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Griffanti L, Gillis G, O'Donoghue MC, Blane J, Pretorius PM, Mitchell R, Aikin N, Lindsay K, Campbell J, Semple J, Alfaro-Almagro F, Smith SM, Miller KL, Martos L, Raymont V, Mackay CE. Adapting UK Biobank imaging for use in a routine memory clinic setting: The Oxford Brain Health Clinic. Neuroimage Clin 2022; 36:103273. [PMID: 36451375 PMCID: PMC9723313 DOI: 10.1016/j.nicl.2022.103273] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/24/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
The Oxford Brain Health Clinic (BHC) is a joint clinical-research service that provides memory clinic patients and clinicians access to high-quality assessments not routinely available, including brain MRI aligned with the UK Biobank imaging study (UKB). In this work we present how we 1) adapted the UKB MRI acquisition protocol to be suitable for memory clinic patients, 2) modified the imaging analysis pipeline to extract measures that are in line with radiology reports and 3) explored the alignment of measures from BHC patients to the largest brain MRI study in the world (ultimately 100,000 participants). Adaptations of the UKB acquisition protocol for BHC patients include dividing the scan into core and optional sequences (i.e., additional imaging modalities) to improve patients' tolerance for the MRI assessment. We adapted the UKB structural MRI analysis pipeline to take into account the characteristics of a memory clinic population (e.g., high amount of white matter hyperintensities and hippocampal atrophy). We then compared the imaging derived phenotypes (IDPs) extracted from the structural scans to visual ratings from radiology reports, non-imaging factors (age, cognition) and to reference distributions derived from UKB data. Of the first 108 BHC attendees (August 2020-November 2021), 92.5 % completed the clinical scans, 88.0 % consented to use of data for research, and 43.5 % completed the additional research sequences, demonstrating that the protocol is well tolerated. The high rates of consent to research makes this a valuable real-world quality research dataset routinely captured in a clinical service. Modified tissue-type segmentation with lesion masking greatly improved grey matter volume estimation. CSF-masking marginally improved hippocampal segmentation. The IDPs were in line with radiology reports and showed significant associations with age and cognitive performance, in line with the literature. Due to the age difference between memory clinic patients of the BHC (age range 65-101 years, average 78.3 years) and UKB participants (44-82 years, average 64 years), additional scans on elderly healthy controls are needed to improve reference distributions. Current and future work aims to integrate automated quantitative measures in the radiology reports and evaluate their clinical utility.
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Affiliation(s)
- Ludovica Griffanti
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom.
| | - Grace Gillis
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - M Clare O'Donoghue
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Jasmine Blane
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Pieter M Pretorius
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Oxford University Hospitals NHS Trust, Oxford, United Kingdom
| | | | - Nicola Aikin
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Karen Lindsay
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Jon Campbell
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Juliet Semple
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Fidel Alfaro-Almagro
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Stephen M Smith
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Karla L Miller
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
| | - Lola Martos
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Vanessa Raymont
- Department of Psychiatry, University of Oxford, United Kingdom; Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Clare E Mackay
- Department of Psychiatry, University of Oxford, United Kingdom; Wellcome Centre for Integrative Neuroimaging, University of Oxford, United Kingdom
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O'Donoghue MC, Blane J, Mitchell R, Aikin N, Lindsay K, Campbell J, Semple J, Raymont V, Martos L, Mackay C. Embedding dementia research in clinical practice: Progress of the Oxford Brain Health Centre. Alzheimers Dement 2021. [DOI: 10.1002/alz.049778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M Clare O'Donoghue
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Jasmine Blane
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Robert Mitchell
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Nicola Aikin
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Karen Lindsay
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Jon Campbell
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Juliet Semple
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Vanessa Raymont
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Lola Martos
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
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Griffanti L, Clare O'Donoghue M, Blane J, Mitchell R, Aikin N, Lindsay K, Campbell J, Semple J, Nobis L, Raymont V, Martos L, Mackay C. Translating magnetic resonance imaging research in clinical practice for dementia: The Oxford Brain Health Centre. Alzheimers Dement 2021. [DOI: 10.1002/alz.051016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - M. Clare O'Donoghue
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Jasmine Blane
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Robert Mitchell
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Nicola Aikin
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Karen Lindsay
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Jon Campbell
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Juliet Semple
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Lisa Nobis
- University of Oxford Oxford United Kingdom
| | - Vanessa Raymont
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
| | - Lola Martos
- University of Oxford Oxford United Kingdom
- Oxford Health NHS Foundation Trust Oxford United Kingdom
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O'Donoghue MC, Raymont V, Fossey J, Semple J, Griffanti L, Zokaei N, Nobre AC, Martos L, Mackay C. The Oxford Brain Health Centre: Embedding dementia research in clinical practice. Alzheimers Dement 2020. [DOI: 10.1002/alz.044907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Jane Fossey
- Oxford Health NHS Trust Oxford United Kingdom
| | | | | | | | | | - Lola Martos
- Oxford Health NHS Foundation Trust Oxford United Kingdom
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Raymont V, O'Donoghue MC, Mak E, Dounavi M, Su L, MacKay C, O'Brien JT, Ritchie CW. Impact of mild head injury on diffusion MRI brain characteristics in midlife: Data from the PREVENT Dementia Study. Alzheimers Dement 2020. [DOI: 10.1002/alz.044517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Elijah Mak
- University of Cambridge Cambridge United Kingdom
| | | | - Li Su
- University of Cambridge Cambridge United Kingdom
| | | | - John T O'Brien
- Department of Psychiatry University of Cambridge Cambridge United Kingdom
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences University of Edinburgh Edinburgh United Kingdom
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Mok RM, O'Donoghue MC, Myers NE, Drazich EHS, Nobre AC. Neural markers of category-based selective working memory in aging. Neuroimage 2019; 194:163-173. [PMID: 30905834 PMCID: PMC6547047 DOI: 10.1016/j.neuroimage.2019.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/30/2019] [Accepted: 03/16/2019] [Indexed: 01/15/2023] Open
Abstract
Working memory (WM) is essential for normal cognitive function, but shows marked decline in aging. The importance of selective attention in guiding WM performance is increasingly recognized. Studies so far are inconclusive about the ability to use selective attention during WM in aging. To investigate the neural mechanisms supporting selective attention in WM in aging, we tested a large group of older adults using functional magnetic resonance imaging whilst they performed a category-based (faces/houses) selective-WM task. Older adults were able to use attention to encode targets and suppress distractors to reach high levels of task performance. A subsequent, surprise recognition-memory task showed strong consequences of selective attention. Attended items in the relevant category were recognized significantly better than items in the ignored category. Neural measures also showed reliable markers of selective attention during WM. Purported control regions including the dorsolateral and inferior prefrontal and anterior cingulate cortex were reliably recruited for attention to both categories. Activation levels in category-sensitive visual cortex showed reliable modulation according to attentional demands, and positively correlated with subsequent memory measures of attention and WM span. Psychophysiological interaction analyses showed that activity in category-sensitive areas were coupled with non-sensory cortex known to be involved in cognitive control and memory processing, including regions in the prefrontal cortex and hippocampus. In summary, we found that older adults were able to recruit a network of brain regions involved in top-down attention during selective WM, and individual differences in attentional control corresponded to the degree of attention-related modulation in the brain.
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Affiliation(s)
- Robert M Mok
- Department of Experimental Psychology, University of Oxford, UK; Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, UK; Department of Experimental Psychology, University College London, 26 Bedford Way, London, WC1H 0AP, UK.
| | - M Clare O'Donoghue
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, UK
| | - Nicholas E Myers
- Department of Experimental Psychology, University of Oxford, UK; Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, UK
| | - Erin H S Drazich
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, UK
| | - Anna C Nobre
- Department of Experimental Psychology, University of Oxford, UK; Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, UK.
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