There has been an increasing use of functional magnetic resonance imaging (fMRI) by the neuroscience community to examine differences in functional connectivity between normal control groups and populations of interest. Understanding the reliability of these functional connections is essential to the study of neurological development and degenerate neuropathological conditions. To date, most research assessing the reliability with which resting-state functional connectivity characterizes the brain’s functional networks has been on scans between 3 and 11 min in length. In our present study, we examine the test–retest reliability and similarity of resting-state functional connectivity for scans ranging in length from 3 to 27 min as well as for time series acquired during the same length of time but excluding half the time points via sampling every second image. Our results show that reliability and similarity can be greatly improved by increasing the scan lengths from 5 min up to 13 min, and that both the increase in the number of volumes as well as the increase in the length of time over which these volumes was acquired drove this increase in reliability. This improvement in reliability due to scan length is much greater for scans acquired during the same session. Gains in intersession reliability began to diminish after 9–12 min, while improvements in intrasession reliability plateaued around 12–16 min. Consequently, new techniques that improve reliability across sessions will be important for the interpretation of longitudinal fMRI studies.
Resting-state fMRI (rs-fMRI) has been demonstrated to have moderate to high reliability and produces consistent patterns of connectivity across a wide variety of subjects, sites, and scanners. However, there is no one agreed upon method to acquire rs-fMRI data. Some sites instruct their subjects, or patients, to lie still with their eyes closed, while other sites instruct their subjects to keep their eyes open or even fixating on a cross during scanning. Several studies have compared those three resting conditions based on connectivity strength. In our study, we assess differences in metrics of test–retest reliability (using an intraclass correlation coefficient), and consistency of the rank-order of connections within a subject and the ranks of subjects for a particular connection from one session to another (using Kendall's W tests). Twenty-five healthy subjects were scanned at three different time points for each resting condition, twice the same day and another time two to three months later. Resting-state functional connectivity measures were evaluated in motor, visual, auditory, attention, and default-mode networks, and compared between the different resting conditions. Of the networks examined, only the auditory network resulted in significantly higher connectivity in the eyes closed condition compared to the other two conditions. No significant between-condition differences in connectivity strength were found in default mode, attention, visual, and motor networks. Overall, the differences in reliability and consistency between different resting conditions were relatively small in effect size but results were found to be significant. Across all within-network connections, and within default-mode, attention, and auditory networks statistically significant greater reliability was found when the subjects were lying with their eyes fixated on a cross. In contrast, primary visual network connectivity was most reliable when subjects had their eyes open (and not fixating on a cross).
The human brain undergoes both morphological and functional modifications across the human lifespan. It is important to understand the aspects of brain reorganization that are critical in normal aging. To address this question, one approach is to investigate age-related topological changes of the brain. In this study, we developed a brain network model using graph theory methods applied to the resting-state functional magnetic resonance imaging data acquired from two groups of normal healthy adults classified by age. We found that brain functional networks demonstrated modular organization in both groups with modularity decreased with aging, suggesting less distinct functional divisions across whole brain networks. Local efficiency was also decreased with aging but not with global efficiency. Besides these brain-wide observations, we also observed consistent alterations of network properties at the regional level in the elderly, particularly in two major functional networks-the default mode network (DMN) and the sensorimotor network. Specifically, we found that measures of regional strength, local and global efficiency of functional connectivity were increased in the sensorimotor network while decreased in the DMN with aging. These results indicate that global reorganization of brain functional networks may reflect overall topological changes with aging and that aging likely alters individual brain networks differently depending on the functional properties. Moreover, these findings highly correspond to the observation of decline in cognitive functions but maintenance of primary information processing in normal healthy aging, implying an underlying compensation mechanism evolving with aging to support higher-level cognitive functioning.
The role of hypoperfusion in Alzheimer’s disease (AD) is a vital component to understanding the pathogenesis of this disease. Disrupted perfusion is not only evident throughout disease manifestation, it is also demonstrated during the pre-clinical phase of AD (i.e., mild cognitive impairment) as well as in cognitively healthy persons at high-risk for developing AD due to family history or genetic factors. Studies have used a variety of imaging modalities (e.g., SPECT, MRI, PET) to investigate AD, but with its recent technological advancements and non-invasive use of blood water as an endogenous tracer, arterial spin labeling (ASL) MRI has become an imaging technique of growing popularity. Through numerous ASL studies, it is now known that AD is associated with both global and regional cerebral hypoperfusion and that there is considerable overlap between the regions implicated in the disease state (consistently reported in precuneus/posterior cingulate and lateral parietal cortex) and those implicated in disease risk. Debate exists as to whether decreased blood flow in AD is a cause or consequence of the disease. Nonetheless, hypoperfusion in AD is associated with both structural and functional changes in the brain and offers a promising putative biomarker that could potentially identify AD in its pre-clinical state and be used to explore treatments to prevent, or at least slow, the progression of the disease. Finally, given that perfusion is a vascular phenomenon, we provide insights from a vascular lesion model (i.e., stroke) and illustrate the influence of disrupted perfusion on brain structure and function and, ultimately, cognition in AD.
Most of what is known about the reorganization of functional brain networks that accompanies normal aging is based on neuroimaging studies in which participants perform specific tasks. In these studies, reorganization is defined by the differences in task activation between young and old adults. However, task activation differences could be the result of differences in task performance, strategy, or motivation, and not necessarily reflect reorganization. Resting-state fMRI provides a method of investigating functional brain networks without such confounds. Here, a support vector machine (SVM) classifier was used in an attempt to differentiate older adults from younger adults based on their resting-state functional connectivity. In addition, the information used by the SVM was investigated to see what functional connections best differentiated younger adult brains from older adult brains. Three separate resting-state scans from 26 younger adults (18-35 yrs) and 26 older adults (55-85) were obtained from the International Consortium for Brain Mapping (ICBM) dataset made publically available in the 1000 Functional Connectomes project www.nitrc.org/projects/fcon_1000. 100 seed-regions from four functional networks with 5 mm3 radius were defined based on a recent study using machine learning classifiers on adolescent brains. Time-series for every seed-region were averaged and three matrices of z-transformed correlation coefficients were created for each subject corresponding to each individual’s three resting-state scans. SVM was then applied using leave-one-out cross-validation. The SVM classifier was 84% accurate in classifying older and younger adult brains. The majority of the connections used by the classifier to distinguish subjects by age came from seed-regions belonging to the sensorimotor and cingulo-opercular networks. These results suggest that age-related decreases in positive correlations within the cingulo-opercular and default networks, and decreases in negative correlations between the default and sensorimotor networks, are the distinguishing characteristics of age-related reorganization.
Stroke is a leading cause of acquired disability resulting in distal upper extremity functional motor impairment. Stroke mortality rates continue to decline with advances in healthcare and medical technology. This has led to an increased demand for advanced, personalized rehabilitation. Survivors often experience some level of spontaneous recovery shortly after their stroke event; yet reach a functional plateau after which there is exiguous motor recovery. Nevertheless, studies have demonstrated the potential for recovery beyond this plateau. Non-traditional neurorehabilitation techniques, such as those incorporating the brain-computer interface (BCI), are being investigated for rehabilitation. BCIs may offer a gateway to the brain’s plasticity and revolutionize how humans interact with the world. Non-invasive BCIs work by closing the proprioceptive feedback loop with real-time, multi-sensory feedback allowing for volitional modulation of brain signals to assist hand function. BCI technology potentially promotes neuroplasticity and Hebbian-based motor recovery by rewarding cortical activity associated with sensory-motor rhythms through use with a variety of self-guided and assistive modalities.
Brain-computer interface (BCI) technology is being incorporated into new stroke rehabilitation devices, but little is known about brain changes associated with its use. We collected anatomical and functional MRI of nine stroke patients with persistent upper extremity motor impairment before, during, and after therapy using a BCI system. Subjects were asked to perform finger tapping of the impaired hand during fMRI. Action Research Arm Test (ARAT), 9-Hole Peg Test (9-HPT), and Stroke Impact Scale (SIS) domains of Hand Function (HF) and Activities of Daily Living (ADL) were also assessed. Group-level analyses examined changes in whole-brain task-based functional connectivity (FC) to seed regions in the motor network observed during and after BCI therapy. Whole-brain FC analyses seeded in each thalamus showed FC increases from baseline at mid-therapy and post-therapy (p < 0.05). Changes in FC between seeds at both the network and the connection levels were examined for correlations with changes in behavioral measures. Average motor network FC was increased post-therapy, and changes in average network FC correlated (p < 0.05) with changes in performance on ARAT (R2 = 0.21), 9-HPT (R2 = 0.41), SIS HF (R2 = 0.27), and SIS ADL (R2 = 0.40). Multiple individual connections within the motor network were found to correlate in change from baseline with changes in behavioral measures. Many of these connections involved the thalamus, with change in each of four behavioral measures significantly correlating with change from baseline FC of at least one thalamic connection. These preliminary results show changes in FC that occur with the administration of rehabilitative therapy using a BCI system. The correlations noted between changes in FC measures and changes in behavioral outcomes indicate that both adaptive and maladaptive changes in FC may develop with this therapy and also suggest a brain-behavior relationship that may be stimulated by the neuromodulatory component of BCI therapy.
This study aims to examine the changes in task-related brain activity induced by rehabilitative therapy using brain-computer interface (BCI) technologies and whether these changes are relevant to functional gains achieved through the use of these therapies. Stroke patients with persistent upper-extremity motor deficits received interventional rehabilitation therapy using a closed-loop neurofeedback BCI device (n = 8) or no therapy (n = 6). Behavioral assessments using the Stroke Impact Scale, the Action Research Arm Test (ARAT), and the Nine-Hole Peg Test (9-HPT) as well as task-based fMRI scans were conducted before, during, after, and 1 month after therapy administration or at analogous intervals in the absence of therapy. Laterality Index (LI) values during finger tapping of each hand were calculated for each time point and assessed for correlation with behavioral outcomes. Brain activity during finger tapping of each hand shifted over the course of BCI therapy, but not in the absence of therapy, to greater involvement of the non-lesioned hemisphere (and lesser involvement of the stroke-lesioned hemisphere) as measured by LI. Moreover, changes from baseline LI values during finger tapping of the impaired hand were correlated with gains in both objective and subjective behavioral measures. These findings suggest that the administration of interventional BCI therapy can induce differential changes in brain activity patterns between the lesioned and non-lesioned hemispheres and that these brain changes are associated with changes in specific motor functions.
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