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Nordvik, J. E.

Publications and source records attributed to Nordvik, J. E..

13 recordsLinked to original sources

Brain disconnectivity mapping of post-stroke fatigue

Stroke patients commonly suffer from post stroke fatigue (PSF). Despite a general consensus that brain perturbations constitute a precipitating event in the multifactorial etiology of PSF, the specific predictive value of conventional lesion characteristics such as size and localization remain unclear. The current study represents a novel approach to assess the neural correlates of PSF in chronic stroke patients. While previous research has focused primarily on lesion location or size, with mixed or inconclusive results, we targeted the extended structural network implicated by the lesion, and evaluated the added explanatory value of a disconnectivity approach with regards to the brain correlates of PSF. To this end, we estimated individual brain disconnectome maps in 84 stroke survivors in the chronic phase ([≥] 3 months post stroke) using information about lesion location and normative white matter pathways obtained from 170 healthy individuals. PSF was measured by the Fatigue Severity Scale (FSS). Voxel wise analyses using non-parametric permutation-based inference were conducted on disconnectome maps to estimate regional effects of disconnectivity. Associations between PSF and global disconnectivity and clinical lesion characteristics were tested by linear models, and we estimated Bayes factor to quantify the evidence for the null and alternative hypotheses, respectively. The results revealed no significant associations between PSF and disconnectome measures or lesion characteristics, with moderate evidence in favor of the null hypothesis. These results suggest that symptoms of post-stroke fatigue are not simply explained by lesion characteristics or brain disconnectome measures in stroke patients in a chronic phase, and are discussed in light of methodological considerations.

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Evidence for reduced long-term potentiation-like visual cortical plasticity in schizophrenia and bipolar disorder

BackgroundSeveral lines of research suggest that impairments in long-term potentiation (LTP)-like synaptic plasticity might be a key pathophysiological mechanism in schizophrenia (SZ) and bipolar disorder type I (BDI) and II (BDII). Using modulations of visually evoked potentials (VEP) of the electroencephalogram, impaired LTP-like visual cortical plasticity has been implicated in patients with BDII, while there has been conflicting evidence in SZ, a lack of research in BDI, and mixed results regarding associations with symptom severity, mood states, and medication. MethodsWe measured the VEP of patients with SZ spectrum disorders (n=31), BDI (n=34), BDII (n=33), and other BD spectrum disorders (n=2), and age-matched healthy control participants (n=200) before and after prolonged visual stimulation. ResultsCompared to healthy controls, modulation of VEP component N1b, but not C1 or P1, was impaired both in patients within the SZ spectrum ({chi}2=35.1, p=3.1x10-9) and BD spectrum ({chi}2=7.0, p=8.2x10-3), including BDI ({chi}2=6.4, p=0.012), but not BDII ({chi}2=2.2, p=0.14). N1b modulation was also more severely impaired in SZ spectrum than BD spectrum patients ({chi}2=14.2, p=1.7x10-4). The reduction in N1b modulation was related to PANSS total scores ({chi}2=10.8, p=1.0x10-3), and nominally to number of psychotic episodes ({chi}2=4.9, p=0.027). Conclusions. These results suggest that LTP-like plasticity is impaired in SZ and BDI, but not BDII, and related to psychotic symptom severity. Adding to previous genetic, pharmacological, and anatomical evidence, these results implicate aberrant synaptic plasticity as a mechanism underlying SZ and BD.

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White matter microstructure across the adult lifespan: A mixed longitudinal and cross-sectional study using advanced diffusion models and brain-age prediction

The macro- and microstructural architecture of human brain white matter undergoes substantial alterations throughout development and ageing. Most of our understanding of the spatial and temporal characteristics of these lifespan adaptations come from magnetic resonance imaging (MRI), including diffusion MRI (dMRI), which enables visualisation and quantification of brain white matter with unprecedented sensitivity and detail. However, with some notable exceptions, previous studies have relied on cross-sectional designs, limited age ranges, and diffusion tensor imaging (DTI) based on conventional single-shell dMRI. In this mixed cross-sectional and longitudinal study (mean interval: 15.2 months) including 702 multi-shell dMRI datasets, we combined complementary dMRI models to investigate age trajectories in healthy individuals aged 18 to 94 years (57.12% women). Using linear mixed effect models and machine learning based brain age prediction, we assessed the age-dependence of diffusion metrics, and compared the age prediction accuracy of six different diffusion models, including diffusion tensor (DTI) and kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), restriction spectrum imaging (RSI), spherical mean technique multi-compartment (SMT-mc), and white matter tract integrity (WMTI). The results showed that the age slopes for conventional DTI metrics (fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], radial diffusivity [RD]) were largely consistent with previous research, and that the highest performing advanced dMRI models showed comparable age prediction accuracy to conventional DTI. Linear mixed effects models and Wilks theorem analysis showed that the FA fine metric of the RSI model and orientation dispersion (OD) metric of the NODDI model showed the highest sensitivity to age. The results indicate that advanced diffusion models (DKI, NODDI, RSI, SMT mc, WMTI) provide sensitive measures of age-related microstructural changes of white matter in the brain that complement and extend the contribution of conventional DTI.

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Experience-dependent modulation of the visual evoked potential: testing effect sizes, retention over time, and associations with age in 415 healthy individuals

Experience-dependent modulation of the visual evoked potential (VEP) is a promising proxy measure of synaptic plasticity in the cerebral cortex. However, existing studies are limited by small to moderate sample sizes as well as by considerable variability in how VEP modulation is quantified. In the present study, we used a large sample (n = 415) of healthy volunteers to compare different quantifications of VEP modulation with regards to effect sizes and retention of the modulation effect over time. We observed significant modulation for VEP components C1 (Cohens d = 0.53), P1 (d = 0.66), N1 (d = -0.27), N1b (d = -0.66), but not P2 (p = 0.1), and in one time-frequency cluster (~30 Hz and ~70 ms post-stimulus; d = -0.48), 2-4 minutes after 2 Hz prolonged visual stimulation. For components N1 (d = -0.21) and N1b (d = -0.38), as well for the time-frequency cluster (d = -0.33), this effect was retained after 54-56 minutes. Moderate to high correlations ({rho} = [0.39, 0.69]) between modulation at different postintervention blocks revealed a relatively high temporal stability in the modulation effect for each VEP component. However, different VEP components also showed markedly different temporal retention patterns. Finally, P1 modulation correlated positively with age (t = 5.26), and was larger for female participants (t = 3.91), with no effects of either age or sex on N1 and N1b potentiation. These results provide strong support for VEP modulation, and especially N1b modulation, as a robust measure of synaptic plasticity, but underscore the need to differentiate between components, and to control for demographic confounders.

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TVA-based modeling of short-term memory capacity, speed of processing and perceptual threshold in chronic stroke patients: Case-control differences, reliability, and sensitivity to cognitive training

Attentional deficits following stroke are common and pervasive, and are important predictors for functional recovery. Attentional functions comprise a set of specific cognitive processes allowing to attend, filter and select among a continuous stream of stimuli. These mechanisms are fundamental for more complex cognitive functions such as learning, planning and cognitive control, all crucial for daily functioning, including social interactions. The distributed functional neuroanatomy of these processes is a likely explanation for the high prevalence of attentional impairments following stroke, and underscores the importance of a clinical implementation of computational approaches allowing for sensitive and specific modeling of attentional sub-processes. The Theory of Visual Attention (TVA) offers a theoretical, computational, neuronal and practical framework to assess the efficiency of visual selection performance and parallel processing of multiple objects. Here, using a whole-report experimental paradigm in a cross-sectional case-control comparison and in six repeated assessments over the course of a three-week intensive computerized cognitive training (CCT) intervention in chronic stroke patients (> 6 months since hospital admission, NIHSS < 7 at hospital discharge), we assessed the sensitivity and reliability of TVA parameters reflecting short-term memory capacity (K), processing speed (C) and perceptual threshold (t0). Cross-sectional group comparisons documented lower short-term memory capacity, slower processing speed and higher perceptual threshold in patients compared to age-matched healthy controls. Further, longitudinal analyses revealed high reliability of the TVA parameters in stroke patients, and higher processing speed at baseline was associated with larger cognitive benefits of the CCT. The results support the feasibility, reliability and sensitivity of TVA-based assessment of attentional functions in chronic stroke patients.

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Clinical utility of brain age prediction in stroke patients: A longitudinal study

Cognitive deficits are important predictors for outcome, independence and quality of life after stroke, but often remain unnoticed and unattended because other impairments are more evident. Computerized cognitive training (CCT) is among the candidate interventions that may alleviate cognitive difficulties, but the evidence supporting its feasibility and effectiveness is scarce, partly due to the lack of tools for outcome prediction and monitoring. Magnetic resonance imaging (MRI) provides candidate markers for disease monitoring and outcome prediction. By integrating information not only about lesion extent and localization, but also regarding the integrity of the unaffected parts of the brain, advanced MRI provides relevant information for developing better prediction models in order to tailor cognitive intervention for patients, especially in a chronic phase.\n\nUsing brain age prediction based on MRI based brain morphometry and machine learning, we tested the hypotheses that stroke patients with a younger-appearing brain relative to their chronological age perform better on cognitive tests and benefit more from cognitive training compared to patients with an older-appearing brain. In this randomized double-blind study, 54 patients who suffered mild stroke (>6 months since hospital admission, NIHSS<7 at hospital discharge) underwent 3-weeks CCT and MRI before and after the intervention. In addition, patients were randomized to one of two groups receiving either active or sham transcranial direct current stimulation (tDCS). We tested for main effects of brain age gap (estimated age - chronological age) on cognitive performance, and associations between brain age gap and task improvement. Finally, we tested if longitudinal changes in brain age gap during the intervention were sensitive to treatment response. Briefly, our results suggest that longitudinal brain age prediction based on automated brain morphometry is feasible and reliable in stroke patients. However, no significant association between brain age and both performance and response to cognitive training were found.

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Functional brain network modeling in sub-acute stroke patients and healthy controls during rest and continuous attentive tracking

A cerebral stroke is characterized by compromised brain function due to an interruption in cerebrovascular blood supply. Although stroke incurs focal damage determined by the vascular territory affected, clinical symptoms commonly involve multiple functions and cognitive faculties that are insufficiently explained by the focal damage alone. Functional connectivity (FC) refers to the synchronous activity between spatially remote brain regions organized in a network of interconnected brain regions. Functional magnetic resonance imaging (fMRI) has advanced this system-level understanding of brain function, elucidating the complexity of stroke outcomes, as well as providing information useful for prognostic and rehabilitation purposes.\n\nWe tested for differences in brain network connectivity between a group of patients with minor ischemic strokes in sub-acute phase (n=44) and matched controls (n=100). As neural network configuration is dependent on cognitive effort, we obtained fMRI data during rest and two load levels of a multiple object tacking (MOT) task. Network nodes and time-series were estimated using independent component analysis (ICA) and dual regression, with network edges defined as the partial temporal correlations between node pairs. The full set of edgewise FC went into a cross-validated regularized linear discriminant analysis (rLDA) to classify groups and cognitive load.\n\nMOT task performance and cognitive tests revealed no significant group differences. While multivariate machine learning revealed high sensitivity to experimental condition, with classification accuracies between rest and attentive tracking approaching 100%, group classification was at chance level, with negligible differences between conditions. Repeated measures ANOVA showed significantly stronger synchronization between a temporal node and a sensorimotor node in patients across conditions. Overall, the results revealed high sensitivity of FC indices to task conditions, and suggest relatively small brain network-level disturbances after clinically mild strokes.

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Brain age prediction reveals aberrant brain white matter in schizophrenia and bipolar disorder: A multi-sample diffusion tensor imaging study

BackgroundSchizophrenia (SZ) and bipolar disorders (BD) share substantial neurodevelopmental components affecting brain maturation and architecture. This necessitates a dynamic lifespan perspective in which brain aberrations are inferred from deviations from expected lifespan trajectories. We applied machine learning to diffusion tensor imaging (DTI) indices of white matter structure and organization to estimate and compare brain age between patients with SZ, BD, and healthy controls across 10 cohorts. MethodsWe trained six cross-validated models using different combinations of DTI data from 927 healthy controls (HC, 18-94 years), and applied the models to the test sets including 648 SZ (18-66 years) patients, 185 BD patients (18-64 years), and 990 HC (17-68 years), estimating brain age for each participant. Group differences were assessed using linear models, accounting for age, sex, and scanner. A meta-analytic framework was applied to assess the heterogeneity and generalizability of the results. Results10-fold cross-validation revealed high accuracy for all models. Compared to controls, the model including all feature sets significantly over-estimated the age of patients with SZ (d=-.29) and BD (d=.18), with similar effects for the other models. The meta-analysis converged on the same findings. Fractional anisotropy (FA) based models showed larger group differences than the models based on other DTI-derived metrics. ConclusionsBrain age prediction based on DTI provides informative and robust proxies for brain white matter integrity. Our results further suggest that white matter aberrations in SZ and BD primarily consist of anatomically distributed deviations from expected lifespan trajectories that generalize across cohorts and scanners.

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A randomized, double blind study of computerized cognitive training in combination with transcranial direct current stimulation (tDCS) in stroke patients - utility of fMRI as marker for training outcome

Computerized cognitive training (CCT) combined with transcranial direct current stimulation (tDCS) has showed some promise in alleviating cognitive impairments in patients with brain disorders, but the robustness and possible mechanisms are unclear. In this prospective double-blind randomized clinical trial, we investigated the feasibility and effectiveness of combining CCT and tDCS, and tested the predictive value of and training-related changes in fMRI-based brain activation during attentive performance (multiple object tracking) obtained at inclusion, before initiating training, and after the three-weeks intervention in chronic stroke patients (> 6 months since hospital admission). Patients were randomized to one of two groups, receiving CCT and either (1) tDCS targeting left dorsolateral prefrontal cortex (1 mA), or (2) sham tDCS, with 40s active stimulation (1 mA) before fade out of the current. 77 patients were enrolled in the study, 54 completed the cognitive training, and 48 completed all training and MRI sessions. We found significant improvement in performance across all trained tasks, but no additional gain of tDCS. fMRI-based brain activation showed high reliability, and higher cognitive performance was associated with increased tracking-related activation in the dorsal attention network (DAN) and default mode network (DMN) as well as anterior cingulate after compared to before the intervention. We found no significant associations between cognitive gain and brain activation measured before training or in the difference in activation after intervention. Combined, these results show significant training effects on trained cognitive tasks in stroke survivors, with no clear evidence of additional gain of concurrent tDCS.

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Dissecting the cognitive phenotype of post-stroke fatigue using drift diffusion modeling of sustained attention

Post-stroke fatigue (PSF) is a prevalent symptom among stroke patients. Its symptom burden is pervasive, persistent and associated with poor rehabilitation outcomes, though its mechanisms are poorly understood. Many patients with PSF experience cognitive difficulties, but studies aiming to identify cognitive correlates of PSF have been largely inconclusive. In contrast to conventional neuropsychological assessment, computational modeling of behavioral data allows for a dissection of specific cognitive processes associated with group or individual differences in fatigue. With the aim to zero in on the cognitive phenotype of PSF, we fitted a hierarchical drift diffusion model (hDDM) to response time data from Attention Network Test (ANT) obtained from 53 chronic stroke patients. The computational model accurately reconstructed the individual level response time distributions in the different ANT conditions, and hDDM regressions identified an interaction between trial number and fatigue symptoms on non-decision time, intuitively indicating that the cognitive phenotype of fatigue entails an increased vulnerability to sustained attentional effort. These novel results demonstrate the significance of considering the sustained nature of cognitive effort when defining the cognitive phenotype of post-stroke fatigue, and suggest that the use of computational approaches offers a further characterization of the specific processes underlying observed behavioral differences.

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Genetic control of variability in subcortical and intracranial volumes

Sensitivity to external demands is essential for adaptation to dynamic environments, but comes at the cost of increased risk of adverse outcomes when facing poor environmental conditions. Here, we apply a novel methodology to perform genome-wide association analysis of mean and variance in nine key brain features (accumbens, amygdala, caudate, hippocampus, pallidum, putamen, thalamus, intracranial volume and cortical thickness), integrating genetic and neuroanatomical data from a large lifespan sample (n=25,575 individuals; 8 to 89 years, mean age 51.9 years). We identify genetic loci associated with phenotypic variability in cortical thickness, thalamus, pallidum, and intracranial volumes. The variance-controlling loci included genes with a documented role in brain and mental health and were not associated with the mean anatomical volumes. This proof-of-principle of the hypothesis of a genetic regulation of brain volume variability contributes to establishing the genetic basis of phenotypic variance (i.e., heritability), allows identifying different degrees of brain robustness across individuals, and opens new research avenues in the search for mechanisms controlling brain and mental health.

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Cross-sectional and longitudinal brain scans reveal accelerated brain aging in multiple sclerosis

Multiple sclerosis (MS) is an inflammatory disorder of the central nervous system. By combining longitudinal MRI-based brain morphometry and brain age estimation using machine learning, we tested the hypothesis that MS patients have higher brain age relative to chronological age than healthy controls (HC) and that longitudinal rate of brain aging in MS patients is associated with clinical course.\n\nSeventy-six MS patients, 71 % females and mean age 34.8 years (range 21-49) at inclusion, were examined with brain MRI at three time points with a mean total follow up period of 4.4 years. A machine learning model was applied on an independent training set of 3208 HC, estimating individual brain age and calculating the difference between estimated brain age and chronological age, termed brain age gap (BAG). We also assessed the longitudinal change rate in BAG in MS individuals. We used additional cross-sectional MRI data from 235 HC for case-control comparison.\n\nMS patients showed increased BAG (4.4 {+/-}6.6 years) compared to HC (Cohens D = 0.69, p = 4.0 x 10-6). Longitudinal estimates of BAG in MS patients suggested an accelerated rate of brain aging corresponding to an annual increase of 0.41 ({+/-}1.23) years compared to chronological aging for the MS patients (p = 0.008).\n\nOn average, patients with MS have significantly higher BAG compared to HC and accelerated rate of brain aging compared to chronological aging. Brain age estimation represents a promising method for evaluation of brain changes in MS, with potential for predicting future outcome and guide treatment.

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Assessing distinct patterns of cognitive aging using tissue-specific brain age prediction based on diffusion tensor imaging and brain morphometry

Multimodal imaging enables sensitive measures of the architecture and integrity of the human brain, but the high-dimensional nature of advanced brain imaging features poses inherent challenges for the analyses and interpretations. Multivariate age prediction reduces the dimensionality to one biologically informative summary measure with potential for assessing deviations from normal lifespan trajectories. A number of studies documented remarkably accurate age prediction, but the differential age trajectories and the cognitive sensitivity of distinct brain tissue classes have to a lesser extent been characterized.\n\nExploring differential brain age models driven by tissue-specific classifiers provides a hitherto unexplored opportunity to disentangle independent sources of heterogeneity in brain biology. We trained machine-learning models to estimate brain age using various combinations of FreeSurfer based morphometry and diffusion tensor imaging based indices of white matter microstructure in 612 healthy controls aged 18-87 years. To compare the tissue- specific brain ages and their cognitive sensitivity we applied each of the 11 models in an independent and cognitively well-characterized sample (n=265, 20-88 years). Correlations between true and estimated age in our test sample were highest for the most comprehensive brain morphometry (r=0.83, CI:0.78-0.86) and white matter microstructure (r=0.79, CI:0.74-0.83) models, confirming sensitivity and generalizability. The deviance from the chronological age were sensitive to performance on several cognitive tests for various models, including spatial Stroop and symbol coding, indicating poorer performance in individuals with an over-estimated age. Tissue-specific brain age models provide sensitive measures of brain integrity, with implications for the study of a range of brain disorders.

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