White Matter Volume Changes Research Articles

Cell-Specific Gene Expressions Underlie Selective White Matter Loss Vulnerability in Mild Traumatic Brain Injury.

Traumatic brain injury (TBI), a risk factor for later-life dementia, leads to salient brain atrophy, particularly in the white matter. It is not clear how white matter atrophy progresses or why some brain regions are damaged while others are spared. We hypothesized that spatial variations of cell-specific gene expression contributed to the selective white matter loss vulnerability following mild TBI (mTBI). Gene expression data were sourced from the publicly available Allen Human Brain Atlas, which comprises microarray data spanning nearly the entire brain, derived from six neurologically normal adult donors. A total of 100 patients with acute stage (within 7 days post-injury) mTBI were enrolled. Of these, 60 patients were followed up at 3 months post-injury and 37 were followed up at 6-12 months post-injury. In addition, 59 healthy controls (HCs), matched for age, gender, and education, were included for comparative analysis. White matter volume changes were analyzed at both the acute stage, 3 months, and 6-12 months follow-up in mTBI patients compared with HCs. Patients with mTBI exhibited significant white matter atrophy in the frontal, parietal, and temporal cortices at 3 months post-injury, which even persisted at 6-12 months follow-up. In addition, mTBI patients with cognitive deficits showed more severe brain atrophy compared with those without cognitive deficits. Crucially, the gene expression marking endothelial cells and S1 pyramidal neurons were associated with increased brain atrophy, whereas the gene expression marking microglia and CA1 pyramidal neurons were associated with decreased brain atrophy in mTBI patients at 3 months post-injury. Microglia and endothelial cells can explain 23.6% of regional variations in the white matter atrophy. These findings suggested that modulating cellular activation, especially by promoting microglial activation at 3 months post-injury, might be a promising approach to prevent white matter atrophy, enhance cognitive outcomes, and reduce the risk of later-life dementia.

Beyond Hypertension: Examining Variable Blood Pressure's Role in Cognition and Brain Structure.

Hypertension or high blood pressure (BP) is one of the 12 modifiable risk factors that contribute to 40% of dementia cases that could be delayed or prevented. Although hypertension is associated with cognitive decline and structural brain changes, less is known about the long-term association between variable BP and cognitive/brain changes. This study examined the relationship between variable BP and longitudinal cognitive, white matter hyperintensity (WMH), gray matter (GM), and white matter (WM) volume change over time and postmortem neuropathology. A total of 4,606 participants (32,776 follow-ups) from RADC Research Resource Sharing Hub (RUSH) and 2,114 participants (9,827 follow-ups) fromtheAlzheimer's Disease Neuroimaging Initiative (ADNI) were included. Participants were divided into 1 of 3 groups: normal, high, or variable BP. Linear-mixed models investigated the relationship between BP and cognition, brain structure, and neuropathology. Older adults with variable BP exhibited the highest rate of cognitive decline followed by high and then normal BP. Increased GM volume loss and WMH burden were also observed in variable compared to high and normal BP. In postmortem neuropathology, both variable and high BP had increased rates compared to normal BP. Results were consistent across the RUSH and ADNI participants, supporting the generalizability of the findings. Damages potentially associated with variable BP may reduce resilience to future dementia-related pathology and increased the risk of dementia more than that caused by high BP. Improved treatment and management of variable BP may help reduce cognitive decline in the older adult population.

Can gray matter loss in early adolescence be explained by white matter growth?

AbstractA fundamental puzzle about brain development is why the volume of gray matter (GM) apparently declines as white matter (WM) grows when children enter adolescence. Since pruned synapses are too small to affect GM volume, a prevailing theory posits that an expanded distribution of myelin causes the inner edge of the GM to “whiten” while total brain volume remains steady, shifting the MRI‐measured WM:GM boundary closer to the brain's outer surface. This theory inherently predicts that GM volume loss is concurrent with WM volume growth across regions, within sexes and over time, although these predictions have yet to be explicitly tested. In this study, we test these predictions by mapping regional GM and WM volumetric changes in 2333 participants of the Adolescent Brain Cognitive Development study aged 9–14 years who each received three MRI scans 2 years apart. We show that average GM and WM volume changes follow distinct spatial, temporal, and sex‐specific patterns, indicating that GM volume loss is not balanced by WM volume growth, although cortical GM thinning is weakly correlated with WM growth in some regions. We conclude that myelin is not the main source of measured GM volume loss, and we propose alternative candidates.

The effect of estradiol add-back: a longitudinal MRI study in prostate cancer patients.

We investigated the effect of estradiol add-back therapy (EAT) on brain activation related to cognitive function and affect in addition to putative changes in gray and white matter volume in testosterone depleted participants with prostate cancer. We conducted a randomized controlled, double-blinded trial in which 40 patients received 0.9 mg of transdermal estradiol per day for 6 months or matched placebo. Anatomical MRI and three functional MRI (fMRI) scans were obtained for the emotion recognition task, verbal memory task, and visuospatial memory task. Activation in corresponding cognitive and affective brain networks was demonstrated for all tasks. Longitudinally, there was no difference in brain activation, reaction time, or accuracy in response to the fMRI tasks between the EAT group and placebo group at 6 months. In addition, there was no detectable change in whole-brain gray or white matter volume or in hippocampal volume between the two groups after 6 months. This study supports earlier findings that EAT does not improve verbal memory or affect and has no immediate effect on hippocampal volume in testosterone depleted patients with prostate cancer.

Lobe‐specific changes in white matter volume and myelination following 6‐month 40 Hz gamma sensory stimulation in patients on the Alzheimer’s disease spectrum

AbstractBackgroundAlthough morphometric changes in Alzheimer’s Disease (AD) occur both in gray and white matter, gray matter changes had been the primary focus of previous work. Recent studies have highlighted the importance of pathological changes in white matter and myelination in AD patients, including early changes to oligodendrocytes and transcription of myelin protein genes in the white matter prior to symptoms of cognitive decline, even in subjects with AD but without other neurological comorbidities (Ferrer et al., 2020). Since neuronal activities, particularly network oscillations have been shown to promote myelination, the present study examined how 40Hz gamma stimulation affected white matter volume and myelination in different cortical lobes in patients with AD.MethodData were obtained from the Overture trial (NCT03555281) in which treatment participants received daily, at‐home, 40Hz gamma sensory stimulation for six months, while placebo participants received sham stimulation (treatment‐to‐placebo ratio 2:1). Magnetic resonance imaging (MRI) data were collected at 1.5 Tesla at baseline, month 3, and month 6. MRI T1 images and T1w/T2w ratios were used to estimate volume (N = 38) and myelination (N = 36), respectively. Using Bayesian linear mixed effects modeling, we estimated white matter volume and myelination percent changes with respect to baseline. Treatment group results were reported in relation to the placebo group.ResultWith respect to the placebo group: In the left hemisphere, the treatment group exhibited reduced white matter atrophy in the frontal lobe (‐3.27±1.4, p = 0.0225), in the temporal lobe (‐3.9±1.76, p = 0.0306), in the parietal lobe (‐3.32±1.43, p = 0.0236), in the occipital lobe (‐4.1±1.72, p = 0.0195) and reduced demyelination in the frontal lobe (‐5.13±2.12, p = 0.0186), in the temporal lobe (‐5.33±2.42, p = 0.0321), in the parietal lobe (‐5.7±2.07 (p = 0.0079), in the occipital lobe (‐5.65±2.52, p = 0.0296). In the right hemisphere, the treatment group trended towards reduced white matter volume loss and demyelination in all lobes, however, demyelination was significantly reduced in the parietal lobe (‐4.48±2.09, p = 0.037), and in the occipital lobe (‐5.5±2.22, p = 0.0165).ConclusionWhite matter atrophy and demyelination were statistically significantly reduced in all lobes of the left hemisphere and trended towards reduction in the right hemisphere, demonstrating that 40Hz sensory stimulation can reduce the neurodegeneration associated with AD.

Demystifying the Role of Radiation Dose Bath in Brain Injury Using Machine Learning.

It is well known that high-dose radiation results in brain injury, the long-term effects of low-dose radiation, however, is uncertain. The purpose of this study was to investigate the role of low-dose bath on MRI changes, on both clinical and micro-architectural levels, using machine learning and computational methods. Six hundreds and fifty-six temporal lobe and 45 whole brain DVHs from patients treated for nasopharyngeal cancer (NPC) with IMRT or proton were included in this study. Temporal lobe injury (TLI) was defined as development of new T1 enhancement on MRI with or without surrounding T2 edema. Patients were divided randomly into train (50%) and test (50%) sets. Accuracy and AUC were used to evaluate the model performance. Minimum redundancy maximum relevance (MRMR) or SHAP algorithms was employed for feature selection. Support vector machine or random forest was used for classification. Automated cortical region segmentation using FreeSurfer v6 was performed in 33 patients with a minimum follow-up of 4 years. Architectural and biological MRI changes were determined in 34 different brain regions for each individual patient. The top-ranked temporal lobe features predicting TLI were V66/V38 for IMRT patients and V10 for proton patients with an AUC of 0.95 and 0.74, respectively. For whole brain, the top features were V16 and V13 with an AUC of 0.70. The rates of TLI at 5 years for V10-20(whole brain) ≥ 180cc and V10-20(whole brain) < 180 were 39.5% and 6.2%, respectively (HR = 5.5, 95% CI 1.4-22.0, p = 0.02). There were global changes in gray matter thickness, with most pronounced changes occurred in parietal lobe (-4.79%, p = 0.007) and occipital lobe (-5.68%, p = 0.03). Similarly, there were diffuse changes in white matter and subcortical volume. After radiation, the frontal lobe increased by 17.5% (p = 0.04), lateral ventricle 41% (p = 0.03), and choroid plexus 34.3% (p = 0.03). Low-dose radiation bath is associated with increased risk of temporal lobe injury and global disruption in brain architecture in NPC survivors.

Brain structural changes in alternating hemiplegia of childhood using single-case voxel-based morphometry analysis.

Alternating hemiplegia of childhood (AHC) is a rare neurodevelopmental disease caused by ATP1A3 mutations. Using voxel-based morphometry (VBM) analysis, we compared an AHC patient cohort with controls. Additionally, with single-case VBM analysis, we assessed the associations between clinical severity and brain volume in patients with AHC. To investigate structural brain changes in gray matter (GM) and white matter (WM) volumes between 9 patients with AHC and 20 age-matched controls, VBM analysis was performed using three-dimensional T1-weighted magnetic resonance imaging. Single-case VBM analysis was also performed on nine patients with AHC to investigate the associations between the respective volumes of GM/WM differences and the motor level, cognitive level, and status epilepticus severity in patients with AHC. Compared with controls, patients with AHC showed significant GM volume reductions in both hippocampi and diffuse cerebellum, and there were WM reductions in both cerebral hemispheres. In patients with AHC, cases with more motor dysfunction, the less GM/WM volume of cerebellum was shown. Three of the six cases with cognitive dysfunction showed a clear GM volume reduction in the insulae. Five of the six cases with status epilepticus showed the GM volume reduction in hippocampi. One case had severe status epilepticus without motor dysfunction and showed no cerebellar atrophy. With single-case VBM analysis, we could show the association between region-specific changes in brain volume and the severity of various clinical symptoms even in a small sample of subjects.

Characteristics of white matter alterations along fibres in patients with bulimia nervosa: A combined voxelwise and tractography study.

Accumulating evidence supports the hypothesis that white matter (WM) abnormalities are involved in the pathophysiology of bulimia nervosa (BN); however, findings from in vivo neuroimaging studies have been inconsistent. We aimed to investigate the possible brain WM alterations, including WM volume and microstructure, in patients with BN. We recruited 43 BN patients and 31 healthy controls (HCs). All participants underwent structural and diffusion tensor imaging. Differences in WM volume and microstructure were evaluated using voxel-based morphometry, tract-based spatial statistics, and automated fibre quantification analysis. Compared with HCs, BN patients showed significantly decreased fractional anisotropy in the middle part of the corpus callosum (nodes 31-32) and increased mean diffusivity in the right cranial nerve V (CN V) (nodes 27-33 and nodes 55-88) and vertical occipital fasciculus (VOF) (nodes 58-85). Moreover, we found decreased axial diffusivity in the right inferior fronto-occipital fasciculus (node 67) and increased radial diffusivity in the CN V (nodes 22-34 and nodes 52-89) and left VOF (nodes 60-66 and nodes 81-85). Meanwhile, WM microstructural changes were correlated with patients' clinical manifestations. We did not find any significant differences in WM volume and the main WM fibre bundle properties between BN patients and HCs. Taken together, these findings provide that BN shows significant brain WM reorganization, but primarily in microstructure (part of WM fibre bundle), which is not sufficient to cause changes in WM volume. The automated fibre quantification analysis could be more sensitive to detect the subtle pathological changes in a point or segment of the WM fibre bundle.

Voxel based morphometry-detected white matter volume loss after multi-modality treatment in high grade glioma patients.

Radiotherapy (RT) and chemotherapy are components of standard multi-modality treatment of high grade gliomas (HGG) aimed at achieving local tumor control. Treatment is neurotoxic and RT plays an important role in this, inducing damage even distant to the RT target volume. This retrospective longitudinal study evaluated the effect of treatment on white matter and gray matter volume in the tumor-free hemisphere of HGG patients using voxel based morphometry (VBM). 3D T1-weighted MR images of 12 HGG patients at multiple timepoints during standard treatment were analyzed using VBM. Segmentation of white matter and gray matter of the tumor-free hemisphere was performed. Multiple general linear models were used to asses white matter and gray matter volumetric differences between time points. A mean RT dose map was created and compared to the VBM results. Diffuse loss of white matter volume, mainly throughout the frontal and parietal lobe, was found, grossly overlapping regions that received the highest RT dose. Significant loss of white matter was first noticed after three cycles of chemotherapy and persisted after the completion of standard treatment. No significant loss of white matter volume was observed between pre-RT and the first post-RT follow-up timepoint, indicating a delayed effect. This study demonstrated diffuse and early-delayed decreases in white matter volume of the tumor-free hemisphere in HGG patients after standard treatment. White matter volume changes occurred mainly throughout the frontal and parietal lobe and grossly overlapped with areas that received the highest RT dose.

Gamma Sensory Stimulation at 40Hz for a 6‐month Period Reduces White Matter Atrophy in Alzheimer’s Disease Patients

AbstractBackgroundAlthough white matter atrophy is observed in normal aging, it is more pronounced in Alzheimer’s Disease (AD) patients. Recently, advanced magnetic resonance imaging (MRI) provided more detailed information which linked changes in white matter to elevated risk and progression of AD. White matter degeneration, myelin loss, and oligodendrocyte damage in AD patients suggest that white matter can be a mechanistically important target in AD patients. Recently, clinical benefits of 40Hz gamma sensory stimulation have been demonstrated in AD patients. Here, we studied the effects of 40Hz gamma sensory stimulation on white matter in patients with clinical presentation of AD spectrum and compared our results to historical data.MethodThe data presented here is from Overture study (NCT03556280) and the Alzheimer's Disease Neuroimaging Initiative (ADNI1) database. Overture study data included treatment group participants who received 1‐hour daily 40Hz gamma auditory‐visual stimulation at home for a 6‐month period and placebo group. Analysis between the groups suggested a difference in white matter atrophy favoring the treatment group. To compare our treatment group with a larger control group, we studied ADNI1. We included a subset of each population so that baseline distributions (age, MMSE, white matter volume) are matched and had Month 6 MRI data. The resulting populations contained N=16 participants from Overture study and N=64 participants from ADNI1. Overture study structural MRI were acquired using 1.5 Tesla MRI and cerebral white matter segmentation was performed using FreeSurfer as it was done in ADNI1. Age, MMSE, white matter volume adjusted least‐square means method is used to assess the percentage changes in white matter volume within 6‐month period.ResultThe Overture study treatment group participants exhibited 0.38±0.82 percentage increase (volume in % of total intracranial volume) and ADNI1 study participants exhibited ‐2.45±0.40 percentage decrease in white matter volume after 6‐month period (p&lt;0.004).ConclusionOur results suggest that 40Hz gamma sensory stimulation therapy for 6‐month period may reduce white matter atrophy, protect axons, and possibly prevent myelin and oligodendrocyte damage in AD patients. Given the crucial role of white matter connecting expansive brain regions, preventing or reducing its atrophy may diminish AD disease progression.

Decoding Brain Fog in Head and Neck Cancer Survivors Using Artificial Intelligence

<h3>Purpose/Objective(s)</h3> Brain fogging, which is characterized by memory decline, word-finding difficulty, and decreased multi-tasking ability, is common in head and neck cancer survivors. The precise causes of brain fog are poorly understood, as MRIs are essentially normal in these patients. The purpose of this study was to use artificial intelligence (AI) to detect micro-architectural and biological changes in the brain that are invisible to human eyes. <h3>Materials/Methods</h3> DVH of temporal lobes and whole brain were obtained in 566 and 60 patients, respectively, who underwent IMRT or proton radiation with concurrent chemotherapy for nasopharyngeal carcinoma. EORTC QLQ-C30 was obtained from 92 patients who enrolled in two prospective clinical studies. Automated cortical region segmentation using an open-source software for processing and analyzing brain MRI images was performed in 33 patients with a minimum follow-up of 4 years. Architectural and biological MRI changes in gray matter, white matter, and subcortical brain regions were determined in 34 brain regions. Graph theory-based brain connectome was evaluated to assess the connectivity between different regions of the brain. Radiomics which employs high-throughput quantitative analysis of image features were performed on the T1- and diffusion-weighted sequences. <h3>Results</h3> Patients experienced a continuous decline of cognitive function after radiation, with a 6.6% in decrease in their first year. The brain received a large low-dose bath with a median V10-20(whole brain) (volume of whole brain that received 10-20 Gy) 170cc, V20-30(whole brain) 50.8cc, V10-20(temporal lobe)11.4cc, and V20-30(temporal lobe) 6.18cc. There were global changes in gray matter thickness, with most pronounced changes occurred in parietal lobe (-4.79%, p=0.007) and occipital lobe (-5.68%, p=0.03). Similarly, there were diffuse changes in white matter and subcortical volume. After radiation, the frontal lobe increased by 17.5% (p=0.04), lateral ventricle 41% (p=0.03), and choroid plexus 34.3% (p=0.03). After radiation, the brain exhibited diffuse disrupted connectivity as characterized by increased clustering coefficient (p=0.002) and decreased modularity (p=0.003). Corpus collusum, choroid plexus, cerebellum, hippocampus, brainstem, medialorbito- and superior-frontal, temporal pole, and inferior temporal were analyzed using radiomics. First order interquartile-range, entropy, uniformity, and GLCM features were found to be statistically significant (p< 0.01). After adjusted for age, gender, and time interval between MRI, IMRT patients developed significant more changes in white matter of the temporal lobe (p=0.03) and corpus callosum (p=0.03) when compared to proton patients. <h3>Conclusion</h3> By employing artificial intelligence and computational methods, we are able to detect global disruption in architecture, connectivity, and function in the brain of head and neck cancer survivors. IMRT affects the brain differently than proton.

Effects of psychosis-associated genetic markers on brain volumetry: a systematic review of replicated findings and an independent validation.

Given psychotic illnesses' high heritability and associations with brain structure, numerous neuroimaging-genetics findings have been reported in the last two decades. However, few findings have been replicated. In the present independent sample we aimed to replicate any psychosis-implicated SNPs (single nucleotide polymorphisms), which had previously shown at least two main effects on brain volume. A systematic review for SNPs showing a replicated effect on brain volume yielded 25 studies implicating seven SNPs in five genes. Their effect was then tested in 113 subjects with either schizophrenia, bipolar disorder, 'at risk mental state' or healthy state, for whole-brain and region-of-interest (ROI) associations with grey and white matter volume changes, using voxel-based morphometry. We found FWER-corrected (Family-wise error rate) (i.e. statistically significant) associations of: (1) CACNA1C-rs769087-A with larger bilateral hippocampus and thalamus white matter, across the whole brain; and (2) CACNA1C-rs769087-A with larger superior frontal gyrus, as ROI. Higher replication concordance with existing literature was found, in decreasing order, for: (1) CACNA1C-rs769087-A, with larger dorsolateral-prefrontal/superior frontal gyrus and hippocampi (both with anatomical and directional concordance); (2) ZNF804A-rs11681373-A, with smaller angular gyrus grey matter and rectus gyri white matter (both with anatomical and directional concordance); and (3) BDNF-rs6265-T with superior frontal and middle cingulate gyri volume change (with anatomical and allelic concordance). Most literature findings were not herein replicated. Nevertheless, high degree/likelihood of replication was found for two genome-wide association studies- and one candidate-implicated SNPs, supporting their involvement in psychosis and brain structure.

Neurometabolic changes in multiple sclerosis: Fingolimod versus beta interferon or glatiramer acetate therapy.

Fingolimod has been shown to be more effective in reducing relapse rate and disability than injectable therapies in clinical trials. An increase in N-acetylaspartate (NAA) as measured by MR spectroscopy is correlated with maintaining axonal metabolic functions. This study compared the neurometabolic and volumetric changes in relapsing-remitting multiple sclerosis (RRMS) patients on fingolimod or injectable therapies with healthy controls (HCs). Ninety-eight RRMS (52 on fingolimod, 46 on injectable therapies (27 on glatiramer acetate and 19 on interferon) were age and sex-matched to 51 HCs. RRMS patients underwent cognitive, fatigue, and mental health assessments, as well as an Expanded disability status scale (EDSS). MRI/S was acquired from the hippocampus, posterior cingulate gyrus (PCG), and prefrontal cortex (PFC). Volumetric and neurometabolic measures were compared across cohorts using a univariate general linear model and correlated with clinical severity and neuropsychological scores. Clinical parameters, MR-volumetric, and neurometabolic profiles showed no differences between treatment groups (p&gt;.05). Compared to HCs, both RRMS cohorts showed volume changes in white matter (-13%), gray matter (-16%), and cerebral spinal fluid (CSF) (+17-23%), as well as reduced NAA (-17%, p = .001, hippocampus), (-7%, p = .001, PCG), and (-9%, p = .001, PFC). MRI/S metrics in three regions were moderately correlated with cognition and fatigue functions. While both treatment arms showed overall similar volumetric and neurometabolic profiles, longitudinal studies are warranted to clarify neurometabolic changes and associations with treatment efficacy.

Cognitive decline in acoustic neuroma patients: An investigation based on resting-state functional magnetic resonance imaging and voxel-based morphometry.

ObjectiveAcoustic neuroma (AN) is a clinically common benign tumor. There are few neuropsychological investigations for AN, especially cognitive neuropsychology. Herein, the study probed into cognitive function changes in AN patients and expounded possible mechanisms through structural and functional magnetic resonance imaging (fMRI).Materials and methodsNeuropsychological tests were performed between 64 patients with AN and 67 healthy controls. Then, using resting-state fMRI, the possible mechanisms of cognitive decline in AN patients were further explored by calculating the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Furthermore, using high-resolution T1-weighted images, voxel-based morphometry (VBM) was adopted to investigate the changes in gray matter volume (GMV) and white matter volume (WMV) in AN patients.ResultsAN patients had worse cognitive performance than those in the healthy controls. Relative to the healthy individuals, the mALFF value was increased in the right caudate nucleus of the patients with left-sided AN (LAN) and the right rectus region of the patients with right-sided AN (RAN). The mReHo values of the bilateral superior frontal gyrus and middle frontal gyrus were decreased in LAN patients. Compared with healthy subjects, the GMV values were elevated in the left fusiform gyrus, parahippocampal gyrus, calcarine gyrus, and cuneus in LAN patients as well as in the right fusiform gyrus and parahippocampal gyrus in RAN patients. Meanwhile, the WMV values showed elevations in the bilateral putamen, left rectal gyrus, and thalamus in LAN patients.ConclusionCognitive dysfunction occurs in AN patients. Cognitive decline in AN patients activates functional activity in some brain regions, thereby compensating for cognition decline. Additionally, the ReHo values were reduced in the frontal lobe in LAN patients, and the connectivity was decreased, affecting the functional differentiation and integration of the brain, which may be associated with the decline in cognitive function. Lateralized brain reorganization induced by unilateral hearing loss was presented in AN patients. LAN caused a more significant interference effect on the brain while RAN patients showed more stable cerebral cortices. Altogether, responding to cognition decline in AN patients, structural reorganization occurs, and compensative increases in cognitive-related brain regions, which compensates for cognitive impairment.

Morphological Changes of Frontal Areas in Male Individuals With HIV: A Deformation-Based Morphometry Analysis.

ObjectivePrevious studies on HIV-infected (HIV+) individuals have revealed brain structural alterations underlying HIV-associated neurocognitive disorders. Most studies have adopted the widely used voxel-based morphological analysis of T1-weighted images or tracked-based analysis of diffusion tensor images. In this study, we investigated the HIV-related morphological changes using the deformation-based morphometry (DBM) analysis of T1-weighted images, which is another useful tool with high regional sensitivity.Materials and MethodsA total of 157 HIV+ (34.7 ± 8.5 years old) and 110 age-matched HIV-uninfected (HIV-) (33.7 ± 10.1 years old) men were recruited. All participants underwent neurocognitive assessments and brain scans, including high-resolution structural imaging and resting-state functional imaging. Structural alterations in HIV+ individuals were analyzed using DBM. Functional brain networks connected to the deformed regions were further investigated in a seed-based connectivity analysis. The correlations between imaging and cognitive or clinical measures were examined.ResultsThe DBM analysis revealed decreased values (i.e., tissue atrophy) in the bilateral frontal regions in the HIV+ group, including bilateral superior frontal gyrus, left middle frontal gyrus, and their neighboring white matter tract, superior corona radiata. The functional connectivity between the right superior frontal gyrus and the right inferior temporal region was enhanced in the HIV+ group, the connectivity strength of which was significantly correlated with the global deficit scores (r = 0.214, P = 0.034), and deficits in learning (r = 0.246, P = 0.014) and recall (r = 0.218, P = 0.031). Increased DBM indexes (i.e., tissue enlargement) of the right cerebellum were also observed in the HIV+ group.ConclusionThe current study revealed both gray and white matter volume changes in frontal regions and cerebellum in HIV+ individuals using DBM, complementing previous voxel-based morphological studies. Structural alterations were not limited to the local regions but were accompanied by disrupted functional connectivity between them and other relevant regions. Disruptions in neural networks were associated with cognitive performance, which may be related to HIV-associated neurocognitive disorders.

Effects of Body Mass Index on Brain Structures in the Elderly: Longitudinal Analyses.

The relationship between obesity and neurocognitive consequences is complex. Here we investigated associations between body mass index (BMI) and subsequent changes in brain structures, cognitive changes, and the onset of dementia after adjustment of a wide range of potential confounding variables using a large prospective cohort data of UK Biobank. After correcting for confounding factors, higher BMI was associated with greater retention in visuospatial memory performance (decline in error numbers) [beta = -0.019 (CI:-0.027~-0.016), N = 39191], increase in depression tendency scores [beta = 0.036(0.027~0.045)] as well as decreased risk of incident dementia [increasing BMI by 1 is associated with HR of 0.981 (CI:0.969~0.992), N = 398782], but not changes in fluid intelligence or reaction time. Whole brain multiple regression analyses (volumetric analyses: N = 1253, other analyses: N = 1241) revealed positive associations between BMI and subsequent changes in regional gray matter volume (rGMV) in multiple areas, regional white matter volume changes in widespread white matter (WM) tracts, fractional anisotropy changes in several tracts, and intracellular volume fraction (ICVF) and orientation dispersion (OD) in widespread areas, and isotropic volume fraction (ISOVF) in a few areas, and negative associations between BMI and subsequent changes in rGMV in the bilateral medial temporal lobe areas, mean, axial and radial diffusivity, and ISOVF in widespread areas. These results are mostly consistent with the view that less BMI precedes greater neurocognitive aging or atrophy, with a few exceptions including OD findings and the rGMV finding of the medial temporal lobes as most of significant longitudinal associations of higher BMI were opposite to those seen in higher age and dementia. Future epidemiological studies should consider separating effects of higher BMI itself from potential confounders.

Brain volume patterns in corticobasal syndrome versus idiopathic Parkinson's disease.

Patients with a corticobasal syndrome (CBS) present a rare form of atypical parkinsonism characterized by asymmetric clinical symptoms and progressive motor and nonmotor impairment, such as apraxia, alien limb phenomenon, aphasia, myoclonus, dystonia, and cognitive impairment. At early stages, clinical differentiation between CBS and idiopathic Parkinson's disease (IPD) can be challenging. Using high-resolution T1-weighted images and voxel-based morphometry (VBM), we sought to identify disease-specific patterns of brain atrophy in a small sample of CBS and IPD patients at early stages of disease. We acquired MR images of 17 patients diagnosed with CBS and compared them with MR images of 17 subjects affected by IPD. Images were preprocessed and analyzed using VBM. When compared to each other, the CBS and IPD patients of our cohort showed differences in regional gray and white matter volume depending on the diagnosis, specifically in the superior longitudinal fascicle. In our small patients' group, VBM was able to detect changes in regional gray and white matter volume between patients affected by CBS and patients with IPD as early as 1.5-2 years after the onset of the first motor symptoms.

Chemotherapy-Induced Cognitive Impairment and Hippocampal Neurogenesis: A Review of Physiological Mechanisms and Interventions.

A wide range of cognitive deficits, including memory loss associated with hippocampal dysfunction, have been widely reported in cancer survivors who received chemotherapy. Changes in both white matter and gray matter volume have been observed following chemotherapy treatment, with reduced volume in the medial temporal lobe thought to be due in part to reductions in hippocampal neurogenesis. Pre-clinical rodent models confirm that common chemotherapeutic agents used to treat various forms of non-CNS cancers reduce rates of hippocampal neurogenesis and impair performance on hippocampally-mediated learning and memory tasks. We review the pre-clinical rodent literature to identify how various chemotherapeutic drugs affect hippocampal neurogenesis and induce cognitive impairment. We also review factors such as physical exercise and environmental stimulation that may protect against chemotherapy-induced neurogenic suppression and hippocampal neurotoxicity. Finally, we review pharmacological interventions that target the hippocampus and are designed to prevent or reduce the cognitive and neurotoxic side effects of chemotherapy.

Morphometric evaluation of traumatic axonal injury and the correlation with post-traumatic cerebral atrophy and functional outcome.

Imaging plays a crucial role in the diagnosis, prognosis and follow-up of traumatic brain injury. Whereas computed tomography plays a pivotal role in the acute setting, magnetic resonance imaging is best suited to detect the true extent of traumatic brain injury, and more specifically diffuse axonal injury. Post-traumatic brain atrophy is a well-known complication of traumatic brain injury. This study investigated the correlation between diffuse axonal injury detected with fluid-attenuated inversion recovery and susceptibility-weighted imaging magnetic resonance imaging, post-traumatic brain atrophy and functional outcome (Glasgow outcome scale - extended). Twenty patients with a closed head injury and diffuse axonal injury detected with fluid-attenuated inversion recovery and susceptibility-weighted imaging were included. The total volumes of the diffuse axonal injury fluid-attenuated inversion recovery lesions were determined for each subject's initial (<14 days) and follow-up magnetic resonance scan (average: day 303 ± 83 standard deviation). The different brain volumes were automatically quantified using a validated and both US Food and Drug Administration-cleared and CE-marked machine learning algorithm (icobrain). The number of susceptibility-weighted imaging lesions and functional outcome scores (Glasgow outcome scale - extended) were retrieved from the Collaborative European NeuroTrauma Effectiveness Research Traumatic Brain Injury dataset. The volumetric fluid-attenuated inversion recovery diffuse axonal injury lesion load showed a significant inverse correlation with functional outcome (Glasgow outcome scale - extended) (r = -0.57; P = 0.0094) and white matter volume change (r = -0.50; P = 0.027). In addition, white matter volume change correlated significantly with the Glasgow outcome scale - extended score (P = 0.0072; r = 0.58). Moreover, there was a strong inverse correlation between longitudinal fluid-attenuated inversion recovery lesion volume change and whole brain volume change (r = -0.63; P = 0.0028). No significant correlation existed between the number of diffuse axonal injury susceptibility-weighted imaging lesions, brain atrophy and functional outcome. Volumetric analysis of diffuse axonal injury on fluid-attenuated inversion recovery imaging and automated brain atrophy calculation are potentially useful tools in the clinical management and follow-up of traumatic brain injury patients with diffuse axonal injury.

Grey and White Matter Volume Changes after Preterm Birth: A Meta-Analytic Approach.

Cross-sectional studies have reported lower brain grey matter volumes (GMV) and white matter volumes (WMV) in preterm (PT) born individuals. While large MRI studies in the normative population have led to a better understanding of brain growth trajectories across the lifespan, such results remain elusive for PT born individuals since large, aggregated datasets of PT born individuals do not exist. To close this gap, we investigated GMV and WMV in PT born individuals as reported in the literature and contrasted it against individual volumetric data and trajectories from the general population. Systematic database search of PubMed and Web of Science in March 2021, and extraction of outcome measures were conducted by two independent reviewers. Individual data on full-term (FT) controls was extracted from freely available databases. Mean GMV, WMV, total intracranial volume (TIV), and mean age at scan were the main outcome measures. Of 532 identified records, nine studies were included with 538 PT born subjects between 1.1 and 28.5 years of age. Reference data was generated from 880 FT controls between 1 and 30 years of age. GMV was consistently lower in PT born individuals from infancy to early adulthood with no evidence for catch-up growth. While GMV changes followed a similar trajectory as FT controls, WMV was particularly low in adolescence after PT birth. Results demonstrate altered brain volumes after PT birth across the first half of lifespan. Future studies should address this issue in large aggregated datasets of PT born individuals.