Specific abnormalities of vision in schizophrenia have been observed to affect high-level and some low-level integration mechanisms, suggesting that people
Morphometric similarity networks (MSNs) estimate organization of the cortex as a biologically meaningful set of similarities between anatomical features at the macro- and microstructural level, derived from multiple structural MRI (sMRI) sequences. These networks are clinically relevant, predicting 40% variance in IQ. However, the sequences required (T1w, T2w, DWI) to produce these networks are longer acquisitions, less feasible in some populations. Thus, estimating MSNs using features from T1w sMRI is attractive to clinical and developmental neuroscience. We studied whether reduced-feature approaches approximate the original MSN model as a potential tool to investigate brain structure. In a large, homogenous dataset of healthy young adults (from the Human Connectome Project, HCP), we extended previous investigations of reduced-feature MSNs by comparing not only T1w-derived networks, but also additional MSNs generated with fewer MR sequences, to their full acquisition counterparts. We produce MSNs that are highly similar at the edge level to those generated with multimodal imaging; however, the nodal topology of the networks differed. These networks had limited predictive validity of generalized cognitive ability. Overall, when multimodal imaging is not available or appropriate, T1w-restricted MSN construction is feasible, provides an appropriate estimate of the MSN, and could be a useful approach to examine outcomes in future studies.
Paediatric traumatic brain injury (pTBI) is a leading cause of disability for children and young adults. Children are a uniquely vulnerable group with the disease process that occurs following a pTBI interacting with the trajectory of normal brain development. Quantitative MRI post-injury has suggested a long-term, neurodegenerative effect of TBI on the morphometry of the brain, in both adult and childhood TBI. Changes to the brain beyond that of anticipated, age-dependant differences may allow us to estimate the state of the brain post-injury and produce clinically relevant predictions for long-term outcome. The current review synthesises the existing literature to assess whether, following pTBI, the morphology of the brain exhibits either i) longitudinal change and/or ii) differences compared to healthy controls and outcomes. The current literature suggests that morphometric differences from controls are apparent cross-sectionally at both acute and late-chronic timepoints post-injury, thus suggesting a non-transient effect of injury. Developmental trajectories of morphometry are altered in TBI groups compared to patients, and it is unlikely that typical maturation overcomes damage post-injury, or even 'catches up' with that of typically-developing peers. However, there is limited evidence for diverted developmental trajectories being associated with cognitive impairment post-injury. The current review also highlights the apparent challenges to the existing literature and potential methods by which these can be addressed.
1 April 2020 in Developmental Cognitive Neuroscience
Brain insults during childhood can perturb the already non-linear trajectory of typical brain maturation. The diffuse effects of injury can be modelled using structural covariance networks (SCN), which change as a function of neurodevelopment. However, SCNs are estimated at the group-level, limiting applicability to predicting individual-subject outcomes. This study aimed to measure the divergence of the brain networks in paediatric traumatic brain injury (pTBI) patients and controls, and investigate relationships with executive functioning (EF) at 24 months post-injury. T1-weighted MRI acquired acutely in 78 child survivors of pTBI and 33 controls underwent 3D-tissue segmentation to estimate cortical thickness (CT) across 68 atlas-based regions-of-interest (ROIs). Using an 'add-one-patient' approach, we estimate a developmental divergence index (DDI). Our approach adopts a novel analytic framework in which age-appropriate reference networks to calculate the DDI were generated from control participants from the ABIDE dataset using a sliding-window approach. Divergence from the age-appropriate SCN was related to reduced EF performance and an increase in behaviours related to executive dysfunctions. The DDI measure showed predictive value with regard to executive functions, highlighting that early imaging can assist in prognosis for cognition.
3 September 2024 in European Journal of Paediatric Neurology
Paediatric acquired demyelinating syndromes (pADS) attack white matter pathways in the brain during an important period of development. Affected children can experience poor functional outcomes, including deficits in specific cognitive domains. Understanding risk factors for poor outcome will guide clinical management of these children. One clinical phenotype which may differentially impact cognitive outcomes is the presence of autoantibodies to myelin oligodendrocyte glycoprotein (MOG). Preliminary research has suggested that cognitive difficulties exist in paediatric patients who test positive for MOG antibodies or MOGAD (Myelin Oligodendrocyte Glycoprotein Associated Disease) however, they experience a less severe profile compared to seronegative counterparts. The current study assesses children diagnosed with pADS who tested positive or negative for MOG-ab using standardised assessments of both intellectual functioning and academic ability. The results show that a subset of MOGAD patients experience clinically significant sequalae in intellectual functioning and academic ability. The neuropsychological profile also differed between children with and without MOG-ab positivity, with seronegative patients more likely to show a clinically relevant difficulties at the individual patient level. Whilst no differences existed at the group-level; the current study demonstrates the relative additional risk of intellectual/academic difficulty associated with MOG-ab seronegativity. This research further supports the growing perspective that MOG-positivity confers a more favourable neuropsychological outlook than is the case for their seronegative counterparts. This broadening consensus offers reassurance for clinicians, families, and patients.
Survivors of pediatric brain tumours are at a high risk of cognitive morbidity. Reliable individual-level predictions regarding the likelihood, degree, and affected domains of cognitive impairment would be clinically beneficial. While established risk factors exist, quantitative MRI analysis may enhance predictive value, above and beyond current clinical risk models. This systematic review addresses the question: “Do MRI markers predict future cognitive functioning in pediatric brain tumour survivors?” We conducted a comprehensive search for studies published up to March 2024 that assessed MRI variables as predictors of later neuropsychological outcomes in pediatric brain tumour patients. Only studies that acquired MRI scans at an earlier timepoint to predict subsequent cognitive test performance were included. Surprisingly, few studies met these criteria, with identified research focusing primarily on MRI measures of cerebellar and white matter damage as features in predicting cognitive outcomes. Ultimately, this review reveals a limited literature, characterized by small sample sizes and poor-quality studies, placing findings at high risk of bias. Consequently, the quality and conclusions drawn from the existing research are constrained, especially in the context of prediction studies. Given the significant implications for this clinical population, this review highlights the urgent need for further investigation and a ‘call to action’ for medical imaging researchers in pediatric neuro-oncology.