Apesar dos numerosos estudos enfocando a compreensão da esquizofrenia, sua etiologia permanece desconhecida. Atualmente, as medicações antipsicóticas disponíveis são baseadas principalmente na hipótese dopaminérgica, porém, apresentam eficácia parcial no tratamento dos sintomas. Diante disso, outros sistemas neurais têm sido investigados e, nesse contexto, a hipótese glutamatérgica conquistou grande importância. Essa hipótese postula a presença de uma hipoatividade do receptor glutamatérgico N-metil-D-aspartato na esquizofrenia e, consequentemente, de uma desregulação na neurotransmissão do óxido nítrico. Um ensaio clínico recente com a administração de nitroprussiato de sódio, um doador de óxido nítrico, mostrou resultados significativos na melhora da sintomatologia de pacientes esquizofrênicos, entretanto, nenhum estudo de neuroimagem investigou quais são os efeitos dessa droga no sistema nervoso central. No crescente campo de estudo da neuroimagem funcional as redes neurais foram descobertas, sendo a default mode network uma das mais estudadas na esquizofrenia. Os recentes estudos de neuroimagem funcional têm evidenciado alterações do funcionamento dessa rede neural nos pacientes portadores da doença, evidenciando assim, a importância da default mode network na compreensão da esquizofrenia. Nesse caminho, o presente estudo investigou os efeitos agudos da administração de nitroprussiato de sódio na conectividade funcional da rede default mode network através da ressonância magnética funcional mediada pelo contraste BOLD (blood oxygen level dependent) em pacientes portadores de esquizofrenia e em voluntários saudáveis. Os pacientes portadores de esquizofrenia foram divididos em dois grupos de acordo com a medicação antipsicótica em uso: grupo sem clozapina (n=13) e grupo com clozapina (n=13). Os voluntários saudáveis também foram divididos em grupo controle (n=14) e grupo controle com tarefa de escuta passiva (n=5). Todos os pacientes portadores de esquizofrenia e o grupo controle foram submetidos a um protocolo de infusão de nitroprussiato de sódio com aquisição simultânea de imagens funcionais. Nossos resultados mostraram um aumento da conectividade funcional da default mode network com a infusão da medicação nos pacientes portadores de esquizofrenia, especialmente no hemisfério direito, enquanto esse mesmo padrão não foi encontrado nos controles saudáveis. Além disso, o aumento na conectividade se mostrou distinto entres os grupos de pacientes avaliados, sendo mais precoce e amplo no grupo de pacientes que não estava em uso do antipsicótico clozapina. Observamos também que o efeito modulatório da droga ocorreu sobre regiões da default mode network já estudadas e fortemente implicadas na fisiopatogenia da esquizofrenia. Assim, nossa investigação neurofuncional contribuiu para a compreensão dos efeitos terapêuticos do nitroprussiato de sódio na sintomatologia de pacientes portadores de esquizofrenia. Nossos achados também reforçam a importância do nitroprussiato de sódio como uma nova ferramenta farmacológica adjuvante no tratamento da esquizofrenia / Despite numerous studies focusing on the understanding of schizophrenia, its etiology remains unknown. Currently, available antipsychotic medications are mainly based on dopamine hypothesis, however, they exhibit partial efficacy in the treatment of the symptoms. Therefore, other neural systems have been investigated and, in this context, the glutamatergic hypothesis gained great importance. This hypothesis postulates the presence of a hypoactivity of the N-methyl-D-aspartate glutamate receptor in schizophrenia and, consequently, a deregulation of nitric oxide neurotransmission. A recent clinical trial with the administration of sodium nitroprusside, a nitric oxide donor, showed significant results in improving the symptoms of schizophrenic patients, however, no neuroimaging study investigated what are the effects of this drug on the central nervous system. The neural networks were discovered from the growing field of functional neuroimaging study and the default mode network is one of the most studied in schizophrenia. The recent functional neuroimaging studies have shown alterations in the functioning of this neural network in patients with the disease, highlighting the importance of the default mode network in the understanding of schizophrenia. In this way, the present study investigated the acute effects of sodium nitroprusside administration in the functional connectivity of the default mode network using blood oxygen level dependent (BOLD) functional magnetic resonance imaging in patients with schizophrenia and healthy volunteers. Schizophrenic patients are divided into two groups according to antipsychotic medication used: group treated without clozapine (n = 13) and group treated with clozapine (n = 13). Healthy volunteers were also divided into control group (n = 14) and control group with passive listening task (n = 5). All schizophrenic patients and healthy volunteers were subjected to a sodium nitroprusside infusion protocol simultaneously to acquisition of functional images. Our results showed increased default mode network functional connectivity with the drug infusion in patients with schizophrenia, mainly in the right hemisphere, while this same pattern was not found in healthy controls. In addition, the increase in connectivity was distinct between groups of patients because it was earlier and more extensive in the group of patients that was not in use of clozapine antipsychotic. We also note that the drug modulatory effect occurred on default mode network regions already studied and strongly implicated in the schizophrenia pathogenesis. Thus, our neurofunctional research contributed to the understanding of the sodium nitroprusside therapeutic effects on the schizophrenia symptoms. Our findings also underline the importance of sodium nitroprusside as a new adjuvant pharmacological tool in the treatment of schizophrenia

Apesar dos numerosos estudos enfocando a compreensão da esquizofrenia, sua etiologia permanece desconhecida. Atualmente, as medicações antipsicóticas disponíveis são baseadas principalmente na hipótese dopaminérgica, porém, apresentam eficácia parcial no tratamento dos sintomas. Diante disso, outros sistemas neurais têm sido investigados e, nesse contexto, a hipótese glutamatérgica conquistou grande importância. Essa hipótese postula a presença de uma hipoatividade do receptor glutamatérgico N-metil-D-aspartato na esquizofrenia e, consequentemente, de uma desregulação na neurotransmissão do óxido nítrico. Um ensaio clínico recente com a administração de nitroprussiato de sódio, um doador de óxido nítrico, mostrou resultados significativos na melhora da sintomatologia de pacientes esquizofrênicos, entretanto, nenhum estudo de neuroimagem investigou quais são os efeitos dessa droga no sistema nervoso central. No crescente campo de estudo da neuroimagem funcional as redes neurais foram descobertas, sendo a default mode network uma das mais estudadas na esquizofrenia. Os recentes estudos de neuroimagem funcional têm evidenciado alterações do funcionamento dessa rede neural nos pacientes portadores da doença, evidenciando assim, a importância da default mode network na compreensão da esquizofrenia. Nesse caminho, o presente estudo investigou os efeitos agudos da administração de nitroprussiato de sódio na conectividade funcional da rede default mode network através da ressonância magnética funcional mediada pelo contraste BOLD (blood oxygen level dependent) em pacientes portadores de esquizofrenia e em voluntários saudáveis. Os pacientes portadores de esquizofrenia foram divididos em dois grupos de acordo com a medicação antipsicótica em uso: grupo sem clozapina (n=13) e grupo com clozapina (n=13). Os voluntários saudáveis também foram divididos em grupo controle (n=14) e grupo controle com tarefa de escuta passiva (n=5). Todos os pacientes portadores de esquizofrenia e o grupo controle foram submetidos a um protocolo de infusão de nitroprussiato de sódio com aquisição simultânea de imagens funcionais. Nossos resultados mostraram um aumento da conectividade funcional da default mode network com a infusão da medicação nos pacientes portadores de esquizofrenia, especialmente no hemisfério direito, enquanto esse mesmo padrão não foi encontrado nos controles saudáveis. Além disso, o aumento na conectividade se mostrou distinto entres os grupos de pacientes avaliados, sendo mais precoce e amplo no grupo de pacientes que não estava em uso do antipsicótico clozapina. Observamos também que o efeito modulatório da droga ocorreu sobre regiões da default mode network já estudadas e fortemente implicadas na fisiopatogenia da esquizofrenia. Assim, nossa investigação neurofuncional contribuiu para a compreensão dos efeitos terapêuticos do nitroprussiato de sódio na sintomatologia de pacientes portadores de esquizofrenia. Nossos achados também reforçam a importância do nitroprussiato de sódio como uma nova ferramenta farmacológica adjuvante no tratamento da esquizofrenia / Despite numerous studies focusing on the understanding of schizophrenia, its etiology remains unknown. Currently, available antipsychotic medications are mainly based on dopamine hypothesis, however, they exhibit partial efficacy in the treatment of the symptoms. Therefore, other neural systems have been investigated and, in this context, the glutamatergic hypothesis gained great importance. This hypothesis postulates the presence of a hypoactivity of the N-methyl-D-aspartate glutamate receptor in schizophrenia and, consequently, a deregulation of nitric oxide neurotransmission. A recent clinical trial with the administration of sodium nitroprusside, a nitric oxide donor, showed significant results in improving the symptoms of schizophrenic patients, however, no neuroimaging study investigated what are the effects of this drug on the central nervous system. The neural networks were discovered from the growing field of functional neuroimaging study and the default mode network is one of the most studied in schizophrenia. The recent functional neuroimaging studies have shown alterations in the functioning of this neural network in patients with the disease, highlighting the importance of the default mode network in the understanding of schizophrenia. In this way, the present study investigated the acute effects of sodium nitroprusside administration in the functional connectivity of the default mode network using blood oxygen level dependent (BOLD) functional magnetic resonance imaging in patients with schizophrenia and healthy volunteers. Schizophrenic patients are divided into two groups according to antipsychotic medication used: group treated without clozapine (n = 13) and group treated with clozapine (n = 13). Healthy volunteers were also divided into control group (n = 14) and control group with passive listening task (n = 5). All schizophrenic patients and healthy volunteers were subjected to a sodium nitroprusside infusion protocol simultaneously to acquisition of functional images. Our results showed increased default mode network functional connectivity with the drug infusion in patients with schizophrenia, mainly in the right hemisphere, while this same pattern was not found in healthy controls. In addition, the increase in connectivity was distinct between groups of patients because it was earlier and more extensive in the group of patients that was not in use of clozapine antipsychotic. We also note that the drug modulatory effect occurred on default mode network regions already studied and strongly implicated in the schizophrenia pathogenesis. Thus, our neurofunctional research contributed to the understanding of the sodium nitroprusside therapeutic effects on the schizophrenia symptoms. Our findings also underline the importance of sodium nitroprusside as a new adjuvant pharmacological tool in the treatment of schizophrenia

BACKGROUND: Schizophrenia manifests as a constellation of both psychotic symptoms (eg. hallucinations, delusions) and so-called negative symptoms. The latter includes anhedonia, avolition, amotivation and they are the strongest predictors of disability. Resting state fMRI (rsfMRI) has demonstrated that the brain is organized into low-dimensional number (7-17) brain networks and this allowed visualization of the relationship between symptom severity and large-scale brain network organization. Traditional rsfMRI analyses have assumed that the spatial organization of these networks are spatially invariant between individuals. This dogma has recently been overturned with the observation that the spatial organization of these brain networks shows significant variation between individuals. We sought to determine if previously observed relationships between symptom severity and network connectivity are actually due to individual differences in spatial organization. METHODS: 44 participants diagnosed with schizophrenia underwent rsfMRI scans and clinical assessment. A multivariate pattern analysis was used to examine how each participant’s whole brain functional connectivity correlates with ‘negative’ symptom severity. RESULTS: Brain connectivity to a region of the right dorso-lateral pre-frontal cortex (r DLPFC) correlates with symptom severity. The result is explained by the individual differences in the topographic distribution of two brain networks: the default mode network (DMN) and the task positive network (TPN). Both networks demonstrate strong (r~0.49) and significant (p<0.001) relationships between topography and symptom severity. For individuals with low symptom severity, this critical region is a part of the DMN. In highly symptomatic individuals, this region is a part of the TPN. CONCLUSIONS: Previously overlooked individual variation in brain organization is tightly linked to individual variation in schizophrenia symptom severity. The recognition of critical links between network topology and pathological symptomology may serve as a guide for future interventions aimed at establishing causal relationships between certain critical regions of the brain and cognitive and behavioral phenotypes. Thus, fMRI and network topology may be translated to a clinical setting as a viable, individual-centered treatment option. / 2020-06-17T00:00:00Z

Individuals who speak more than one language have been found to enjoy a number of benefits not directly associated with the use of the languages themselves. One of these benefits is that bilingual individuals appear to develop symptoms of dementia 4-5 years later than comparable individuals who speak just one language. Studies on this topic, however, do not consistently account for factors including if the individual learned their second language as a child or later in life, or their language proficiency. In an attempt to more carefully examine these variables, this study looks at structural and resting-state functional MRI scans of the default mode network, English and Spanish (where applicable) proficiency, language background, and demographics of young healthy adults who fall into one of three groups: early bilinguals, late bilinguals, and monolinguals. Of the three groups, late bilinguals were found to have a small but statistically significantly higher level of connectivity compared with early bilinguals in the region of the medial prefrontal cortex; patterns found examining number of languages and language proficiency in relation to functional connectivity and research group also supported this finding. These results indicate studying a language after adolescence could provide neuroprotective benefits of a nature that could potentially help delay symptoms of dementia. Age, gender, ethnicity, level of education, English language proficiency, and Spanish language use did not result in statistically significant findings, the latter of which challenges using frequency of language use to define bilingualism.

Caruthers argues that the mindreading capacity and the introspective capacity are in fact one and the same capacity. This single capacity relies on the same sub-personal "interpretive" mechanism that takes sensory information as input and produces attitudes as output. I use neuroscience research to show that if the “interpretive mechanism” exists, and moreover that it operates in accordance to Caruthers’ description in mindreading tasks, (e.g. detecting external cues and paying attention to others’ behavior), then this operation would have to be handled or implemented at the neural level by the Task Oriented Neural Network. On the other hand, it is well known that self-referential thought, including introspective thought is handled by the Default Mode Network. This consequence is problematic for the view that self and other attitude attributions are done by the same mechanism. The same cognitive operation can not be implemented by two distinct neural networks that are in competition with one another. Moreover, the Default Mode neural network and the Task Oriented networks implement such different types of thinking that they oppose and interrupt one another’s functioning. If the only difference between the two networks were that one simply handles a larger quantity of information than the other, then they wouldn’t be in competition. It appears that there is indeed something special about the very nature of self-referential information such that it determines the type of operations involved in its processing. / text

Individuals with Parkinson’s disease (PD) often show cognitive impairments in addition to motor symptoms, with the majority of PD patients converting to dementia as the disease progresses. The changes in the microstructural integrity of key nodes in resting state networks (RSNs) could be a good indicator of the cognitive effects of PD on brain regions as it progresses to dementia. To assess the association between cognitive effects and microstructural change, the microstructural integrity of the regions of interest (ROIs) in 4 resting state networks (RSN), specifically the default mode network (DMN), based on DTI were obtained in three separate groups of patients with PD. One group of patients (PD-N) were cognitively normal, while the second group of patients (PD-MCI) reflect the transitional phase of mild cognitive impairment prior to dementia, and the third group of patients (PD-D) possessed a clear diagnosis of dementia. A comparison group of healthy controls (HC) were included, matched across the three patient groups. The PD-D group showed worse microstructural integrity for the majority of the ROIs across the 4 networks. The loss of structural integrity in the PD-MCI group was more selective, with some ROIs showing similar changes to PD-D, and others showing similar changes to the PD-N group. The PD-N group fail to show any changes in the structural integrity of any ROIs, relative to HC. For future study, a combined structural / functional study should be performed to examine if there are similar changes across both measures.

Previous work has linked the onset and progression of Alzheimer’s Disease (AD) to changes in the Default Mode Network (DMN), including greater atrophy within the hippocampus (HC) as well as diminished functional connectivity and effective connectivity between anatomical DMN structures. Animal models have described the HC as a primary region of interest in studying the effects of exercise on adult neurogenesis and memory performance. Human studies have demonstrated that aerobic exercise leads to greater cardiorespiratory fitness and improved functional connectivity in the DMN for healthy adults. The goal of this study is to go beyond the predictions of human and animal studies to investigate how cardiorespiratory fitness may be used to estimate effective connectivity between the HC and the other DMN structures for young adults using resting state fMRI. Due to the data driven nature of this study, no hypothesis has been formulated. To investigate, data from 25 sedentary young adults was analyzed. Data included a resting state fMRI procedure and a cardiorespiratory fitness test, each taken from part of a larger ongoing clinical trial in the Brain Plasticity and Neuroimaging (BPN) Lab at Boston University (BU). We utilized group independent component analysis (GICA) to identify the regions that define the DMN and Conditional Granger Causality Analysis (CGCA) to determine effective connectivity between these regions. GICA indicated 9 structural regions in the DMN, consistent with previous work. This resulted in 72 possible instances of effective connectivity. The difference of causal influence between regions was calculated for each pair of DMN regions for CGCA, resulting in 36 possible instances of causal connectivity. Linear regression models were created to analyze the effect of cardiorespiratory fitness on effective connectivity between DMN regions and found 11 linear models which exhibited a significant (p > 0.05) relationship. Eight of eleven models involved the left or right hippocampus, showing that greater cardiorespiratory fitness is correlated with changes effective connectivity between the HC and the PCC, MPFC, or LTC. These results provide proof of concept that cardiorespiratory fitness in young adults is associated with changes DMN effective connectivity, particularly involving the hippocampus. This adds to the literature suggesting extended aerobic exercise, which is known to increase cardiorespiratory fitness and has been shown to increase the volume of the HC in older adults, may be neuroprotective of the HC across the lifespan. Further investigation is required to explore how effective connectivity in the DMN changes following an aerobic exercise intervention.

This essay investigates the relationship between a malfunctioning Default Mode Network (DMN) and the diagnosis of Major Depressive Disorder (MDD). A deeper understanding of how the DMN affects those brain processes which are implicated in MDD may offer new approaches to reduce the suffering of the very large number of MDD-afflicted patients. The MDD-DMN relationship has been investigated by studying scientific articles within the field of cognitive neuroscience and searching the articles for clues on how a malfunctioning DMN might correlate with the diagnosis of MDD. The essay concludes that there is much experimental evidence in support of there being a strong coupling between a malfunctioning DMN and the diagnosis of MDD.

The default mode network (DMN) consists of a set of interconnected brain regions supporting autobiographical memory, our concept of the self, and the internal monologue. These processes must be maintained at all times and consume the highest amount of the brain’s energy during its baseline state. However, when faced with an active, externally-directed cognitive task, the DMN shows a small, but significant, decrease in activity. The reduction in DMN activity during the performance of an active, externally-directed task compared to a baseline state is termed task-induced deactivation (TID), which is thought to ‘free-up’ resources required to respond to external demands. However, older adults show a reduced level of TID in the DMN. Recently, it has begun to be appreciated that this decrease in TID may be associated with poorer cognitive performance, especially during tasks placing high demands on executive function (EF). Diminished DMN TID has not only been associated with increasing age but also with multiple age-related neurobiological correlates such as accumulating Alzheimer’s disease (AD) pathology and reductions in white matter (WM) connectivity. However, these biological factors—age, WM connectivity reductions and increasing AD pathology—are themselves related. Based on the literature, we hypothesized that declining WM connectivity may represent a common pathway by which both age and AD pathology contribute to diminished DMN TID. Further, we hypothesized that declines in DMN function and WM connectivity would predict poorer in EF. Three experiments were carried out to test these hypotheses. Experiment 1 tested whether WM connectivity predicted the level of DMN TID during a task requiring a high level of EF. Results from 117 adults (ages 25-83) showed that WM connectivity declined with increasing age, and that this decline in WM connectivity was directly associated with reduced DMN TID during the task. Experiment 2 tested whether declines in WM connectivity explained both age-related and AD pathology-related declines in DMN TID. Results from 29 younger adults and 35 older adults showed that declining WM connectivity was associated with increasing age and AD pathology, and that this decline in WM connectivity was a common pathway for diminished DMN TID associated with either aging or AD pathology. Experiment 3 investigated whether measures of WM connectivity and DMN TID at baseline could predict EF measured using clinically-used tests. Results from 29 older adults from Experiment 2 showed that less DMN TID predicted poorer EF at baseline and diminished WM connectivity at baseline predicted a greater decline in EF after 3 years. Further, WM connectivity explained reductions in EF predicted by baseline AD pathology, as well as further reductions in EF not predicted by baseline AD pathology. Together the results of these studies suggest that WM connectivity is a key pathway for age-related and AD pathology-related patterns of diminished DMN TID associated with poorer EF. Further, WM connectivity may represent a potential therapeutic target for interventions attempting to prevent future declines in EF occurring in aging and AD.

Abstract In the 1990s researchers discovered task-deactivated regions in the human brain. Together, these areas make up the default mode network (DMN). It was originally proposed to act as a balancing mechanism between different brain systems, explaining the deactivations, but is now mostly studied with regards to internal awareness, such as daydreaming and mental imagery. The purpose of this thesis is to present a summary of DMN research, focusing on the network’s suggested role in internal awareness. This will be done by reviewing a wide variety of research that either explicitly or indirectly correlate default mode network features with aspects of consciousness and internal awareness. The subjective experience of being conscious have been a source of argument primarily among philosophers, but the qualities we feel are intimately linked to cognitive functions that are supported by the regions found in the DMN. Cognitive neuroscience may therefore be able to contribute to the concept of internal awareness and consciousness.