Probing resting-state functional connectivity in the infant brain: methods and potentiality

Early brain development is characterized by rapid growth and perpetual reconfiguration, driven by a dynamic milieu of heterogeneous processes. Moreover, potent postnatal brain plasticity engenders increased vulnerability to environmental stimuli. However, little is known regarding the ontogeny and temporal manifestations of inter- and intra-regional functional connectivity that comprise functional brain networks. Recently, resting-state functional magnetic resonance imaging (fMRI) emerged as a promising non-invasive neuroinvestigative tool, measuring spontaneous fluctuations in blood oxygen level dependent (BOLD) signal at rest that reflect baseline neuronal activity. Its application has expanded to infant populations in the past decade, providing unprecedented insight into functional organization of the developing brain, as well as early biomarkers of abnormal/ disease states. However, rapid extension of the resting-state technique to infant populations leaves many methodological issues need to be resolved prior to standardization of the technique. The purpose of this thesis is to describe a protocol for intrinsic functional connectivity analysis, and extraction of resting-state networks in infants <12 months of age using the data-driven approach independent component analysis (ICA). To begin, we review the evolution of resting-state fMRI application in infant populations, including the biological premise for neural networks. Next, we present a protocol designed such that investigators without previous knowledge in the field can implement the analysis and reliably obtain viable results consistent with previous literature. Presented protocol provides detailed, albeit basic framework for RSN analysis, with interwoven discussion of basic theory behind each technique, as well as the rationale behind selecting parameters. The overarching goal is to catalyze efforts towards development of robust, infant-specific acquisition and preprocessing pipelines, as well as promote greater transparency by researchers regarding methods used. Finally, we review the literature, current methodological challenges and potential future directions for the field of infant resting-state fMRI

Enhanced pre-frontal functional-structural networks to support postural control deficits after traumatic brain injury in a pediatric population

Traumatic brain injury (TBI) affects the structural connectivity, triggering the re-organization of structural-functional circuits in a manner that remains poorly understood. We focus here on brain networks re-organization in relation to postural control deficits after TBI. We enrolled young participants who had suffered moderate to severeTBI, comparing them to young typically developing control participants. In comparison to control participants, TBI patients (but not controls) recruited prefrontal regions to interact with two separated networks: 1) a subcortical network including part of the motor network, basal ganglia, cerebellum, hippocampus, amygdala, posterior cingulum and precuneus; and 2) a task-positive network, involving regions of the dorsal attention system together with the dorsolateral and ventrolateral prefrontal regions

Development of quality standards for multi-center, longitudinal magnetic resonance imaging studies in clinical neuroscience

Magnetic resonance imaging (MRI) data is generated by a complex procedure. Many possible sources of error exist which can lead to a worse signal. For example, hidden defective components of a MRI-scanner, changes in the static magnetic field caused by a person simply moving in the MRI scanner room as well as changes in the measurement sequences can negatively affect the signal-to-noise ratio (SNR). A comprehensive, reproducible, quality assurance (QA) procedure is necessary, to ensure reproducible results both from the MRI equipment and the human operator of the equipment. To examine the quality of the MRI data, there are two possibilities. On the one hand, water or gel-filled objects, so-called "phantoms", are regularly measured. Based on this signal, which in the best case should always be stable, the general performance of the MRI scanner can be tested. On the other hand, the actually interesting data, mostly human data, are checked directly for certain signal parameters (e.g., SNR, motion parameters). This thesis consists of two parts. In the first part a study-specific QA-protocol was developed for a large multicenter MRI-study, FOR2107. The aim of FOR2107 is to investigate the causes and course of affective disorders, unipolar depression and bipolar disorders, taking clinical and neurobiological effects into account. The main aspect of FOR2107 is the MRI-measurement of more than 2000 subjects in a longitudinal design (currently repeated measurements after 2 years, further measurements planned after 5 years). To bring MRI-data and disease history together, MRI-data must provide stable results over the course of the study. Ensuring this stability is dealt with in this part of the work. An extensive QA, based on phantom measurements, human data analysis, protocol compliance testing, etc., was set up. In addition to the development of parameters for the characterization of MRI-data, the used QA-protocols were improved during the study. The differences between sites and the impact of these differences on human data analysis were analyzed. The comprehensive quality assurance for the FOR2107 study showed significant differences in MRI-signal (for human and phantom data) between the centers. Occurring problems could easily be recognized in time and be corrected, and must be included for current and future analyses of human data. For the second part of this thesis, a QA-protocol (and the freely available associated software "LAB-QA2GO") has been developed and tested, and can be used for individual studies or to control the quality of an MRI-scanner. This routine was developed because at many sites and in many studies, no explicit QA is performed nevertheless suitable, freely available QA-software for MRI-measurements is available. With LAB-QA2GO, it is possible to set up a QA-protocol for an MRI-scanner or a study without much effort and IT knowledge. Both parts of the thesis deal with the implementation of QA-procedures. High quality data and study results can be achieved only by the usage of appropriate QA-procedures, as presented in this work. Therefore, QA-measures should be implemented at all levels of a project and should be implemented permanently in project and evaluation routines

Neural correlates of post-traumatic brain injury (TBI) attention deficits in children

Traumatic brain injury (TBI) in children is a major public health concern worldwide. Attention deficits are among the most common neurocognitive and behavioral consequences in children post-TBI which have significant negative impacts on their educational and social outcomes and compromise the quality of their lives. However, there is a paucity of evidence to guide the optimal treatment strategies of attention deficit related symptoms in children post-TBI due to the lack of understanding regarding its neurobiological substrate. Thus, it is critical to understand the neural mechanisms associated with TBI-induced attention deficits in children so that more refined and tailored strategies can be developed for diagnoses and long-term treatments and interventions. This dissertation is the first study to investigate neurobiological substrates associated with post-TBI attention deficits in children using both anatomical and functional neuroimaging data. The goals of this project are to discover the quantitatively measurable markers utilizing diffusion tensor imaging (DTI), structural magnetic resonance imaging (MRI), and functional MRI (fMRI) techniques, and to further identify the most robust neuroimaging features in predicting severe post-TBI attention deficits in children, by utilizing machine learning and deep learning techniques. A total of 53 children with TBI and 55 controls from age 9 to 17 are recruited. The results show that the systems-level topological properties in left frontal regions, parietal regions, and medial occipitotemporal regions in structural and functional brain network are significantly associated with inattentive and/or hyperactive/impulsive symptoms in children post-TBI. Semi-supervised deep learning modeling further confirms the significant contributions of these brain features in the prediction of elevated attention deficits in children post-TBI. The findings of this project provide valuable foundations for future research on developing neural markers for TBI-induced attention deficits in children, which may significantly assist the development of more effective and individualized diagnostic and treatment strategies

Learning and comparing functional connectomes across subjects

Functional connectomes capture brain interactions via synchronized fluctuations in the functional magnetic resonance imaging signal. If measured during rest, they map the intrinsic functional architecture of the brain. With task-driven experiments they represent integration mechanisms between specialized brain areas. Analyzing their variability across subjects and conditions can reveal markers of brain pathologies and mechanisms underlying cognition. Methods of estimating functional connectomes from the imaging signal have undergone rapid developments and the literature is full of diverse strategies for comparing them. This review aims to clarify links across functional-connectivity methods as well as to expose different steps to perform a group study of functional connectomes

Intact Bilateral Resting-State Networks in the Absence of the Corpus Callosum

Temporal correlations between different brain regions in the resting-state BOLD signal are thought to reflect intrinsic functional brain connectivity (Biswal et al., 1995; Greicius et al., 2003; Fox et al., 2007). The functional networks identified are typically bilaterally distributed across the cerebral hemispheres, show similarity to known white matter connections (Greicius et al., 2009), and are seen even in anesthetized monkeys (Vincent et al., 2007). Yet it remains unclear how they arise. Here we tested two distinct possibilities: (1) functional networks arise largely from structural connectivity constraints, and generally require direct interactions between functionally coupled regions mediated by white-matter tracts; and (2) functional networks emerge flexibly with the development of normal cognition and behavior and can be realized in multiple structural architectures. We conducted resting-state fMRI in eight adult humans with complete agenesis of the corpus callosum (AgCC) and normal intelligence, and compared their data to those from eight healthy matched controls. We performed three main analyses: anatomical region-of-interest-based correlations to test homotopic functional connectivity, independent component analysis (ICA) to reveal functional networks with a data-driven approach, and ICA-based interhemispheric correlation analysis. Both groups showed equivalently strong homotopic BOLD correlation. Surprisingly, almost all of the group-level independent components identified in controls were observed in AgCC and were predominantly bilaterally symmetric. The results argue that a normal complement of resting-state networks and intact functional coupling between the hemispheres can emerge in the absence of the corpus callosum, favoring the second over the first possibility listed above

Brain differences between persistent and remitted attention deficit hyperactivity disorder

Previous resting state studies examining the brain basis of attention deficit hyperactivity disorder have not distinguished between patients who persist versus those who remit from the diagnosis as adults. To characterize the neurobiological differences and similarities of persistence and remittance, we performed resting state functional magnetic resonance imaging in individuals who had been longitudinally and uniformly characterized as having or not having attention deficit hyperactivity disorder in childhood and again in adulthood (16 years after baseline assessment). Intrinsic functional brain organization was measured in patients who had a persistent diagnosis in childhood and adulthood (n = 13), in patients who met diagnosis in childhood but not in adulthood (n = 22), and in control participants who never had attention deficit hyperactivity disorder (n = 17). A positive functional correlation between posterior cingulate and medial prefrontal cortices, major components of the default-mode network, was reduced only in patients whose diagnosis persisted into adulthood. A negative functional correlation between medial and dorsolateral prefrontal cortices was reduced in both persistent and remitted patients. The neurobiological dissociation between the persistence and remittance of attention deficit hyperactivity disorder may provide a framework for the relation between the clinical diagnosis, which indicates the need for treatment, and additional deficits that are common, such as executive dysfunctions.McGovern Institute for Brain Research at MIT (Poitras Center for Affective Disorders Research)Massachusetts General Hospital (Paediatric Psychopharmacology Council Fund

Multimodality evaluation of the pediatric brain: DTI and its competitors

The development of the human brain, from the fetal period until childhood, happens in a series of intertwined neurogenetical and histogenetical events that are influenced by environment. Neuronal proliferation and migration, cell aggregation, axonal ingrowth and outgrowth, dendritic arborisation, synaptic pruning and myelinisation contribute to the ‘plasticity of the developing brain'. These events taken together contribute to the establishment of adult-like neuroarchitecture required for normal brain function. With the advances in technology today, mostly due to the development of non-invasive neuroimaging tools, it is possible to analyze these structural events not only in anatomical space but also longitudinally in time. In this review we have highlighted current ‘state of the art' neuroimaging tools. Development of the new MRI acquisition sequences (DTI, CHARMED and phase imaging) provides valuable insight into the changes of the microstructural environment of the cortex and white matter. Development of MRI imaging tools dedicated for analysis of the acquired images (i) TBSS and ROI fiber tractography, (ii) new tissue segmentation techniques and (iii) morphometric analysis of the cortical mantle (cortical thickness and convolutions) allows the researchers to map the longitudinal changes in the macrostructure of the developing brain that go hand-in-hand with the acquisition of cognitive skills during childhood. Finally, the latest and the newest technologies, like connectom analysis and resting state fMRI connectivity analysis, today, for the first time provide the opportunity to study the developing brain through the prism of maturation of the systems and networks beyond individual anatomical areas. Combining these methods in the future and modeling the hierarchical organization of the brain might ultimately help to understand the mechanisms underlying complex brain structure function relationships of normal development and of developmental disorder