Structural brain abnormalities are central to schizophrenia (SZ), but it remains unknown whether they are linked to dysmaturational processes crossing diagnostic boundaries, aggravating across ...disease stages, and driving the neurodiagnostic signature of the illness. Therefore, we investigated whether patients with SZ (N = 141), major depression (MD; N = 104), borderline personality disorder (BPD; N = 57), and individuals in at-risk mental states for psychosis (ARMS; N = 89) deviated from the trajectory of normal brain maturation. This deviation was measured as difference between chronological and the neuroanatomical age (brain age gap estimation BrainAGE). Neuroanatomical age was determined by a machine learning system trained to individually estimate age from the structural magnetic resonance imagings of 800 healthy controls. Group-level analyses showed that BrainAGE was highest in SZ (+5.5 y) group, followed by MD (+4.0), BPD (+3.1), and the ARMS (+1.7) groups. Earlier disease onset in MD and BPD groups correlated with more pronounced BrainAGE, reaching effect sizes of the SZ group. Second, BrainAGE increased across at-risk, recent onset, and recurrent states of SZ. Finally, BrainAGE predicted both patient status as well as negative and disorganized symptoms. These findings suggest that an individually quantifiable "accelerated aging" effect may particularly impact on the neuroanatomical signature of SZ but may extend also to other mental disorders.
Employing X-ray photon correlation spectroscopy, we measure the kinetics and dynamics of a pressure-induced liquid–liquid phase separation (LLPS) in a water–lysozyme solution. Scattering invariants ...and kinetic information provide evidence that the system reaches the phase boundary upon pressure-induced LLPS with no sign of arrest. The coarsening slows down with increasing quench depths. The g 2 functions display a two-step decay with a gradually increasing nonergodicity parameter typical for gelation. We observe fast superdiffusive (γ ≥ 3/2) and slow subdiffusive (γ < 0.6) motion associated with fast viscoelastic fluctuations of the network and a slow viscous coarsening process, respectively. The dynamics age linearly with time τ ∝ t w, and we observe the onset of viscoelastic relaxation for deeper quenches. Our results suggest that the protein solution gels upon reaching the phase boundary.
Functional MRI (fMRI) of default mode network (DMN) brain activity during resting state is gaining attention as a potential non-invasive biomarker to diagnose incipient Alzheimer's disease. The aim ...of this study was to identify effects of normal aging on the DMN using different methods of fMRI processing and evaluation.
fMRI was acquired in 17 young and 21 old healthy subjects and the data were analyzed with (a) volumes of interest (VOI)-based signal time course and (b) independent component analyses (ICA). In the first approach, the strength of DMN region inter-connectivity (as expressed with correlation coefficients) was of primary interest, the second method provided a measure of the magnitude of DMN co-activation.
The older subjects exhibited significantly lower DMN activity in the posterior cingulate (PCC, t-test P<.001) as well as a tendency to lower activity in all other DMN regions in comparison to the younger subjects. We found no significant effect of age on DMN inter-connectivity. Conclusion. Effects of normal aging such as loss of PCC co-activity could be detected by ICA, but not by signal time course correlation analyses of DMN inter-connectivity. This either indicates lower sensitivity of inter-connectivity measures to detect subtle DMN changes or indicate that ICA and time course analyses determine different properties of DMN co-activation. Our results, therefore, provide fundamental knowledge for a potential future use of functional MRI as biomarker for neurodegenerative dementias where diminished DMN activity needs to be reliably differentiated from that observed in health aging.
This prospective trial was designed to compare the performance characteristics of five different screening tests in parallel for the detection of advanced colonic neoplasia: CT colonography (CTC), ...colonoscopy (OC), flexible sigmoidoscopy (FS), faecal immunochemical stool testing (FIT) and faecal occult blood testing (FOBT).
Average risk adults provided stool specimens for FOBT and FIT, and underwent same-day low-dose 64-multidetector row CTC and OC using segmentally unblinded OC as the standard of reference. Sensitivities and specificities were calculated for each single test, and for combinations of FS and stool tests. CTC radiation exposure was measured, and patient comfort levels and preferences were assessed by questionnaire.
221 adenomas were detected in 307 subjects who completed CTC (mean radiation dose, 4.5 mSv) and OC; 269 patients provided stool samples for both FOBT and FIT. Sensitivities of OC, CTC, FS, FIT and FOBT for advanced colonic neoplasia were 100% (95% CI 88.4% to 100%), 96.7% (82.8% to 99.9%), 83.3% (95% CI 65.3% to 94.4%), 32% (95% CI 14.9% to 53.5) and 20% (95% CI 6.8% to 40.7%), respectively. Combination of FS with FOBT or FIT led to no relevant increase in sensitivity. 12 of 45 advanced adenomas were smaller than 10 mm. 46% of patients preferred CTC and 37% preferred OC (p<0.001).
High-resolution and low-dose CTC is feasible for colorectal cancer screening and reaches sensitivities comparable with OC for polyps >5 mm. For patients who refuse full bowel preparation and OC or CTC, FS should be preferred over stool tests. However, in cases where stool tests are performed, FIT should be recommended rather than FOBT.
The performance of many desert plant species in North America may decline with the warmer and drier conditions predicted by climate change models, thereby accelerating land degradation and reducing ...ecosystem productivity. We paired repeat measurements of plant canopy cover with climate at multiple sites across the Chihuahuan Desert over the last century to determine which plant species and functional types may be the most sensitive to climate change. We found that the dominant perennial grass,
Bouteloua eriopoda
, and species richness had nonlinear responses to summer precipitation, decreasing more in dry summers than increasing with wet summers. Dominant shrub species responded differently to the seasonality of precipitation and drought, but winter precipitation best explained changes in the cover of woody vegetation in upland grasslands and may contribute to woody-plant encroachment that is widespread throughout the southwestern United States and northern Mexico. Temperature explained additional variability of changes in cover of dominant and subdominant plant species. Using a novel empirically based approach we identified "climate pivot points" that were indicative of shifts from increasing to decreasing plant cover over a range of climatic conditions. Reductions in cover of annual and several perennial plant species, in addition to declines in species richness below the long-term summer precipitation mean across plant communities, indicate a decrease in the productivity for all but the most drought-tolerant perennial grasses and shrubs in the Chihuahuan Desert. Overall, our regional synthesis of long-term data provides a robust foundation for forecasting future shifts in the composition and structure of plant assemblages in the largest North American warm desert.
Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of ...coronary and cardiovascular events.
In 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed.
We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 Q1-Q3, 23-360 versus 8 0-83,
<0.0001; similar for hard/total cardiovascular events). Some progression algorithms added to the predictive value of baseline CT and risk assessment in terms of C-statistic or integrated discrimination index, especially for total cardiovascular events. However, CAC progression did not improve models including CAC
and 5-year risk factors. An excellent prognosis was found for 921 participants with double-zero CAC
=CAC
=0 (10-year coronary and hard/total cardiovascular risk: 1.4%, 2.0%, and 2.8%), which was for participants with incident CAC 1.8%, 3.8%, and 6.6%, respectively. When CAC
progressed from 1 to 399 to CAC
≥400, coronary and total cardiovascular risk were nearly 2-fold in comparison with subjects who remained below CAC
=400. Participants with CAC
≥400 had high rates of hard coronary and hard/total cardiovascular events (10-year risk: 12.0%, 13.5%, and 30.9%, respectively).
CAC progression is associated with coronary and cardiovascular event rates, but adds only weakly to risk prediction. What counts is the most recent CAC value and risk factor assessment. Therefore, a repeat scan >5 years after the first scan may be of additional value, except when a double-zero CT scan is present or when the subjects are already at high risk.
During the past decade, the application of advanced MR imaging techniques in neuropsychiatric disorders has seen a rapid increase. Disease-specific alterations in brain function can be assessed by ...fMRI. Structural GM and WM properties are increasingly investigated by DTI and voxel-based approaches like VBM. These methods provide neurobiologic correlates for brain architecture and function, evaluation tools for therapeutic approaches, and potential early markers for diagnosis. Having provided insight into principles of functional and structural imaging and delineated common findings in mild cognitive impairment and Alzheimer disease in Part 1 of this review, we will now focus on autism and schizophrenia as common psychiatric disorders covering different stages of the life span. This review concludes by summarizing current applications, limitations, and future prospects in the field of MR imaging-based neuroimaging.
Abstract Objective Aims were (1) to determine the diagnostic accuracy of Dual Energy CT (DECT) in the detection of perfusion defects and (2) to evaluate the potential of DECT to improve the ...sensitivity for PE. Methods 15 patients underwent Dual Energy pulmonary CT angiography (DE CTPA) and a combination of lung perfusion SPECT/CT and ventilation scintigraphy. CTPA and DE iodine distribution maps as well as perfusion SPECT/CT and inhalation scintigrams were reviewed for pulmonary embolism (PE) diagnosis. DECT and SPECT perfusion images were assessed regarding localization and extent of perfusion defects. Diagnostic accuracy of DE iodine (perfusion) maps was determined with reference to SPECT/CT. Diagnostic accuracies for PE detection of DECT and of SPECT/CT with ventilation scintigraphy were calculated with reference to the consensus reading of all modalities. Results DE CTPA had a sensitivity/specificity of 100%/100% for acute PE, while the combination of SPECT/CT and ventilation scintigraphy had a sensitivity/specificity of 85.7%/87.5%. For perfusion defects, DECT iodine maps had a sensitivity/specificity of 76.7% and 98.2%. Conclusion DECT is able to identify pulmonary perfusion defects with good accuracy. This technique may potentially enhance the diagnostic accuracy in the assessment of PE.
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