Indiana University-Purdue University Indianapolis (IUPUI) / Prodromal Alzheimer’s disease (AD) has recently been identified as a disease state where pathophysiological changes may progress despite the absence of significant clinical symptoms. Yet, the specific processes of neural dysfunction occurring during this preclinical phase remain unclear. Resting state fMRI (RS-fMRI) in combination with brain connectomic measurements may be able to provide ways to measure subtle connectivity changes in different neurological disease states. For instance, RS-fMRI scans allow us to determine functionally connected yet spatially distinct brain regions that can then be separated into resting-state networks (RSNs). More recently, the exploration of RSNs in disease states have proved promising since they have been reliably altered when compared to a control population. By using brain connectomic approaches to assess functional connectivity we can evaluate the human connectome from a different and more global perspective to help us better understand and detect prodromal neurodegenerative disease states.

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

Resting-state fMRI (rsfMRI) has been widely used to map intrinsic brain network organization of the human brain both in health and in pathological conditions. However, the neural underpinnings and dynamic rules governing brain-wide rsfMRI coupling remain unclear. Filling this knowledge gap is of crucial importance, given our current inability to decode and reverse-engineer clinical signatures of aberrant connectivity into interpretable neurophysiological events that can help understand or diagnose brain disorders. Toward this goal, here we combined chemogenetics, rsfMRI, and in vivo electrophysiology in the mouse to investigate how regional manipulations of brain activity (i.e. neural inhibition, or excitation) causally contribute to whole-brain fMRI network organization. In a first set of proof of concept investigations, we empirically probed the widely held notion that neural inhibition of a cortical node would result in reduced fMRI coupling of the silenced area and its long-range terminals. Surprisingly, we found that chronic inhibition of the mouse medial prefrontal cortex (PFC) via viral overexpression of a potassium channel paradoxically increased fMRI connectivity between the inhibited area and its direct thalamo-cortical targets. Notably, acute chemogenetic inhibition of the PFC reproduced analogous patterns of fMRI overconnectivity. Using in vivo electrophysiology, we found that chemogenetic inhibition of the PFC enhances low frequency (0.1 - 4 Hz) oscillatory power via suppression of neural firing not phase-locked to slow rhythms, resulting in increased slow and δ band coherence between areas that exhibit fMRI overconnectivity. These results provide causal evidence that cortical inactivation can counterintuitively increase fMRI connectivity via enhanced, less-localized slow oscillatory processes, with important implications for neural modeling and interpretation of fMRI overconnectivity in brain disorders. Importantly, our observation that neural inhibition of the PFC results in fMRI overconnectivity allowed us to predict that neural activation of the same area might produce opposite results, i.e. fMRI underconnectivity and neural desynchronization. To test this hypothesis, we used chemogenetics to increase local excitatory-inhibitory (E/I) balance in the PFC. As predicted, chemogenetic stimulation of CamkII-expressing neurons, or inhibition of fast-spiking parvalbumin-expressing neurons, produced similar rsfMRI signatures of rsfMRI underconnectivity. Both manipulations produced analogous electrophysiological signatures characterized by increased firing activity and a robust LFP power shift towards higher (i.e. γ) frequencies, effectively reversing the corresponding neural signature observed in DREADD inhibition studies. Importantly, the same E/I affecting perturbations were also associated with socio-communicative deficits in behaving mice hence underscoring the behavioral relevance of the employed manipulations. These results show that excitatory/inhibitory balance critically biases brain-wide fMRI coupling, pointing at a possible unifying mechanistic link between E/I imbalance and rsfMRI connectivity disruption in developmental disorders. More broadly, these investigations reveal a set of fundamental rules linking regional brain activity to macroscale functional connectivity, offering opportunities to physiologically interpret rsfMRI signatures of functional dysconnectivity in human brain disorders.

A significant subset of women plagued with breast cancer continue to experience chronic neuropathic pain (CNP) long after undergoing cancer treatment. Medical interventions such as pharmacotherapy and/or surgery have been most widely used to abate painful symptoms with limited efficacy. Other alternatives are required given a heavy reliance on pharmaceuticals can lead to tolerance, dependence and severe side effects. Possibilities include cognitive behavioural therapy (CBT), physical therapy, and mindfulness interventions to supplement pharmacotherapies. Mindfulness practice in particular has been offered to a variety of chronic pain groups including breast cancer patients, however evidence is lacking to support its effectiveness in CNP for breast cancer survivors (BCS). The purpose of the present study was to explore the benefits a mindfulness-based stress reduction program (MBSR) may have on altering the underlying neuronal correlates linked with pain-related symptoms associated with CNP in BCS. The primary objective was to investigate how mindfulness training might possibly mediate the brain’s capacity for emotional reactivity, white matter integrity, and activation of the default mode network (DMN) and how these changes may correlate with levels of pain severity and pain interference, improving overall quality of life. To achieve these results, several brain imaging techniques were used in order to observe the correlation between the subjective experience of pain and the objective manifestation of brain changes that may be potentiated by MBSR training. A total of 23 participants were placed in either an 8 week MBSR intervention group (n=13) or a waitlist control group (n =10). All women were scanned with MRI before and after the 8 week intervention regardless of group allotment. The following neuroimaging modalities were used for each scanning session: resting state fMRI (rsfMRI) to monitor changes to functional connectivity in the default mode network (DMN); Diffusion Tensor Imaging (DTI) to assess the structural integrity of white matter tracts; and the Emotional Stroop Task (EST) to examine emotional reactivity in response to pain related stimuli. Exploratory results from this pilot study indicate that improvements to functional connectivity were apparent in the MBSR group relative to control, indicative of more efficient communication in areas related to attention, self-awareness, emotion regulation and pain. Improvements were also noted as increased cerebral white matter health and reduced emotional reactivity to pain related stimuli in the group of MBSR trained participants relative to control. Additionally, these functional and structural changes correlated with the self-reported pain measures in the MBSR group, suggesting that the MBSR group demonstrated improvements to ratings of pain severity and pain interference whereas the opposite occurred with the control group. The results have been interpreted as improvements to patients’ perception of pain and quality of life post MBSR training, however, were not limited to the subjective experience of pain. The inclusion of neuroimaging modalities provides objective and empirical support for MBSR training as it highlights the underlying brain mechanisms that were altered as part of MBSR treatment. Ultimately, the evidence suggests that MBSR could be incorporated as part of the treatment protocol for women experiencing CNP post breast cancer treatment.