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      Individualized Prediction of PTSD Symptom Severity in Trauma Survivors From Whole-Brain Resting-State Functional Connectivity

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          Abstract

          Previous studies have demonstrated relations between spontaneous neural activity evaluated by resting-state functional magnetic resonance imaging (fMRI) and symptom severity in post-traumatic stress disorder. However, few studies have used brain-based measures to identify imaging associations with illness severity at the level of individual patients. This study applied connectome-based predictive modeling (CPM), a recently developed data-driven and subject-level method, to identify brain function features that are related to symptom severity of trauma survivors. Resting-state fMRI scans and clinical ratings were obtained 10–15 months after the earthquake from 122 earthquake survivors. Symptom severity of post-traumatic stress disorder features for each survivor was evaluated using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS-IV). A functionally pre-defined atlas was applied to divide the human brain into 268 regions. Each individual’s functional connectivity 268 × 268 matrix was created to reflect correlations of functional time series data across each pair of nodes. The relationship between CAPS-IV scores and brain functional connectivity was explored in a CPM linear model. Using a leave-one-out cross-validation (LOOCV) procedure, findings showed that the positive network model predicted the left-out individual’s CAPS-IV scores from resting-state functional connectivity. CPM predicted CAPS-IV scores, as indicated by a significant correspondence between predicted and actual values ( r = 0.30, P = 0.001) utilizing primarily functional connectivity between visual cortex, subcortical-cerebellum, limbic, and motor systems. The current study provides data-driven evidence regarding the functional brain features that predict symptom severity based on the organization of intrinsic brain networks and highlights its potential application in making clinical evaluation of symptom severity at the individual level.

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          Most cited references 56

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          Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain.

          An anatomical parcellation of the spatially normalized single-subject high-resolution T1 volume provided by the Montreal Neurological Institute (MNI) (D. L. Collins et al., 1998, Trans. Med. Imag. 17, 463-468) was performed. The MNI single-subject main sulci were first delineated and further used as landmarks for the 3D definition of 45 anatomical volumes of interest (AVOI) in each hemisphere. This procedure was performed using a dedicated software which allowed a 3D following of the sulci course on the edited brain. Regions of interest were then drawn manually with the same software every 2 mm on the axial slices of the high-resolution MNI single subject. The 90 AVOI were reconstructed and assigned a label. Using this parcellation method, three procedures to perform the automated anatomical labeling of functional studies are proposed: (1) labeling of an extremum defined by a set of coordinates, (2) percentage of voxels belonging to each of the AVOI intersected by a sphere centered by a set of coordinates, and (3) percentage of voxels belonging to each of the AVOI intersected by an activated cluster. An interface with the Statistical Parametric Mapping package (SPM, J. Ashburner and K. J. Friston, 1999, Hum. Brain Mapp. 7, 254-266) is provided as a freeware to researchers of the neuroimaging community. We believe that this tool is an improvement for the macroscopical labeling of activated area compared to labeling assessed using the Talairach atlas brain in which deformations are well known. However, this tool does not alleviate the need for more sophisticated labeling strategies based on anatomical or cytoarchitectonic probabilistic maps.
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            Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research--past, present, and future.

            The prevailing neurocircuitry models of anxiety disorders have been amygdalocentric in form. The bases for such models have progressed from theoretical considerations, extrapolated from research in animals, to in vivo human imaging data. For example, one current model of posttraumatic stress disorder (PTSD) has been highly influenced by knowledge from rodent fear conditioning research. Given the phenomenological parallels between fear conditioning and the pathogenesis of PTSD, we have proposed that PTSD is characterized by exaggerated amygdala responses (subserving exaggerated acquisition of fear associations and expression of fear responses) and deficient frontal cortical function (mediating deficits in extinction and the capacity to suppress attention/response to trauma-related stimuli), as well as deficient hippocampal function (mediating deficits in appreciation of safe contexts and explicit learning/memory). Neuroimaging studies have yielded convergent findings in support of this model. However, to date, neuroimaging investigations of PTSD have not principally employed conditioning and extinction paradigms per se. The recent development of such imaging probes now sets the stage for directly testing hypotheses regarding the neural substrates of fear conditioning and extinction abnormalities in PTSD.
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              A neuromarker of sustained attention from whole-brain functional connectivity

              Although attention plays a ubiquitous role in perception and cognition, researchers lack a simple way to measure a person’s overall attentional abilities. Because behavioral measures are diverse and difficult to standardize, we pursued a neuromarker of an important aspect of attention, sustained attention, using functional magnetic resonance imaging. To this end, we identified functional brain networks whose strength during a sustained attention task predicted individual differences in performance. Models based on these networks generalized to previously unseen individuals, even predicting performance from resting-state connectivity alone. Furthermore, these same models predicted a clinical measure of attention—symptoms of attention deficit hyperactivity disorder—from resting-state connectivity in an independent sample of children and adolescents. These results demonstrate that whole-brain functional network strength provides a broadly applicable neuromarker of sustained attention.
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                Author and article information

                Contributors
                Journal
                Front Behav Neurosci
                Front Behav Neurosci
                Front. Behav. Neurosci.
                Frontiers in Behavioral Neuroscience
                Frontiers Media S.A.
                1662-5153
                21 December 2020
                2020
                : 14
                Affiliations
                1Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University , Chengdu, China
                2Research Unit of Psychoradiology, Chinese Academy of Medical Sciences , Chengdu, China
                3Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University , Chengdu, China
                4Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati , Cincinnati, OH, United States
                5Mental Health Institute, The Second Xiangya Hospital of Central South University , Changsha, China
                Author notes

                Edited by: Seth Davin Norrholm, Wayne State University, United States

                Reviewed by: Bruno Jacson Martynhak, Federal University of Paraná, Brazil; Daniela Rabellino, Western University, Canada; Margit Jehna, Medical University of Graz, Austria

                *Correspondence: Qiyong Gong qiyonggong@ 123456hmrrc.org.cn

                Specialty section: This article was submitted to Pathological Conditions, a section of the journal Frontiers in Behavioral Neuroscience

                Article
                10.3389/fnbeh.2020.563152
                7779396
                Copyright © 2020 Suo, Lei, Li, Yang, Li, Sweeney and Gong.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 56, Pages: 10, Words: 7531
                Funding
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Award ID: 81621003, 81820108018, 82001800
                Categories
                Behavioral Neuroscience
                Original Research

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