Gess Jennifer L, Fausett Jennifer S, Kearney-Ramos Tonisha E, Kilts Clinton D, James George Andrew
Psychiatric Research Institute, University of Arkansas for Medical Sciences Little Rock, Arkansas, 72205-7199.
Brain Behav. 2014 Sep;4(5):650-64. doi: 10.1002/brb3.243. Epub 2014 Jul 9.
Functional neuroimaging has great potential to inform clinical decisions, whether by identifying neural biomarkers of illness progression and severity, predicting therapeutic response, or selecting suitable patients for surgical interventions. Yet a persisting barrier to functional neuroimaging's clinical translation is our incomplete understanding of how normative variance in cognition, personality, and behavior shape the brain's structural and functional organization. We propose that modeling individual differences in these brain-behavior relationships is crucial for improving the accuracy of neuroimaging biomarkers for neurologic and psychiatric disorders.
We addressed this goal by initiating the Cognitive Connectome Project, which bridges neuropsychology and neuroimaging by pairing nine cognitive domains typically assessed by clinically validated neuropsychological measures with those tapped by canonical neuroimaging tasks (motor, visuospatial perception, attention, language, memory, affective processing, decision making, working memory, and executive function). To date, we have recruited a diverse sample of 53 participants (mean [SD], age = 32 [9.7] years, 31 females).
As a proof of concept, we first demonstrate that our neuroimaging task battery can replicate previous findings that task performance recruits intrinsic brain networks identified during wakeful rest. We then expand upon these previous findings by showing that the extent to which these networks are recruited by task reflects individual differences in cognitive ability. Specifically, performance on the Judgment of Line Orientation task (a clinically validated measure of visuospatial perception) administered outside of the MRI scanner predicts the magnitude of task-induced activity of the dorsal visual network when performing a direct replication of this task within the MRI scanner. Other networks (such as default mode and right frontoparietal) showed task-induced changes in activity that were unrelated to task performance, suggesting these networks to not be involved in visuospatial perception.
These findings establish a methodological framework by which clinical neuropsychology and functional neuroimaging may mutually inform one another, thus enhancing the translation of functional neuroimaging into clinical decision making.
功能神经影像学在为临床决策提供信息方面具有巨大潜力,无论是通过识别疾病进展和严重程度的神经生物标志物、预测治疗反应,还是为手术干预选择合适的患者。然而,功能神经影像学临床转化的一个持续障碍是我们对认知、人格和行为的正常变异如何塑造大脑的结构和功能组织的理解不完整。我们提出,对这些脑-行为关系中的个体差异进行建模对于提高神经影像学生物标志物对神经和精神疾病的准确性至关重要。
我们通过启动认知连接组项目来实现这一目标,该项目通过将通常由临床验证的神经心理学测量评估的九个认知领域与典型神经影像学任务(运动、视觉空间感知、注意力、语言、记忆、情感处理、决策、工作记忆和执行功能)所涉及的领域配对,将神经心理学和神经影像学联系起来。迄今为止,我们已经招募了53名参与者的多样化样本(平均[标准差],年龄 = 32 [9.7]岁,31名女性)。
作为概念验证,我们首先证明我们的神经影像学任务组可以复制先前的发现,即任务表现会激活清醒休息期间识别出的内在脑网络。然后,我们扩展了这些先前的发现,表明这些网络被任务激活的程度反映了认知能力的个体差异。具体而言,在MRI扫描仪外进行的线方向判断任务(视觉空间感知的临床验证测量)的表现预测了在MRI扫描仪内直接重复此任务时背侧视觉网络任务诱导活动的大小。其他网络(如默认模式和右额顶叶)显示任务诱导的活动变化与任务表现无关,这表明这些网络不参与视觉空间感知。
这些发现建立了一个方法框架,通过该框架临床神经心理学和功能神经影像学可以相互提供信息,从而加强功能神经影像学在临床决策中的转化。