1,299 research outputs found

    A neuroimaging investigation of bipolar disorder and the neurocognitive effects of 5-HT7 antagonists

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    Bipolar disorder is a psychiatric disorder characterised by pathological mood states, but there is growing recognition of the role of cognitive impairment and dysfunction of emotional processes, which has a profound impact on quality of life. Many people with bipolar disorders exhibit brain volume impairment associated with cognitive dysfunction and an increased risk of dementia. In this thesis, I conducted a systematic review to understand the relationships between mood disorders and the 5-HT7 receptor. The 5-HT7 receptor is related to depression and anxiety, but the relationship between 5-HT7 and mania remains unclear; in addition, sleep and memory were also related to the 5-HT7 receptor. Followed by these findings, in the next two chapters, I examined the effects of 5-HT7 antagonists, using JNJ-18038683, on emotional and cognitive functioning, as well as their neural substrates. I then reported on neuroimaging investigations examining the effects of 5-HT7 antagonists on emotional processing and cognitive function in healthy volunteers to gain insight into their potential mode of action and utility for bipolar disorder. In fMRI analyses, the drug acted on 5-HT7 receptors potentially improving cognitive performance by modulating the function of the Cognitive Control Network in healthy controls. In the above-mentioned chapters, I gained a better understanding of the 5-HT7 antagonist, JNJ-18038683, and the putative promising effects for pharmacological treatments. However, the approach taken has some limitations, including a small sample size, potential participant bias, and a lack of systematic control of medication dose and duration of administration. In addition, in Chapter 5, I explored the brain basis of bipolar disorder and its links to cognitive and emotional dysfunction using a new ‘brain age’ approach. Individuals with bipolar disorder were found to have increased brain age compared to healthy controls. I hope that these findings can be applied to pharmacological treatment for individuals with bipolar disorder, ultimately allowing patients to benefit from the drug in the future

    Central nervous system involvement in chronic inflammatory demyelinating polyradiculoneuropathy—MRS and DTI study

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    ObjectiveThe current research aimed to analyze the alterations within the motor cortex and pyramidal pathways and their association with the degree of damage within the peripheral nerve fibers in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). To achieve that goal, we investigated the microstructural changes within the pyramidal white matter tracts using diffusion tensor imaging (DTI) parameters, evaluated metabolic alterations in both precentral gyri using magnetic resonance spectroscopy (MRS) ratios, and correlated them with the neurographic findings in patients with CIDP.MethodsThe spectroscopic ratios of NAA/Cr, Cho/Cr, and mI/Cr from both precentral gyri and the values of fractional anisotropy (FA), axial diffusivity (AD), and mean diffusivity (MD) from both of the corticospinal tracts were correlated with the results of neurological and neurographic findings. The comparison of DTI parameters between the patients and controls was performed using Student’s t-test or the Mann–Whitney U test. Due to the lack of normal distribution of most variables, Spearman’s Rho rank coefficient was used to test all correlations. All analyses were performed at a significant level of alpha = 0.05 using STATISTICA 13.3.ResultsCompared to the control group (CG), the patient group showed significantly lower ratios of NAA/Cr (1.66 ± 0.11 vs. 1.61 ± 0.15; p = 0.022), higher ratios of ml/Cr in the right precentral gyrus (0.57 ± 0.15 vs. 0.61 ± 0.08; p = 0.005), and higher levels of Cho/Cr within the left precentral gyrus (0.83 ± 0.09 vs. 0.88 ± 0.14, p = 0.012). The DTI parameters of MD from the right CST and AD from the right and left CSTs showed a strong positive correlation (0.52–0.53) with the sural sensory nerve action potential (SNAP) latency of the right sural nerve. There were no other significant correlations between other DTI and MRS parameters and neurographic results.SignificanceIn our study, significant metabolic alterations were found in the precentral gyri in patients with CIDP without clinical symptoms of central nervous system involvement. The revealed changes reflected neuronal loss or dysfunction, myelin degradation, and increased gliosis. Our results suggest coexisting CNS damage in these patients and may provide a new insight into the still unknown pathomechanism of CIDP

    Neuroimaging investigations of cortical specialisation for different types of semantic knowledge

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    Embodied theories proposed that semantic knowledge is grounded in motor and perceptual experiences. This leads to two questions: (1) whether the neural underpinnings of perception are also necessary for semantic cognition; (2) how do biases towards different sensorimotor experiences cause brain regions to specialise for particular types of semantic information. This thesis tackles these questions in a series of neuroimaging and behavioural investigations. Regarding question 1, strong embodiment theory holds that semantic representation is reenactment of corresponding experiences, and brain regions for perception are necessary for comprehending modality-specific concepts. However, the weak embodiment view argues that reenactment may not be necessary, and areas near to perceiving regions may be sufficient to support semantic representation. In the particular case of motion concepts, lateral occipital temporal cortex (LOTC) has been long identified as an important area, but the roles of its different subregions are still uncertain. Chapter 3 examined how different parts of LOTC reacted to written descriptions of motion and static events, using multiple analysis methods. A series of anterior to posterior sub-regions were analyzed through univariate, multivariate pattern analysis (MVPA), and psychophysical interaction (PPI) analyses. MVPA revealed strongest decoding effects for motion vs. static events in the posterior parts of LOTC, including both visual motion area (V5) and posterior middle temporal gyrus (pMTG). In contrast, only the middle portion of LOTC showed increased activation for motion sentences in univariate analyses. PPI analyses showed increased functional connectivity between posterior LOTC and the multiple demand network for motion events. These findings suggest that posterior LOTC, which overlapped with the motion perception V5 region, is selectively involved in comprehending motion events, while the anterior part of LOTC contributes to general semantic processing. Regarding question 2, the hub-and-spoke theory suggests that anterior temporal lobe (ATL) acts as a hub, using inputs from modality-specific regions to construct multimodal concepts. However, some researchers propose temporal parietal cortex (TPC) as an additional hub, specialised in processing and integrating interaction and contextual information (e.g., for actions and locations). These hypotheses are summarized as the "dual-hub theory" and different aspects of this theory were investigated in in Chapters 4 and 5. Chapter 4 focuses on taxonomic and thematic relations. Taxonomic relations (or categorical relations) occur when two concepts belong to the same category (e.g., ‘dog’ and ‘wolf’ are both canines). In contrast, thematic relations (or associative relations) refer to situations that two concepts co-occur in events or scenes (e.g., ‘dog’ and ‘bone’), focusing on the interaction or association between concepts. Some studies have indicated ATL specialization for taxonomic relations and TPC specialization for thematic relations, but others have reported inconsistent or even converse results. Thus Chapter 4 first conducted an activation likelihood estimation (ALE) meta-analysis of neuroimaging studies contrasting taxonomic and thematic relations. This found that thematic relations reliably engage action and location processing regions (left pMTG and SMG), while taxonomic relations only showed consistent effects in the right occipital lobe. A primed semantic judgement task was then used to test the dual-hub theory’s prediction that taxonomic relations are heavily reliant on colour and shape knowledge, while thematic relations rely on action and location knowledge. This behavioural experiment revealed that action or location priming facilitated thematic relation processing, but colour and shape did not lead to priming effects for taxonomic relations. This indicates that thematic relations rely more on action and location knowledge, which may explain why the preferentially engage TPC, whereas taxonomic relations are not specifically linked to shape and colour features. This may explain why they did not preferentially engage left ATL. Chapter 5 concentrates on event and object concepts. Previous studies suggest ATL specialization for coding similarity of objects’ semantics, and angular gyrus (AG) specialization for sentence and event structure representation. In addition, in neuroimaging studies, event semantics are usually investigated using complex temporally extended stimuli, unlike than the single-concept stimuli used to investigate object semantics. Thus chapter 5 used representational similarity analysis (RSA), univariate analysis, and PPI analysis to explore neural activation patterns for event and object concepts presented as static images. Bilateral AGs encoded semantic similarity for event concepts, with the left AG also coding object similarity. Bilateral ATLs encoded semantic similarity for object concepts but also for events. Left ATL exhibited stronger coding for events than objects. PPI analysis revealed stronger connections between left ATL and right pMTG, and between right AG and bilateral inferior temporal gyrus (ITG) and middle occipital gyrus, for event concepts compared to object concepts. Consistent with the meta-analysis in chapter 4, the results in chapter 5 support the idea of partial specialization in AG for event semantics but do not support ATL specialization for object semantics. In fact, both the meta-analysis and chapter 5 findings suggest greater ATL involvement in coding objects' associations compared to their similarity. To conclude, the thesis provides support for the idea that perceptual brain regions are engaged in conceptual processing, in the case of motion concepts. It also provides evidence for a specialised role for TPC regions in processing thematic relations (pMTG) and event concepts (AG). There was mixed evidence for specialisation within the ATLs and this remains an important target for future research

    Impact of Head Injury on Cognitive Functioning and Social Cognition in UK-based Female Rugby Players

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    Introduction: Increasing attention is focused on the potential long-term impact of sports-related mild traumatic brain injuries (SRmTBI). Evidence suggests poorer cognitive and psychosocial outcomes in SRmTBI, including increased risk of developing certain neurodegenerative conditions. Research to date has focused on males neglecting female athletes, despite evidence suggesting sex-specific differences in frequency and recovery of SRmTBI. Aims: To explore the association between SRmTBI and cognitive functioning with a specific focus on social cognition in female rugby players. Method: A quantitative cross-sectional design was employed allowing for thirteen female rugby players with a history of SRmTBI to complete a neuropsychological battery of general cognitive functioning and social cognition. Results: Weaknesses relative to normative data, were found for domains of social cognition including theory of mind and cognitive empathy, despite typical scores on domains of general cognitive functioning relative to normative data. Group level analysis confirmed poorer performance for theory of mind and cognitive empathy measures in contrast to overall performance on domains of general cognitive functioning. Discussion: Findings from this preliminary study indicate that measures of social cognition should be incorporated into routine assessment and management of SRmTBI. Further research is needed to investigate the association between social cognition and SRmTBI

    Recommended Implementation of Quantitative Susceptibility Mapping for Clinical Research in The Brain: A Consensus of the ISMRM Electro-Magnetic Tissue Properties Study Group

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    This article provides recommendations for implementing quantitative susceptibility mapping (QSM) for clinical brain research. It is a consensus of the ISMRM Electro-Magnetic Tissue Properties Study Group. While QSM technical development continues to advance rapidly, the current QSM methods have been demonstrated to be repeatable and reproducible for generating quantitative tissue magnetic susceptibility maps in the brain. However, the many QSM approaches available give rise to the need in the neuroimaging community for guidelines on implementation. This article describes relevant considerations and provides specific implementation recommendations for all steps in QSM data acquisition, processing, analysis, and presentation in scientific publications. We recommend that data be acquired using a monopolar 3D multi-echo GRE sequence, that phase images be saved and exported in DICOM format and unwrapped using an exact unwrapping approach. Multi-echo images should be combined before background removal, and a brain mask created using a brain extraction tool with the incorporation of phase-quality-based masking. Background fields should be removed within the brain mask using a technique based on SHARP or PDF, and the optimization approach to dipole inversion should be employed with a sparsity-based regularization. Susceptibility values should be measured relative to a specified reference, including the common reference region of whole brain as a region of interest in the analysis, and QSM results should be reported with - as a minimum - the acquisition and processing specifications listed in the last section of the article. These recommendations should facilitate clinical QSM research and lead to increased harmonization in data acquisition, analysis, and reporting

    Serial sectioning PSOCT and 2PM for imaging post-mortem human brain and neurodegeneration

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    The study of aging and neurodegenerative processes in the human brain necessitates a comprehensive understanding of its myeloarchitectonic, cytoarchitectonic, and vascular structures. While recent computational advances have enabled volumetric reconstruction of the human brain using stained slices, the standard histological processing methods have often led to tissue distortions and loss, making deformation-free reconstruction challenging. Therefore, the development of a multi-scale and volumetric imaging technique that can accurately measure multiple structures within the intact brain would be a significant technical breakthrough. In this work, we present the development of an integrated approach that combines serial sectioning Polarization Sensitive Optical Coherence Tomography (PSOCT) and Two Photon Microscopy (2PM) to provide label-free multi-contrast imaging of human brain tissue. Our method allows for the simultaneous visualization of scattering, birefringence, and autofluorescence properties of the post-mortem human brain. By utilizing high-throughput reconstruction of 4x4x2cm3 sample blocks and simple registration of PSOCT and 2PM images, we enable comprehensive analysis of myelin content, cellular information, and vascular structure. PSOCT provides mesoscopic images and enables quantitative measurement of those brain structures, while 2PM provide complementary microscopic validation and enrichment of cellular and capillary information. This combined approach reveals myelin density and structure maps of the whole brain block and supplies intricate vessel and capillary networks as well as lipofuscin-filled cell soma across cortical regions, providing insights into the myeloarchitectural, cellular and vascular changes associated with neurodegenerative diseases such as Alzheimer's disease (AD) and Chronic Traumatic Encephalopathy (CTE)

    Cerebrovascular dysfunction in cerebral small vessel disease

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    INTRODUCTION: Cerebral small vessel disease (SVD) is the cause of a quarter of all ischaemic strokes and is postulated to have a role in up to half of all dementias. SVD pathophysiology remains unclear but cerebrovascular dysfunction may be important. If confirmed many licensed medications have mechanisms of action targeting vascular function, potentially enabling new treatments via drug repurposing. Knowledge is limited however, as most studies assessing cerebrovascular dysfunction are small, single centre, single imaging modality studies due to the complexities in measuring cerebrovascular dysfunctions in humans. This thesis describes the development and application of imaging techniques measuring several cerebrovascular dysfunctions to investigate SVD pathophysiology and trial medications that may improve small blood vessel function in SVD. METHODS: Participants with minor ischaemic strokes were recruited to a series of studies utilising advanced MRI techniques to measure cerebrovascular dysfunction. Specifically MRI scans measured the ability of different tissues in the brain to change blood flow in response to breathing carbon dioxide (cerebrovascular reactivity; CVR) and the flow and pulsatility through the cerebral arteries, venous sinuses and CSF spaces. A single centre observational study optimised and established feasibility of the techniques and tested associations of cerebrovascular dysfunctions with clinical and imaging phenotypes. Then a randomised pilot clinical trial tested two medications’ (cilostazol and isosorbide mononitrate) ability to improve CVR and pulsatility over a period of eight weeks. The techniques were then expanded to include imaging of blood brain barrier permeability and utilised in multi-centre studies investigating cerebrovascular dysfunction in both sporadic and monogenetic SVDs. RESULTS: Imaging protocols were feasible, consistently being completed with usable data in over 85% of participants. After correcting for the effects of age, sex and systolic blood pressure, lower CVR was associated with higher white matter hyperintensity volume, Fazekas score and perivascular space counts. Lower CVR was associated with higher pulsatility of blood flow in the superior sagittal sinus and lower CSF flow stroke volume at the foramen magnum. Cilostazol and isosorbide mononitrate increased CVR in white matter. The CVR, intra-cranial flow and pulsatility techniques, alongside blood brain barrier permeability and microstructural integrity imaging were successfully employed in a multi-centre observational study. A clinical trial assessing the effects of drugs targeting blood pressure variability is nearing completion. DISCUSSION: Cerebrovascular dysfunction in SVD has been confirmed and may play a more direct role in disease pathogenesis than previously established risk factors. Advanced imaging measures assessing cerebrovascular dysfunction are feasible in multi-centre studies and trials. Identifying drugs that improve cerebrovascular dysfunction using these techniques may be useful in selecting candidates for definitive clinical trials which require large sample sizes and long follow up periods to show improvement against outcomes of stroke and dementia incidence and cognitive function

    Biomarker presentation, amyloid status, and connectivity between the prefrontal cortex and hippocampus in studies of clinical Alzheimer’s disease/dementia

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    Through rigorous research over the past 100 years, great strides have been made in identifying the neuropathological basis of Alzheimer’s disease (AD), its’ prognosis, and the onset of cognitive symptoms. Proteins such as amyloid-beta (Aβ) plaques and tau are recognized as primary biomarkers that define AD and neuroimaging methods have been developed to measure these proteins in vivo allowing for changes to be monitored in life. These advances have led to the view that AD is a continuum rather than one inclusive state. However, there remains a great deal about AD that is still not understood. Such ambiguities range from an imprecise understanding of the neuropathological events that result in dementia to remaining uncertainty as to why some older adults exhibit symptoms of dementia whereas other retain sharp cognitive abilities in old age despite similar underlying pathology. In an effort to fill some of these gaps in our knowledge, the overarching goals of the work in this dissertation were to disambiguate some of these nuances by examining neurobiological features of AD in living older adults. Data for the first two studies was collected from older adults enrolled in the nationwide Alzheimer’s Disease Neuroimaging Initiative (ADNI) and data in the third study came from participants aged 50 years and older enrolled in a cohort study at the Boston University Alzheimer’s Disease Research Center (BU-ADRC). In the first study, our objective was to investigate links between brain structure, cognitive performance, and neuropathology in participants within the ADNI who identified as Black or African American (BoAA). Relatively little is known about dementia in this population so our goal was to assess if there would be an increase in AD biomarkers abnormalities between the three clinical syndrome groups: cognitively normal, mildly cognitively impaired (MCI), and dementia. Our findings supported this hypothesis as we found decreased cortical thickness in five of seven selected regions of interest (ROI), decreased hippocampal volume, increased white matter hyperintensities, worsened measures of cognition and function, decreased cerebrospinal fluid (CSF) measures of Aβ1-42 , and elevated measures of CSF tau between clinical syndrome groups. In the next study, we utilized a different subset of ADNI participants to examine how crossing the threshold in Aβ burden from being amyloid negative (A-) to amyloid positive (A+) as measured on positron emission tomography (PET) scans may relate to other neuropathological AD biomarkers and cognition. To make this assessment, we identified two groups of ADNI participants: one who converted in Aβ burden from A- to A+ as measured by amyloid retention on [18F]-labeled florbetapir PET and another who did not convert (e.g. remained A-) over the same follow-up period. We found increased prevalence of APOE ε4, greater annualized percent volume loss in selected brain regions, and lower CSF Aβ1-42 in the amyloid converter group compared to the non-converter group. Amyloid ligand binding on florbetapir PET was also significantly different between the two groups on PET scans taken at two timepoints. In the last study, we used diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) data from the BU-ADRC to assess the integrity of the cingulum bundle in participants cognitively ranging from normal to amnestic MCI to those with dementia. We found weakened integrity of the cingulum bundle in both dorsal and ventral circuits in participants with worsened cognitive function. Furthermore, we found relationships between diffusion metrics of the cingulum, volume of selected ROI, and measures of executive function and memory. The findings of this study show that age-related changes are likely present in a circuit that connects the prefrontal cortex to medial temporal regions of the brain and that weakening of structural connectivity is related to cognitive decline. This collection of studies reiterates the complicated nature of AD. Factors such as race, genetics, transitions in biomarker status and perhaps yet to be discovered forms of pathology, all have the potential to modify the clinical presentation of AD. The studies completed in this dissertation help to advance our knowledge but more work is needed to solidify our understanding of the basis of AD

    Artificial Intelligence for Cognitive Health Assessment: State-of-the-Art, Open Challenges and Future Directions

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    The subjectivity and inaccuracy of in-clinic Cognitive Health Assessments (CHA) have led many researchers to explore ways to automate the process to make it more objective and to facilitate the needs of the healthcare industry. Artificial Intelligence (AI) and machine learning (ML) have emerged as the most promising approaches to automate the CHA process. In this paper, we explore the background of CHA and delve into the extensive research recently undertaken in this domain to provide a comprehensive survey of the state-of-the-art. In particular, a careful selection of significant works published in the literature is reviewed to elaborate a range of enabling technologies and AI/ML techniques used for CHA, including conventional supervised and unsupervised machine learning, deep learning, reinforcement learning, natural language processing, and image processing techniques. Furthermore, we provide an overview of various means of data acquisition and the benchmark datasets. Finally, we discuss open issues and challenges in using AI and ML for CHA along with some possible solutions. In summary, this paper presents CHA tools, lists various data acquisition methods for CHA, provides technological advancements, presents the usage of AI for CHA, and open issues, challenges in the CHA domain. We hope this first-of-its-kind survey paper will significantly contribute to identifying research gaps in the complex and rapidly evolving interdisciplinary mental health field

    MR in vivo tractography for the reconstruction of cranial nerves course

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    Aim The aim of my Ph.D. was to implement a diffusion tensor tractography (DTT) pipeline to reconstruct cranial nerve I (olfactory) to study COVID-19 patients, and anterior optic pathway (AOP, including optic nerve, chiasm, and optic tract) to study patients with sellar/parasellar tumors, and with Leber’s Hereditary Optic Neuropathy (LHON). Methods We recruited 23 patients with olfactory dysfunction after COVID-19 infection (mean age 37±14 years, 12 females); 27 patients with sellar/parasellar tumors displacing the optic chiasm eligible for endonasal endoscopic surgery (mean age 53. ±16.4 years, 13 female) and 6 LHON patients (mutation 11778/MT-ND4, mean age 24.9±15.7 years). Sex- and age-matched healthy control were also recruited. In LHON patients, optical coherence tomography (OCT) was performed. Acquisitions were performed on a clinical high field 3-T MRI scanner, using a multi-shell HARDI (High Angular Resolution Diffusion Imaging) sequence (b-values 0-300-1000-2000 s/mm2, 64 maximum gradient directions, 2mm3 isotropic voxel). DTT was performed with a multi-tissue spherical deconvolution approach and mean diffusivity (MD) DTT metrics were compared with healthy controls using an unpaired t-test. Correlations of DTT metrics with clinical data were sought by regression analysis. Results In all 23 hypo/anosmic patients with previous COVID-19 infection the CN I was successfully reconstructed with no DTT metrics alterations, thus suggesting the pathogenetic role of central olfactory cortical system dysfunction. In all 27 patients with sellar/parasellar tumors the AOP was reconstructed, and in 11/13 (84.7%) undergoing endonasal endoscopic surgery the anatomical fidelity of the reconstruction was confirmed; a significant decrease in MD within the chiasma (p<0.0001) was also found. In LHON patients a reduction of MD in the AOP was significantly associated with OCT parameters (p=0.036). Conclusions Multi-shell HARDI diffusion-weighted MRI followed by multi-tissue spherical deconvolution for the DTT reconstruction of the CN I and AOP has been implemented, and its utility demonstrated in clinical practice
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