compared motor regions. RESULTS Twelve children with cerebral palsy (mean age, 11.5 years) and 12 typically developing children (mean age, 10.3 years) participated. Altered DTI outcomes were found throughout the whole brain for the cerebral palsy group. SCALE, developed to evaluate selective voluntary motor control in cerebral palsy, showed significant positive correlations with fractional anisotropy in more WM voxels throughout the whole brain and for motor regions, including the corticospinal tract and corpus callosum, compared with GMFM. A significant negative correlation between radial diffusivity and SCALE, but not GMFM, was found within the corpus callosum. CONCLUSIONS SCALE was a more sensitive clinical correlate of motor and whole-brain WM tract impairment in children with spastic bilateral cerebral palsy, suggesting greater anisotropy and myelination in these regions for those with higher selective voluntary motor control.
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Affiliation(s)
- A Vuong
- From the Departments of Bioengineering (A.V., S.H.J.)
- Orthopaedic Surgery (A.V., E.G.F., L.A.S.)
- Center for Cerebral Palsy at UCLA/Orthopaedic Institute for Children (A.V., E.G.F., L.A.S.), Los Angeles, California
| | - E G Fowler
- Orthopaedic Surgery (A.V., E.G.F., L.A.S.)
- Center for Cerebral Palsy at UCLA/Orthopaedic Institute for Children (A.V., E.G.F., L.A.S.), Los Angeles, California
| | | | - L A Staudt
- Orthopaedic Surgery (A.V., E.G.F., L.A.S.)
- Center for Cerebral Palsy at UCLA/Orthopaedic Institute for Children (A.V., E.G.F., L.A.S.), Los Angeles, California
| | - H Yokota
- Department of Diagnostic Radiology and Radiation (H.Y.), Chiba University Hospital, Chiba, Japan
| | - S H Joshi
- From the Departments of Bioengineering (A.V., S.H.J.)
- Ahmanson-Lovelace Brain Mapping Center in the Department of Neurology (S.H.J.), University of California Los Angeles, Los Angeles, California
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27
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Bennett R, Joshi SH. A CNN and LSTM Network for Eye-Blink Classification from MRI Scanner Monitoring Videos. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:3463-3466. [PMID: 34891985 DOI: 10.1109/embc46164.2021.9629937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Eye closure changes brain activity, so eye-blink tracking of subjects undergoing resting-state functional magnetic resonance imaging (fMRI) is relevant for identifying when a subject blinks, falls asleep, or keeps their eyes closed. Existing MRI eye-tracking solutions use commercially available MR-compatible video cameras with tracking software that can fail on low-quality videos. In this paper, we propose a two-stage convolutional recurrent neural network to classify open and closed eyes from frames of MRI eye-tracking videos under variable camera conditions. The model extracts visual features from each video frame using a convolutional neural network based on the Inception-v3 model, then uses a long short-term memory network to incorporate temporal information encoded in the sequence of visual features over time. Our model is implemented in Keras and demonstrated on a dataset of MRI eye-tracking videos from the Human Connectome Project. We manually labelled frames from the dataset for training and evaluation. The network was able to classify eye-blink states with a precision of 0.739 and recall of 0.835 on a previously unseen holdout dataset under varying camera conditions, eye position, and video quality.Clinical relevance- Functional mapping studies in psychiatry and neuro-development which rely on a resting state fMRI protocol may yield divergent results depending on whether the subject keeps their eyes closed or open or whether the subject falls asleep. The clinical relevance of this work is to introduce the eye state (closed or open) in brain imaging studies as a prospective covariate, and as a feature that can potentially control for sleep state as a confounding factor.
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28
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Wade BSC, Hellemann G, Espinoza RT, Woods RP, Joshi SH, Redlich R, Dannlowski U, Jorgensen A, Abbott CC, Oltedal L, Narr KL. Accounting for symptom heterogeneity can improve neuroimaging models of antidepressant response after electroconvulsive therapy. Hum Brain Mapp 2021; 42:5322-5333. [PMID: 34390089 PMCID: PMC8519875 DOI: 10.1002/hbm.25620] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/01/2021] [Revised: 05/21/2021] [Accepted: 07/29/2021] [Indexed: 12/19/2022] Open
Abstract
Depression symptom heterogeneity limits the identifiability of treatment‐response biomarkers. Whether improvement along dimensions of depressive symptoms relates to separable neural networks remains poorly understood. We build on work describing three latent symptom dimensions within the 17‐item Hamilton Depression Rating Scale (HDRS) and use data‐driven methods to relate multivariate patterns of patient clinical, demographic, and brain structural changes over electroconvulsive therapy (ECT) to dimensional changes in depressive symptoms. We included 110 ECT patients from Global ECT‐MRI Research Collaboration (GEMRIC) sites who underwent structural MRI and HDRS assessments before and after treatment. Cross validated random forest regression models predicted change along symptom dimensions. HDRS symptoms clustered into dimensions of somatic disturbances (SoD), core mood and anhedonia (CMA), and insomnia. The coefficient of determination between predicted and actual changes were 22%, 39%, and 39% (all p < .01) for SoD, CMA, and insomnia, respectively. CMA and insomnia change were predicted more accurately than HDRS‐6 and HDRS‐17 changes (p < .05). Pretreatment symptoms, body‐mass index, and age were important predictors. Important imaging predictors included the right transverse temporal gyrus and left frontal pole for the SoD dimension; right transverse temporal gyrus and right rostral middle frontal gyrus for the CMA dimension; and right superior parietal lobule and left accumbens for the insomnia dimension. Our findings support that recovery along depressive symptom dimensions is predicted more accurately than HDRS total scores and are related to unique and overlapping patterns of clinical and demographic data and volumetric changes in brain regions related to depression and near ECT electrodes.
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Affiliation(s)
- Benjamin S C Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, California, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Randall T Espinoza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, California, USA
| | - Ronny Redlich
- Institute of Translational Psychiatry, Department of Mental Health, University of Münster, Münster, Germany.,Department of Clinical Psychology, University of Halle, Halle, Germany
| | - Udo Dannlowski
- Institute of Translational Psychiatry, Department of Mental Health, University of Münster, Münster, Germany
| | | | - Christopher C Abbott
- Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Mohn Medical Imaging and Visualization Centre, Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
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29
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Roos A, Wedderburn CJ, Fouche JP, Subramoney S, Joshi SH, Woods RP, Zar HJ, Narr KL, Stein DJ, Donald KA. Central white matter integrity alterations in 2-3-year-old children following prenatal alcohol exposure. Drug Alcohol Depend 2021; 225:108826. [PMID: 34182371 PMCID: PMC8299546 DOI: 10.1016/j.drugalcdep.2021.108826] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/19/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) remains a potentially preventable, but pervasive risk factor to neurodevelopment. Yet, evidence is lacking on the impact of alcohol on brain development in toddlers. This study aimed to investigate the impact of PAE on brain white matter integrity in 2-3-year-old children. METHODS Children (n = 83, 30-37 months old) of the Drakenstein Child Health Study birth cohort, underwent diffusion MRI on a 3 T Siemens scanner during natural sleep. Parameters were extracted in children with PAE (n = 25, 56 % boys) and unexposed controls (n = 58, 62 % boys) using Tract-based Spatial Statistics, and compared by group. The contribution of maternal tobacco smoking to white matter differences was also explored. RESULTS Children with PAE had altered fractional anisotropy, radial diffusivity and axial diffusivity in brain stem, limbic and association tracts compared to unexposed controls. Notably lower fractional anisotropy was found in the uncinate fasciculus, and lower mean and radial diffusivity were found in the fornix stria terminalis and corticospinal tract (FDR corrected p < 0.05). There was a significant interaction effect of PAE and prenatal tobacco exposure which lowered mean, radial and axial diffusivity in the corticospinal tract significantly in the PAE group but not controls. CONCLUSION Widespread altered white matter microstructural integrity at 2-3 years of age is consistent with findings in neonates in the same and other cohorts, indicating persistence of effects of PAE through early life. Findings also highlight that prenatal tobacco exposure impacts the association of PAE on white matter alterations, amplifying effects in tracts underlying motor function.
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Affiliation(s)
- Annerine Roos
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa; Department of Pediatrics and Child Health, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa.
| | - Catherine J. Wedderburn
- Department of Pediatrics and Child Health, University of Cape Town, South Africa,Neuroscience Institute, University of Cape Town, South Africa,Department of Clinical Research, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Jean-Paul Fouche
- Neuroscience Institute, University of Cape Town, South Africa,Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Sivenesi Subramoney
- Department of Pediatrics and Child Health, University of Cape Town, South Africa
| | - Shantanu H. Joshi
- Departments of Neurology and of Bioengineering, University of California, Los Angeles, USA
| | - Roger P. Woods
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Heather J. Zar
- Department of Pediatrics and Child Health, University of Cape Town, South Africa
| | - Katherine L. Narr
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Dan J. Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa,Neuroscience Institute, University of Cape Town, South Africa,Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Kirsten A. Donald
- Department of Pediatrics and Child Health, University of Cape Town, South Africa,Neuroscience Institute, University of Cape Town, South Africa
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30
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Leaver AM, Vasavada M, Kubicki A, Wade B, Loureiro J, Hellemann G, Joshi SH, Woods RP, Espinoza R, Narr KL. Hippocampal subregions and networks linked with antidepressant response to electroconvulsive therapy. Mol Psychiatry 2021; 26:4288-4299. [PMID: 32029885 PMCID: PMC7415508 DOI: 10.1038/s41380-020-0666-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 12/11/2019] [Accepted: 01/28/2020] [Indexed: 01/29/2023]
Abstract
Electroconvulsive therapy (ECT) has been repeatedly linked to hippocampal plasticity. However, it remains unclear what role hippocampal plasticity plays in the antidepressant response to ECT. This magnetic resonance imaging (MRI) study tracks changes in separate hippocampal subregions and hippocampal networks in patients with depression (n = 44, 23 female) to determine their relationship, if any, with improvement after ECT. Voxelwise analyses were restricted to the hippocampus, amygdala, and parahippocampal cortex, and applied separately for responders and nonresponders to ECT. In analyses of arterial spin-labeled (ASL) MRI, nonresponders exhibited increased cerebral blood flow (CBF) in bilateral anterior hippocampus, while responders showed CBF increases in right middle and left posterior hippocampus. In analyses of gray matter volume (GMV) using T1-weighted MRI, GMV increased throughout bilateral hippocampus and surrounding tissue in nonresponders, while responders showed increased GMV in right anterior hippocampus only. Using CBF loci as seed regions, BOLD-fMRI data from healthy controls (n = 36, 19 female) identified spatially separable neurofunctional networks comprised of different brain regions. In graph theory analyses of these networks, functional connectivity within a hippocampus-thalamus-striatum network decreased only in responders after two treatments and after index. In sum, our results suggest that the location of ECT-related plasticity within the hippocampus may differ according to antidepressant outcome, and that larger amounts of hippocampal plasticity may not be conducive to positive antidepressant response. More focused targeting of hippocampal subregions and/or circuits may be a way to improve ECT outcome.
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Affiliation(s)
- Amber M. Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Center for Translational Imaging, Department of Radiology,
Northwestern University, Chicago, IL, 60611,Corresponding Author: Amber M. Leaver Ph.D.,
Address: 737 N Michigan Ave, Suite 1600, Chicago, IL 60611, Phone 312 694 2966,
Fax 310 926 5991,
| | - Megha Vasavada
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Antoni Kubicki
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Joana Loureiro
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, 90095
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Roger P. Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, 90095
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, 90095
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of
Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Department of Psychiatry and Biobehavioral Sciences,
University of California Los Angeles, Los Angeles, CA, 90095
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31
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Nunez E, Lizarraga A, Joshi SH. SrvfNet: A Generative Network for Unsupervised Multiple Diffeomorphic Functional Alignment. Conf Comput Vis Pattern Recognit Workshops 2021; 2021:4476-4484. [PMID: 35794879 PMCID: PMC9255233 DOI: 10.1109/cvprw53098.2021.00505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We present SrvfNet, a generative deep learning framework for the joint multiple alignment of large collections of functional data comprising square-root velocity functions (SRVF) to their templates. Our proposed framework is fully unsupervised and is capable of aligning to a predefined template as well as jointly predicting an optimal template from data while simultaneously achieving alignment. Our network is constructed as a generative encoder-decoder architecture comprising fully-connected layers capable of producing a distribution space of the warping functions. We demonstrate the strength of our framework by validating it on synthetic data as well as diffusion profiles from magnetic resonance imaging (MRI) data.
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Affiliation(s)
- Elvis Nunez
- Department of Electrical and Computer Engineering, UCLA
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Andrew Lizarraga
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Shantanu H Joshi
- Department of Bioengineering, UCLA
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, UCLA
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32
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Sahib AK, Loureiro JR, Vasavada MM, Kubicki A, Wade B, Joshi SH, Woods RP, Congdon E, Espinoza R, Narr KL. Modulation of inhibitory control networks relate to clinical response following ketamine therapy in major depression. Transl Psychiatry 2020; 10:260. [PMID: 32732915 PMCID: PMC7393172 DOI: 10.1038/s41398-020-00947-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 01/21/2023] Open
Abstract
Subanesthetic ketamine is found to induce fast-acting and pronounced antidepressant effects, even in treatment resistant depression (TRD). However, it remains unclear how ketamine modulates neural function at the brain systems-level to regulate emotion and behavior. Here, we examined treatment-related changes in the inhibitory control network after single and repeated ketamine therapy in TRD. Forty-seven TRD patients (mean age = 38, 19 women) and 32 healthy controls (mean age = 35, 18 women) performed a functional magnetic resonance imaging (fMRI) response inhibition task at baseline, and 37 patients completed the fMRI task and symptom scales again 24 h after receiving both one and four 0.5 mg/kg intravenous ketamine infusions. Analyses of fMRI data addressed effects of diagnosis, time, and differences between treatment remitters and non-remitters. Significant decreases in brain activation were observed in the inhibitory control network, including in prefrontal and parietal regions, and visual cortex following serial ketamine treatment, p < 0.05 corrected. Remitters were distinguished from non-remitters by having lower functional activation in the supplementary motor area (SMA) prior to treatment, which normalized towards controls following serial ketamine treatment. Results suggest that ketamine treatment leads to neurofunctional plasticity in executive control networks including the SMA during a response-inhibitory task. SMA changes relate to reductions in depressive symptoms, suggesting modulation of this network play an important role in therapeutic response. In addition, early changes in the SMA network during response inhibition appear predictive of overall treatment outcome, and may serve as a biomarker of treatment response.
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Affiliation(s)
- Ashish K Sahib
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Joana Ra Loureiro
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Megha M Vasavada
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Antoni Kubicki
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Benjamin Wade
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
| | - Roger P Woods
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, Los Angeles, CA, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
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33
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Prieto‐Márquez A, Garcia‐Porta J, Joshi SH, Norell MA, Makovicky PJ. Modularity and heterochrony in the evolution of the ceratopsian dinosaur frill. Ecol Evol 2020; 10:6288-6309. [PMID: 32724514 PMCID: PMC7381594 DOI: 10.1002/ece3.6361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 01/01/2023] Open
Abstract
The fossil record provides compelling examples of heterochrony at macroevolutionary scales such as the peramorphic giant antlers of the Irish elk. Heterochrony has also been invoked in the evolution of the distinctive cranial frill of ceratopsian dinosaurs such as Triceratops. Although ceratopsian frills vary in size, shape, and ornamentation, quantitative analyses that would allow for testing hypotheses of heterochrony are lacking. Here, we use geometric morphometrics to examine frill shape variation across ceratopsian diversity and within four species preserving growth series. We then test whether the frill constitutes an evolvable module both across and within species, and compare growth trajectories of taxa with ontogenetic growth series to identify heterochronic processes. Evolution of the ceratopsian frill consisted primarily of progressive expansion of its caudal and caudolateral margins, with morphospace occupation following taxonomic groups. Although taphonomic distortion represents a complicating factor, our data support modularity both across and within species. Peramorphosis played an important role in frill evolution, with acceleration operating early in neoceratopsian evolution followed by progenesis in later diverging cornosaurian ceratopsians. Peramorphic evolution of the ceratopsian frill may have been facilitated by the decoupling of this structure from the jaw musculature, an inference that predicts an expansion of morphospace occupation and higher evolutionary rates among ceratopsids as indeed borne out by our data. However, denser sampling of the meager record of early-diverging taxa is required to test this further.
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Affiliation(s)
- Albert Prieto‐Márquez
- Institut Català de Paleontologia Miquel CrusafontUniversitat Autònoma de BarcelonaBarcelonaSpain
- Integrative Research CenterField Museum of Natural HistoryChicagoILUSA
| | - Joan Garcia‐Porta
- CREAFBarcelonaSpain
- Department of BiologyWashington UniversitySt. LouisMOUSA
| | - Shantanu H. Joshi
- Department of Neurology and Ahmanson Lovelace Brain Mapping CenterUniversity of California, Los AngelesLos AngelesCAUSA
| | - Mark A. Norell
- Division of PaleontologyAmerican Museum of Natural HistoryNew YorkNYUSA
| | - Peter J. Makovicky
- Integrative Research CenterField Museum of Natural HistoryChicagoILUSA
- Department of Earth and Environmental SciencesUniversity of MinnesotaMinneapolisMNUSA
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34
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Fowler EG, Oppenheim WL, Greenberg MB, Staudt LA, Joshi SH, Silverman DHS. Brain Metabolism During A Lower Extremity Voluntary Movement Task in Children With Spastic Cerebral Palsy. Front Hum Neurosci 2020; 14:159. [PMID: 32528261 PMCID: PMC7263017 DOI: 10.3389/fnhum.2020.00159] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Reduced selective voluntary motor control (SVMC) is a primary impairment due to corticospinal tract (CST) injury in spastic cerebral palsy (CP). There are few studies of brain metabolism in CP and none have examined brain metabolism during a motor task. Nine children with bilateral spastic CP [Age: 6-11 years, Gross Motor Function Classification System (GMFCS) Levels II-V] completed this study. SVMC was evaluated using Selective Control Assessment of the Lower Extremity (SCALE) ranging from 0 (absent) to 10 (normal). Brain metabolism was measured using positron emission tomography (PET) scanning in association with a selective ankle motor task. Whole brain activation maps as well as ROI averaged metabolic activity were correlated with SCALE scores. The contralateral sensorimotor and superior parietal cortex were positively correlated with SCALE scores (p < 0.0005). In contrast, a negative correlation of metabolic activity with SCALE was found in the cerebellum (p < 0.0005). Subsequent ROI analysis showed that both ipsilateral and contralateral cerebellar metabolism correlated with SCALE but the relationship for the ipsilateral cerebellum was stronger (R 2 = 0.80, p < 0.001 vs. R 2 = 0.46, p = 0.045). Decreased cortical and increased cerebellar activation in children with less SVMC may be related to task difficulty, activation of new motor learning paradigms in the cerebellum and potential engagement of alternative motor systems when CSTs are focally damaged. These results support SCALE as a clinical correlate of neurological impairment.
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Affiliation(s)
- Eileen G Fowler
- Center for Cerebral Palsy, Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, United States.,Tarjan Center at UCLA, Los Angeles, CA, United States
| | - William L Oppenheim
- Center for Cerebral Palsy, Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marcia B Greenberg
- Center for Cerebral Palsy, Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Loretta A Staudt
- Center for Cerebral Palsy, Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H Joshi
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Daniel H S Silverman
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, United States.,Ahmanson Translational Imaging Division, UCLA Health System, Los Angeles, CA, United States
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35
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Abstract
Rate-invariant or reparameterization-invariant matching between functions and shapes of curves, respectively, is an important problem in computer vision and medical imaging. Often, the computational cost of matching using approaches such as dynamic time warping or dynamic programming is prohibitive for large datasets. Here, we propose a deep neural-network-based approach for learning the warping functions from training data consisting of a large number of optimal matches, and use it to predict optimal diffeomorphic warping functions. Results show prediction performance on a synthetic dataset of bump functions and two-dimensional curves from the ETH-80 dataset as well as a significant reduction in computational cost.
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Affiliation(s)
- Elvis Nunez
- Department of Applied Mathematics and Statistics, Johns Hopkins University.,Ahmanson Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Shantanu H Joshi
- Ahmanson Lovelace Brain Mapping Center, Department of Neurology, UCLA.,Department of Bioengineering, UCLA
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36
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Wedderburn CJ, Subramoney S, Yeung S, Fouche JP, Joshi SH, Narr KL, Rehman AM, Roos A, Ipser J, Robertson FC, Groenewold NA, Gibb DM, Zar HJ, Stein DJ, Donald KA. Neuroimaging young children and associations with neurocognitive development in a South African birth cohort study. Neuroimage 2020; 219:116846. [PMID: 32304884 PMCID: PMC7443699 DOI: 10.1016/j.neuroimage.2020.116846] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/14/2020] [Accepted: 04/06/2020] [Indexed: 11/25/2022] Open
Abstract
Magnetic resonance imaging (MRI) is an indispensable tool for investigating brain development in young children and the neurobiological mechanisms underlying developmental risk and resilience. Sub-Saharan Africa has the highest proportion of children at risk of developmental delay worldwide, yet in this region there is very limited neuroimaging research focusing on the neurobiology of such impairment. Furthermore, paediatric MRI imaging is challenging in any setting due to motion sensitivity. Although sedation and anesthesia are routinely used in clinical practice to minimise movement in young children, this may not be ethical in the context of research. Our study aimed to investigate the feasibility of paediatric multimodal MRI at age 2–3 years without sedation, and to explore the relationship between cortical structure and neurocognitive development at this understudied age in a sub-Saharan African setting. A total of 239 children from the Drakenstein Child Health Study, a large observational South African birth cohort, were recruited for neuroimaging at 2–3 years of age. Scans were conducted during natural sleep utilising locally developed techniques. T1-MEMPRAGE and T2-weighted structural imaging, resting state functional MRI, diffusion tensor imaging and magnetic resonance spectroscopy sequences were included. Child neurodevelopment was assessed using the Bayley-III Scales of Infant and Toddler Development. Following 23 pilot scans, 216 children underwent scanning and T1-weighted images were obtained from 167/216 (77%) of children (median age 34.8 months). Furthermore, we found cortical surface area and thickness within frontal regions were associated with cognitive development, and in temporal and frontal regions with language development (beta coefficient ≥0.20). Overall, we demonstrate the feasibility of carrying out a neuroimaging study of young children during natural sleep in sub-Saharan Africa. Our findings indicate that dynamic morphological changes in heteromodal association regions are associated with cognitive and language development at this young age. These proof-of-concept analyses suggest similar links between the brain and cognition as prior literature from high income countries, enhancing understanding of the interplay between cortical structure and function during brain maturation. MRI data are challenging to acquire in the early years of life. Paediatric MRI without sedation is feasible in sub-Saharan Africa, with 77% success. The Drakenstein Child Health study has novel MRI data of South African children. Morphological features of the cortex associate with neurocognitive development. Structure-cognition relationships in heteromodal association regions at 2–3 years.
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Affiliation(s)
- Catherine J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, UK; Neuroscience Institute, University of Cape Town, South Africa.
| | - Sivenesi Subramoney
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Shunmay Yeung
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, UK
| | | | - Shantanu H Joshi
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | - Katherine L Narr
- Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | - Andrea M Rehman
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Annerine Roos
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa; SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Jonathan Ipser
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa
| | - Frances C Robertson
- Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Cape Universities Brain Imaging Centre (CUBIC), Cape Town, South Africa
| | - Nynke A Groenewold
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa
| | - Diana M Gibb
- MRC Clinical Trials Unit, University College, London, UK
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; SAMRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, South Africa; Department of Psychiatry, University of Cape Town, South Africa; SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa
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37
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Lee D, Donald KA, Dalal T, Wedderburn CJ, Roos A, Ipser J, Subramoney S, Zar HJ, Stein DJ, Narr KL, Hellemann G, Woods RP, Joshi SH. BRAIN NETWORK CONNECTIVITY FROM MATCHING CORTICAL FEATURE DENSITIES. Proc IEEE Int Symp Biomed Imaging 2020; 2020:995-998. [PMID: 33299534 PMCID: PMC7722986 DOI: 10.1109/isbi45749.2020.9098689] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We present a new method for constructing structural inference brain networks from functional measures of cortical features. Instead of averaging vertex-wise cortical features, we propose the use of full functions of spatial densities of measures such as thickness and use two dimensional pairwise correlations between regions to construct population networks. We show increased within group correlations for both healthy controls and toddlers with prenatal alcohol exposure compared to the existing mean-based correlation approach. Further, we also show significant differences in brain connectivity between the healthy controls and the exposed group.
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Affiliation(s)
- David Lee
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, USA
- Department of Bioengineering, UCLA USA
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, SA
- Neuroscience Institute, University of Cape Town, SA
| | - Taykhoom Dalal
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, USA
- Department of Computer Science, UCLA USA
| | - Catherine J Wedderburn
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, SA
- Neuroscience Institute, University of Cape Town, SA
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, UK
| | - Annerine Roos
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, SA
- Neuroscience Institute, University of Cape Town, SA
- Department of Psychiatry, Stellenbosch University, SA
| | - Jonathan Ipser
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, SA
- Department of Psychiatry, Stellenbosch University, SA
| | | | - Heather J Zar
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, SA
- SAMRC Unit on Child & Adolescent Health, University of Cape Town, SA
| | - Dan J Stein
- Neuroscience Institute, University of Cape Town, SA
- Department of Psychiatry and Mental Health, University of Cape Town, SA
- SAMRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, SA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA, USA
| | | | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, USA
- Department of Psychiatry and Biobehavioral Sciences, UCLA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA, USA
- Department of Bioengineering, UCLA USA
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38
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Sahib AK, Loureiro JRA, Vasavada MM, Kubicki A, Joshi SH, Wang K, Woods RP, Congdon E, Wang DJJ, Boucher ML, Espinoza R, Narr KL. Single and repeated ketamine treatment induces perfusion changes in sensory and limbic networks in major depressive disorder. Eur Neuropsychopharmacol 2020; 33:89-100. [PMID: 32061453 PMCID: PMC8869841 DOI: 10.1016/j.euroneuro.2020.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 11/19/2019] [Revised: 01/10/2020] [Accepted: 01/26/2020] [Indexed: 12/15/2022]
Abstract
Ketamine infusion therapy can produce fast-acting antidepressant effects in patients with major depressive disorder (MDD). Yet, how single and repeated ketamine treatment induces brain systems-level neuroplasticity underlying symptom improvement is unknown. Advanced multiband imaging (MB) pseudo-continuous arterial spin labeling (pCASL) perfusion MRI data was acquired from patients with treatment resistant depression (TRD) (N = 22, mean age=35.2 ± 9.95 SD, 27% female) at baseline, and 24 h after receiving single, and four subanesthetic (0.5 mg/kg) intravenous ketamine infusions. Changes in global and regional CBF were compared across time points, and relationships with overall mood, anhedonia and apathy were examined. Comparisons between patients at baseline and controls (N = 18, mean age=36.11 ± 14.5 SD, 57% female) established normalization of treatment effects. Results showed increased regional CBF in the cingulate and primary and higher-order visual association regions after first ketamine treatment. Baseline CBF in the fusiform, and acute changes in CBF in visual areas were related to symptom improvement after single and repeated ketamine treatment, respectively. In contrast, after serial infusion therapy, decreases in regional CBF were observed in the bilateral hippocampus and right insula with ketamine treatment. Findings demonstrate that neurophysiological changes occurring with single and repeated ketamine treatment follow both a regional and temporal pattern including sensory and limbic regions. Initial changes are observed in the posterior cingulate and precuneus and primary and higher-order visual areas, which relate to clinical responses. However, repeated exposure to ketamine, though not relating to clinical outcome, appears to engage deeper limbic structures and insula. ClinicalTrials.gov: Biomarkers of Fast Acting Therapies in Major Depression, https://clinicaltrials.gov/ct2/show/NCT02165449, NCT02165449.
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Affiliation(s)
- Ashish K Sahib
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Joana R A Loureiro
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Megha M Vasavada
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Antoni Kubicki
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Shantanu H Joshi
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Kai Wang
- Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
| | - Roger P Woods
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States
| | - Eliza Congdon
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 635 Charles E Young Drive South Suite, Los Angeles, CA 90095-7334, United States
| | - Danny J J Wang
- Laboratory of FMRI Technology (LOFT), Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States
| | - Michael L Boucher
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 635 Charles E Young Drive South Suite, Los Angeles, CA 90095-7334, United States
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 635 Charles E Young Drive South Suite, Los Angeles, CA 90095-7334, United States
| | - Katherine L Narr
- Department of Neurology, Ahamason-Lovelace Brain Mapping Center, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 635 Charles E Young Drive South Suite, Los Angeles, CA 90095-7334, United States.
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39
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Lee DS, Sahib A, Wade B, Narr KL, Hellemann G, Woods RP, Joshi SH. Multimodal Data Registration for Brain Structural Association Networks. Med Image Comput Comput Assist Interv 2019; 11765:373-381. [PMID: 33336210 PMCID: PMC7744134 DOI: 10.1007/978-3-030-32245-8_42] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We present a method for multimodal brain data registration that aligns shapes of nodal network configurations in an invertible manner. We use ideas from shape analysis to represent an individual subject data configuration as an element on a hypersphere, where geodesics have closed form solutions. The method not only performs inter-subject data registration, but also allows for the construction of a population data template to which all subject data configurations can be registered. Results show compression of data measures and significant reduction in variance after registration. We also observe increased predictive power of regions of interest (ROI) node identification, significant increases in pairwise network connectivity measures, as well as significant increases in canonical correlations with age after registration.
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Affiliation(s)
- David S Lee
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Ashish Sahib
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
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Goukasian N, Porat S, Blanken A, Avila D, Zlatev D, Hurtz S, Hwang KS, Pierce J, Joshi SH, Woo E, Apostolova LG. Cognitive Correlates of Hippocampal Atrophy and Ventricular Enlargement in Adults with or without Mild Cognitive Impairment. Dement Geriatr Cogn Dis Extra 2019; 9:281-293. [PMID: 31572424 PMCID: PMC6751474 DOI: 10.1159/000490044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 12/28/2017] [Accepted: 05/15/2018] [Indexed: 12/25/2022] Open
Abstract
We analyzed structural magnetic resonance imaging data from 58 cognitively normal and 101 mild cognitive impairment subjects. We used a general linear regression model to study the association between cognitive performance with hippocampal atrophy and ventricular enlargement using the radial distance method. Bilateral hippocampal atrophy was associated with baseline and longitudinal memory performance. Left hippocampal atrophy predicted longitudinal decline in visuospatial function. The multidomain ventricular analysis did not reveal any significant predictors.
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Affiliation(s)
- Naira Goukasian
- University of Vermont, Larner College of Medicine, Burlington, Vermont, USA
| | - Shai Porat
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Anna Blanken
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - David Avila
- Irvine School of Medicine, University of California, Irvine, California, USA
| | - Dimitar Zlatev
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sona Hurtz
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Kristy S Hwang
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jonathan Pierce
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Shantanu H Joshi
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Ellen Woo
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Liana G Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Leaver AM, Vasavada M, Joshi SH, Wade B, Woods RP, Espinoza R, Narr KL. Mechanisms of Antidepressant Response to Electroconvulsive Therapy Studied With Perfusion Magnetic Resonance Imaging. Biol Psychiatry 2019; 85:466-476. [PMID: 30424864 PMCID: PMC6380917 DOI: 10.1016/j.biopsych.2018.09.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 09/10/2018] [Accepted: 09/23/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Converging evidence suggests that electroconvulsive therapy (ECT) induces neuroplasticity in patients with severe depression, though how this relates to antidepressant response is less clear. Arterial spin-labeled functional magnetic resonance imaging tracks absolute changes in cerebral blood flow (CBF) linked with brain function and offers a potentially powerful tool when observing neurofunctional plasticity with functional magnetic resonance imaging. METHODS Using arterial spin-labeled functional magnetic resonance imaging, we measured global and regional CBF associated with clinically prescribed ECT and therapeutic response in patients (n = 57, 30 female) before ECT, after two treatments, after completing an ECT treatment "index" (∼4 weeks), and after long-term follow-up (6 months). Age- and sex-matched control subjects were also scanned twice (n = 36, 19 female), ∼4 weeks apart. RESULTS Patients with lower baseline global CBF were more likely to respond to ECT. Regional CBF increased in the right anterior hippocampus in all patients irrespective of clinical outcome, both after 2 treatments and after ECT index. However, hippocampal CBF increases postindex were more pronounced in nonresponders. ECT responders exhibited CBF increases in the dorsomedial thalamus and motor cortex near the vertex ECT electrode, as well as decreased CBF within lateral frontoparietal regions. CONCLUSIONS ECT induces functional neuroplasticity in the hippocampus, which could represent functional precursors of ECT-induced increases in hippocampal volume reported previously. However, excessive functional neuroplasticity within the hippocampus may not be conducive to positive clinical outcome. Instead, our results suggest that although hippocampal plasticity may contribute to antidepressant response in ECT, balanced plasticity in regions relevant to seizure physiology including thalamocortical networks may also play a critical role.
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Affiliation(s)
- Amber M. Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Department of Radiology, Northwestern University, Chicago, IL, 60611,Corresponding Author: Amber M. Leaver Ph.D., Address: 737 N Michigan Ave, Suite 1600,Chicago, IL 60611, Phone 312 694 2966, Fax 310 926 5991,
| | - Megha Vasavada
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095
| | - Roger P. Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095
| | - Katherine L. Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, 90095,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, 90095
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42
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Lee DS, Loureiro J, Narr KL, Woods RP, Joshi SH. Elastic Registration of Single Subject Task Based fMRI Signals. Med Image Comput Comput Assist Interv 2018; 11072:154-162. [PMID: 31106303 DOI: 10.1007/978-3-030-00931-1_18] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Single subject task-based fMRI analyses generally suffer from low detection sensitivity with parameter estimates from the general linear model (GLM) lying below the significance threshold especially for similar contrasts or conditions. In this paper, we present a shape-based approach for alignment of condition-specific time course activity for single subject task-based fMRI. Our approach extracts signals for each condition from the entire time course, constructs an unbiased average of those signals, and warps each signal to the mean. As the warping is diffeomorphic, non-linear and allows large deformations of time series if required, we term this approach as elastic functional registration. On a single subject level, our method significantly detects more clusters and more activated voxels in relevant subcortical regions in healthy controls.
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Affiliation(s)
- David S Lee
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Joana Loureiro
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
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43
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Phillips OR, Joshi SH, Narr KL, Shattuck DW, Singh M, Di Paola M, Ploner CJ, Prüss H, Paul F, Finke C. Superficial white matter damage in anti-NMDA receptor encephalitis. J Neurol Neurosurg Psychiatry 2018; 89:518-525. [PMID: 29101253 PMCID: PMC5899027 DOI: 10.1136/jnnp-2017-316822] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/09/2017] [Accepted: 10/19/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Clinical brain MRI is normal in the majority of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. However, extensive deep white matter damage wasrecently identifiedin these patients using diffusion weighted imaging. Here, our aim was to study a particularly vulnerable brain compartment, the late myelinating superficial white matter. METHODS Forty-six patients with anti-NMDAR encephalitis were included. Ten out of these were considered neurologically recovered (modified Rankin scale of zero), while 36 patients were non-recovered. In addition, 30 healthy controls were studied. MRI data were collected from all subjects and superficial white matter mean diffusivity derived from diffusion tensor imaging was compared between groups in whole brain, lobar and vertex-based analyses. Patients underwent comprehensive cognitive testing, and correlation analyses were performed between cognitive performance and superficial white matter integrity. RESULTS Non-recovered patients showed widespread superficial white matter damage in comparison to recovered patients and healthy controls. Vertex-based analyses revealed that damage predominated in frontal and temporal lobes. In contrast, the superficial white matter was intact in recovered patients. Importantly, persistent cognitive impairments in working memory, verbal memory, visuospatial memory and attention significantly correlated with damage of the superficial white matter in patients. CONCLUSIONS Anti-NMDAR encephalitis is associated with extensive superficial white matter damage in patients with incomplete recovery. The strong association with impairment in several cognitive domains highlights the clinical relevance of white matter damage in this disorder and warrants investigations of the underlying pathophysiological mechanisms.
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Affiliation(s)
- Owen Robert Phillips
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California, USA
| | - Shantanu H Joshi
- Department of Neurology, Ahmanson Lovelace Brain Mapping Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Katherine L Narr
- Department of Neurology, Ahmanson Lovelace Brain Mapping Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - David W Shattuck
- Department of Neurology, Ahmanson Lovelace Brain Mapping Center, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Manpreet Singh
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, Stanford, California, USA
| | - Margherita Di Paola
- Department of Mental Health, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Christoph J Ploner
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Harald Prüss
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Friedemann Paul
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Berlin, Germany.,Experimental and Clinical Research Center, Charité Universitätsmedizin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Carsten Finke
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Leaver AM, Wade B, Vasavada M, Hellemann G, Joshi SH, Espinoza R, Narr KL. Fronto-Temporal Connectivity Predicts ECT Outcome in Major Depression. Front Psychiatry 2018; 9:92. [PMID: 29618992 PMCID: PMC5871748 DOI: 10.3389/fpsyt.2018.00092] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [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: 11/03/2017] [Accepted: 03/06/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is arguably the most effective available treatment for severe depression. Recent studies have used MRI data to predict clinical outcome to ECT and other antidepressant therapies. One challenge facing such studies is selecting from among the many available metrics, which characterize complementary and sometimes non-overlapping aspects of brain function and connectomics. Here, we assessed the ability of aggregated, functional MRI metrics of basal brain activity and connectivity to predict antidepressant response to ECT using machine learning. METHODS A radial support vector machine was trained using arterial spin labeling (ASL) and blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) metrics from n = 46 (26 female, mean age 42) depressed patients prior to ECT (majority right-unilateral stimulation). Image preprocessing was applied using standard procedures, and metrics included cerebral blood flow in ASL, and regional homogeneity, fractional amplitude of low-frequency modulations, and graph theory metrics (strength, local efficiency, and clustering) in BOLD data. A 5-repeated 5-fold cross-validation procedure with nested feature-selection validated model performance. Linear regressions were applied post hoc to aid interpretation of discriminative features. RESULTS The range of balanced accuracy in models performing statistically above chance was 58-68%. Here, prediction of non-responders was slightly higher than for responders (maximum performance 74 and 64%, respectively). Several features were consistently selected across cross-validation folds, mostly within frontal and temporal regions. Among these were connectivity strength among: a fronto-parietal network [including left dorsolateral prefrontal cortex (DLPFC)], motor and temporal networks (near ECT electrodes), and/or subgenual anterior cingulate cortex (sgACC). CONCLUSION Our data indicate that pattern classification of multimodal fMRI metrics can successfully predict ECT outcome, particularly for individuals who will not respond to treatment. Notably, connectivity with networks highly relevant to ECT and depression were consistently selected as important predictive features. These included the left DLPFC and the sgACC, which are both targets of other neurostimulation therapies for depression, as well as connectivity between motor and right temporal cortices near electrode sites. Future studies that probe additional functional and structural MRI metrics and other patient characteristics may further improve the predictive power of these and similar models.
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Affiliation(s)
- Amber M Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Benjamin Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Megha Vasavada
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States
| | - Randall Espinoza
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
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Lee DS, Leaver A, Narr KL, Woods RP, Joshi SH. Measuring Brain Connectivity via Shape Analysis of fMRI Time Courses and Spectra. Connectomics Neuroimaging (2017) 2017; 10511:125-133. [PMID: 29953126 DOI: 10.1007/978-3-319-67159-8_15] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present a shape matching approach for functional magnetic resonance imaging (fMRI) time course and spectral alignment. We use ideas from differential geometry and functional data analysis to define a functional representation for fMRI signals. The space of fMRI functions is then equipped with a reparameterization invariant Riemannian metric that enables elastic alignment of both amplitude and phase of the fMRI time courses as well as their power spectral densities. Experimental results show significant increases in pairwise node to node correlations and coherences following alignment. We apply this method for finding group differences in connectivity between patients with major depression and healthy controls.
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Affiliation(s)
- David S Lee
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Amber Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology University of California Los Angeles, CA
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46
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Pal S, Woods RP, Panjiyar S, Sowell E, Narr KL, Joshi SH. A Riemannian Framework for Linear and Quadratic Discriminant Analysis on the Tangent Space of Shapes. Conf Comput Vis Pattern Recognit Workshops 2017; 2017:726-734. [PMID: 29201534 PMCID: PMC5710852 DOI: 10.1109/cvprw.2017.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We present a Riemannian framework for linear and quadratic discriminant classification on the tangent plane of the shape space of curves. The shape space is infinite dimensional and is constructed out of square root velocity functions of curves. We introduce the notion of mean and covariance of shape-valued random variables and samples from a tangent space to the pre-shapes (invariant to translation and scaling) and then extend it to the full shape space (rotational invariance). The shape observations from the population are approximated by coefficients of a Fourier basis of the tangent space. The algorithms for linear and quadratic discriminant analysis are then defined using reduced dimensional features obtained by projecting the original shape observations on to the truncated Fourier basis. We show classification results on synthetic data and shapes of cortical sulci, corpus callosum curves, as well as facial midline curve profiles from patients with fetal alcohol syndrome (FAS).
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Affiliation(s)
- Susovan Pal
- UCLA Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Roger P Woods
- UCLA Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Suchit Panjiyar
- Department of Computer Science, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elizabeth Sowell
- Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, Los Angeles, CA, USA
| | - Katherine L Narr
- UCLA Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Shantanu H Joshi
- UCLA Brain Mapping Center, University of California, Los Angeles, Los Angeles, CA, USA
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47
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Wade BSC, Sui J, Njau S, Leaver AM, Vasvada M, Gutman BA, Thompson PM, Espinoza R, Woods RP, Abbott CC, Narr KL, Joshi SH. DATA-DRIVEN CLUSTER SELECTION FOR SUBCORTICAL SHAPE AND CORTICAL THICKNESS PREDICTS RECOVERY FROM DEPRESSIVE SYMPTOMS. Proc IEEE Int Symp Biomed Imaging 2017; 2017:502-506. [PMID: 30713592 DOI: 10.1109/isbi.2017.7950570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Patients with major depressive disorder (MDD) who do not achieve full symptomatic recovery after antidepressant treatment have a higher risk of relapse. Compared to pharmacotherapies, electroconvulsive therapy (ECT) more rapidly produces a greater extent of response in severely depressed patients. However, prediction of which candidates are most likely to improve after ECT remains challenging. Using structural MRI data from 42 ECT patients scanned prior to ECT treatment, we developed a random forest classifier based on data-driven shape cluster selection and cortical thickness features to predict remission. Right hemisphere hippocampal shape and right inferior temporal cortical thickness was most predictive of remission, with the predicted probability of recovery decreasing when these regions were thicker prior to treatment. Remission was predicted with an average 73% balanced accuracy. Classification of MRI data may help identify treatment-responsive patients and aid in clinical decision-making. Our results show promise for the development of personalized treatment strategies.
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Affiliation(s)
- Benjamin S C Wade
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA.,Imaging Genetics Center, USC
| | - Jing Sui
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM
| | - Stephanie Njau
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Amber M Leaver
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Megha Vasvada
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | | | | | | | - Roger P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | | | - Katherine L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
| | - Shantanu H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, UCLA
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48
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Yang Y, Joshi SH, Jahanshad N, Thompson PM, Baker LA. Neural correlates of proactive and reactive aggression in adolescent twins. Aggress Behav 2017; 43:230-240. [PMID: 27766650 DOI: 10.1002/ab.21683] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 10/08/2015] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 11/05/2022]
Abstract
Verbal and physical aggression begin early in life and steadily decline thereafter in normal development. As a result, elevated aggressive behavior in adolescence may signal atypical development and greater vulnerability for negative mental and health outcomes. Converging evidence suggests that brain disturbances in regions involved in impulse control, emotional regulation, and sensation seeking may contribute to heightened aggression. However, little is known regarding the neural mechanisms underlying subtypes of aggression (i.e., proactive and reactive aggression) and whether they differ between males and females. Using a sample of 106 14-year-old adolescent twins, this study found that striatal enlargement was associated with both proactive and reactive aggression. We also found that volumetric alterations in several frontal regions including smaller middle frontal and larger orbitofrontal cortex were correlated with higher levels of aggression in adolescent twins. In addition, cortical thickness analysis showed that thickness alterations in many overlapping regions including middle frontal, superior frontal, and anterior cingulate cortex and temporal regions were associated with aggression in adolescent twins. Results support the involvement of fronto-limbic-striatal circuit in the etiology of aggression during adolescence. Aggr. Behav. 43:230-240, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Yaling Yang
- Department of Pediatrics, Children's Hospital Los Angeles; University of Southern California; Los Angeles California
| | - Shantanu H. Joshi
- Department of Neurology; David Geffen School of Medicine at University of California Los Angeles; Los Angeles California
| | - Neda Jahanshad
- Department of Neurology; University of Southern California; Los Angeles California
| | - Paul M. Thompson
- Department of Neurology; University of Southern California; Los Angeles California
| | - Laura A. Baker
- Department of Psychology; University of Southern California; Los Angeles California
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Chiba Y, Phillips OR, Onopa AK, Joshi SH, Grau JR, Takenoshita S, Nishino S, Singh MK. 0944 SUPERFICIAL WHITE MATTER AND CORTICAL THICKNESS ASSOCIATED WITH PARASOMNIAS IN CHILDREN. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.943] [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: 11/13/2022] Open
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Njau S, Joshi SH, Espinoza R, Leaver AM, Vasavada M, Marquina A, Woods RP, Narr KL. Neurochemical correlates of rapid treatment response to electroconvulsive therapy in patients with major depression. J Psychiatry Neurosci 2017; 42:6-16. [PMID: 27327561 PMCID: PMC5373714 DOI: 10.1503/jpn.150177] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is a highly effective brain stimulation treatment for severe depression. Identifying neurochemical changes linked with ECT may point to biomarkers and predictors of successful treatment response. METHODS We used proton magnetic resonance spectroscopy (1H-MRS) to measure longitudinal changes in glutamate/glutamine (Glx), creatine (Cre), choline (Cho) and N-acetylaspartate (NAA) in the dorsal (dACC) and subgenual anterior cingulate cortex (sgACC) and bilateral hippocampus in patients receiving ECT scanned at baseline, after the second ECT session and after the ECT treatment series. Patients were compared with demographically similar controls at baseline. Controls were assessed twice to establish normative values and variance. RESULTS We included 50 patients (mean age 43.78 ± 14 yr) and 33 controls (mean age 39.33 ± 12 yr) in our study. Patients underwent a mean of 9 ± 4.1 sessions of ECT. At baseline, patients showed reduced Glx in the sgACC, reduced NAA in the left hippocampus and increased Glx in the left hippocampus relative to controls. ECT was associated with significant increases in Cre in the dACC and sgACC and decreases in NAA in the dACC and right hippocampus. Lower NAA levels in the dACC at baseline predicted reductions in depressive symptoms. Both ECT and symptom improvement were associated with decreased Glx in the left hippocampus and increased Glx in the sgACC. LIMITATIONS Attrition and clinical heterogeneity may have masked more subtle findings. CONCLUSION ECT elicits robust effects on brain chemistry, impacting Cre, NAA and Glx, which suggests restorative and neurotrophic processes. Differential effects of Glx in the sgACC and hippocampus, which approach control values with treatment, may reflect previously implicated underactive cortical and overactive subcortical limbic circuitry in patients with major depression. NAA levels at baseline are predictive of therapeutic outcome and could inform future treatment strategies.
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Affiliation(s)
| | | | | | | | | | | | | | - Katherine L. Narr
- Correspondence to: K. Narr, 635 Charles E Young Dr S #225, University of California Los Angeles, Los Angeles CA 90095;
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