Basal Ganglia Volumes Research Articles

Larger Gray Matter Volume in the Basal Ganglia of Heavy Cannabis Users Detected by Voxel-Based Morphometry and Subcortical Volumetric Analysis.

Background: Structural imaging studies of cannabis users have found evidence of both cortical and subcortical volume reductions, especially in cannabinoid receptor-rich regions such as the hippocampus and amygdala. However, the findings have not been consistent. In the present study, we examined a sample of adult heavy cannabis users without other substance abuse to determine whether long-term use is associated with brain structural changes, especially in the subcortical regions.Method: We compared the gray matter volume of 14 long-term, heavy cannabis users with non-using controls. To provide robust findings, we conducted two separate studies using two different MRI techniques. Each study used the same sample of cannabis users and a different control group, respectively. Both control groups were independent of each other. First, whole-brain voxel-based morphometry (VBM) was used to compare the cannabis users against 28 matched controls (HC1 group). Second, a volumetric analysis of subcortical regions was performed to assess differences between the cannabis users and a sample of 100 matched controls (HC2 group) obtained from a local database of healthy volunteers.Results: The VBM study revealed that, compared to the control group HC1, the cannabis users did not show cortical differences nor smaller volume in any subcortical structure but showed a cluster (p < 0.001) of larger GM volume in the basal ganglia, involving the caudate, putamen, pallidum, and nucleus accumbens, bilaterally. The subcortical volumetric analysis revealed that, compared to the control group HC2, the cannabis users showed significantly larger volumes in the putamen (p = 0.001) and pallidum (p = 0.0015). Subtle trends, only significant at the uncorrected level, were also found in the caudate (p = 0.05) and nucleus accumbens (p = 0.047).Conclusions: This study does not support previous findings of hippocampal and/or amygdala structural changes in long-term, heavy cannabis users. It does, however, provide evidence of basal ganglia volume increases.

Voxel-based morphometry analysis of structural brain scans in skin-picking disorder

BackgroundSkin-picking disorder (SPD) is characterized by the excessive and repetitive manipulation of one's own skin resulting in tissue damage and impaired social functioning. There are only a few studies with small sample sizes that examined possible brain abnormalities in SPD, which is classified as a syndrome related to obsessive-compulsive disorders (OCD). MethodThe current voxel-based morphometry (VBM) study compared data from 35 SPD patients and 35 control participants including both genders (mean age = 35 years, SD = 15). In addition, patients' self-reports on symptom severity, duration and impairment were correlated with grey matter volumes (GMV) in regions of interest (basal ganglia, orbitofrontal cortex (OFC), insula). ResultsRelative to controls, the patients showed reduced GMV in the OFC and in the insula. Basal ganglia volume did not differ between the groups. Within the SPD group, disorder-related impairment and symptom duration were negatively correlated with GMV in basal ganglia regions. DiscussionThis study indicated that SPD patients show GMV abnormalities in regions concerned with interoception (insula) and reinforcement of behavior (OFC). Whether the correlational findings are disorder-specific or reflect secondary processes needs to be investigated in a future longitudinal study with additional clinical control groups.

T238. Antipsychotic Treatment and the Basal Ganglia: A Structural MRI Study

MRI studies demonstrate morphological brain changes after antipsychotic treatment, but the mechanism is unknown. We investigated if basal ganglia volumes differ by treatment status in psychosis and bipolar disorders. We hypothesized an association with dosage, remission status and estimated receptor occupancy.

Cortical thickness, stance control, and arithmetic skill: An exploratory study in premanifest Huntington disease

BackgroundHuntington disease (HD) is an inherited neurodegenerative disorder most commonly manifesting in adulthood. Identification of biomarkers tracking neurodegeneration before the onset of motor symptoms is important for future interventional studies. Our study aimed to contribute in the phenotypic characterization of the premanifest HD phase. Methods28 premanifest subjects (preHD), 25 age-matched controls, and 12 manifest HD patients were enrolled for the study. The participants underwent a multimodal protocol including cognitive evaluations, arithmetic ability test, posturography, composite cerebellar functional test (CCFS), and brain 3T-MRI. PreHD were divided at the group median for predicted years to expected onset into “far-from-onset” (>15 years, PreHD-far), and “close-to-onset” (≤15 years, preHD-close). Basal ganglia volumes and cortical thickness were computed using FreeSurfer. ResultsPreHD-close showed significantly lower scores than controls in Symbol Digit Modalities Test (p = 0.017), Arithmetic subtraction task (p = 0.04), and MMSE (p < 0.006). At posturography, preHD-close showed increased sway velocity (<0.04) and distance (p < 0.02) compared to controls. PreHD-close had reduced striatum and globus pallidus volumes and left occipital cortical thinning compared to controls. Compared to PreHD far-from-onset, PreHD-close showed bilateral cortical thinning in occipital and parahippocampal regions, inversely correlating with burden score and prognostic index for HD. CCFS only differed between controls and manifest HD. PreHD far-from-onset did not show significant differences in comparison with controls. ConclusionsWe confirmed that quantitative brain MRI represents a valid biomarker of neurodegeneration in preHD. Posturography and Arithmentic tests seem promising tools for detecting early changes in premanifest HD, but need to be further confirmed in large cohorts.

Abstract WP344: Basal Ganglia Atrophy in Cerebral Amyloid Angiopathy

Background/Purpose: Cerebral Amyloid Angiopathy (CAA) is associated with cortical and white matter atrophy. We hypothesized that atrophy in CAA extended into the subcortical gray matter as well and might explain previously observed alterations in subcortical gray matter diffusion-tensor properties. Methods: We compared multimodal MRIs from 80 prospectively enrolled non-demented patients with probable CAA, to two other cohorts: 80 Healthy Controls (HC) and 80 patients with Alzheimer’s Disease (AD) from the AD Neuroimaging Initiative. Validated FreeSurfer algorithms were used to calculate Gray Matter (GMV) and Basal Ganglia Volumes (BGV), expressed as percentage of intracranial volume (ICV). High-resolution diffusion scans were used to calculate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) within the basal ganglia. A visual basal ganglia atrophy scale was also developed to compare atrophy between 93 patients with CAA-related intracerebral hemorrhage (CAA-ICH) and 93 age-matched patients diagnosed with Hypertensive Arteriopathy and ICH (HTN-ICH). Results: CAA patients (mean age: 70.3 ± 8.5) were age-matched to HC (71.8 ± 3.7) and AD patients (70.4 ± 6.8). Patients with CAA had significantly lower BGV (1.16% ± 0.14) when compared to both HC (1.30% ± 0.13, p&lt;0.0001) and AD (1.23% ± 0.12, p=0.003). Within the CAA cohort, there was a positive association between BGV and GMV (r=0.45, p&lt;0.0001) and negative association between BGV and FA (r=-0.36, p=0.001). All associations remained independent after correcting for age, sex, and presence of hypertension. For the clinical ICH cohorts, patients diagnosed with CAA-ICH displayed significantly lower visually rated BGV when compared to similar aged patients with HTN-ICH (mean age: 68.5 for both groups, basal ganglia atrophy scale: 7.31 ± 1.03 vs 8.24 ± 1.14, p&lt;0.0001). Conclusions: Patients with CAA displayed substantial atrophy in the basal ganglia when compared to HC, AD, and HTN-ICH patients. Within the CAA cohort, greater basal ganglia atrophy was independently correlated with greater cortical atrophy and previously observed increases in basal ganglia anisotropy. The mechanisms for and clinical manifestations of CAA-related basal ganglia atrophy remain to be determined.

Basal ganglia involvement in ARX patients: The reason for ARX patients very specific grasping?

The ARX (Aristaless Related homeoboX) gene was identified in 2002 as responsible for XLAG syndrome, a lissencephaly characterized by an almost complete absence of cortical GABAergic interneurons, and for milder forms of X-linked Intellectual Disability (ID) without apparent brain abnormalities. The most frequent mutation found in the ARX gene, a duplication of 24 base pairs (c.429_452dup24) in exon 2, results in a recognizable syndrome in which patients present ID without primary motor impairment, but with a very specific upper limb distal motor apraxia associated with a pathognomonic hand-grip, described as developmental Limb Kinetic Apraxia (LKA).In this study, we first present ARX expression during human fetal brain development showing that it is strongly expressed in GABAergic neuronal progenitors during the second and third trimester of pregnancy. We show that although ARX expression strongly decreases towards the end of gestation, it is still present after birth in some neurons of the basal ganglia, thalamus and cerebral cortex, suggesting that ARX also plays a role in more mature neuron functioning. Then, using morphometric brain MRI in 13 ARX patients carrying c.429_452dup24 mutation and in 13 sex- and age-matched healthy controls, we show that ARX patients have a significantly decreased volume of several brain structures including the striatum (and more specifically the caudate nucleus), hippocampus and thalamus as well as decreased precentral gyrus cortical thickness. We observe a significant correlation between caudate nucleus volume reduction and motor impairment severity quantified by kinematic parameter of precision grip.As basal ganglia are known to regulate sensorimotor processing and are involved in the control of precision gripping, the combined decrease in cortical thickness of primary motor cortex and basal ganglia volume in ARX dup24 patients is very likely the anatomical substrate of this developmental form of LKA.

The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders.

Brief cognitive screens lack the sensitivity to detect mild cognitive impairment (MCI) or support differential diagnoses. The objective of this study was to validate the 10-minute, tablet-based University of California, San Francisco (UCSF) Brain Health Assessment (BHA) to overcome these limitations. Cross-sectional. UCSF Memory and Aging Center. Older adults (N=347) (neurologically healthy controls (n=185), and individuals diagnosed with MCI (n=99), dementia (n=42), and as normal with concerns (n=21)). The BHA includes subtests of memory, executive function and speed, visuospatial skills, and language and an optional informant survey. Participants completed the Montreal Cognitive Assessment (MoCA) and criterion-standard neuropsychological tests. Standardized structural 3T brain magnetic resonance imaging was performed in 145 participants. At a fixed 85% specificity rate, the BHA had 100% sensitivity to dementia and 84% to MCI; the MoCA had 75% sensitivity to dementia and 25% to MCI. The BHA had 83% sensitivity to MCI likely due to AD and 88% to MCI unlikely due to AD, and the MoCA had 58% sensitivity to MCI likely AD and 24% to MCI unlikely AD. The BHA subtests demonstrated moderate to high correlations with the criterion-standard tests from their respective cognitive domains. Memory test performance correlated with medial temporal lobe volumes; executive and speed with frontal, parietal, and basal ganglia volumes; and visuospatial with right parietal volumes. The BHA had excellent combined sensitivity and specificity to detect dementia and MCI, including MCI due to diverse etiologies. The subtests provide efficient, valid measures of neurocognition that are critical in making a differential diagnosis.

Tics and Tourette: a clinical, pathophysiological and etiological review.

Describe developments in the etiological understanding of Tourette syndrome. Tourette syndrome is a complex heterogenous clinical syndrome, which is not a unitary entity. Pathophysiological models describe gamma-aminobutyric acid-ergic-associated disinhibition of cortico-basal ganglia motor, sensory and limbic loops. MRI studies support basal ganglia volume loss, with additional white matter and cerebellar changes. Tourette syndrome cause likely involves multiple vulnerability genes and environmental factors. Only recently have some vulnerability gene findings been replicated, including histidine decarboxylase and neurexin 1, yet these rare variants only explain a small proportion of patients. Planned large genetic studies will improve genetic understanding. The role of inflammation as a contributor to disease expression is now supported by large epidemiological studies showing an association with maternal autoimmunity and childhood infection. Investigation of blood cytokines, blood mRNA and brain mRNA expression support the role of a persistent immune activation, and there are similarities with the immune literature of autistic spectrum disorder. Current treatment is symptomatic, although there is a better appreciation of factors that influence treatment response. At present, therapeutics is focused on symptom-based treatments, yet with improved etiological understanding, we will move toward disease-modifying therapies in the future.

Brain Structural Changes following HIV Infection: Meta-Analysis.

Numerous studies have used structural neuroimaging to measure HIV effects on brain macroarchitecture. While many have reported changes in total brain volume, gray matter volume, white matter volume, CSF volume, and basal ganglia volume following HIV infection, quantitative inconsistencies observed across studies are large. Our aim was to evaluate the consistency and temporal stability of serostatus effects on a range of structural neuroimaging measures. PubMed, reference lists, and corresponding authors. The meta-analysis included 19 cross-sectional studies reporting HIV effects on cortical and subcortical volume from 1993 to 2016. Random-effects meta-analysis was used to estimate individual study standardized mean differences and study heterogeneity. Meta-regression was used to examine the effects of the study publication year. Meta-analysis revealed standardized mean differences related to the serostatus of -0.65 (P = .002) for total brain volume, -0.28 for gray matter volume (P = .008), -0.24 (P = .076) for white matter volume, and 0.56 (P = .001) for CSF volume. Basal ganglia volume differences related to serostatus were not significant. Nevertheless, estimates of between-study heterogeneity suggested that much of the observed variance was between studies. Publication year was associated with recent reductions in many neurostructural effects. Many studies pooled participants with varying durations of treatment, disease, and comorbidities. Image-acquisition methods changed with time. While published studies of HIV effects on brain structure had substantial variations that are likely to result from changes in HIV treatment practice during the study period, quantitative neurostructural measures can reliably detect the effects of HIV infection during treatment, serving as reliable biomarkers.

Stereological Analysis of the Brain in Methamphetamine Abusers Compared to the Controls

Background: Methamphetamine (MA) is an addictive and stimulant drug that its abuse causes psychological and cognitive symptoms. MA abuse can cause structural changes in the brain. Objectives: The current study aimed to evaluate stereological changes of the brains of MA abusers, compared to the controls. Patients and Methods: The current case-control study was conducted on magnetic resonance (MR) images from MA abusers and healthy controls (n = 10 in each group), in Zahedan, Iran. The convenience sampling method was employed to select the subjects. MR images of the brains of the 2 groups in frontal, coronal, and sagittal axes with 4-mm slide thickness and 0.5-mm intervals were acquired. Parameters including total volume (V) and volume density (Vv) of different parts of the brain were estimated based on the Cavalieri point counting stereological method. To analyze the data, descriptive statistics and the Mann-Whitney U-test were applied. The significance level was considered P < 0.05. Results: The results showed that the volume of the cerebellum, the volume and volume density of the ventricles, and gray matter volume and volume density, and the basal ganglia volume density in MA group was significantly smaller than those of the controls (P < 0.05). But, white matter volume and volume density in the MA abusers were significantly larger than those of the healthy subjects (P < 0.05). In addition, there were no significant differences between the total brain, the hippocampus, and the basal ganglia volumes between the 2 groups. Conclusions: According to the results of the current study, MA abuse can cause structural changes in the brain components. MR imaging by the stereological methods can be employed as a technique to determine the level of such damages in substance abusers.

The impact of vascular risk factors on brain volume and lesion load in patients with early multiple sclerosis

Background: Vascular risk factors (VRF) in multiple sclerosis (MS) patients have been associated with lower brain volumes. It is currently unknown if this association already exists in early MS and how it develops over time. Methods: We identified 82 patients with clinically isolated syndrome (CIS) (n = 61) or with early relapsing-remitting MS (n = 21) and assessed their VRF including arterial hypertension, hyperlipidaemia, diabetes mellitus and smoking. We analysed T2-lesion load, normalized brain volume (NBV), cortical grey (cGMV) and white matter volumes (WMV), thalamic and basal ganglia volumes at baseline and follow-up magnetic resonance imaging (MRI) and assessed the percentage of brain volume change (PBVC) using SIENA. Results: Patient mean age was 32.4 (±8.7) years and 54 (65%) were women. Median follow-up period was 42 (29–54) months. In total, 26 patients (31.7%) had one or more VRF (VRF+). At baseline, VRF+ patients had a lower NBV (1530.9 cm3 vs 1591.2 cm3, p = 0.001), a lower cGMV (628.5 cm3 vs 668.6 cm3, p = 0.002) and WMV (752.2 cm3 vs 783.9 cm3, p = 0.009) than VRF-negative patients. Similar results were obtained at follow-up. PBVC was comparable between patients with and without VRF. Conclusion: VRF are associated with lower brain volume already in early MS but do not lead to increased brain volume loss during 3.5 years of follow-up.

Basal ganglia and ventricle volume in first-episode psychosis. A family and clinical study

Patients with first-episode psychosis (FEP) exhibit considerable heterogeneity in subcortical brain volumes. We sought to compare ventricle and basal ganglia volumes in FEP patients (n = 50) with those in unaffected relatives (n = 21) and healthy controls (n = 24). Participants were assessed with a semistructured interview and underwent structural magnetic resonance imaging (MRI). Patients had significantly larger left lateral, right lateral and third ventricle volumes than their siblings and larger third ventricle volumes than controls. Additionally, they showed a trend toward significance by having larger right caudate nuclei than controls. Moreover, FEP patients showed lower caudate and putamen laterality indexes (leftward shifts) than healthy controls but not regarding their siblings. Besides, negative dimension was directly associated with lateral and third ventricle volumes and positive dimension with thalamus and ventral diencephalon nuclei. Our findings added evidence to the associations between early enlargement of brain ventricles and negative symptoms, and between early enlargement of thalamic and ventral-diencephalon nuclei and positive symptoms. Moreover, the cumulative exposition to antipsychotics in FEP patients might be related to enlargement of certain subcortical structures, such as the right nucleus accumbens and third ventricle.

Basal ganglia involvement in ARX gene mutated patients: The reason for very specific grasping in ARX mutated patients?

Objective: The ARX (Aristaless Related homeoboX) gene was identified in 2002 as responsible for a lissencephaly characterized by an almost complete absence of cortical GABAergic interneurons (OMIM#300215), and for milder forms of X-linked Intellectual Disability (ID) without apparent brain abnormalities. The most frequent mutation found in this gene (c.429_452dup24) results in a recognizable syndrome: ARX patients exhibit ID, without primary motor impairment, but with a very specific upper limb distal motor apraxia associated with a pathognomonic hand-grip. The goal of the present study was to find a possible neuroanatomical dysmorphic pattern that could help to explain the specific motor phenotype of ARX patients. Methods: We first analyzed ARX expression in the normal developing and in adult human brain, and second we performed a kinematic and morphometric brain MRI in 13 ARX patients (all with the same c.429_452dup24 mutation, mean age=20.3 years) and in 13 sex- and age-matched healthy controls (mean age=20.6 years). 3D T1-weighted MRI data were analyzed with FreeSurfer version 5.3. We also built up a 3D model of the basal ganglia. Results: ARX patients had a significantly decreased striatal volume [F(1,24)=9.2, p=0.005] (especially caudate nucleus), associated with a decreased cortical thickness in precentral gyrus, two brain structures where ARX was strongly expressed. Furthermore, we observed a significant correlation (r2=0.46, p=0.001) between the volume of the caudate nucleus and the degree of motor impairment quantified by kinematic parameters of the precision grip: the smaller the caudate nucleus volume was, the more impaired the kinematic parameter was. Conclusion: As basal ganglia are known to regulate sensorimotor processing and are especially involved in the control of precision gripping, the combined decrease in cortical thickness of primary sensorimotor cortex and in basal ganglia volume in ARX dup24 patients is very likely involved in their specific motor phenotype.

Long-term attention deficits combined with subcortical and cortical structural central nervous system alterations in young adults born small for gestational age

BackgroundBeing born small for gestational age has been associated with neurodevelopmental disabilities and smaller gray matter volumes in childhood. However, it is not known if these changes persist in adults and whether SGA has any impact on attention memory and IQ. AimsThe goal of this study was to evaluate the association between birth weight and gray matter anatomy in adults born small for gestational age at term, in relation to IQ, attention and memory. Materials and methodsThis prospective follow-up study at age 20 included 39 adults born small for gestational age at term and 37 adults born appropriate for gestational age at term. Detailed neurocognitive skills were assessed (IQ, attention and memory). Anatomical images were analyzed using Voxel-Based-Morphometry and FreeSurfer. ResultsAdults born small for gestational age at term had lower performances in subtests assessing attention and executive functions. They also showed smaller total intracranial volume; smaller volumes and surface areas in the frontal lobe, inferior/middle parietal and temporal gyrus; smaller cerebellum, thalamus and basal ganglia volumes. Interestingly, all these structures correlated with attention subtests. ConclusionThese results highlight the persistent effects of being born small for gestational age on attention and associated brain structures.

Brain correlates of progressive olfactory loss in Parkinson's disease

BackgroundOlfactory dysfunction is present in a large proportion of patients with Parkinson's disease (PD) upon diagnosis. However, its progression over time has been poorly investigated. The few available longitudinal studies lack control groups or MRI data. ObjectiveTo investigate the olfactory changes and their structural correlates in non-demented PD over a four-year follow-up. MethodsWe assessed olfactory function in a sample of 25 PD patients and 24 normal controls of similar age using the University of Pennsylvania Smell Identification test (UPSIT). Structural magnetic resonance imaging data, obtained with a 3-T Siemens Trio scanner, were analyzed using FreeSurfer software. ResultsAnalysis of variance showed significant group (F = 53.882; P < 0.001) and time (F = 6.203; P = 0.016) effects, but the group-by-time interaction was not statistically significant. UPSIT performance declined ≥1.5 standard deviations in 5 controls and 7 patients. Change in UPSIT scores of patients correlated positively with volume change in the left putamen, right thalamus, and right caudate nucleus. ConclusionOlfactory loss over time in PD and controls is similar, but we have observed significant correlation between this loss and basal ganglia volumes only in patients.

Effect of exposure to polycyclic aromatic hydrocarbons on basal ganglia and attention-deficit hyperactivity disorder symptoms in primary school children

BackgroundPolycyclic aromatic hydrocarbons (PAHs) have been proposed as environmental risk factors for attention deficit hyperactivity disorder (ADHD). The effects of these pollutants on brain structures potentially involved in the pathophysiology of ADHD are unknown. ObjectiveThe aim of this study was to investigate the effects of PAHs on basal ganglia volumes and ADHD symptoms in school children. MethodsWe conducted an imaging study in 242 children aged 8–12years, recruited through a set of representative schools of the city of Barcelona, Spain. Indoor and outdoor PAHs and benzo[a]pyrene (BPA) levels were assessed in the school environment, one year before the MRI assessment. Whole-brain volumes and basal ganglia volumes (caudate nucleus, globus pallidus, putamen) were derived from structural MRI scans using automated tissue segmentation. ADHD symptoms (ADHD/DSM-IV Scales, American Psychiatric Association 2002) were reported by teachers, and inattentiveness was evaluated with standard error of hit reaction time in the attention network computer-based test. ResultsTotal PAHs and BPA were associated with caudate nucleus volume (CNV) (i.e., an interquartile range increase in BPA outdoor level (67pg/m3) and indoor level (76pg/m3) was significantly linked to a decrease in CNV (mm3) (β=−150.6, 95% CI [−259.1, −42.1], p=0.007, and β=−122.4, 95% CI [−232.9, −11.8], p=0.030 respectively) independently of intracranial volume, age, sex, maternal education and socioeconomic vulnerability index at home). ADHD symptoms and inattentiveness increased in children with higher exposure to BPA, but these associations were not statistically significant. ConclusionsExposure to PAHs, and in particular to BPA, is associated with subclinical changes on the caudate nucleus, even below the legislated annual target levels established in the European Union. The behavioral consequences of this induced brain change were not identified in this study, but given the caudate nucleus involvement in many crucial cognitive and behavior processes, this volume reduction is concerning for the children's neurodevelopment.

Accelerated aging of the putamen in patients with major depressive disorder.

Growing evidence indicates that major depressive disorder (MDD) is characterized by accelerated biological aging, including greater age-related changes in physiological functioning. The disorder is also associated with abnormal neural reward circuitry, particularly in the basal ganglia (BG). Here we assessed age-related changes in BG volume in both patients with MDD and healthy control participants. We obtained whole-brain T1-weighted images from patients with MDD and healthy controls. We estimated grey matter volumes of the BG, including the nucleus accumbens, caudate, pallidum and putamen. Volumes were assessed using multivariate analysis of covariance (MANCOVA) with age as a covariate, followed by appropriate post hoc tests. We included 232 individuals (116 patients with MDD) in our analysis. The MANCOVA yielded a significant group × age interaction (p = 0.043). Analyses for each region yielded a significant group × age interaction in the putamen (univariate test, p = 0.005; permutation test, p = 0.004); this effect was not significant in the other regions. The negative association between age and putamen volume was twice as large in the MDD than in the control group (-35.2 v. -16.7 mm3/yr), indicating greater age-related volumetric decreases in the putamen in individuals with MDD than in controls. These findings are cross-sectional; future studies should assess the longitudinal impact of accelerated aging on anhedonia and neural indices of reward processing. Our results indicate that putamen aging is accelerated in patients with MDD. Thus, the putamen may uniquely contribute to the adverse long-term effects of depressive psychopathology and may be a useful target for the treatment of MDD across the lifespan.

Brain Lesions among Orally Fed and Gastrostomy-Fed Dysphagic Preterm Infants: Can Routine Qualitative or Volumetric Quantitative Magnetic Resonance Imaging Predict Feeding Outcomes?

The usefulness of qualitative or quantitative volumetric magnetic resonance imaging (MRI) in early detection of brain structural changes and prediction of adverse outcomes in neonatal illnesses warrants further investigation. Our aim was to correlate certain brain injuries and the brain volume of feeding-related cortical and subcortical regions with feeding method at discharge among preterm dysphagic infants. Using a retrospective observational study design, we examined MRI data among 43 (22 male; born at 31.5 ± 0.8 week gestation) infants who went home on oral feeding or gastrostomy feeding (G-tube). MRI scans were segmented, and volumes of brainstem, cerebellum, cerebrum, basal ganglia, thalamus, and vermis were quantified, and correlations were made with discharge feeding outcomes. Chi-squared tests were used to evaluate MRI findings vs. feeding outcomes. ANCOVA was performed on the regression model to measure the association of maturity and brain volume between groups. Out of 43 infants, 44% were oral-fed and 56% were G-tube fed at hospital discharge (but not at time of the study). There was no relationship between qualitative brain lesions and feeding outcomes. Volumetric analysis revealed that cerebellum was greater (p < 0.05) in G-tube fed infants, whereas cerebrum volume was greater (p < 0.05) in oral-fed infants. Other brain regions did not show volumetric differences between groups. This study concludes that neither qualitative nor quantitative volumetric MRI findings correlate with feeding outcomes. Understanding the complexity of swallowing and feeding difficulties in infants warrants a comprehensive and in-depth functional neurological assessment.

Striatal dysfunction in X‐linked dystonia‐parkinsonism is associated with disease progression

X-linked dystonia-parkinsonism (XDP) is an inherited neurodegenerative adult-onset movement disorder associated with striatal atrophy. As the dopaminergic system has not yet been systemically studied in this basal ganglia model disease, it is unclear whether nigrostriatal dysfunction contributes to parkinsonism in XDP. Pre- and post-synaptic dopaminergic function was assessed in XDP. A total of 10 123 jod-benzamide (IBZM) single-photon emission computed tomography (SPECT) images were obtained for nine patients aged 42.3 ± 9.5 years (SD; range 30-52) and one asymptomatic mutation carrier (38 years), and four ioflupane (FP-CIT) SPECT images were obtained for four patients, aged 41.5 ± 11.6 years (range 30-52 years). Structural magnetic resonance imaging was also performed for all mutation carriers and 10 matched healthy controls. All patients were men who suffered from severe, disabling segmental or generalized dystonia and had varying degrees of parkinsonism. IBZM SPECT images were pathological in 8/9 symptomatic patients with distinct reduced post-synaptic tracer uptake in the caudate nucleus and putamen, and unremarkable in the asymptomatic mutation carrier. Longer disease duration was correlated with lower IBZM binding ratios. All subjects exhibited slightly reduced FP-CIT uptake values compared to controls for each analyzed region (-37% to -41%) which may be linked to basal ganglia volume loss. Visual inspection revealed physiological FP-CIT uptake in 1/4 patients. This nuclear imaging study provides evidence that the functional decline of post-synaptic dopaminergic neurotransmission is related to disease duration and ongoing neurodegeneration. Given the severe striatal cell loss which could be verified with post-synaptic nuclear imaging, both parkinsonism and dystonia in XDP are probably mainly due to striatal dysfunction.

Psychological intervention with working memory training increases basal ganglia volume: A VBM study of inpatient treatment for methamphetamine dependence

Psychological intervention with working memory training increases basal ganglia volume: A VBM study of inpatient treatment for methamphetamine dependence