BACKGROUND:Neuroimaging studies have consistently revealed neuroanatomical abnormalities in individuals with bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SZ). However, it remains unknown whether and to what extent disorder-selective gray matter variations occur in these prominent psychiatric disorders. This study conducted a meta-analysis of 25 years of published voxel-based morphometry (VBM) research to assess the presence of selective and robust neuroanatomical substrates of gray matter variation in BD, MDD, and SZ. METHODS:Peer-reviewed experiments encompassing subjects with target disorders were systematically searched in the MEDLINE database. Additionally, peer-reviewed data on 30 other psychiatric disorders and 65 neurological diseases were obtained from the BrainMap database. Experiments reporting whole-brain group comparisons between patients and healthy controls were included if they identified significant reductions in gray matter morphometry. RESULTS:The data were analyzed using the Bayes fACtor mOdeliNg algorithm. A total of 1,021 VBM experiments were included, comprising 29,540 patients and 28,177 healthy controls. Primary analyses of psychiatric data revealed strong evidence of gray matter reduction in the right middle temporal gyrus for BD and the posterior dorsal anterior cingulate cortex for SZ (P ≥ 95% selectivity). The robustness of these findings was confirmed using the fail-safe method tailored to the neuroimaging meta-analytic environment. No selective findings were observed in additional analyses that included neurological diseases. CONCLUSIONS:Taken together, these findings offer a framework that underscores the significance of diagnosis-selective neural substrates in psychopathology, a new perspective that could inform distinct pathophysiological processes and assist in diagnosis and treatment.
Cognitive reserve (CR) refers to the capacity of the brain to sustain cognitive performance despite age-related changes or pathophysiological conditions. Task-based functional magnetic resonance imaging (tb-fMRI) has been instrumental in exploring its neural correlates. CR is traditionally assessed through socio-behavioral proxies such as education, intelligence quotient, or composite indices. However, these proxies vary considerably in definition and application, posing challenges regarding their validity and consistency across experiments. This systematic review and meta-analysis examined whether these proxies are associated with consistent brain activation patterns in healthy adults. A literature search identified 12 eligible tb-fMRI experiments (n = 802 participants) reporting whole-brain CR-related activation. A coordinate-based meta-analysis using permutation of subject images-signed differential mapping (PSI-SDM) was conducted to assess consistent activation patterns across experiments, complemented by meta-regression analyses to examine whether differences in proxy type accounted for inter-study variability. The PSI-SDM meta-analysis yielded no significant clusters of activation. A qualitative synthesis of individual experiments further highlighted a lack of topographical consistency. These findings indicate that widely used socio-behavioral proxies are not associated with detectable, reproducible convergent patterns in tb-fMRI, revealing a measurement gap in current CR research. This null convergence likely reflects methodological heterogeneity and conceptual inconsistency in the literature, rather than the absence of CR-related neural mechanisms.
The gut–brain axis, a bidirectional communication network between the gastrointestinal system and the brain, significantly influences mental health and behavior. Probiotics, live microorganisms conferring health benefits, have garnered attention for their potential to modulate this axis. However, their effects on brain function through gut microbiota modulation remain controversial. This systematic review examines the effects of probiotics on brain activity and functioning, focusing on randomized controlled trials using both resting-state and task-based functional magnetic resonance imaging (fMRI) methodologies. Studies investigating probiotic effects on brain activity in healthy individuals and clinical populations (i.e., major depressive disorder and irritable bowel syndrome) were identified. In healthy individuals, task-based fMRI studies indicated that probiotics modulate brain activity related to emotional regulation and cognitive processing, particularly in high-order areas such as the amygdala, precuneus, and orbitofrontal cortex. Resting-state fMRI studies revealed changes in connectivity patterns, such as increased activation in the Salience Network and reduced activity in the Default Mode Network. In clinical populations, task-based fMRI studies showed that probiotics could normalize brain function in patients with major depressive disorder and irritable bowel syndrome. Resting-state fMRI studies further suggested improved connectivity in mood-regulating networks, specifically in the subcallosal cortex, amygdala and hippocampus. Despite promising findings, methodological variability and limited sample sizes emphasize the need for rigorous, longitudinal research to clarify the beneficial effects of probiotics on the gut–brain axis and mental health.
Co-activation of distinct brain areas provides a valuable measure of functional interaction, or connectivity, between them. One well-validated way to investigate the co-activation patterns of a precise area is meta-analytic connectivity modeling (MACM), which performs a seed-based meta-analysis on task-based functional magnetic resonance imaging (task-fMRI) data. While MACM stands as a powerful automated tool for constructing robust models of whole-brain human functional connectivity, its inherent limitation lies in its inability to capture the distinct interrelationships among multiple brain regions. Consequently, the connectivity patterns highlighted through MACM capture the direct relationship of the seed region with third brain regions, but also a (less informative) residual relationship between the third regions themselves. As a consequence of this, this technique does not allow to evaluate to what extent the observed connectivity pattern is really associated with the fact that the seed region is activated, or it just reflects spurious co-activations unrelated with it. In order to overcome this methodological gap, we introduce a meta-analytic Bayesian-based method, called meta-analytic connectivity perturbation analysis (MACPA), that allows to identify the unique contribution of a seed region in shaping whole-brain connectivity. We validate our method by analyzing one of the most complex and dynamic structures of the human brain, the amygdala, indicating that MACPA may be especially useful for delineating region-wise co-activation networks.
In recent years, the glymphatic system has received increasing attention due to its possible implications in biological mechanisms associated with neurodegeneration. In the field of human brain mapping, this led to the development of diffusion tensor image analysis along the perivascular space (DTI-ALPS) index. While this index has been repeatedly used to investigate possible differences between neurodegenerative disorders and healthy controls, a comprehensive evaluation of its stability across multiple measurements and different disorders is still missing. In this study, we perform a Bayesian meta-analysis aiming to assess the consistency of the DTI-ALPS results previously reported for 12 studies on Parkinson's disease and 11 studies on Alzheimer's disease. We also evaluated if the measured value of the DTI-ALPS index can quantitatively inform the diagnostic process, allowing disambiguation between these two disorders. Our results, expressed in terms of Bayes' Factor values, confirmed that the DTI-ALPS index is consistent in measuring the different functioning of the glymphatic system between healthy subjects and patients for both Parkinson's disease (Log10(BF10) = 30) and Alzheimer's disease (Log10(BF10) = 10). Moreover, we showed that the DTI-ALPS can be used to compare these two disorders directly, therefore providing a first proof of concept supporting the reliability of taking into consideration this neuroimaging measurement in the diagnostic process. Our study underscores the potential of the DTI-ALPS index in advancing our understanding of neurodegenerative pathologies and enhancing clinical diagnostics.
Despite over two decades of neuroimaging research, a unanimous definition of the pattern of structural variation associated with autism spectrum disorder (ASD) has yet to be found. One potential impeding issue could be the sometimes ambiguous use of measurements of variations in gray matter volume (GMV) or gray matter concentration (GMC). In fact, while both can be calculated using voxel-based morphometry analysis, these may reflect different underlying pathological mechanisms. We conducted a coordinate-based meta-analysis, keeping apart GMV and GMC studies of subjects with ASD. Results showed distinct and non-overlapping patterns for the two measures. GMV decreases were evident in the cerebellum, while GMC decreases were mainly found in the temporal and frontal regions. GMV increases were found in the parietal, temporal, and frontal brain regions, while GMC increases were observed in the anterior cingulate cortex and middle frontal gyrus. Age-stratified analyses suggested that such variations are dynamic across the ASD lifespan. The present findings emphasize the importance of considering GMV and GMC as distinct yet synergistic indices in autism research.
Functional magnetic resonance imaging research employing regional homogeneity (ReHo) analysis has uncovered aberrant local brain connectivity in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in comparison with healthy controls. However, the precise localization, extent, and possible overlap of these aberrations are still not fully understood. To bridge this gap, we applied a novel meta-analytic and Bayesian method (minimum Bayes Factor Activation Likelihood Estimation, mBF-ALE) for a systematic exploration of local functional connectivity alterations in MCI and AD brains. We extracted ReHo data via a standardized MEDLINE database search, which included 35 peer-reviewed experiments, 1,256 individuals with AD or MCI, 1,118 healthy controls, and 205 x-y-z coordinates of ReHo variation. We then separated the data into two distinct datasets: one for MCI and the other for AD. Two mBF-ALE analyses were conducted, thresholded at “very strong evidence” (mBF ≥ 150), with a minimum cluster size of 200 mm³. We also assessed the spatial consistency and sensitivity of our Bayesian results using the canonical version of the ALE algorithm. For MCI, we observed two clusters of ReHo decrease and one of ReHo increase. Decreased local connectivity was notable in the left precuneus (Brodmann area – BA 7) and left inferior temporal gyrus (BA 20), while increased connectivity was evident in the right parahippocampal gyrus (BA 36). The canonical ALE confirmed these locations, except for the inferior temporal gyrus. In AD, one cluster each of ReHo decrease and increase were found, with decreased connectivity in the right posterior cingulate cortex (BA 30 extending to BA 23) and increased connectivity in the left posterior cingulate cortex (BA 31). These locations were confirmed by the canonical ALE. The identification of these distinct functional connectivity patterns sheds new light on the complex pathophysiology of MCI and AD, offering promising directions for future neuroimaging-based interventions. Additionally, the use of a Bayesian framework for statistical thresholding enhances the robustness of neuroimaging meta-analyses, broadening its applicability to small datasets.
Activation likelihood estimation (ALE) is among the most used algorithms to perform neuroimaging meta-analysis. Since its first implementation, several thresholding procedures had been proposed, all referred to the frequentist framework, returning a rejection criterion for the null hypothesis according to the critical p-value selected. However, this is not informative in terms of probabilities of the validity of the hypotheses. Here, we describe an innovative thresholding procedure based on the concept of minimum Bayes factor (mBF). The use of the Bayesian framework allows to consider different levels of probability, each of these being equally significant. In order to simplify the translation between the common ALE practice and the proposed approach, we analised six task-fMRI/VBM datasets and determined the mBF values equivalent to the currently recommended frequentist thresholds based on Family Wise Error (FWE). Sensitivity and robustness toward spurious findings were also analyzed. Results showed that the cutoff log(10)(mBF) = 5 is equivalent to the FWE threshold, often referred as voxel-level threshold, while the cutoff log(10)(mBF) = 2 is equivalent to the cluster-level FWE (c-FWE) threshold. However, only in the latter case voxels spatially far from the blobs of effect in the c-FWE ALE map survived. Therefore, when using the Bayesian thresholding the cutoff log(10)(mBF) = 5 should be preferred. However, being in the Bayesian framework, lower values are all equally significant, while suggesting weaker level of force for that hypothesis. Hence, results obtained through less conservative thresholds can be legitimately discussed without losing statistical rigor. The proposed technique adds therefore a powerful tool to the human-brain-mapping field.
We recently showed that an expanding pattern of morphological alteration can be detected during disease progression in Schizophrenia. Here we used the Bayes Factor to test whether brain regions involved in early phases are highly disorder-specific and therefore potentially considered as biomarkers.
Introduction:Stroke-related deficits often include motor impairments and gait dysfunction, leading to a limitation of social activities and consequently affecting the quality of life of stroke survivors. Neurorehabilitation takes advantage of the contribution of different techniques in order to achieve more benefits for patients. Robotic devices help to improve the outcomes of physical rehabilitation. Moreover, motor imagery seems to play a role in neurological rehabilitation since it leads to the activation of the same brain areas as actual movements. This study investigates the use of a combined physical and cognitive protocol for gait rehabilitation in stroke patients.Methods:Specifically, we tested the efficacy of a 5-week training program using a robotic orthosis (P.I.G.R.O.) in conjunction with motor imagery training. Twelve chronic stroke patients participated in the study. We evaluated balance and gait performance before and after the training. Six of them underwent fMRI examination before and after the training to assess the effects of the protocol on brain plasticity mechanisms in motor and imagery tasks.Results:Our results show that the rehabilitation protocol can effectively improve gait performance and balance and reduce the risk of falls in stroke patients. Furthermore, the fMRI results suggest that rehabilitation is associated with cerebral plastic changes in motor networks.Discussion:The present findings, if confirmed by future research, have the potential to advance the development of new, more effective rehabilitation approaches for stroke patients, improving their quality of life and reducing the burden of stroke-related disability.
ABSTRACT:A 78-year-old man with synchronous diagnosis of prostate cancer and lung adenocarcinoma was referred to our institute for prostate cancer staging with [ 18 F]F-prostate-specific membrane antigen (PSMA) 1007 PET/CT. In addition to the previously known lesion of the right lung, PSMA-targeted PET/CT highlighted 2 areas of abnormal uptake in the brain, in the left frontal and temporal lobes. A subsequent MRI confirmed the lesions observed on PET/CT. Because PSMA-targeting radiopharmaceuticals do not accumulate in healthy brain parenchyma, and recent literature reported promising performances of PSMA-targeted PET/CT in gliomas and metastases from tumors other than prostate cancer, this employment of PSMA radioligands needs to be further explored.
The cingulate cortex is known to be a complex structure, involved in several cognitive and emotional functions, as well as being altered by a variety of brain disorders. This heterogeneity is reflected in the multiple parceling models proposed in the literature. At the present, sub-regions of the cingulate cortex had been identified taking into account functional and structural connectivity, as well as cytological and electrochemical properties. In the present work, we propose an innovative node-wise parceling approach based on meta-analytic Bayesian co-alteration. To this aim, 193 case–control voxel-based morphometry experiments were analyzed, and the Patel’s κ index was used to assess probability of morphometric co-alteration between nodes placed in the cingulate cortex and in the rest of the brain. Hierarchical clustering was then applied to identify nodes in the cingulate cortex exhibiting a similar pattern of whole-brain co-alteration. The obtained dendrogram highlighted a robust fronto-parietal cluster compatible with the default mode network, and being supported by the interplay between the retrosplenial cortex and the anterior and posterior cingulate cortex, rarely described in the literature. This ensemble was further confirmed by the analysis of functional patterns. Leveraging on co-alteration to investigate cortical organization could, therefore, allow to combine multimodal information, resolving conflicting results sometimes coming from the separate use of singular modalities. Crucially, this provides a valuable way to understand the pathological brain using data driven, whole-brain informed and context-specific evidence in a way not yet explored in the field.
BACKGROUND:Autism spectrum disorder (ASD) is a set of developmental conditions with widespread neuroanatomical abnormalities and a strong genetic basis. Although neuroimaging studies have indicated anatomical changes in grey matter (GM) morphometry, their associations with gene expression remain elusive. METHODS:Here, we aim to understand how gene expression correlates with neuroanatomical atypicalities in ASD. To do so, we performed a coordinate-based meta-analysis to determine the common GM variation pattern in the autistic brain. From the Allen Human Brain Atlas, we selected eight genes from the SHANK, NRXN, NLGN family and MECP2, which have been implicated with ASD, particularly in regards to altered synaptic transmission and plasticity. The gene expression maps for each gene were built. We then assessed the correlation between the gene expression maps and the GM alteration maps. Lastly, we projected the obtained clusters of GM alteration-gene correlations on top of the canonical resting state networks, in order to provide a functional characterization of the structural evidence. RESULTS:We found that gene expression of most genes correlated with GM alteration (both increase and decrease) in regions located in the default mode network. Decreased GM was also correlated with gene expression of some ASD genes in areas associated with the dorsal attention and cerebellar network. Lastly, single genes were found to be significantly correlated with increased GM in areas located in the somatomotor, limbic and ganglia/thalamus networks. CONCLUSIONS:This approach allowed us to combine the well beaten path of genetic and brain imaging in a novel way, to specifically investigate the relation between gene expression and brain with structural damage, and individuate genes of potential interest for further investigation in the functional domain.
The present work is a replication article based on the paper "Are there shared neural correlates between dyslexia and ADHD? A meta-analysis of voxel-based morphometry studies" by McGrath and Stoodley (2019). In the original research, the authors used activation likelihood estimation (ALE), a technique to perform coordinate-based meta-analysis (CBMA), to investigate the existence of brain regions undergoing gray matter alteration in association with both attention-deficit/hyper-activity disorder (ADHD) and dyslexia. Here, the same voxel-based morphometry dataset was analyzed, while using the permutation-subject images version of signed differential mapping (PSI-SDM) in place of ALE. Overall, the replication converged with the original paper in showing a limited overlap between the two conditions. In particular, no significant effect was found for dyslexia, therefore precluding any form of comparison between the two disorders. The possible influences of biological sex, age, and medication status were also ruled out. Our findings are in line with literature about gray matter alteration associated with ADHD and dyslexia, often showing conflicting results. Therefore, although neuropsychological and clinical evidence suggest some convergence between ADHD and dyslexia, more future research is sorely needed to reach a consensus on the neuroimaging domain in terms of patterns of gray matter alteration.
Asymmetries in gray matter alterations raise important issues regarding the pathological co-alteration between hemispheres. Since homotopic areas are the most functionally connected sites between hemispheres and gray matter co-alterations depend on connectivity patterns, it is likely that this relationship might be mirrored in homologous interhemispheric co-altered areas. To explore this issue, we analyzed data of patients with Alzheimer's disease, schizophrenia, bipolar disorder and depressive disorder from the BrainMap voxel-based morphometry database. We calculated a map showing the pathological homotopic anatomical co-alteration between homologous brain areas. This map was compared with the meta-analytic homotopic connectivity map obtained from the BrainMap functional database, so as to have a meta-analytic connectivity modeling map between homologous areas. We applied an empirical Bayesian technique so as to determine a directional pathological co-alteration on the basis of the possible tendencies in the conditional probability of being co-altered of homologous brain areas. Our analysis provides evidence that: the hemispheric homologous areas appear to be anatomically co-altered; this pathological co-alteration is similar to the pattern of connectivity exhibited by the couples of homologues; the probability to find alterations in the areas of the left hemisphere seems to be greater when their right homologues are also altered than vice versa, an intriguing asymmetry that deserves to be further investigated and explained.
According to the predictive coding (PC) theory, the brain is constantly engaged in predicting its upcoming states and refining these predictions through error signals. Despite extensive research investigating the neural bases of this theory, to date no previous study has systematically attempted to define the neural mechanisms of predictive coding across studies and sensory channels, focussing on functional connectivity. In this study, we employ a coordinate-based meta-analytical approach to address this issue. We first use the Activation Likelihood Estimation (ALE) algorithm to detect spatial convergence across studies, related to prediction error and encoding. Overall, our ALE results suggest the ultimate role of the left inferior frontal gyrus and left insula in both processes. Moreover, we employ a meta-analytic connectivity method (Seed-Voxel Correlations Consensus). This technique reveals a large, bilateral predictive network , which resembles large-scale networks involved in task-driven attention and execution. In sum, we find that: (i) predictive processing seems to occur more in certain brain regions than others, when considering different sensory modalities at a time; (ii) there is no evidence, at the network level, for a distinction between error and prediction processing.
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess pathophysiological models of how the disorder develops is an important target for the clinical practice. We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization. Results reveal a cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region found altered among c-HR, RDSZ and ChSZ. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ. These findings support the current neuroprogressive models of SZ and integrate this deterioration with the clinical evolution of the disease.
Recent developments in network neuroscience suggest reconsidering what we thought we knew about the Default Mode Network (DMN). Although this network has always been seen as unitary and associated with the resting state, a new deconstructive line of research is pointing out that the DMN could be divided into multiple subsystems supporting different functions. By now, it is well known that the DMN is not only deactivated by tasks, but also involved in affective, mnestic, and social paradigms, among others. Nonetheless, it is starting to become clear that the array of activities in which it is involved, might also be extended to more extrinsic functions. The present meta-analytic study is meant to push this boundary a bit further. The BrainMap database was searched for all experimental paradigms activating the DMN, and their activation maps were then computed. An additional map of task-induced deactivations was also created. A Multidimensional Scaling indicated that such maps could be arranged along an anatomo-psychological gradient, which goes from midline core activations, associated with the most internal functions, to the involvement of lateral cortices in more external tasks. Further investigations suggested that such extrinsic mode is especially related to reward, semantic, and emotional functions. However, an important finding was that the variability of task-induced DMN anatomic redistribution was hard to recapitulate, as none of the maps, or any linear combination of them, could represent the whole space of its dynamical reconfiguration. Altogether, our findings suggest that the DMN may be characterized by a richer functional diversity and a more spatial complexity than previously suggested.
BACKGROUND:Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by atypical brain anatomy and connectivity. Graph-theoretical methods have mainly been applied to detect altered patterns of white matter tracts and functional brain activation in individuals with ASD. The network topology of gray matter (GM) abnormalities in ASD remains relatively unexplored.METHODS:An innovative meta-connectomic analysis on voxel-based morphometry data (45 experiments, 1,786 subjects with ASD) was performed in order to investigate whether GM variations can develop in a distinct pattern of co-alteration across the brain. This pattern was then compared with normative profiles of structural and genetic co-expression maps. Graph measures of centrality and clustering were also applied to identify brain areas with the highest topological hierarchy and core sub-graph components within the co-alteration network observed in ASD.RESULTS:Individuals with ASD exhibit a distinctive and topologically defined pattern of GM co-alteration that moderately follows the structural connectivity constraints. This was not observed with respect to the pattern of genetic co-expression. Hub regions of the co-alteration network were mainly left-lateralized, encompassing the precuneus, ventral anterior cingulate, and middle occipital gyrus. Regions of the default mode network appear to be central in the topology of co-alterations.CONCLUSION:These findings shed new light on the pathobiology of ASD, suggesting a network-level dysfunction among spatially distributed GM regions. At the same time, this study supports pathoconnectomics as an insightful approach to better understand neuropsychiatric disorders.
Brain disorders tend to impact on many different regions in a typical way: alterations do not spread randomly; rather, they seem to follow specific patterns of propagation that show a strong overlap between different pathologies. The insular cortex is one of the brain areas more involved in this phenomenon, as it seems to be altered by a wide range of brain diseases. On these grounds we thoroughly investigated the impact of brain disorders on the insular cortices analyzing the patterns of their structural co-alteration. We therefore investigated, applying a network analysis approach to meta-analytic data, 1) what pattern of gray matter alteration is associated with each of the insular cortex parcels; 2) whether or not this pattern correlates and overlaps with its functional meta-analytic connectivity; and, 3) the behavioral profile related to each insular co-alteration pattern. All the analyses were repeated considering two solutions: one with two clusters and another with three. Our study confirmed that the insular cortex is one of the most altered cerebral regions among the cortical areas, and exhibits a dense network of co-alteration including a prevalence of cortical rather than sub-cortical brain regions. Regions of the frontal lobe are the most involved, while occipital lobe is the less affected. Furthermore, the co-alteration and co-activation patterns greatly overlap each other. These findings provide significant evidence that alterations caused by brain disorders are likely to be distributed according to the logic of network architecture, in which brain hubs lie at the center of networks composed of co-altered areas. For the first time, we shed light on existing differences between insula sub-regions even in the pathoconnectivity domain.