Near-Infrared Neuroimaging with NinPy

There has been substantial recent growth in the use of non-invasive optical brain imaging in studies of human brain function in health and disease. Near-infrared neuroimaging (NIN) is one of the most promising of these techniques and, although NIN hardware continues to evolve at a rapid pace, software tools supporting optical data acquisition, image processing, statistical modeling, and visualization remain less refined. Python, a modular and computationally efficient development language, can support functional neuroimaging studies of diverse design and implementation. In particular, Python's easily readable syntax and modular architecture allow swift prototyping followed by efficient transition to stable production systems. As an introduction to our ongoing efforts to develop Python software tools for structural and functional neuroimaging, we discuss: (i) the role of non-invasive diffuse optical imaging in measuring brain function, (ii) the key computational requirements to support NIN experiments, (iii) our collection of software tools to support NIN, called NinPy, and (iv) future extensions of these tools that will allow integration of optical with other structural and functional neuroimaging data sources. Source code for the software discussed here will be made available at www.nmr.mgh.harvard.edu/Neural_SystemsGroup/software.html

Psychiatric Symptom Profiles Predict Functional Impairment

Objective: Mental illness often interferes with daily functioning and an individual's pattern of psychiatric signs and symptoms may predict risk of future disability. Understanding the linkage between psychiatric symptoms and impaired functioning is critical for accurate rehabilitation planning and legal assessment. Here, we investigated the stability of functional impairment measures over 18 months and their association with psychiatric symptoms. Moreover, we developed a clinical self-report measure that allows estimation of functional impairment levels over 18 month observation periods.Methods: Consecutively treated outpatients and daycare patients (N = 155) from several psychiatric units in Switzerland completed the Dissociative Experiences Scale, Somatoform Dissociation Questionnaire, Multidimensional Inventory for Dissociation, Beck Depression Inventory, Brief Symptom Inventory, and WHO Disability Assessment Schedule at baseline, 6, 12, and 18 month follow-up examinations. The association between symptoms functional impairment over time was investigated using longitudinal linear mixed models. Penalized regression was used to identify questionnaire items that best predicted functional impairment.Results: We found high stability in the extent of functional impairment over 18 months. Fear of negative evaluation, fatigue, concentration problems, negative alterations in mood, and dissociative symptoms showed the strongest association with functional impairment measures. The empirically derived scale for functional impairment prediction explained between 0.62 and 0.77 of the variance in disability across various life domains.Conclusion: Given the capability for somatic and mental symptoms associated with social anxiety, depression, and dissociation to predict future disability, these symptoms have strong potential for guiding rehabilitation planning and prognostic evaluation in insurance medicine. The Functional Impairment Prediction Scale may serve as a valuable, empirical-based extension in legal assessments of how work capacity is affected by psychological factors

Stimulus Complexity and Categorical Effects in Human Auditory Cortex: An Activation Likelihood Estimation Meta-Analysis

Investigations of the functional organization of human auditory cortex typically examine responses to different sound categories. An alternative approach is to characterize sounds with respect to their amount of variation in the time and frequency domains (i.e., spectral and temporal complexity). Although the vast majority of published studies examine contrasts between discrete sound categories, an alternative complexity-based taxonomy can be evaluated through meta-analysis. In a quantitative meta-analysis of 58 auditory neuroimaging studies, we examined the evidence supporting current models of functional specialization for auditory processing using grouping criteria based on either categories or spectro-temporal complexity. Consistent with current models, analyses based on typical sound categories revealed hierarchical auditory organization and left-lateralized responses to speech sounds, with high speech sensitivity in the left anterior superior temporal cortex. Classification of contrasts based on spectro-temporal complexity, on the other hand, revealed a striking within-hemisphere dissociation in which caudo-lateral temporal regions in auditory cortex showed greater sensitivity to spectral changes, while anterior superior temporal cortical areas were more sensitive to temporal variation, consistent with recent findings in animal models. The meta-analysis thus suggests that spectro-temporal acoustic complexity represents a useful alternative taxonomy to investigate the functional organization of human auditory cortex

An fMRI study of unconditioned responses in post-traumatic stress disorder

Background: Both fear and pain processing are altered in post-traumatic stress disorder (PTSD), as evidenced by functional neuroimaging studies showing increased amygdala responses to threats, and increased insula, putamen and caudate activity in response to heat pain. Using psychophysiology and functional magnetic resonance imaging, we studied conditioned and unconditioned autonomic and neuronal responses in subjects with PTSD versus trauma-exposed non-PTSD control (TENC) subjects. A design using an electric shock selected by subjects to be 'highly annoying but not painful' as an unconditioned stimulus (US) with partially reinforced cues allowed us to partly disentangle the expectancy- and prediction-error components from sensory components of the unconditioned response. Results: Whereas responses to the conditioned stimulus (CS) were similar in PTSD and TENC, the former displayed higher putamen, insula, caudate and amygdala responses to the US. Reactivity to the US in the anterior insula correlated with PTSD symptom severity. Functional connectivity analyses using the putamen as a seed region indicated that TENC subjects had increased amygdala-putamen connectivity during US delivery; this connection was disengaged in PTSD. Conclusions: Our results indicate that although neural processing of fear learning in people with PTSD seems to be comparable with controls, neural responses to unconditioned aversive stimuli in PTSD seem to be increased

Why is Clinical fMRI in a Resting State?

While resting state fMRI (rs-fMRI) has gained widespread application in neuroimaging clinical research, its penetration into clinical medicine has been more limited. We surveyed a neuroradiology professional group to ascertain their experience with rs-fMRI, identify perceived barriers to using rs-fMRI clinically and elicit suggestions about ways to facilitate its use in clinical practice. The electronic survey also collected information about demographics and work environment using Likert scales. We found that 90% of the respondents had adequate equipment to conduct rs-fMRI and 82% found rs-fMRI data easy to collect. Fifty-nine percent have used rs-fMRI in their past research and 72% reported plans to use rs-fMRI for research in the next year. Nevertheless, only 40% plan to use rs-fMRI in clinical practice in the next year and 82% agreed that their clinical fMRI use is largely confined to pre-surgical planning applications. To explore the reasons for the persistent low utilization of rs-fMRI in clinical applications, we identified barriers to clinical rs-fMRI use related to the availability of robust denoising procedures, single-subject analysis techniques, demonstration of functional connectivity map reliability, regulatory clearance, reimbursement, and neuroradiologist training opportunities. In conclusion, while rs-fMRI use in clinical neuroradiology practice is limited, enthusiasm appears to be quite high and there are several possible avenues in which further research and development may facilitate its penetration into clinical practice

An fMRI study of unconditioned responses in post-traumatic stress disorder

BACKGROUND: Both fear and pain processing are altered in post-traumatic stress disorder (PTSD), as evidenced by functional neuroimaging studies showing increased amygdala responses to threats, and increased insula, putamen and caudate activity in response to heat pain. Using psychophysiology and functional magnetic resonance imaging, we studied conditioned and unconditioned autonomic and neuronal responses in subjects with PTSD versus trauma-exposed non-PTSD control (TENC) subjects. A design using an electric shock selected by subjects to be 'highly annoying but not painful' as an unconditioned stimulus (US) with partially reinforced cues allowed us to partly disentangle the expectancy- and prediction-error components from sensory components of the unconditioned response. RESULTS: Whereas responses to the conditioned stimulus (CS) were similar in PTSD and TENC, the former displayed higher putamen, insula, caudate and amygdala responses to the US. Reactivity to the US in the anterior insula correlated with PTSD symptom severity. Functional connectivity analyses using the putamen as a seed region indicated that TENC subjects had increased amygdala-putamen connectivity during US delivery; this connection was disengaged in PTSD. CONCLUSIONS: Our results indicate that although neural processing of fear learning in people with PTSD seems to be comparable with controls, neural responses to unconditioned aversive stimuli in PTSD seem to be increased

第840回千葉医学会整形外科例会 47.

In the “loud-tone” procedure, a series of brief, loud, pure-tone stimuli are presented in a task-free situation. It is an established paradigm for measuring autonomic sensitization in posttraumatic stress disorder (PTSD). Successful use of this procedure during fMRI requires elicitation of brain responses that have sufficient signal-noise ratios when recorded in a supine, rather than sitting, position. We investigated the modulating effects of posture and stimulus spectral composition on peripheral psychophysiological responses to loud sounds. Healthy subjects (N = 24) weekly engaged in a loud-tone-like procedure that presented 500 msec, 95 dB sound pressure level, pure-tone or white-noise stimuli, either while sitting or supine and while peripheral physiological responses were recorded. Heart rate, skin conductance, and eye blink electromyographic responses were larger to white-noise than pure-tone stimuli (p’s < 0.001, generalized eta squared 0.073–0.076). Psychophysiological responses to the stimuli were similar in the sitting and supine position (p’s ≥ 0.082). Presenting white noise, rather than pure-tone, stimuli may improve the detection sensitivity of the neural concomitants of heightened autonomic responses by generating larger responses. Recording in the supine position appears to have little or no impact on psychophysiological response magnitudes to the auditory stimuli

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Treatment-Induced Neuroplasticity Following Intensive Speech Therapy and a Home Practice Program in Fifteen Cases of Chronic Aphasia

Introduction Evidence suggests that intensive aphasia therapy can take advantage of the brain’s potential to ‘overcome learned non-use’ (Pulvermuller & Berthier, 2008). Many patients have shown significant language improvements, but few studies have examined the neuroplastic changes accompanying such improvements over time. The current study examined changes in behavior and fMRI activity in 15 aphasic individuals who were tested pre-/post-treatment and six months after use of a tablet-based home practice program. Methods Twenty participants with chronic moderate-to-severe post-stroke aphasia completed a 2-week intensive treatment program. The primary outcome measure was confrontation naming on sets of treated (TR) or untreated (UNTR) drawings of common objects (Snodgrass & Vanderwart, 1980) and picturable actions (Masterson & Druks, 1998). Participant characteristics included a range of time post-onset (MPO=6-142; mean=26.8); auditory comprehension (BDAE-3 percentile: 6th-83rd; mean=47th); naming (BNT % correct=0-78; mean=44.4); sentence repetition (BDAE-3 percentile: 5th-80th; mean=39th). Following treatment, participants autonomously practiced retrieving words for half TR and half UNTR actions and objects with an iPad-based home practice (HP) program for six months. Functional MRI data were acquired on a 3T system at three time-points from 15 MR-compatible participants who completed the HP program (S1:pre-treatment; S2:post-treatment; S3:6mos post-HP). Participants overtly named blocks of TR, matched UNTR, and consistently correct (CORR) pictures of objects and actions in S1 and S2. Pictures were blocked by practice condition, i.e., practiced (PR) or unpracticed (UNPR) in S3. SPM8 was used for pre-processing (realign, co-register with 3D MPRAGE, segment, indirectly normalize to MNI template and smooth data) and statistical modeling. Lesions were masked and excluded from the normalization process. First-level t-tests examined task-related activation during CORR, TR, and UNTR picture naming (S1/ S2) and during CORR, PR, and UNPR picture naming (S3). Results Aphasic participants made significant gains in naming TR targets following the treatment phase and PR targets following the HP phase, even in the scanner. Contrasts by training condition and over time revealed partially overlapping ‘signature’ activity patterns that were unique to each aphasic individual. Within subject significant clusters had nearly identical voxels of peak activity across time and training/practice conditions. We present here two participants, one non-fluent (JBR) and one fluent (ACL), who both made behavioral progress during treatment and HP program (see Figure). JBR’s ‘signature’ pattern of activity (p<.05, FWE) included: • Generally smaller amplitude and spatial extent of activity over time, but slightly greater for TR/PR and UNTR/UNPR than CORR; ACL’s ‘signature’ pattern included: • Generally smaller amplitude and spatial extent of activity in network post-treatment, with greatest and most asymmetrically right hemisphere activity post-HP; • Activity in R posSTG decreased over time for CORR pictures while increasing over time for TR/PR pictures Discussion Short-term intensive treatment followed by a home practice program can produce enduring language improvements that provide rich opportunities for investigating treatment-induced neuroplasticity in aphasia. Given the high degree of individual variability in lesion location/extent, and the resulting variability in aphasia type/severity, it makes sense to examine treatment-induced changes in neural activity patterns within subjects where ‘signature’ patterns of activity are remarkably reliable across time