Visuomotor behaviour – from handling simple objects to operating complex devices – is of fundamental importance in our everyday lives, yet there is relatively little evidence as to how healthy ageing affects these processes. A central role is played by the human capacity for reaching and grasping. Grasping an object requires complex visuomotor transformations, including processing of the object’s extrinsic features (it’s spatial location) and intrinsic features (such as size and shape). It has been documented that action relevant intrinsic object properties automatically facilitate specific motor actions despite being task-irrelevant, the so-called object affordance effect. These effects have been demonstrated for (1) grasp type (precision and power grips being facilitated by small and large objects) and (2) object-orientation (whereby right and left handed grasps are facilitated by object-orientation), and might underlie the effortlessness with which humans can interact with objects. Yet, these paradigms have not previously been employed in the study of healthy ageing, and little is known concerning how these processes change over the life span. Elucidating these changes is of particular importance as age-related degeneration of white matter integrity is well documented. Consequently, if successful visuomotor behaviour relies on white matter integrity, age-related reductions in affordance effects should be observed. This prediction was tested in a series of experiments. Experiment 1 investigated age-differences in object-size compatibility effects, and results corroborated our prediction of age-related reductions in object-size effects. Experiment 2 investigated age-differences in (1) spatial compatibility effects versus object-orientation effects, and (2) the locus of the effects (facilitation versus interference effects). Results revealed (1) some evidence of larger affordance than spatial effects in both age-groups, and (2) interference effects in the younger group and both facilitation and interference effects in the older group, showing a potential change in processing modes or strategies. Experiments 3 and 4 addressed the main competing account, the attention-directing hypothesis (according to which attentional shifts are responsible for the generation of automatic response codes, rather than the affects arising from afforded actions), by using a novel stimulus set in which such attentional differences can be ruled out. Results provided strong evidence in favour of the object-size affordance hypothesis. A final neuroimaging experiment investigated age-differences in the object-size effect and its neural correlates by combining behavioural, functional MRI and diffusion tensor imaging (DTI) data. Results revealed evidence of age-differences, both on the behavioural and functional level. For the DTI data, we investigated all four diffusion metrics (something which is not frequently reported in the healthy ageing literature), and found widespread age-related differences in white matter integrity. The empirical findings presented in this thesis offer a significant contribution to ageing research, by further elucidating the relationship between age-related neurophysiological changes and visuomotor behaviour. The overall picture which emerged from this series of experiments was consistent with our prediction of age-related reductions in affordance effects. Furthermore, it is likely that these age-differences may have, at least in part, a neurophysiological basis.

Non-cognitive features including personality changes are increasingly recognized in the three PPA variants (semantic-svPPA, non fluent-nfvPPA, and logopenic-lvPPA). However, differences in emotion processing among the PPA variants and its association with white matter tracts are unknown. We compared emotion detection across the three PPA variants and healthy controls (HC), and related them to white matter tract integrity and cortical degeneration. Personality traits in the PPA group were also examined in relation to white matter tracts. Thirty-three patients with svPPA, nfvPPA, lvPPA, and 32 HC underwent neuropsychological assessment, emotion evaluation task (EET), and MRI scan. Patients' study partners were interviewed on the Clinical Dementia Rating Scale (CDR) and completed an interpersonal traits assessment, the Interpersonal Adjective Scale (IAS). Diffusion tensor imaging of uncinate fasciculus (UF), superior longitudinal fasciculus (SLF) and inferior longitudinal fasciculus (ILF), and voxel-based morphometry to derive gray matter volumes for orbitofrontal cortex (OFC), anterior temporal lobe (ATL) regions were performed. In addition, gray matter volumes of white matter tract-associated regions were also calculated: inferior frontal gyrus (IFG), posterior temporal lobe (PTL), inferior parietal lobe (IPL) and occipital lobe (OL). ANCOVA was used to compare EET performance. Partial correlation and multivariate linear regression were conducted to examine association between EET and neuroanatomical regions affected in PPA. All three variants of PPA performed significantly worse than HC on EET, and the svPPA group was least accurate at recognizing emotions. Performance on EET was related to the right UF, SLF, and ILF integrity. Regression analysis revealed EET performance primarily relates to the right UF integrity. The IAS subdomain, cold-hearted, was also associated with right UF integrity. Disease-specific emotion recognition and personality changes occur in the three PPA variants and are likely associated with disease-specific neuroanatomical changes. Loss of white matter integrity contributes as significantly as focal atrophy in behavioral changes in PPA.

Mild traumatic brain injury (mTBI) is a common and often inconspicuous wound that is frequently associated with chronic low-grade symptoms and cognitive dysfunction. Previous evidence suggests that daily blue wavelength light therapy may be effective at reducing fatigue and improving sleep in patients recovering from mTBI. However, the effects of light therapy on recovering brain structure remain unexplored. In this study, we analyzed white matter diffusion properties, including generalized fractional anisotropy, and the quantity of water diffusion in isotropic (i.e., isotropic diffusion) and anisotropic fashion (i.e., quantitative anisotropy, QA) for fibers crossing 11 brain areas known to be significantly affected following mTBI. Specifically, we investigated how 6 weeks of daily morning blue light exposure therapy (compared to an amber-light placebo condition) impacted changes in white matter diffusion in individuals with mTBI. We observed a significant impact of the blue light treatment (relative to the placebo) on the amount of water diffusion (QA) for multiple brain areas, including the corpus callosum, anterior corona radiata, and thalamus. Moreover, many of these changes were associated with improvements in sleep latency and delayed memory. These findings suggest that blue wavelength light exposure may serve as one of the potential non-pharmacological treatments for facilitating structural and functional recovery following mTBI; they also support the use of QA as a reliable neuro-biomarker for mTBI therapies.

Background: Given that brain pathology precedes clinical symptoms in Alzheimer’s disease (AD), identifying pre-symptomatic biomarkers is critical in order to implement symptom-delaying strategies as early as possible. Magnetic resonance imaging (MRI) is an ideal method for detecting early brain changes in Alzheimer's disease, as it is non-invasive, easily repeatable, and widely available. To date, MRI biomarker research has largely focused on neuronal loss in grey matter, but there is a lack of research on white matter and its relationship with cognitive performance. Diffusion tensor imaging (DTI) is a MRI-based technique that is particularly sensitive to microstructural white matter characteristics, making it an ideal method to study white matter changes. Methods: Longitudinal DTI and clinical data from the Alzheimer’s Disease Neuroimaging Initiative 2 database were used to examine the 1) within-group microstructural white matter changes in individuals with AD and healthy aging controls at baseline and year one; 2) the between-group microstructural differences in individuals with AD and controls at both time points; and 3) the relationship between white matter and cognitive performance at both time points. Results: 1) Within-group: Tract-based Spatial Statistics reveal that individuals with AD have reduced fractional anisotropy (FA) and increased mean diffusivity (MD) in the corpus callosum; internal and external capsule; corona radiata; posterior thalamic radiations; superior and inferior longitudinal fasciculus; fronto-occipital fasciculus; cingulate gyri; fornix; uncinate fasciculus; tapetum; medial lemniscus; cerebellar and cerebral peduncle; and hippocampal cingulum at year one compared to baseline. Controls also had reduced FA and increased MD at year one compared to baseline, but such changes were less extensive and did not include the hippocampal cingulum. 2) Between-group: Relative to controls, individuals with AD had lower FA and higher MD in the corpus callosum, internal and external capsule; corona radiata; posterior thalamic radiation; superior and inferior longitudinal fasciculus and fronto-occipital fasciculus; cingulate gyri; fornix; uncinate fasciculus; tapetum and hippocampal cingulum. 3) There was a positive relationship between FA and an ADNI- derived memory composite score in individuals with AD. Conclusion: The results revealed that DTI holds potential as an AD biomarker given its sensitivity to detect microstructural white matter characteristics. Longitudinal tracking of brain imaging and AD clinical signs in large cohorts are necessary to further evaluate potential clinical utility. / Graduate

Orientadores: Anelyssa Cysne Frota D'Abreu, Fernando Cendes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-27T01:17:26Z (GMT). No. of bitstreams: 1 Pinheiro_GiordannaLuizaSelingardi_M.pdf: 1372164 bytes, checksum: e02f4b5ec43afe35e676ab843e98cda0 (MD5) Previous issue date: 2015 / Resumo: A distonia é uma síndrome caracterizada por espasmos e contrações musculares, prolongados e involuntários, causando movimentos de torção e posturas anormais, frequentemente dolorosos. A distonia craniocervical (DCC) ocorre quando há contração das musculaturas da cabeça, face e pescoço; podendo ser focal ou segmentar. Estas são as distonias mais frequentes em indivíduos adultos. O tratamento com a toxina botulínica é o mais indicado para a DCC, mas seu efeito é temporário. Disfunção ou lesão dos gânglios da base sempre foi considerado o componente central na sua fisiopatologia, porém estudos mais recentes mostram o envolvimento de diversas outras regiões cerebrais como o córtex sensorio-motor e cerebelo. O presente estudo avaliou as alterações estruturais da substância branca em 40 pacientes comparando-os a 40 controles saudáveis. Secundariamente os mesmos pacientes foram divididos em 4 grupos: blefarospasmo, blefarospasmo + oromandibular, blefarospasmo + oromandibular + cervical e cervical. Todos passaram por uma avaliação clínica detalhada, envolvendo revisão do histórico, exame neurológico e exame de ressonância magnética. As análises da técnica de imagem por tensor de difusão (DTI) foram feitas através do software Trato baseado em estatística espacial (TBSS), onde foram avaliados anisotropia fracional (FA) e difusividade média (MD). Também foram realizadas técnicas baseada em região de interesse (ROI) e tractografia nesses pacientes. Não encontramos diferenças significativas no FA e MD nas análises realizadas, sugerindo que a microestrutura da substância branca dos pacientes com DCC encontra-se preservada. Futuros estudos utilizando análises funcionais podem desvendar um acometimento funcional dos circuitos cerebrais, sem que haja necessariamente acometimento estrutural da substância branca / Abstract: Dystonia is a syndrome characterized by involuntary muscle contractions, causing twisting movements and abnormal postures, which are often painful. Craniocervical dystonia (CCD) involves the contraction of the head and neck muscles. It is the most frequent dystonia in adults, and it can be focal or segmental. Botulinum toxin is the best treatment for CCD, although the effect is temporary. Classically considered secondary to a dysfunction or lesion in the basal ganglia circuit, recent studies have shown the involvement of the sensorimotor areas and the cerebellum. In the present study, we evaluated the structural brain changes in 40 patients comparing them to 40 healthy controls. Secondarily, we divided the patients into 4 groups based on dystonia localization: blepharospasm, blepharospasm + oromandibular, blepharospasm + oromandibular + cervical and cervical. Patients and controls underwent the same MRI acquisition protocol in a 3T Philips Achieva MRI scanner. All patients were assessed by an experienced neurologist specialized in Movement Disorders. We performed DTI analyzes with Tract-Based Spatial Statistics (TBSS) and we evaluated the fractional anisotropy and the mean diffusivity. We performed two confirmatory analyses using a ROI based approach and tractography. There were no microstructural alterations neither in the primary nor the secondary analysis. We did not find microstructure changes in the white matter of subjects with craniocervical dystonia. Further studies should evaluate the presence of functional and connectivity abnormalities in these subjects / Mestrado / Fisiopatologia Médica / Mestra em Ciências

Motion capture technology and Magnetic Resonance Imaging with Diffusion Tensor Imaging (MRI-DTI) were used in this work to detect subtle abnormalities in patients with mild traumatic brain injury (MTBI). A new concept, termed dynamic variability, is introduced in this work to quantify and localize gait variability. Three chronic MTBI patients were recruited from the Veterans Affair Medical Center in Iowa City, IA, and three healthy controls with height, weight, and gender matched to the patients were recruited from the Reserve Officers' Training Corps in Iowa City, IA. Kinematic and kinetic data of the subjects were collected during the performance of three gait testing scenarios. The first test involved single-task walking and was used as a baseline. The second and third tests were dual tasks that involved walking while performing a cognitive or motor task and were designed to magnify gait abnormalities. The results showed that MTBI patients had reduced gait velocity, shortened stride length, and larger step width; findings that are consistent with those published in the literature. The new dynamic variability factor found that, as compared to controls, MTBI patients had more variability in their hip and ankle joint moments. MRI-DTI has been used to detect dysfunction of the major white matter tracts in chronic MTBI patients; although, the sample size of this study was too small to detect a difference between the MTBI and control subjects. The imaging and gait abnormalities are suggestive of frontal lobe-white matter tracts dysfunction.

The semester thesis describes the basic principles of MRI, methods for measuring diffusion coefficients and creating DWI and DTI images. As a result a practical implementation of program was implemented in Matlab, based on theoretical knowledge of the problem.

Episode dépressif caractérisé (EDC) devient de plus en plus fréquent dans le monde entier. Les imageries fonctionnelles et volumétriques ont trouvé des activations anormales et des réductions de la substance grise cérébrale des patients d’EDC. Pourtant, le pattern des connexions cérébrales (le connectome structurel) des patients en EDC en imagerie de diffusion est peu connu et incomplet. L’objectif de ce travail est d’étudier le connectome structurel des patients d’EDC. Pendant 3 ans du 03/2014 au 03/2017, 56 patients d’EDC et 31 sujets sains de contrôles ont inclus dans l’étude. Tous ces patients ont reçu le même traitement de dépression de venlafaxine et ont été suivi 3 mois. Ils ont reçu l’évaluation clinique et d’IRM anatomique et de la diffusion cérébrale à l’inclusion et à 3 mois.Les contrôles ne sont évalués qu’à l’inclusion. A 3 mois, 37 patients sur 56 ont fini toutes les évaluations.On a trouvé que l’ancienne usage de l’antidépresseur (AD) et l’ancien épisode de dépression lient respectivement à l’augmentation et à la diminution de l’anisotropie cérébrale des patients déprimés. Aucune différence de l’anisotropie cérébrale entre les patients et les sujets sains à l’inclusion et à 3 mois du traitement n’a été détectée. La réponse à l’AD ne lie pas à l’anisotropie cérébrale des patients à l’inclusion et à 3 mois. La topographie des connexions semble modifiée mais pas significative. Ce résultat a mis en évidence pour la première fois 2 affections opposites de l’AD et de la dépression sur le connectome structurel cérébral à long terme. / Major depressive disorder (MDD) is expanding on worldwide. Functional and volumetric imaging found abnormal activities and reductions in cerebral gray matter in MDD patients. However, the pattern of brain connections (structural connectome) of MDD patients in diffusion imaging remains unclear. The objective of this work is to study the structural connectome of MDD patients. For 3 years from 03/2014 to 03/2017, 56 MDD patients and 31 healthy controls (HC) were included in the study. All of these patients received the same venlafaxine depression treatment and were followed for 3 months. They received clinical evaluation and anatomical MRI and cerebral diffusion at baseline and at 3 months. HC are evaluated once at inclusion. At 3 months, 37 out of 56 patients completed all assessments. The old use of the antidepressant drugs (AD) and the previous episode of depression have been found to be related to the increased and decreased of cerebral anisotropy in depressed patients, respectively. No differences in cerebral anisotropy between patients and HC at baseline and at 3 months of treatment were detected. The response to AD is not related to patients’ cerebral anisotropy at baseline and at 3 months. The topography of the connections seems modified but not significant. This result showed for the first time 2 opposing affections of AD and depression on the cerebral structural connectome in long term.

Blast-related mild traumatic brain injury (mTBI) is a common injury among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans due to the frequent use of improvised explosive devices (IEDs). A significant minority of veterans with blast-related mTBI complain of postconcussion symptoms (PCS) and cognitive difficulties, even years after the injury. Studies have suggested that these behavioral sequelae are primarily linked to mental health disorders such as posttraumatic stress disorder (PTSD). However, mTBI is associated with neural changes and the impact of these changes on behavioral sequelae is unclear. As such, this dissertation had three goals. First, this dissertation assessed whether the severity of PCS in blast-exposed individuals is associated with the extent of mTBI-related neural injury. Results revealed that individuals with mTBI with loss of consciousness (LOC) had significantly more white matter abnormalities than no-TBI controls and that these white matter abnormalities were spatially variable across individuals. Importantly, the extent of white matter abnormality was associated with physical PCS severity and mediated the relationship between mTBI with LOC and physical PCS. Second, this dissertation examined whether these white matter abnormalities were also associated with overall cognitive impairment. In light of the observed variability in white matter injury, a measure of overall cognitive status that takes into account heterogeneity of cognitive impairment was used. Results showed that the extent of white matter abnormality was associated with cognitive status and mediated the relationship between mTBI with LOC and cognitive impairment. Third, this dissertation examined performance and brain function in the context of an experimental measure of cognitive control known to be sensitive to residual effects of mTBI. Results revealed that although behavioral performance was similar across groups, the mTBI group had enhanced functional connectivity between brain networks important for task performance, suggesting a potential compensatory mechanism in mTBI. Together, the findings of this dissertation suggest that mTBI is associated with structural and functional connectivity alterations years after the injury. Further, this dissertation suggests that whereas structural connectivity changes may have negative behavioral consequences, changes in functional connectivity may serve as a compensatory mechanism for successful performance.

BACKGROUND: White matter (WM) aberrations have been broadly characterized in schizophrenia using standard diffusion tensor imaging (DTI) techniques. The present study aims to distinguish WM alterations in the early course of schizophrenia using advanced diffusion measures of free-water corrected fractional anisotropy (FAt) and free-water fractional volume (FW), in addition to examining their association with neurocognition, social cognition, and clinical measures. We report baseline results from a longitudinal study investigating the effects of cognitive enhancement therapy (CET) on brain structure and function in schizophrenia. METHODS: The sample consisted of 46 early course schizophrenia patients and 20 healthy controls. Diffusion-weighted images were processed using a free-water imaging pipeline, that separately models diffusion of water in tissue (FAt) and the extracellular space (FW). Tract-Based Spatial Statistics was performed on the FAt and FW diffusion tensor maps and average measures from 24 bilateral regions of interest (ROIs) were extracted. We examined WM structural differences between patients and controls and further investigated WM relations to neurocognition, social cognition, and clinical measures specifically in schizophrenia. RESULTS: Patients showed significant FAt reductions in the body of the corpus callosum, posterior thalamic radiation (PTR), cingulate gyrus, anterior corona radiata, corpus callosum, and corona radiata and FW elevations in the posterior corona radiata (PCR), uncinate fasciculus (UNC), and PTR compared to controls. For patients, positive correlations between FAt and working memory were observed in the PCR and fornix & stria terminalis (FXST). Negative associations between FW and attention/vigilance were observed in the UNC. Positive correlations between FAt and theory of mind (ToM) were observed in average whole-brain and FXST. Negative associations between FW and ToM were observed in average whole-brain and PCR. Positive correlations between FW and negative symptom severity were observed in the external capsule. CONCLUSION: Using free-water imaging, we report WM aberrations and FW elevations in the early course of schizophrenia in addition to neural correlates associated with cognition and clinical measures. Future investigations on the longitudinal effects of CET are warranted for a greater understanding of the underlying neural correlates of clinical manifestations in schizophrenia. / 2020-06-14T00:00:00Z