The authors thank Gongjun JI for computer software support. This research was partially supported by the National Natural Science Foundation of China (no. 81201156, 81271517); the Zhejiang Provincial Natural Science Foundation of China (no. LY16H180007, LY13H180016, 2013C33G1360236), and the Science Foundation from the Health Commission of Zhejiang Province (no. 2013RCA001, 201522257).

This study was approved by the Ethics Committee of Zhejiang Provincial People&#39;s Hospital. Every enrolled subject signed a written informed consent.
1. Sample Classification and Screening
<ol>
	<li>Diagnose and divide 116 patients into AD and MCI groups. 
	NOTE: Use the 2011 National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer&#39;s Disease and Related Disorders Association (NINCDS-ADRDA) diagnostic criteria and the Mini-Mental State Examination...

<ol>
	<li>Delbeuck, X., Van der Linden, M., Collette, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Alzheimer's+disease+as+a+disconnection+syndrome?.">Alzheimer's disease as a disconnection syndrome?.</a> Neuropsychol Rev. 13 (2), 79-92 (2003).</li><li>Wang, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Altered+functional+connectivity+in+early+Alzheimer's+disease:+a+resting-state+fMRI+study.">Altered functional connectivity in early Alzheimer's disease: a resting-state fMRI study.</a> Hum Brain Mapp. 28 (10), 967-978 (2007).</li><li>Zhong, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Altered+effective+connectivity+patterns+of+the+default+mode+network+in+Alzheimer's+disease:+an+fMRI+study.">Altered effective connectivity patterns of the default mode network in Alzheimer's disease: an fMRI study.</a> Neurosci Lett. 578, 171-175 (2014).</li><li>Gusnard, D. A., Raichle, M. E., Raichle, M. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Searching+for+a+baseline:+functional+imaging+and+the+resting+human+brain.">Searching for a baseline: functional imaging and the resting human brain.</a> Nat Rev Neurosci. 2 (10), 685-694 (2001).</li><li>Greicius, M. D., Krasnow, B., Reiss, A. L., Menon, V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+connectivity+in+the+resting+brain:+a+network+analysis+of+the+default+mode+hypothesis.">Functional connectivity in the resting brain: a network analysis of the default mode hypothesis.</a> Proc Natl Acad Sci U S A. 100 (1), 253-258 (2003).</li><li>Ries, M. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Task-dependent+posterior+cingulate+activation+in+mild+cognitive+impairment.">Task-dependent posterior cingulate activation in mild cognitive impairment.</a> NeuroImage. 29 (2), 485-492 (2006).</li><li>Braak, H., Braak, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Neuropathological+stageing+of+Alzheimer-related+changes.">Neuropathological stageing of Alzheimer-related changes.</a> Acta Neuropathol. 82 (4), 239-259 (1991).</li><li>Liao, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluating+the+effective+connectivity+of+resting+state+networks+using+conditional+Granger+causality.">Evaluating the effective connectivity of resting state networks using conditional Granger causality.</a> Biol Cybern. 102 (1), 57-69 (2010).</li><li>Miao, X., Wu, X., Li, R., Chen, K., Yao, L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Altered+connectivity+pattern+of+hubs+in+default-mode+network+with+Alzheimer's+disease:+an+Granger+causality+modeling+approach.">Altered connectivity pattern of hubs in default-mode network with Alzheimer's disease: an Granger causality modeling approach.</a> PloS one. 6 (10), e25546 (2011).</li><li>Yu, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Directed+functional+connectivity+of+posterior+cingulate+cortex+and+whole+brain+in+Alzheimer's+disease+and+mild+cognitive+impairment.">Directed functional connectivity of posterior cingulate cortex and whole brain in Alzheimer's disease and mild cognitive impairment.</a> Curr Alzheimer Res. , (2016).</li><li>Kaminski, M., Ding, M., Truccolo, W. A., Bressler, S. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluating+causal+relations+in+neural+systems:+granger+causality,+directed+transfer+function+and+statistical+assessment+of+significance.">Evaluating causal relations in neural systems: granger causality, directed transfer function and statistical assessment of significance.</a> Biol Cybern. 85 (2), 145-157 (2001).</li><li>Zang, Z. X., Yan, C. G., Dong, Z. Y., Huang, J., Zang, Y. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Granger+causality+analysis+implementation+on+MATLAB:+a+graphic+user+interface+toolkit+for+fMRI+data+processing.">Granger causality analysis implementation on MATLAB: a graphic user interface toolkit for fMRI data processing.</a> J Neurosci Methods. 203 (2), 418-426 (2012).</li><li>Hedden, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Disruption+of+functional+connectivity+in+clinically+normal+older+adults+harboring+amyloid+burden.">Disruption of functional connectivity in clinically normal older adults harboring amyloid burden.</a> J Neurosci. 29 (40), 12686-12694 (2009).</li><li>Liao, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Small-world+directed+networks+in+the+human+brain:+multivariate+Granger+causality+analysis+of+resting-state+fMRI.">Small-world directed networks in the human brain: multivariate Granger causality analysis of resting-state fMRI.</a> NeuroImage. 54 (4), 2683-2694 (2011).</li><li>Liao, W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluating+the+effective+connectivity+of+resting+state+networks+using+conditional+Granger+causality.">Evaluating the effective connectivity of resting state networks using conditional Granger causality.</a> Biol Cybern. 102 (1), 57-69 (2010).</li><li>Zhang, H. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+of+PCC+functional+connectivity+characteristics+in+resting-state+fMRI+in+mild+Alzheimer's+disease.">Detection of PCC functional connectivity characteristics in resting-state fMRI in mild Alzheimer's disease.</a> Behav Brain Res. 197 (1), 103-108 (2009).</li><li>Deshpande, G., Hu, X., Stilla, R., Sathian, K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effective+connectivity+during+haptic+perception:+a+study+using+Granger+causality+analysis+of+functional+magnetic+resonance+imaging+data.">Effective connectivity during haptic perception: a study using Granger causality analysis of functional magnetic resonance imaging data.</a> NeuroImage. 40 (4), 1807-1814 (2008).</li><li>Bressler, S. L., Seth, A. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Wiener-Granger+causality:+a+well+established+methodology.">Wiener-Granger causality: a well established methodology.</a> NeuroImage. 58 (2), 323-329 (2011).</li></ol>

This report presents a process for comparing the directed functional connectivity from the PCC to the whole brain and from the whole brain to the PCC between AD, MCI and control groups. Moreover, a key step in this process is the classification and screening of sample before the experiment. Thus, the classification and screening criteria are crucial because the accuracy of the results can be affected if they are erroneous. As listed in the protocol, we used 2011 NINCDS-ADRDA diagnostic criteria and MMSE, and the criteria...

AD is a degenerative disease of the central nervous system that can be diagnosed using histopathology, electrophysiology, and neuroimaging1. The memory-related DMN is a vital system of the interacting brain regions associated with AD, and its abnormal function is characteristic of AD2,3. The PCC is an important region of the traditional default network in the resting state and plays pivotal roles in episodic memory, spatial attention, self-evaluation, and other cognitive functions4,5,6,7. In addition, it might be an imaging marker for monitoring AD progression. Using GCA, Liao et al. found that the PCC is a region of multiple cytoarchitectonics with multiple connections and plays an important role in functional brain structure8. Zhong et al. reported that the PCC was a convergence center that received interactions from most of the other regions within the DMN3. Furthermore, Miao et al. demonstrated that in the DMN hub regions, the PCC has the greatest causal effect relationship with other nodes9. Together, all this evidence indicates thatthe directed connection of the PCC is valuable in AD research and the PCC needs to be further studied in-depth as a vital region of the DMN.
The previous studies were confined to the connectivity between the PCC and other regions within the DMN; however, the changes in directed functional connectivity between the PCC and brain regions outside the DMN, as well as their influence on AD have not yet been explored10. Our study further investigated this unexplored functional connectivity in normal healthy controls, patients with MCI, and patients with AD. By observing the directed connectivity between the PCC and whole brain regions, we aimed to elucidate the functional changes in the brain related to AD progression, and thereby establish a novel objective basis for assessing the severity of the disease.
Functional connectivity refers to an interregional interaction that can be represented by synchronous Low Frequency Fluctuations (LFFs) in the cerebral Blood Oxygen Level Dependent (BOLD) fMRI signal. Therefore, in order to observe the functional connectivity between the PCC and other brain regions, we analyzed the functional connectivity between the PCC and the whole brain network by fMRI using GCA, with the PCC as the Region of Interest (ROI). This technique directly derives the fundamental relationship of each node using data obtained from neuroimaging11. Recently, GCA has been applied to electroencephalogram (EEG) and fMRI studies to reveal the causal effects among brain regions12. All these studies indicated that the GCA technique might be optimal for detecting the causal relationship of each node in the brain.

<table border="0" cellpadding="0" cellspacing="0" width="909">
	<tbody>
		<tr height="120">
			<td height="120" style="height:120px;width:192px;">116 patients</td>
			<td style="width:169px;">Zhejiang Provincial People&#8217;s hospital</td>
			<td style="width:207px;">-</td>
			<td style="width:341px;">This study was approved by the ethics committee of Zhejiang Provincial People&#8217;s hospital. Every enrolled subject signed a written informed consent form.</td>
		</tr>
		<tr height="153">
			<td height="153" style="height:153px;width:192px;">Siemens Trio 3.0 T MRI scanner</td>
			<td style="width:169px;">Siemens, Erlangen, Germany</td>
			<td style="width:207px;">20571</td>
			<td style="width:341px;">Equipped with AudioComfort that reduces acoustic noise up to 90%; Provides high performance at a low noise level; Ultra light-weight coil; Unique MRI sequence design; Supports up to 400 pounds without restrictions.</td>
		</tr>
		<tr height="201">
			<td height="201" style="height:201px;width:192px;">RESTplus</td>
			<td style="width:169px;">Hangzhou Normal University,Hangzhou,Zhejiang,China</td>
			<td style="width:207px;">20160122</td>
			<td style="width:341px;">RESTplus evolved from REST (Resting-State fMRI Data Analysis Toolkit), a convenient toolkit to calculate Functional Connectivity (FC), Regional Homogeneity(ReHo), Amplitude of Low-Frequency Fluctuation (ALFF), Fractional ALFF (fALFF), Gragner causality, degree centrality, voxel-mirrored homotopic connectivity (VMHC) and perform statistical analysis.</td>
		</tr>
		<tr height="220">
			<td height="220" style="height:220px;width:192px;">DPARSF</td>
			<td style="width:169px;">Hangzhou Normal University,Hangzhou,Zhejiang,China</td>
			<td style="width:207px;">130615</td>
			<td style="width:341px;">Data Processing Assistant for Resting-State fMRI (DPARSF) is a convenient plug-in software within DPABI, which is based on SPM. You just need to arrange your DICOM files, and click a few buttons to set parameters, DPARSF will then give all the preprocessed data, functional connectivity, ReHo, ALFF/fALFF, degree centrality, voxel-mirrored homotopic connectivity (VMHC) results.</td>
		</tr>
		<tr height="111">
			<td height="111" style="height:111px;width:192px;">SPSS</td>
			<td style="width:169px;">SPSS Inc., Chicago, IL, USA</td>
			<td style="width:207px;">-</td>
			<td style="width:341px;">SPSS offers detailed analysis options to look deeper into your data and spot trends that you might not have noticed.</td>
		</tr>
	</tbody>
</table>

application of granger causality analysis of the directed functional connection in alzheimer's disease and mild cognitive impairment

Impaired functional connectivity in the Default Mode Network (DMN) may be involved in the progression of Alzheimer&#39;s Disease (AD). The Posterior Cingulate Cortex (PCC) is a potential imaging marker for monitoring the progression of AD. Previous studies did not focus on the functional connectivity between the PCC and nodes in regions outside the DMN, but our study is an effort to explore these overlooked functional connections. For collecting data, we used functional Magnetic Resonance Imaging (fMRI) and Granger Causality Analysis (GCA). fMRI provides a non-invasive method for studying the dynamic interactions between the different brain regions. GCA is a statistical hypothesis test for determining whether one-time series is useful in forecasting another. In simple terms, it is judged by comparing the &#34;Known all the information on the last moment, the distribution of the probability of X at this time&#34; and the &#34;Known all the information on the last moment except Y, the distribution of the probability of X at this time&#34;, to determine whether there is a causal relationship between Y and X. This definition is based on the complete information source and stationary chronological sequence. The main step of this analysis is to use X and Y to establish the regression equation and draw a causal relationship by a hypothetical test. Since GCA can measure causal effects, we used it to investigate the anisotropy of the functional connectivity and explore the hub function of the PCC. Here, we screened 116 participants for MRI scanning, and after preprocessing the data obtained from neuroimaging, we used GCA to derive the causal relationship of each node. Finally, we concluded that the directed connection is significantly different between the Mild Cognitive Impairment (MCI) and AD groups, both from the PCC to the whole brain and from the whole brain to the PCC.

Demographic information
Table 1 presents the characteristics of the subjects. All the subjects had an education level of junior school or above. Age, gender, and education level were similar between the three groups (P &#62;0.05), while the MMSE scores were significantly different (p &#60;0.01).
Directed brain functional connectivity
<p...

Watch this Scientific Journal Video about Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer's Disease and Mild Cognitive Impairment at JoVE.com

Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer&#039;s Disease and Mild Cognitive Impairment

Based on resting-state functional magnetic resonance imaging with Granger causality analysis, we investigated the alterations in the directed functional connectivity between the posterior cingulate cortex and whole brain in patients with Alzheimer&#39;s Disease (AD), patients with Mild Cognitive Impairment (MCI), and healthy controls.

Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer's Disease and Mild Cognitive Impairment

Impaired functional connectivity in the Default Mode Network (DMN) may be involved in the progression of Alzheimer&#39;s Disease (AD). The Posterior ...

The overall goal of this Granger Causality Analysis is to study directed functional connectivity in the brain related to Alzheimer's disease progression, thereby establishing a novel objective basis for assessing the severity of the disease. This method can help answer key question in the Alzheimer's disease field, such as the directed connectivity between the PCC and whole brain regions. The main advantage of this technique is that it measures the causal effects of FMRI time series and it shows the dynamics and the directions of poor signal.The implication of this technique extend towards the diagnosis of progression of Alzheimer's disease because it compares the directed functional connectivity between AD, MCI and the control groups. Through this method can provide insight into scaling directed functional connectivity of Alzheimer's, it can also be applied to other system such as electroying cephalogram studies. Generally, individual who are new to this method will struggle if they're unfamiliar with the software's operation.We first have add here for the semester, and then we rate the prior literatures about Granger Causality Analysis. While having a real-world demonstration of this method, it's critical because there are multiples to be noted beyond what can be written in the text. Begin by opening RESTplus through the software and left click on Pipeline.Import the relevant files into RESTplus. Select the work directory and then the starting EPI and T1 directories. Next, to convert Dicom files to Nifti check off the DicomToNifti box in Preprocessing.And check off the EPI Dicom to Nifiti and the T1 to Nifiti parameters. Remove the first 10 time points by checking off the RemoveFirstTimePoints and setting the end parameter as 10. Then, check off the Slice timing box.Set the slice number according to the RS FMRI parameters of the study and enter the slice order. Check Realign to correct the time and head motion. Then, perform spacial normalization by checking off Normalize and leave the default parameters at the bottom.Use the T1 image unified segmentation and all heads standardized to the same space by selecting the parameters. Normalize by using T1 image unified segmentation and European. Next select smooth to perform spacial smoothing using an isotropic Gaussian kernal with a full width at half maximum of 6 mm.Remove the linear trend by checking off Detrend. Select nuisance covariates regression in the following, six head motion parameters, global mean signal, white matter signal, and cerebrospinal fluid signal in order to increase the signal to noise ratio. Finally select filter to retain signals between 0.01 to 0.08 hertz.Remove high frequency physiological noise as well as remove low frequency drift. Begin by performing the voxel-wise Granger Causality Analysis, or GCA, by using the REST GCA in the REST toolbox. In the Postprocessing box, check off GCA.Set the order as one in the default. Select Define ROI and choose the spherical ROI to define the region of interest. Select next.Identify seed points of interest in the posterior singular cortex, or PCC, by setting the center coordinates and radius of the seed ROI based on the known data and select OK.Then select Run and OK to run the program. Next, find folders named ZGCA and GCA after processing of relevant file data. Sort out the files of ZGCA and classify them into four subfolders, XX, XY, YX, YY accordingly.Within the software, open RESTplus and left click on Statistical Analysis. Left click on REST Two-Sample T-Test. Name the output result as T1XY and set the output directory.Left click on Add Group Images to open the XY subfolder in the AD Results folder and the XY subfolder in the NC Results folder. Next, left click to open the BrainMask subfile in the mask folder. Then select Compute to run the program.Name the output results as T2XY and set the output directory. Left click on Add Group Images to open the XY subfolder in the AD Results folder. And the XY subfolder in the MCI Results folder.Repeat computation of the brain mask file to obtain outputs for T3XY, T1YX, T2YX, and T3YX for a total of six files. Left click on Viewer of RESTplus to view the resulting files. Import the template named Ch2 in Underlay.Finally, find the six resulting files in the output directory and fill in the overlay one by one. Create the final graph using the six output files. After the active nodes in the whole brain were first identified, GCA technology was used to determine the directed functional connectivity from the PCC to the whole brain.And from the whole brain to the PCC in the AD, MCI, and control groups. The directed connectivity from the whole brain to the PCC was enhanced in the AD group as compared to the normal control group and primarily focused in the bilateral cerebellar region outside the DMN. The directed connectivity from the PCC to the whole brain was significantly reduced in the AD group as compared to the controls with the main regions such as the right precuneus and left meta frontal gyrus belonging to the DMN.While masters, this technique can be done in 14 hours if it is performed properly. While attempting this procedure, it's important to remember that all file and the photo names must be in English and can not have spaces. After it's development this technique paved the way for reserachers in the field of FMRI to explore the directed factional connectivity in the progression of Alzheimer's disease.After watching this video, you should have a good understanding of how to start it the directed factional connectivity in the brain related to AD progression. Thereby establish a narrow objective basis for assessing the severity of the disease.

application-granger-causality-analysis-directed-functional-connection

Research

JoVE Journal

Medicine

An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth involved in organized sports such as competitive hockey are nearly six times more likely to suffer a severe concussion compared to children involved in other leisure physical activities2. While the most common cognitive sequelae of mTBI appear similar for children and adults, the recovery profile and breadth of consequences in children remains largely unknown2, as does the influence of pre-injury characteristics (e.g. gender) and injury details (e.g. magnitude and direction of impact) on long-term outcomes. Competitive sports, such as hockey, allow the rare opportunity to utilize a pre-post design to obtain pre-injury data before concussion occurs on youth characteristics and functioning and to relate this to outcome following injury. Our primary goals are to refine pediatric concussion diagnosis and management based on research evidence that is specific to children and youth. To do this we use new, multi-modal and integrative approaches that will:
 1.Evaluate the immediate effects of head trauma in youth 
2.Monitor the resolution of post-concussion symptoms (PCS) and cognitive performance during recovery 
3.Utilize new methods to verify brain injury and recovery
To achieve our goals, we have implemented the Head Impact Telemetry (HIT) System. (Simbex; Lebanon, NH, USA). This system equips commercially available Easton S9 hockey helmets (Easton-Bell Sports; Van Nuys, CA, USA) with single-axis accelerometers designed to measure real-time head accelerations during contact sport participation 3 - 5. By using telemetric technology, the magnitude of acceleration and location of all head impacts during sport participation can be objectively detected and recorded. We also use functional magnetic resonance imaging (fMRI) to localize and assess changes in neural activity specifically in the medial temporal and frontal lobes during the performance of cognitive tasks, since those are the cerebral regions most sensitive to concussive head injury 6. Finally, we are acquiring structural imaging data sensitive to damage in brain white matter.

This article provides an overview of a multi-modal approach to mild traumatic brain injury diagnosis and recovery in youth. This approach combines neuropsychological testing with functional magnetic resonance imaging and the Head Impact Telemetry System to monitor the relationship between head impacts and brain activity during cognitive testing.

One of the most commonly reported injuries in children who participate in sports is concussion or mild traumatic brain injury (mTBI)1. Children and youth ...

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer's Disease

Our laboratory uses event-related EEG potentials (ERPs) to understand and support behavioral investigations of episodic memory in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD). Whereas behavioral data inform us about the patients' performance, ERPs allow us to record discrete changes in brain activity. Further, ERPs can give us insight into the onset, duration, and interaction of independent cognitive processes associated with memory retrieval. In patient populations, these types of studies are used to examine which aspects of memory are impaired and which remain relatively intact compared to a control population. The methodology for collecting ERP data from a vulnerable patient population while these participants perform a recognition memory task is reviewed. This protocol includes participant preparation, quality assurance, data acquisition, and data analysis. In addition to basic setup and acquisition, we will also demonstrate localization techniques to obtain greater spatial resolution and source localization using high-density (128 channel) electrode arrays.

Examining the Characteristics of Episodic Memory using Event-related Potentials in Patients with Alzheimer&#039;s Disease

The methodology for collecting high-density event-related potential data while patients with Alzheimer's disease perform a recognition memory task is reviewed. This protocol will include subject preparation, quality assurance, data acquisition, and data analysis.

Our laboratory uses event-related EEG potentials (ERPs) to understand and support behavioral investigations of episodic memory in patients with amnestic ...

The Use of Primary Human Fibroblasts for Monitoring Mitochondrial Phenotypes in the Field of Parkinson's Disease

Parkinson's disease (PD) is the second most common movement disorder and affects 1% of people over the age of 60 1. Because ageing is the most important risk factor, cases of PD will increase during the next decades 2. Next to pathological protein folding and impaired protein degradation pathways, alterations of mitochondrial function and morphology were pointed out as further hallmark of neurodegeneration in PD 3-11.
After years of research in murine and human cancer cells as in vitro models to dissect molecular pathways of Parkinsonism, the use of human fibroblasts from patients and appropriate controls as ex vivo models has become a valuable research tool, if potential caveats are considered. Other than immortalized, rather artificial cell models, primary fibroblasts from patients carrying disease-associated mutations apparently reflect important pathological features of the human disease.
Here we delineate the procedure of taking skin biopsies, culturing human fibroblasts and using detailed protocols for essential microscopic techniques to define mitochondrial phenotypes. These were used to investigate different features associated with PD that are relevant to mitochondrial function and dynamics. Ex vivo, mitochondria can be analyzed in terms of their function, morphology, colocalization with lysosomes (the organelles degrading dysfunctional mitochondria) and degradation via the lysosomal pathway. These phenotypes are highly relevant for the identification of early signs of PD and may precede clinical motor symptoms in human disease-gene carriers. Hence, the assays presented here can be utilized as valuable tools to identify pathological features of neurodegeneration and help to define new therapeutic strategies in PD.

The Use of Primary Human Fibroblasts for Monitoring Mitochondrial Phenotypes in the Field of Parkinson&#039;s Disease

Fibroblasts from patients carrying mutations in Parkinson's disease-causing genes represent an easily accessible ex vivo model to study disease-associated phenotypes. Live cell imaging gives the opportunity to study morphological and functional parameters in living cells. Here we describe the preparation of human fibroblasts and subsequent monitoring of mitochondrial phenotypes.

Parkinson's disease (PD) is the second most  common movement disorder and affects 1% of people over the age of 60 1. Because ageing is  the most important ...

Quantitative Analysis of Chromatin Proteomes in Disease

In the nucleus reside the proteomes whose functions are most intimately linked with gene regulation. Adult mammalian cardiomyocyte nuclei are unique due to the high percentage of binucleated cells,1 the predominantly heterochromatic state of the DNA, and the non-dividing nature of the cardiomyocyte which renders adult nuclei in a permanent state of interphase.2 Transcriptional regulation during development and disease have been well studied in this organ,3-5 but what remains relatively unexplored is the role played by the nuclear proteins responsible for DNA packaging and expression, and how these proteins control changes in transcriptional programs that occur during disease.6 In the developed world, heart disease is the number one cause of mortality for both men and women.7 Insight on how nuclear proteins cooperate to regulate the progression of this disease is critical for advancing the current treatment options.
Mass spectrometry is the ideal tool for addressing these questions as it allows for an unbiased annotation of the nuclear proteome and relative quantification for how the abundance of these proteins changes with disease. While there have been several proteomic studies for mammalian nuclear protein complexes,8-13 until recently14 there has been only one study examining the cardiac nuclear proteome, and it considered the entire nucleus, rather than exploring the proteome at the level of nuclear sub compartments.15 In large part, this shortage of work is due to the difficulty of isolating cardiac nuclei. Cardiac nuclei occur within a rigid and dense actin-myosin apparatus to which they are connected via multiple extensions from the endoplasmic reticulum, to the extent that myocyte contraction alters their overall shape.16 Additionally, cardiomyocytes are 40% mitochondria by volume17 which necessitates enrichment of the nucleus apart from the other organelles. Here we describe a protocol for cardiac nuclear enrichment and further fractionation into biologically-relevant compartments. Furthermore, we detail methods for label-free quantitative mass spectrometric dissection of these fractions-techniques amenable to in vivo experimentation in various animal models and organ systems where metabolic labeling is not feasible.

Advances in mass spectrometry have allowed the high throughput analysis of protein expression and modification in a host of tissues. Combined with subcellular fractionation and disease models, quantitative mass spectrometry and bioinformatics can reveal new properties in biological systems. The method described herein analyzes chromatin-associated proteins in the setting of heart disease and is readily applicable to other in vivo models of human disease.

In the nucleus reside the proteomes whose functions are most intimately linked with gene regulation. Adult mammalian cardiomyocyte nuclei are unique due ...

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly

Obtaining in vivo human brain tissue volumetrics from MRI is often complicated by various technical and biological issues. These challenges are exacerbated when significant brain atrophy and age-related white matter changes (e.g. Leukoaraiosis) are present. Lesion Explorer (LE) is an accurate and reliable neuroimaging pipeline specifically developed to address such issues commonly observed on MRI of Alzheimer's disease and normal elderly. The pipeline is a complex set of semi-automatic procedures which has been previously validated in a series of internal and external reliability tests1,2. However, LE's accuracy and reliability is highly dependent on properly trained manual operators to execute commands, identify distinct anatomical landmarks, and manually edit/verify various computer-generated segmentation outputs.
LE can be divided into 3 main components, each requiring a set of commands and manual operations: 1) Brain-Sizer, 2) SABRE, and 3) Lesion-Seg. Brain-Sizer's manual operations involve editing of the automatic skull-stripped total intracranial vault (TIV) extraction mask, designation of ventricular cerebrospinal fluid (vCSF), and removal of subtentorial structures. The SABRE component requires checking of image alignment along the anterior and posterior commissure (ACPC) plane, and identification of several anatomical landmarks required for regional parcellation. Finally, the Lesion-Seg component involves manual checking of the automatic lesion segmentation of subcortical hyperintensities (SH) for false positive errors.
While on-site training of the LE pipeline is preferable, readily available visual teaching tools with interactive training images are a viable alternative. Developed to ensure a high degree of accuracy and reliability, the following is a step-by-step, video-guided, standardized protocol for LE's manual procedures.

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer&#039;s Disease and Normal Elderly

Lesion Explorer (LE) is a semi-automatic, image-processing pipeline developed to obtain regional brain tissue and subcortical hyperintensity lesion volumetrics from structural MRI of Alzheimer's disease and normal elderly. To ensure a high level of accuracy and reliability, the following is a video-guided, standardized protocol for LE's manual procedures.

Obtaining in vivo human brain tissue volumetrics from MRI is often complicated by various technical and biological issues. These challenges are ...

Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy

Functional connectivity MRI (fcMRI) is an fMRI method that examines the connectivity of different brain areas based on the correlation of BOLD signal fluctuations over time. Temporal Lobe Epilepsy (TLE) is the most common type of adult epilepsy and involves multiple brain networks. The default mode network (DMN) is involved in conscious, resting state cognition and is thought to be affected in TLE where seizures cause impairment of consciousness. The DMN in epilepsy was examined using seed based fcMRI. The anterior and posterior hubs of the DMN were used as seeds in this analysis. The results show a disconnection between the anterior and posterior hubs of the DMN in TLE during the basal state. In addition, increased DMN connectivity to other brain regions in left TLE along with decreased connectivity in right TLE is revealed. The analysis demonstrates how seed-based fcMRI can be used to probe cerebral networks in brain disorders such as TLE.

The Default Mode Network (DMN) in Temporal Lobe Epilepsy (TLE) is analyzed in the resting state of the brain using seed-based functional connectivity MRI (fcMRI).

Functional connectivity MRI (fcMRI) is an fMRI method that examines the connectivity of different brain areas based on the correlation of BOLD signal ...

Motor and Hippocampal Dependent Spatial Learning and Reference Memory Assessment in a Transgenic Rat Model of Alzheimer's Disease with Stroke

Alzheimer&#39;s disease (AD) is a debilitating neurodegenerative disease that results in neurodegeneration and memory loss. While age is a major risk factor for AD, stroke has also been implicated as a risk factor and an exacerbating factor. The co-morbidity of stroke and AD results in worsened stroke-related motor control and AD-related cognitive deficits when compared to each condition alone. To model the combined condition of stroke and AD, a novel transgenic rat model of AD, with a mutated form of amyloid precursor protein (a key protein involved in the development of AD) incorporated into its DNA, is given a small unilateral striatal stroke.
For a model with the combination of both stroke and AD, behavioral tests that assess stroke-related motor control, locomotion and AD-related cognitive function must be implemented. The cylinder task involves a cost-efficient, multipurpose apparatus that assesses spontaneous forelimb motor use. In this task, a rat is placed in a cylindrical apparatus, where the rat will spontaneously rear and contact the wall of the cylinder with its forelimbs. These contacts are considered forelimb motor use and quantified during video analysis after testing. Another cost-efficient motor task implemented is the beam-walk task, which assesses forelimb control, hindlimb control and locomotion. This task involves a rat walking across a wooden beam allowing for the assessment of limb motor control through analysis of forelimb slips, hindlimb slips and falls. Assessment of learning and memory is completed with Morris water maze for this behavioral paradigm. The protocol starts with spatial learning, whereby the rat locates a stationary hidden platform. After spatial learning, the platform is removed and both short-term and long-term spatial reference memory is assessed. All three of these tasks are sensitive to behavioral differences and completed within 28 days for this model, making this paradigm time-efficient and cost-efficient.

Motor and Hippocampal Dependent Spatial Learning and Reference Memory Assessment in a Transgenic Rat Model of Alzheimer&#039;s Disease with Stroke

To investigate the co-morbid Alzheimer&#39;s disease (AD) and stroke condition in a novel model, three behavior tasks are described that assess both motor control and cognitive behaviors. These tasks include the beam-walk task, cylinder task and Morris water maze.

Alzheimer&#39;s disease (AD) is a debilitating neurodegenerative disease that results in neurodegeneration and memory loss. While age is a major risk ...

Quantitative 3D In Silico Modeling (q3DISM) of Cerebral Amyloid-beta Phagocytosis in Rodent Models of Alzheimer's Disease

Neuroinflammation is now recognized as a major etiological factor in neurodegenerative disease. Mononuclear phagocytes are innate immune cells responsible for phagocytosis and clearance of debris and detritus. These cells include CNS-resident macrophages known as microglia, and mononuclear phagocytes infiltrating from the periphery. Light microscopy has generally been used to visualize phagocytosis in rodent or human brain specimens. However, qualitative methods have not provided definitive evidence of in vivo phagocytosis. Here, we describe quantitative 3D in silico modeling (q3DISM), a robust method allowing for true 3D quantitation of amyloid-&#946; (A&#946;) phagocytosis by mononuclear phagocytes in rodent Alzheimer&#39;s Disease (AD) models. The method involves fluorescently visualizing A&#946; encapsulated within phagolysosomes in rodent brain sections. Large z-dimensional confocal datasets are then 3D reconstructed for quantitation of A&#946; spatially colocalized within the phagolysosome. We demonstrate the successful application of q3DISM to mouse and rat brains, but this methodology can be extended to virtually any phagocytic event in any tissue.

Quantitative 3D In Silico Modeling q3DISM of Cerebral Amyloid-beta Phagocytosis in Rodent Models of Alzheimer&#039;s Disease

We developed a methodology for quantitative 3D in silico modeling (q3DISM) of cerebral amyloid-&#946; (A&#946;) phagocytosis by mononuclear phagocytes in rodent models of Alzheimer&#39;s disease. This method can be generalized for the quantitation of virtually any phagocytic event in vivo.

Neuroinflammation is now recognized as a major etiological factor in neurodegenerative disease. Mononuclear phagocytes are innate immune cells responsible ...

Whole-brain Segmentation and Change-point Analysis of Anatomical Brain MRI&#8212;Application in Premanifest Huntington's Disease

Recent advances in MRI offer a variety of useful markers to identify neurodegenerative diseases. In Huntington&#39;s disease (HD), regional brain atrophy begins many years prior to the motor onset (during the &#34;premanifest&#34; period), but the spatiotemporal pattern of regional atrophy across the brain has not been fully characterized. Here we demonstrate an online cloud-computing platform, &#34;MRICloud&#34;, which provides atlas-based whole-brain segmentation of T1-weighted images at multiple granularity levels, and thereby, enables us to access the regional features of brain anatomy. We then describe a regression model that detects statistically significant inflection points, at which regional brain atrophy starts to be noticeable, i.e. the &#34;change-point&#34;, with respect to a disease progression index. We used the CAG-age product (CAP) score to index the disease progression in HD patients. Change-point analysis of the volumetric measurements from the segmentation pipeline, therefore, provides important information of the order and pattern of structural atrophy across the brain. The paper illustrates the use of these techniques on T1-weighted MRI data of premanifest HD subjects from a large multicenter PREDICT-HD study. This design potentially has wide applications in a range of neurodegenerative diseases to investigate the dynamic changes of brain anatomy.

Whole-brain Segmentation and Change-point Analysis of Anatomical Brain MRI&amp;#8212;Application in Premanifest Huntington&#039;s Disease

This paper describes a statistical model for volumetric MRI data analysis, which identifies the &#34;change-point&#34; when brain atrophy begins in premanifest Huntington&#39;s disease. Whole-brain mapping of the change-points is achieved based on brain volumes obtained using an atlas-based segmentation pipeline of T1-weighted images.

Recent advances in MRI offer a variety of useful markers to identify neurodegenerative diseases. In Huntington&#39;s disease (HD), regional brain atrophy ...