White matter development during adolescence as shown by diffusion MRI

Previous volumetric developmental MRI studies of the brain have shown white matter development continuing through adolescence and into adulthood. This review presents current findings regarding white matter development and organization from diffusion MRI studies. The general trend during adolescence (age 12–18 years) is towards increasing fractional anisotropy (FA) with age and decreasing mean diffusivity (MD) with age, findings primarily due to decreasing radial diffusivity with age. However, results of studies vary as to the regional specificity of such age-related changes, likely due in part to methodological issues. Another general trend is for FA to positively correlate and MD to negatively correlate with cognitive function. This trend is however region-specific, task-specific, and population-specific; some studies have in fact found negative correlations of FA and positive correlations of MD in specific regions with specific measures of cognitive performance. There are also published reports of sexual dimorphism in white matter development, indicating differing developmental trajectories between males and females as well as differing relationships developmentally between white matter architecture and cognitive function. There is a need for more research to further elucidate the development of white matter and its relation to cognitive function during this critical developmental period.     

An Exercise in Psychological Growth*

The author presents a case report followed by a self- assessment exercise which was generated spontaneously in collaboration with the patient herself during the treatment process. The lists of questions, designed to provoke thought and stimulate maturation, were found to be quite helpful especially in making important life decisions. It is proposed as a learning tool and template for use by those confronting similar issues. Lois Gerby, MA, is a psychologist and family therapist in private practice, 32 Hapalmach St., Suite 32/7, Jerusalem, Israel 92542 (jack.friedman@mail.mcgill.ca). *Translation by Yacov Friedman and Haim Sherrf.     

Managing Frustration for Children (MFC) Group Intervention for ADHD: An Open Trial of a Novel Group Intervention for Deficient Emotion Regulation

Deficient emotion regulation is a common and impairing area of difficulty among children with ADHD. Few interventions specifically address deficient emotion regulation. The Managing Frustration for Children With ADHD (MFC) group treatment was developed to specifically target deficient emotion regulation deficits common to children with ADHD. The MFC was developed as a 12-week multisystemic intervention for emotion regulation deficits among children with ADHD. An open trial assessed the effectiveness of the MFC as an adjunctive treatment for deficient emotion regulation among children with ADHD. Fifty-two children with ADHD ages 9–11 (42 boys, 10 girls) were enrolled in the MFC, with 44 completing treatment. The majority (71.2%) of participants had at least one comorbid internalizing, externalizing, or learning disorder. Intent-to-treat repeated-measures ANCOVA suggested significant decreases in emotion regulation deficits, mood difficulties, and externalizing difficulties following completion of treatment. More than half (53%) of children who completed treatment experienced reliable and clinically significant improvement in at least one area of functioning. The MFC demonstrated promising initial effectiveness in addressing the emotion regulation deficits of children with ADHD.     

Does experienced pain affects local brain volumes? Insights from a clinical acute pain model

Background/Objective:To study pain-brain morphometry associations as a function of post-surgery stages (anesthesia, pain and analgesia) in an acute pain model. Method:Impacted mandible third molar were extracted. Before surgery, an anatomical T1 scan was obtained. Regional brain volumen and subcortical nuclei shapes were obtained. Statistical analyses were done using multiple regression, being pain scores the predictors and voxel volumes, subcortical nuclei volumes and subcortical nuclei shapes, the outcomes. Results:Pain was significantly larger at pain than at anesthesia and analgesia stages, and was higher during anesthesia than during analgesia. Pain intensity was related to grey matter in several cortical (Insula, Mid Frontal and Temporal Gyruses, Precuneus, Anterior Cingulate), and subcortical nuclei (Hippocampus, Thalamus, Putamen, Amygdala), depending of the post-surgical stage. A larger number of brain areas showed significance at pain that at anesthesia and analgesia stages. Conclusions:The relationships of regional brain volumes and subcortical nuclei shapes with pain scores seemed to be unsteady, as they changed with the patient's actual pain stage.     

Cerebral lateralization and general intelligence: gender differences in a transcranial Doppler study

The present study evaluated cerebral lateralization during Raven's progressive matrices (RPM) paradigm in female and male subjects. Bilateral simultaneous transcranial Doppler (TCD) ultrasound was used to measure mean blood flow velocities (MBFV) in the right and left middle cerebral arteries (MCAs) in 24 (15 females and 9 males) right-handed normal subjects. The female subjects used a left hemisphere strategy, while males used a right hemisphere strategy to successfully solve RPM tasks. This implies that general intelligence is associated with neural systems within one hemisphere that are accessible to a variety of cognitive processes.     

Cognitive therapy for irritable bowel syndrome is associated with reduced limbic activity, GI symptoms, and anxiety

This study sought to identify brain regions that underlie symptom changes in severely affected IBS patients undergoing cognitive therapy (CT). Five healthy controls and 6 Rome II diagnosed IBS patients underwent psychological testing followed by rectal balloon distention while brain neural activity was measured with O-15 water positron emission tomography (PET) before and after a brief regimen of CT. Pre-treatment resting state scans, without distention, were compared to post-treatment scans using statistical parametric mapping (SPM). Neural activity in the parahippocampal gyrus and inferior portion of the right cortex cingulate were reduced in the post-treatment scan, compared to pre-treatment (x, y, z coordinates in MNI standard space were -30, -12, -30, P=0.017; 6, 34, -8, P=0.023, respectively). Blood flow values at these two sites in the controls were intermediate between those in the pre- and post-treatment IBS patients. Limbic activity changes were accompanied by significant improvements in GI symptoms (e.g., pain, bowel dysfunction) and psychological functioning (e.g., anxiety, worry). The left pons (-2, -26, -28, P=0.04) showed decreased neural activity which was correlated with post-treatment anxiety scores. Changes in neural activity of cortical-limbic regions that subserve hypervigilance and emotion regulation may represent biologically oriented change mechanisms that mediate symptom improvement of CT for IBS.     

Do differences in brain activation challenge universal theories of dyslexia?

It has been commonly agreed that developmental dyslexia in different languages has a common biological origin: a dysfunction of left posterior temporal brain regions dealing with phonological processes. Siok, Perfetti, Jin, and Tan (2004, Nature, 431, 71-76) challenge this biological unity theory of dyslexia: Chinese dyslexics show no deficits in posterior temporal brain regions but a functional disruption of the left middle frontal gyrus. Here, I will argue that these data do not challenge universal cognitive theories of dyslexia according to which weaknesses in the ability to process the phonological features of language are at the origin of dyslexia.     

Ethical,and practical issues in applying functional imaging to the clinical management of Alzheimer's disease

This review outlines ethical, legal, and practical issues related to conducting functional imaging research with Alzheimer's disease (AD) patients. Imaging techniques, with an emphasis on functional MRI and positron emission tomography, are compared and contrasted with respect to the manner in which they can be applied to issues of clinical relevance to AD. Methodological difficulties are raised to assist with critical evaluation of current imaging results. Various potential clinical applications of functional imaging are briefly reviewed and discussed with respect to associated ethical conflicts.     

Temporal parameters as cues to phrasal boundaries: a comparison of processing by left- and right-hemisphere brain-damaged individuals

Two experiments were conducted to examine the ability of left- (LHD) and right-hemisphere-damaged (RHD) patients and normal controls to use temporal cues in rendering phrase grouping decisions. The phrase "pink and black and green" was manipulated to signal a boundary after "pink" or after "black" by altering pre-boundary word durations and pause durations at the boundary in a stepwise fashion. Stimuli were presented to listeners auditorily along with a card with three alternative groupings of colored squares from which to select the presented alternative. Results revealed that normal controls were able to use both temporal cues to identify the intended grouping. In contrast, LHD patients required longer than normal pause durations to consistently identify the intended grouping, suggesting a higher than normal threshold for perception of temporal prosodic cues. Surprisingly, the RHD patients exhibited great difficulty with the task, perhaps due to the limited acoustic cues available in the stimuli.