Feb 24

Structural Abnormalities in the Brains of Human Subjects Who Use Methamphetamine

We visualize, for the first time, the profile of structural deficits in the human brain associated with chronic methamphetamine (MA) abuse. Studies of human subjects who have used MA chronically have revealed deficits in dopaminergic and serotonergic systems and cerebral metabolic abnormalities. Using magnetic resonance imaging (MRI) and new computational brain-mapping techniques, we determined the pattern of structural brain alterations associated with chronic MA abuse in human subjects and related these deficits to cognitive impairment. We used high-resolution MRI and surface-based computational image analyses to map regional abnormalities in the cortex, hippocampus, white matter, and ventricles in 22 human subjects who usedMAand 21 age-matched, healthy controls. Cortical maps revealed severe gray-matter deficits in the cingulate, limbic, and paralimbic cortices ofMAabusers (averaging 11.3% below control;p-0.05). On average,MAabusers had 7.8% smaller hippocampal volumes than control subjects ( p-0.01; left, p-0.01; right, p-0.05) and significant white-matter hypertrophy (7.0%; p - 0.01). Hippocampal deficits were mapped and correlated with memory performance on a word-recall test ( p- 0.05). MRI-based maps suggest that chronic methamphetamine abuse causes a selective pattern of cerebral deterioration that contributes to impaired memory performance. MA may selectively damage the medial temporal lobe and, consistent with metabolic studies, the cingulate–limbic cortex, inducing neuroadaptation, neuropil reduction, or cell death. Prominent white-matter hypertrophy may result from altered myelination and adaptive glial changes, including gliosis secondary to neuronal damage. These brain substrates may help account for the symptoms of MA abuse, providing therapeutic targets for drug-induced brain injury.
Key words: methamphetamine; brain imaging; drug abuse; MRI; cortex; hippocampus; limbic system; memory introduction Methamphetamine (MA) abuse is a growing epidemic worldwide. Read the rest of this entry »

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Feb 20

We report the dynamic anatomical sequence of human cortical gray matter development between the age of 4–21 years using quantitative four-dimensional maps and time-lapse sequences. Thirteen healthy children for whom anatomic brain MRI scans were obtained every 2 years, for 8–10 years, were studied. By using models of the cortical surface and sulcal landmarks and a statistical model for gray matter density, human cortical development could be visualized across the age range in a spatiotemporally detailed time-lapse sequence. The resulting time-lapse ‘‘movies’’ reveal that (i) higher-order association cortices mature only after lower-order somatosensory and visual cortices, the functions of which they integrate, are developed, and (ii) phylogenetically older brain areas mature earlier than newer ones. Direct comparison with normal cortical development may help understanding of some neurodevelopmental disorders such as childhood-onset schizophrenia or autism.


Human brain development is structurally and functionally a nonlinear process, and understanding normal brain maturation is essential for understanding neurodevelopmental disorders. The heteromodal nature of cognitive brain
development is evident from studies of neurocognitive performance, functional imaging (functional MRI or positronemission tomography) , and electroencephalogram coherence studies. Prior imaging studies show regional nonlinear changes in gray matter (GM) density during childhood and adolescence with prepubertal increase followed by postpubertal loss. The GM density on MRI is an indirect measure of a complex architecture of glia, vasculature, and neurons with dendritic and synaptic processes. Studies of GM maturation show a loss in corticalGMdensity over time, which temporally correlates with postmortem findings of increased synaptic pruning during adolescence and early adulthood. Here we present a study of cortical GM development in children and adolescents by using a brain-mapping technique and a prospectively studied sample of 13 healthy children (4–21 years old), who were scanned with MRI every 2 years for 8–10 years. Because the scans were obtained repeatedly on the same subjects over time, statistical extrapolation of points in between scans enabled construction of an animated time-lapse sequence (‘‘movie’’) of pediatric brain development. We hypothesized that GM development in childhood through early adulthood would be nonlinear as described before and would progress in a localized, region-specific manner coinciding with the functional maturation. We also predicted that the regions associated with more primary functions (e.g., primary motor cortex) would develop earlier compared with the regions that are involved with more complex and integrative tasks (e.g., temporal lobe).
The result is a dynamic map of GM maturation in the pre- and postpubertal period. Our results, while highlighting the remarkable heterogeneity, show that the cortical GM development appears to follow the functional maturation sequence, with the primary sensorimotor cortices along with frontal and occipital poles maturing first, and the remainder of the cortex developing in a parietal-to-frontal (back-to-front) direction. The superior temporal cortex, which contains association areas that integrate information from several sensory modalities, matured last. Furthermore, the maturation of the cortex also appeared to follow the evolutionary sequence in which these regions were created. Read the rest of this entry »

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Feb 18

Here we report on detailed three-dimensional maps revealing how brain structure is influenced by individual genetic differences. A genetic continuum was detected, in which brain structure was increasingly similar in subjects with increasing genetic affinity. Genetic factors significantly influenced cortical structure in Broca’s and Wernicke’s language areas, as well as frontal brain regions (r2 MZ > 0.8, p < 0.05). Preliminary correlations were performed suggesting that frontal gray matter differences may be linked to Spearman’s g, which measures successful test performance across multiple cognitive domains (p < 0.05). These genetic brain maps reveal how genes determine individual differences, and may shed light on the heritability of cognitive and linguistic skills, as well as genetic liability for diseases that affect the human cortex.


The degree to which genes and environment determine brain structure and function is of fundamental importance. Largescale neuroimaging and genetic studies are beginning to uncover normal and disease-specific patterns of gene and brain function in large human populations. Yet, little is known about the genetic control of human brain structure, and how much individual genotype accounts for the wide variations among individual brains. Recent reports show that many cognitive skills are surprisingly heritable, with strong genetic influences on IQ, verbal and spatial abilities, perceptual speed and even some personality qualities, including emotional reactions to stress. These genetic relationships persist even after statistical adjustments are made for shared family environments, which tend to make members of the same family more similar. Given that genetic and environmental factors, in utero and throughout lifetime, shape the physical development of the brain, we aimed to map patterns of brain structure that are under significant genetic control, and determine whether these structural features are linked with measurable differences in cognitive function. The few existing studies of brain structure in twins suggest that the overall volume of the brain itself and some brain structures, including the corpus callosum and ventricles, are somewhat genetically influenced, whereas gyral patterns, observed qualitatively or by comparing their twodimensional projections, are much less heritable. To make the transition from volumes of structures to detailed maps of genetic influences, advances in brain mapping technology have allowed the detailed mapping of structural features of the human cortex, including gray matter distribution, gyral patterning, and brain asymmetry. These features each vary with age, gender, handedness, hemispheric dominance and cognitive
performance in both health and disease. Composite maps of these features, generated for large populations, can reveal patterns not observable in an individual. Such patterns include statistical maps that show whether heredity and nongenetic factors are involved in determining specific aspects of brain structure.
Among the structural features that are genetically regulated and have implications for cortical function is the distribution of gray matter across the cortex. This varies widely across normal individuals, with developmental waves of gray matter gain and loss
subsiding by adulthood, and complex deficit patterns observed in Alzheimer’s disease, schizophrenia, and healthy subjects at genetic risk for these disorders. In this study, we began by comparing the average differences in gray matter (Fig. 1) in groups of unrelated subjects, dizygotic (DZ) and monozygotic (MZ) twins (see Methods). Although both types of twins share gestational and postgestational rearing environments, DZ twins share, on average, half their segregating genes, whereas MZ twins are normally genetically identical (with rare exceptions due to somatic mutations).
We found that brain structure is under significant genetic control, in a broad anatomical region that includes frontal and language-related cortices. The quantity of frontal gray matter, in particular, was most similar in individuals who were genetically alike; intriguingly, these individual differences in brain structure were tightly linked with individual differences in IQ (intelligence quotient). The resulting genetic brain maps reveal a strong relationship between genes, brain structure and behavior, suggesting
that highly heritable aspects of brain structure may be fundamental in determining individual differences in cognition. Read the rest of this entry »

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Feb 11

Abstract
Negative symptoms generally refer to a reduction in normal functioning. In schizophrenia they encompass apathy, anhedonia, flat affect, avolition, social withdrawal and, on some accounts, psychomotor retardation.


Negative symptoms have been identified in other psychiatric disorders, including melancholic depression, and also in neurological disorders, such Parkinson’s disease. Achieving a better understanding of negative symptoms constitutes a priority in mental health. Primarily, negative symptoms represent an unrelenting, intractable and disabling feature for patients, often amounting to a severe burden on families, carers and the patients themselves. Identifying and understanding subgroups within disorders may also contribute to the clinical care and scientific understanding of the pathophysiology of these disorders. The purpose of this paper is to review the current literature on negative symptoms in schizophrenia and explore the idea that negative symptoms may play an important role not only in other psychiatric disorders such as melancholic depression, but also in neurological disorders, such as Parkinson’s disease. In each disorder negative symptoms manifest with similar motor and cognitive impairments and are associated with comparable neuropathological and biochemical findings, possibly reflecting analogous impairments in the functioning of frontostriatal-limbic circuits.

Negative symptoms are a cluster of symptoms generally characterised by the absence of normal levels of activation, initiative, and affect. They are a well established aspect of the symptomatology in schizophrenia. Unlike the episodic, treatment–responsive nature of positive symptoms, negative symptoms in schizophrenia tend to be enduring and less reactive to medication. They are perhaps the most unrelenting and disabling features , constituting a severe burden on relatives as well as on the patient themselves. Over the past decade there has been a resurgence of interest in negative symptoms, related partially to their significant prognostic value and additionally to the development and partial success of atypical antipsychotic medication in treating negative symptoms.
Although negative symptoms are considered an important feature of schizophrenia, they are not pathognomic of it.
Over recent years, the concept of negative symptoms has also been described as a prominent feature, distinct from depression, in other neurological and psychiatric disorders including melancholic depression ; Parkinson’s disease; Alzheimer’s disease; fronto-temporal dementia.
Recognising that negative symptoms are not limited to patients with schizophrenia is important, not only for clinical implications regarding potential treatment, but also to enhance the current understanding of the neurobiological substrate of an apparently homogeneous group of symptoms. To avoid variability within studies and consequent inconsistency between findings, it is essential for both research and clinical purposes to have an understanding of the existence of subgroups. The purpose of this paper is to review the current literature on negative symptoms in schizophrenia and explore the idea that negative symptoms play an important role in other neurological and psychiatric disorders, in particular melancholic depression and Parkinson’s disease. Clinical presentations and aetiological models will be considered. Read the rest of this entry »

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