Age- and gender effects on brainstem MR-planimetry
Stephanie Mangesius (Innsbruck | AT)
Aims: MR planimetry of brainstem structures can be helpful for the discrimination of parkinsonian syndromes. The aim of this study was to evaluate age- and gender effects on brainstem MR-planimetric measures.
Methods: MR-planimetric measures including brainstem diameters (midbrain, pons, middle and superior cerebellar peduncle) and areas (pontine and midbrain), the ratios derived from both midbrain-to-pons diameters and areas as well as the Magnetic Resonance Parkinson Index (MRPI) were assessed on 1.5 Tesla weighted MR images in a large cohort of 97 healthy controls (mean age 62.8 years; SD 10.9 years; female-to-male-ratio = 49:48). Planimetric measures were performed on an imaging database program (IMPAX EE). Gender- and age-related differences of all as well as of combined planimetric measurements were calculated using univariate and multivariate GLMs, and repeated for the population relevant for the differential diagnosis of parkinsonism, aged 50 to 80 years.
Results: Univariate and multivariate analyses showed significant effects of gender on both pontine measurements (p < 0.05 for all) with male subjects showing larger measurements, and significant effects of age on midbrain measurements (p ≤ 0.001 for all) as well as on combined measurements and ratios derived from midbrain-to-pontine measurements (p < 0.01 for all). Intriguingly, there were neither gender nor age effects on combined measurements nor midbrain diameter in the population aged 50 to 80 years.
Conclusion: Although age and gender might influence single brainstem MR-planimetric measures, our results indicate that there is no need for age- or gender-specific cut-offs for the age group relevant for the differential diagnosis of neurodegenerative parkinsonism.
Graph-based analysis of the change of the resting state connectivity networks under the open monitoring meditation
Sergiy Pereverzyev Jr. (Innsbruck | AT)
Aims: The open monitoring meditation (OMM) is a part of the mindfulness meditation, and it is currently under the active research investigations. The aim of our study is to examine the influence of the OMM on the resting state (RS) connectivity networks (CNs) using the tools of the graph-based analysis.
Methods: 26 persons took part in our study. Before they began an OMM training, their RS functional magnetic resonance imaging (rsfMRI) data were collected under the usual RS conditions. Approximately after 2 months of the OMM training, their rsfMRI data were collected during OMM. The rsfMRI data were standardly preprocessed, and the signals for the brain regions in the Anatomical Automatic Labelling (AAL) atlas were obtained. We considered RSCNs that consist of the connections between brain regions whose signals are highly correlated (we took the correlation threshold 0.8). As analysis tools, we use the connection frequencies and also various concepts of the graph theory.
Results: Our first results show that the OMM leads to the decrease of the size of the RSCNs, which indicates the diminishing of the communication between brain regions under the OMM. The analysis of the connection frequency distributions reveals that many connections with low frequency in the normal RSCNs become switched off in the OMM RSCNs, which is consistent with the view that the meditation activities have a focusing effect on the communication in the brain. A careful analysis of the connection frequencies for discovering the specific changes of the communication in the brain under the OMM, and also the application of the various tools of the graph theory, are currently in progress. These additional results are expected to be available at the time of the 5th OHBM Alpine Chapter Symposium.
Conclusion: OMM changes the structure of the RSCNs. The OMM RSCNs become generally smaller, and not frequent connections of the normal RSCNs are switched off by the OMM. Further description of the influence of the OMM on the structure of the RSCNs is planned to be available at the time of the Symposium.
Acknowledgements: Our research is partially supported by the Austrian Science Fund (FWF): project P 29514-N32.
Flexible use of emotional resources in resilient emerging adults – An fMRI study.
Christian Siedentopf (Innsbruck | AT)
Resilience is an individual's ability to successfully cope with adversity, trauma, threats or stress. In threatening situations, resilient individuals use emotional resources more effectively than less resilient individuals. In a previous study this was reflected in insular activation. We used a repeated recovery from threat task with low- and high-trait resilient individuals (HighR and LowR). We hypothesized that activity in the insula under threat should differ between HighR and LowR individuals.
PARTICIPANTS: We measured 70 participants in total (mean age: 22,8 years, 34 female). Resilience was measured with the resilience questionnaire (Rscore). For analysis, we selected 20 LowR (Resilience Scale < 135) and 19 HighR (Resilience Scale > 155) individuals. We also measured personality (“Big-Five“-Personality-traits), stress level (Perceived Stress Scale PSS-14) and GSI (Global severety index) was calculated from the questionnaire Brief Symptom Inventory BSI.
PROCEDURE: For the task we presented aversiv and neutral picture from the International Affective Picture System IAPS, preceded by a cue. A ‘threat’ cue was followed by an aversive or neutral picture (50/50 frequency) and a ‘no-threat’ cue was always followed by a neutral picture.
For fMRI we used a pseudoradimized block design, the presentation time were for cue (4, 8 or 12 s), followed from a picture (3 s) and a fixcross (4, 8, or 12 s). We measured BOLD in a 3T Verio Siemens scanner, EPI, TR = 2.4 s, 143 volumes per run, 5 runs in total.
For the Contrast: Cue ‘threat’ : aversive picture vs neutral picture we found in a ROI Analysis a significant activations of the Insula (n = 70). In the ROI Analysis comparison of the HighR and LowR we see a significant activation of the Insula for the aversive pictures (two groups, n = 39)
Less resilient individuals showed greater activation of the left insula for threatening pictures. The insula has been associated with processing aversive emotions such as disgust and anxiety. It should be noted that HighR individuals also differ from LowR individuals with regard to personality, stress level and symptom load. They are less neurotic and score higher on extraversion, openness, conscientiousness and agreeableness. They also experience less stress.
Waugh, C. E. et al. (2008). The neural correlates of trait resilience when anticipating and recovering from threat. Social, Cognitive and Affective Neurosciences, 3, 223-332.
The Influence of Daily Caffeine Consumption on Human Brain Morphometry and Cognition
Yu-Shiuan Lin (Basel | CH)
Aim: Caffeine is the most commonly used psychostimulant worldwide. Underlying its well-known benefit on vigilance, caffeine dampens the accumulation of sleep homeostatic pressure. Increased sleep pressure, e.g. prolonged wakefulness or fragmented sleep, is associated with lower cerebral grey matter (GM) volume1-3 and cell death4-6. We are therefore interested in whether daily caffeine intake leads to changes in GM through its regular influence on sleep homeostasis. Methods: In our double-blind crossover study, each of the 20 male caffeine consumers (26.2± 4.1 y/o, daily intake 471.5± 112.24 mg) completed caffeine (3x 150 mg/day) and placebo for 10 days. Sleep polysomnography was performed the evening of day 9. GM was measured via T1-weighted MPRAGE (1x1x1mm3, TR=2000ms, TE=3.37ms) in a 3T fMRI scanner. Caffeine effect on voxel-wise GM was estimated by flexible factorial model. Due to the bias caused by caffeine-induced reduction in cerebral blood flow (CBF)7, 2D-EPI ASL (4x4x4mm3, TR=3000ms, TE=12ms) was performed, and voxel-to-voxel multimodal mixed model was applied to adjust coefficients. Sleep EEG slow wave activity (SWA, 0.75- 4.5hz) was quantified as the index of sleep pressure. AUC of caffeine and paraxanthine (AUC-CAPX) was calculated to quantify the substance exposure. To examine the verbal working memory related to the GM alterations, we examined the accuracy and reaction time (RT) in N-Back task. Results: In the caffeine condition, total GM was lower compared to placebo (p< .001). Voxel-wise analyses indicated that the most prominent GM decrease was in medial temporal lobe (mTL) including hippocampus (pFWE< .05). Lower total and mTL GM were associated with AUC-CAPX (p< .001). SWA did not differ between conditions and exerted no mediation on caffeine-associated GM reduction. However, the variance of total GM was fully accounted by the total CBF reduction, but not mTL CBF to mTL GM. N-back data indicated a worse accuracy and longer RT during rejection response (missed and correct rejection, pall< .05) in caffeine condition, while AUC-CAPX was positively associated with accuracy and RT (pall< .05). Conclusion: While total GM estimation is confounded by the variance of total CBF, hippocampal GM is reduced during daily caffeine consumption independent of SWA and hippocampal CBF. Verbal working memory is better at higher acute caffeine exposure but worse in daily intake, that implies the distinction between acute and long-term effects of caffeine.
Supra- and infratentorial atrophy following clinically isolated syndromes: A 30-year follow-up study
Lukas Haider (London/ England | GB)
Aim: Brain atrophy, and the neurodegeneration underlying it, starts early in multiple sclerosis (MS), however the long-term clinical relevance of early atrophy is not known. We aimed to assess brain atrophy rates following clinically isolated syndromes (CIS) suggestive of MS, and their relationship with long-term clinical outcomes.
Methods: 132 people presenting with a CIS were recruited between 1984-87 and followed up clinically and with magnetic resonance imaging (MRI) one, five, ten, 14, 20 and now 30 years later. Using the MRI scans, third ventricular width and medullary width were measured. Clinical outcomes (CIS, relapsing remitting (RR) and secondary progressive (SP) MS, and death due to MS) and expanded disability status scale (EDSS) scores were determined at 30 years.
Results: Infratentorial atrophy, as measured by the change in medullary width (MEDW) 0-5 differed significantly between CIS vs. SPMS (p = 0.000) and CIS vs. MSRD (p = 0.005). Supratentorial atrophy, measured by the change in third ventricular width (TVW) 0-10 did not differ over 0-5 years, but did over 0-10 years between CIS vs. SPMS (p = 0.048) and CIS vs. MSRD (p = 0.043). The change in medullary width and white matter lesions from 0-5 years was associated with Expanded Disability Status Scale scores at 30 years, correcting for the total intracranial volume and gender giving an R2 of 0.413, p = 0.000.
Conclusions: Medullary atrophy measurements within 5 years of a CIS, and third ventricular width within 10 years, are related to clinical outcomes over the next 20 to 25 years. This suggests that the processes underlying brain atrophy, and ultimately less favourable clinical outcomes, are already active at, or soon after, the clinical onset of MS.
Neuropsychological profile in a patient with Coffin-Siris-Syndrom: a case report
Nina Bechtel (Basel | CH)
Coffin-Siris syndrome (CSS) is a very rare genetic disorder that occurs worldwide with no ethnic predisposition. Until now approximately 200 cases have been documented.
The disorder is characterized by coarse facial features, hypertrichosis, hypoplastic to absent fifth fingernails or toenails and agenesis of the corpus callosum might occur. In these children mild to severe intellectual disability have been reported. Affected children may also have speech delays, where the expressive language seems to be more affected than the receptive language, as well as attention problems/hyperactivity and delays in motor development.
Here we describe a 5 years and 7 month old patient with a newly diagnosed CSS with a mutation in the ARID1A-gene that underwent neuropsychological testing. Intelligence was measured using the K-ABC II and the expressive language abilities performing the P-ITPA. To measure the graphomotor skills the subtest “patterns” from the SON-R 2 ½ - 7 was used. To assess behavioural difficulties and attention problems the VBV 3-6 and DISYPS III questionnaires were handed out to the parents as well as the kindergarten teacher.
Results showed an intellectual profile in the range of a learning disability with a firm weakness in the expressive language, the verbal short-term memory as well as graphomotor skills. On a behavioural level, the patient was seen to be easily distracted which was in line with the information of the questionnaires that pointed out difficulties in the area of attention problems and motor restlessness.
Altogether these neuropsychological findings are consistent with the previous literature pointing out strong speech difficulties, behavioural and motor problems, even though in our case, the overall cognitive impairment seems to be milder.