To assess the time course of brain atrophy and the difference across clinical subtypes in multiple sclerosis (MS).
The percent brain volume change (PBVC) was computed on existing longitudinal (2 time ...points) T1-weighted MRI from untreated (trial and nontrial) patients with MS. Patients (n = 963) were classified as clinically isolated syndromes suggestive of MS (CIS, 16%), relapsing-remitting (RR, 60%), secondary progressive (SP, 15%), and primary progressive (9%) MS. The median length of follow-up was 14 months (range 12-68).
There was marked heterogeneity of the annualized PBVC (PBVC/y) across MS subtypes (p = 0.003), with higher PBVC/y in SP than in CIS (p = 0.003). However, this heterogeneity disappeared when data were corrected for the baseline normalized brain volume. When the MS population was divided into trial and nontrial subjects, the heterogeneity of PBVC/y across MS subtypes was present only in the second group, due to the higher PBVC/y values found in trial data in CIS (p = 0.01) and RR (p < 0.001). The estimation of the sample sizes required for demonstrating a reduction of brain atrophy in patients in a placebo-controlled trial showed that this was larger in patients with early MS than in those with the progressive forms of the disease.
This first large study in untreated patients with multiple sclerosis (MS) with different disease subtypes shows that brain atrophy proceeds relentlessly throughout the course of MS, with a rate that seems largely independent of the MS subtype, when adjusting for baseline brain volume.
Brain atrophy studies often use FSL-BET (Brain Extraction Tool) as the first step of image processing. Default BET does not always give satisfactory results on 3DT1 MR images, which negatively ...impacts atrophy measurements. Finding the right alternative BET settings can be a difficult and time-consuming task, which can introduce unwanted variability.
To systematically analyze the performance of BET in images of MS patients by varying its parameters and options combinations, and quantitatively comparing its results to a manual gold standard.
Images from 159 MS patients were selected from different MAGNIMS consortium centers, and 16 different 3DT1 acquisition protocols at 1.5T or 3T. Before running BET, one of three pre-processing pipelines was applied: (1) no pre-processing, (2) removal of neck slices, or (3) additional N3 inhomogeneity correction. Then BET was applied, systematically varying the fractional intensity threshold (the “f” parameter) and with either one of the main BET options (“B” — bias field correction and neck cleanup, “R” — robust brain center estimation, or “S” — eye and optic nerve cleanup) or none. For comparison, intracranial cavity masks were manually created for all image volumes. FSL-FAST (FMRIB's Automated Segmentation Tool) tissue-type segmentation was run on all BET output images and on the image volumes masked with the manual intracranial cavity masks (thus creating the gold-standard tissue masks). The resulting brain tissue masks were quantitatively compared to the gold standard using Dice overlap coefficient (DOC). Normalized brain volumes (NBV) were calculated with SIENAX. NBV values obtained using for SIENAX other BET settings than default were compared to gold standard NBV with the paired t-test.
The parameter/preprocessing/options combinations resulted in 20,988 BET runs. The median DOC for default BET (f=0.5, g=0) was 0.913 (range 0.321–0.977) across all 159 native scans. For all acquisition protocols, brain extraction was substantially improved for lower values of “f” than the default value. Using native images, optimum BET performance was observed for f=0.2 with option “B”, giving median DOC=0.979 (range 0.867–0.994). Using neck removal before BET, optimum BET performance was observed for f=0.1 with option “B”, giving median DOC 0.983 (range 0.844–0.996). Using the above BET-options for SIENAX instead of default, the NBV values obtained from images after neck removal with f=0.1 and option “B” did not differ statistically from NBV values obtained with gold-standard.
Although default BET performs reasonably well on most 3DT1 images of MS patients, the performance can be improved substantially. The removal of the neck slices, either externally or within BET, has a marked positive effect on the brain extraction quality. BET option “B” with f=0.1 after removal of the neck slices seems to work best for all acquisition protocols.
S'il est admis que le bien-être est plus que l'image inversée de la détresse psychologique et qu'il recouvre des composantes affectives et cognitives, les dimensions sous-jacentes à ce concept sont ...mal connues. Cet article présente les résultats des validations de contenu, de construit et concomitante d'une nouvelle Échelle de Mesure des Manifestations du Bien-être Psychologique (EMMBEP). Son originalité est de reposer sur une liste initiale de manifestations d'une bonne santé psychologique rapportées par une population non clinique dans le cadre d'épisodes vécus. Les dimensions factorielles identifiées ne reposent donc plus sur le modèle théorique qu'en proposent leurs auteurs mais sur les construits qui structurent le contenu populaire du bien-être. Nous concluons à la pertinence de coupler des mesures de la santé mentale positive aux mesures de la détresse dans les enquêtes épidémiologiques et de santé publique. Psychological well-being scales used in epidemiologic surveys usually show high construct validity. The content validation, however, is less convincing since these scales rest on lists of items that reflect the theoretical model of the authors. In this study we present results of the construct and criterion validation of a new Well-Being Manifestations Measure Scale (WBMMS) founded on an initial list of manifestations derived from an original content validation in a general population. It is concluded that national and public health epidemiologic surveys should include both measures of positive and negative mental health.
Objective
Evaluate the effect of subcutaneous interferon β-1a (sc IFN β-1a) versus placebo on the evolution of T1-weighted MRI lesions and central brain atrophy in in patients with a first clinical ...demyelinating event (FCDE).
Methods
Post hoc analysis of baseline-to-24 month MRI data from patients with an FCDE who received sc IFN β-1a 44 μg once- (qw) or three-times-weekly (tiw), or placebo, in REFLEX. Patients were grouped according to treatment regimen or conversion to clinically definite MS (CDMS) status. The intensity of new lesions on unenhanced T1-weighted images was classified as T1 iso- or hypo-intense (black holes) and percentage ventricular volume change (PVVC) was assessed throughout the study.
Results
In patients not converting to CDMS, sc IFN β-1a tiw or qw, versus placebo, reduced the overall number of new lesions (
P
< 0.001 and
P
= 0.005) and new T1 iso-intense lesions (
P
< 0.001 and
P
= 0.002) after 24 months; only sc IFN β-1a tiw was associated with fewer T1 hypo-intense lesions versus placebo (
P
< 0.001). PVVC findings in patients treated with sc IFN β-1a suggested pseudo-atrophy that was ~ fivefold greater versus placebo in the first year of treatment (placebo 1.11%; qw 4.28%; tiw 6.76%;
P
< 001); similar findings were apparent for non-converting patients.
Conclusions
In patients with an FCDE, treatment with sc IFN β-1a tiw for 24 months reduced the number of new lesions evolving into black holes.
Focal lesions and brain atrophy are the most extensively studied aspects of multiple sclerosis (MS), but the image acquisition and analysis techniques used can be further improved, especially those ...for studying within-patient changes of lesion load and atrophy longitudinally. Improved accuracy and sensitivity will reduce the numbers of patients required to detect a given treatment effect in a trial, and ultimately, will allow reliable characterization of individual patients for personalized treatment. Based on open issues in the field of MS research, and the current state of the art in magnetic resonance image analysis methods for assessing brain lesion load and atrophy, this paper makes recommendations to improve these measures for longitudinal studies of MS. Briefly, they are (1) images should be acquired using 3D pulse sequences, with near-isotropic spatial resolution and multiple image contrasts to allow more comprehensive analyses of lesion load and atrophy, across timepoints. Image artifacts need special attention given their effects on image analysis results. (2) Automated image segmentation methods integrating the assessment of lesion load and atrophy are desirable. (3) A standard dataset with benchmark results should be set up to facilitate development, calibration, and objective evaluation of image analysis methods for MS.
The presence of cortical lesions (CLs) and their topographic distribution in the brains of patients with multiple sclerosis (MS) have been clearly shown by recent histopathologic studies. CLs can ...also be assessed in vivo, with less sensitivity, by using specific MRI sequences. MRI-based lesion probability maps (LPMs) may partially overcome this lack of sensitivity and provide unique information on the spatial distribution and frequency of CLs in MS.
A total of 149 patients with MS (103 relapsing-remitting RR and 46 primary progressive PP) underwent an MRI examination, which included the double inversion recovery (DIR) sequence for CL assessment. CL masks were then obtained for each patient and a cortical LPM (cLPM) was created for each MS subtype.
CLs were mainly distributed in the frontal (RR = 51.8%; PP = 50.5%) and temporal (RR = 30.4%; PP = 35.5%) lobes, with a prominent involvement of the motor (RR = 37.8%; PP = 30.6%) and anterior cingulate (RR = 9.2%; PP = 10.6%) cortices. The extent of brain lobe affected by CLs was higher in RR than in PP patients. The frequency of CL occurrence was higher in PP than in RR patients. Both measurements, however, did not show differences between the 2 MS subtypes at voxel-wise analysis.
Patients with RRMS and PPMS share more similarities than differences in terms of CL number, volume, topographic distribution, and frequency. The similarities between histopathologic data and the findings reported here suggest that DIR images can accurately illustrate the focal pathology occurring in the cortical regions of patients with MS, providing clinically relevant information.
Although the emotion regulation (ER) literature is vast, two emerging areas are particularly noteworthy. First, as opposed to the traditional blanket characterization of ER strategies as adaptive or ...maladaptive, theoretical models have highlighted the adaptability of greater ER flexibility (i.e., flexibly implementing ER strategies based on the context). Second, instead of focusing on how individuals independently regulate emotions, researchers are increasingly examining how ER can occur with the help of another person, a process known as interpersonal emotion regulation (IER). This study is the first to integrate these two emerging areas of research and to apply the two main theories of ER flexibility to investigate the effect of IER flexibility on negative and positive affect. A sample of 384 adults (Mage = 38.58 years, SD = 13.82) residing predominantly in North America completed this 14-day daily diary study. As expected, greater repertoire and greater responsivity to feedback were associated with more adaptive affective outcomes (i.e., less negative affect and/or more positive affect). However, unexpected findings also emerged: Greater context sensitivity did not significantly predict affect, and the covariation of within-strategy variability and environmental variability predicted higher negative affect. Findings provide initial evidence that IER adaptiveness is influenced by one's ability to flexibly implement IER strategies (i.e., IER flexibility). The results also highlight the components of IER flexibility (namely greater repertoire and responsivity to feedback) that predict daily adaptive affective consequences.
To assess the presence of cortical lesions (CLs) as detected by MRI in subjects with radiologically isolated syndrome (RIS).
Fifteen subjects with RIS underwent an MRI examination, including a double ...inversion recovery sequence for CL assessment. T2-hyperintense white matter (WM) lesion volume (LV) and normalized volumes of brain and cortex were also obtained.
Thirty-four CLs were identified in 6 of 15 (40%) subjects with RIS and predominantly distributed in frontotemporal lobes. CLs were frequent in subjects with RIS with immunoglobulin G oligoclonal bands on CSF, cervical cord lesions, and dissemination in time on brain MRI. WM LV was higher in subjects with CLs than in those without CLs (11.5 ± 10.1 vs 3.9 ± 2.8 cm(3), p = 0.04). Indeed, CL number and volume correlated with WM LV (r = 0.57, p = 0.03 and r = 0.61, p = 0.01). All subjects with CLs were classified in a previous study as having a very high probability of having relapsing-remitting multiple sclerosis (MS) on a logistic regression analysis of quantitative MRI indices.
We found CLs in subjects with RIS, a condition characterized by the unanticipated MRI finding of WM lesions highly suggestive of MS in the absence of a clinical scenario. CLs were mainly localized to the frontotemporal lobes and were associated with important markers of evolution to MS.
In children and adults, individual differences in patterns of respiratory sinus arrhythmia (RSA; i.e., interactions between resting RSA and RSA reactivity to stress) have emerged as a central ...predictor of internalizing symptoms. However, it is unclear whether individual differences in patterns of RSA also contribute to internalizing symptoms during the key developmental period of early adolescence, when rates of internalizing symptoms sharply increase. In the present multi-wave longitudinal study, we assessed whether patterns of RSA predicted trajectories of the two most common types of internalizing symptoms among adolescents: anxiety and depression. In the baseline session, we assessed RSA at rest and in response to a psychosocial stressor (Trier Social Stress Test TSST) in a sample of 75 early adolescents (Mage = 12.85). Youth then completed measures of anxiety and depressive symptoms at baseline and four times over approximately two years. Findings indicate that RSA patterns predicted trajectories of anxiety, but not depression. Specifically, region of significance analyses indicated that individuals with high resting RSA who demonstrated RSA augmentation to the lab stressor evinced decreasing anxiety over the follow-up period. In direct contrast, adolescents with high resting RSA in combination with RSA withdrawal to the stressor exhibited a trajectory of increasing anxiety. Findings provide preliminary evidence for understanding RSA as a developmentally salient risk or protective factor.
●Examined RSA patterns in early adolescence and trajectories of symptoms.●RSA patterns predicted trajectories of anxiety, but not depression.●RSA reactivity associated with changes in anxiety among those with high resting RSA.●Preliminary evidence for adopting a developmental perspective to RSA-symptom link.
Introduction
Co‐rumination is an interpersonal emotion regulation strategy in which negative feelings and problems are discussed perseveratively with another person. Although co‐rumination is salient ...in adolescence, research to date has focused on co‐rumination occurring in person and has not kept pace with the surge in digital communication that begins in adolescence. This study examined the degree, associations among, and consequences (i.e., depressive symptoms, and friendship quality) of adolescents' co‐rumination via in‐person, text, social media, and phone modalities.
Methods
Adolescents (n = 109; 51 girls, 57 boys, 1 nonbinary; Mage = 12.83 years) residing in Canada, completed self‐report questionnaires on co‐rumination, depressive symptoms, and friendship quality for up to 2 years.
Results
Adolescents engaged in co‐rumination across all modalities, particularly in‐person. Findings indicated a negative association between in‐person co‐rumination at baseline and in‐person co‐rumination over time. Whereas less text co‐rumination was associated with increased depressive symptoms over time, greater phone co‐rumination was associated with increased depressive symptoms over time. Although greater in‐person co‐rumination was positively associated with friendship quality concurrently, it was negatively associated with friendship quality prospectively.
Conclusions
Taken together, co‐rumination outcomes may vary depending on communication modality. Implications for adolescents' mental and social wellbeing are discussed.
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