Correlations Between Psychological Status and Perception of Facial Expression

Objective@#Facial affect recognition is associated with neuropsychological status and psychiatric diseases. We hypothesized that facial affect recognition is associated with psychological status and perception of other affects. @*Methods@#A total of 80 images depicting facial affect, including 20 Neutral, 20 Angry, 20 Fear, and 20 Sad, were screened for use in our research. A total of 100 healthy individuals were asked to rate these images using a 10-point Likert scale and complete psychological scales assessing the emotional statuses and cognitive functions. @*Results@#The participants’ emotional state of aggression, attention, and impulsivity may have been associated with their interpretation of the Angry facial expressions. The participants often rated the Angry facial expressions as Fear. The participants rated Fear images as Angry or Sad. In response to a Sad facial expression, the participants reported psychological statuses of attention and impulsivity which were associated with the facial expression rating. The participants rated the Sad expression as Angry or Fear. @*Conclusion@#The psychological statuses of the participants were significantly correlated with their interpretation of facial affects. In particular, a psychological state of attention was often correlated with incorrect affect ratings. Attention and impulsivity could affect the rating of the sad facial expressions.

Effect of Parental Perception on the Prevalence of Adolescent Internet Gaming Disorder During the COVID-19 Pandemic

Objective@#During the coronavirus disease (COVID-19) pandemic, several studies have found that Internet usage and gaming times have increased among adolescents. Parents’ Internet literacy and attitudes toward Internet gaming have been reported to affect children’s Internet gaming disorder (IGD). We hypothesized that parents’ attitudes toward Internet use and gaming would affect the prevalence of IGD among adolescents. @*Methods@#A total of 199 mothers of children who played Internet games were surveyed online to gather information regarding their demographic characteristics, children’s Internet use patterns, psychological factors, and Internet gaming literacy. @*Results@#Among adolescents, increased Internet usage or gaming time was not associated with IGD, but the presence of attention deficit hyperactivity disorder (ADHD) was. Among parents, anxiety, depression, and family togetherness were not related to IGD, but a positive perception of gaming protected against the development of IGD, whereas a negative perception was a risk factor for IGD. @*Conclusion@#Increased gaming time neither causes nor correlates with IGD in adolescents, even though ADHD may be a risk factor for IGD. Parents’ positive or negative perceptions of gaming can be protective or present a risk factor, respectively, for their children’s development of IGD.

Brain Network Connectivity and Association with Catechol-O-Methyltransferase Gene Polymorphism in Korean Attention-Deficit Hyperactivity Disorder Children

Objective@#We sought to determine if the links between and within the default mode network (DMN) and dorsal attention network (DAT) exhibited different conditions according to catechol-O-methyltransferase (COMT) gene polymorphism in relationship to attention-deficit hyperactivity disorder (ADHD) symptoms. @*Methods@#Fifty-seven children with ADHD and 48 healthy controls (HCs) were administered an intelligence test, the Children’s Depression Inventory, the Korean ADHD rating scale, and continuous performance test. Resting-state brain functional MRI scans were obtained, and COMT genotyping was performed to distinguish valine carriers and methionine homozygotes. @*Results@#Compared to controls, children with ADHD showed increased ADHD scale scores, increased visual commission errors, and increased functional connectivity (FC) within the DMN and DAT. Compared to all children with ADHD, children with the methionine homozygote and those who were valine carriers showed increased FC within the DMN and DAT and decreased FC between the DMN and DAT. FC within the DMN was also increased in HC valine carriers compared to HC children with the methionine homozygote, and in children with ADHD who were valine carriers compared to HC valine carriers. @*Conclusion@#We observed increased brain connectivity within the DMN and DAT and altered brain connectivity within and between the DMN and DAT associated with COMT polymorphism in children with ADHD.

Neural Signature for Auditory Hallucinations in Schizophrenia: A High-Resolution Positron Emission Tomography Study with Fludeoxyglucose (¹⁸F)

OBJECTIVE: Auditory hallucinations (AHs) are a core symptom of schizophrenia. We investigated the neural signature of AHs by comparing hallucinating patients with schizophrenia with non-hallucinating patients with schizophrenia. METHODS: We recruited hallucinating patients with schizophrenia meeting the criteria for persistent, prominent, and predominant AHs (n=10) and non-hallucinating patients with schizophrenia (n=12). Various clinical assessments were performed incluing Psychotic Symptom Rating Scale for Auditory Hallucinations. Using fludeoxyglucose (¹⁸F) positron emission tomography, regional differences in neural activity between the groups were analyzed. RESULTS: The regions of interest analysis showed significantly lower standardized uptake value ratio (SUVR) in the superior, middle, and inferior frontal gyri, and higher SUVR in the putamen in patients with AHs versus patients without AHs. These findings were confirmed in the voxel-wise analysis. CONCLUSION: Our findings indicate that hypoactivity in the frontal and cingulate gyri, coupled with hyperactivity in the temporal gyrus and putamen, may contribute to the pathophysiology of AHs.

Glucose Hypometabolism in Hippocampal Subdivisions in Alzheimer's Disease: A Pilot Study Using High-Resolution ¹⁸F-FDG PET and 7.0-T MRI

BACKGROUND AND PURPOSE: Atrophy of the hippocampus is an important clinical diagnostic marker of Alzheimer's disease (AD), and so assessments of hippocampal activity and its subdivisions might provide invaluable information. This study compared the glucose metabolism of hippocampal subdivisions in mild-AD patients and healthy controls. METHODS: High-resolution T2*-weighted gradient-echo magnetic resonance imaging (MRI) images and ¹⁸F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) images were acquired using 7.0-T MRI and high-resolution research tomograph FDG-PET, respectively, in 9 early-stage AD patients and 10 healthy subjects. The hippocampal body was divided into three equal parts (anterior, middle, and posterior), and in each part a region of interest (ROI) was drawn over the cornus ammonis (CA)1, CA2/3, CA4/dentate gyrus (DG), and subiculum. The standardized uptake values of the hippocampal subdivisions were calculated for each ROI as ratios relative to the pons standardized uptake value. Statistical analysis was conducted using the Mann-Whitney U test. RESULTS: Patients with early-stage AD patients showed significantly less metabolic activity than healthy controls focally in the middle (p=0.050) and posterior (p=0.034) CA2/3 regions of the right hippocampus, and significantly less activity throughout the left hippocampal body in the anterior CA2/3 (p=0.027) and CA4/DG (p=0.027) regions, the middle CA1 region (p=0.011), and the posterior CA1 (p=0.034), CA2/3 (p=0.007), and CA4/DG (p=0.014) regions. CONCLUSIONS: It was possible to use high-resolution PET-MRI fusion images to identify hippocampus subdivisions and assess glucose metabolism in the subfields. Reductions in metabolic activity were found to vary along the hippocampal axis in early-stage AD patients.

Functional Connectivity of the Hippocampus in Early- and vs. Late-Onset Alzheimer's Disease

BACKGROUND AND PURPOSE: Early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD) have different clinical and neuroimaging characteristics, but memory decline is usually present in both types. However, there have been few functional studies focused on the hippocampus in Alzheimer's disease. We therefore investigated the functional connectivity between the hippocampus and other brain regions using resting-state fMRI and compared the findings between EOAD and LOAD. METHODS: We recruited 13 patients with EOAD and 19 patients with LOAD at the early disease stage. Twenty-one young controls and ten old controls were also recruited. Each participant completed a standardized neuropsychological battery of tests and underwent T1-weighted structural MRI. fMRI data were acquired during the resting state using 3-T MRI. The functional connectivity to the hippocampus was calculated based on automated anatomical labeling templates. RESULTS: The functional connectivity from the hippocampus to other brain regions differed between patients with EOAD and LOAD. The LOAD patients showed decreased hippocampal connectivity to cortical regions, such as to the middle temporal cortex, orbitofrontal cortex, postcentral cortex, supramarginal cortex, and rolandic operculum. In contrast, EOAD patients showed smaller functional changes of the cortical regions connected to the hippocampus, such as the middle frontal cortex. CONCLUSIONS: EOAD and LOAD patients exhibited different hippocampal connectivity. The memory decline in EOAD may be due to brain areas other than the hippocampus.

Balance Deficit and Brain Connectivity in Children with Attention-Deficit/Hyperactivity Disorder

OBJECTIVE: We aimed to assess disturbances in postural and gait balance and functional connectivity within the brain regions controlling balance in children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Thirteen children with ADHD and 13 age- and sex-matched controls were recruited. Gait balance was assessed by the difference in the center of pressure (COP) between the left and right foot, as well as the difference in plantar pressure between the left and right foot during gait. Neuroimaging data were acquired using a 3.0 Tesla MRI scanner. Functional connectivity between the vermis of the cerebellum and all other brain regionswas assessed. RESULTS: The difference in plantar pressure between the left foot and right foot in the ADHD group was greater than that observed in the control group. The average COP jerk score of the right foot in the ADHD group was higher than that observed in the control group. A higher functional connectivity between the cerebellum and the right middle frontal gyrus (premotor cortex) and medial frontal gyrus (cingulate gyrus) was observed in the control group relative to the ADHD group. In the ADHD group, the difference in plantar pressure between the left and right foot was also negatively correlated with the beta-value within the middle frontal gyrus. CONCLUSION: Children with ADHD had disturbance of balance as assessed by plantar pressure. Decreased brain connectivity from the cerebellum to the premotor cortex and anterior cingulate was associated with disturbances of posture and balance in children with ADHD.

Experience with 7.0 T MRI in Patients with Supratentorial Meningiomas

Meningiomas are typically diagnosed by their characteristic appearance on conventional magnetic resonance imaging (MRI). However, detailed image findings regarding peri- and intra-tumoral anatomical structures, tumor consistency and vascularity are very important in pre-surgical planning and surgical outcomes. At the 7.0 T MRI achieving ultra-high resolution, it could be possible to obtain more useful information in surgical strategy. Four patients who were radiologically diagnosed with intracranial meningioma in 1.5 T MRI underwent a 7.0 T MRI. Three of them underwent surgery afterwards, and one received gamma knife radiosurgery. In our study, the advantages of 7.0 T MRI over 1.5 T MRI were a more detailed depiction of the peri- and intra-tumoral vasculature and a clear delineation of tumor-brain interface. In the safety issues, all patients received 7.0 T MRI without any adverse event. One disadvantage of 7.0 T MRI was the reduced image quality of skull base lesions. 7.0 T MRI in patients with meningiomas could provide useful information in surgical strategy, such as the peri-tumoral vasculature and the tumor-brain interface.

Contrast-enhanced Magnetic Resonance Imaging of Brain Metastases at 7.0T versus 1.5T: A Preliminary Result

PURPOSE: To compare the depiction of brain metastases on contrast-enhanced images with 7.0 tesla (T) and at 1.5T MRI. MATERIALS AND METHODS: Four consecutive patients with brain metastases were scanned on 7.0T whole-body scanner and 1.5T MRI. A 3D T1-weighted gradient echo sequence (3D T1-GRE) at 1.5T (voxel size = 0.9 x 0.9 x 1.5 mm3 after double-dose, gadoterate meglumine, Gd-DOTA) was compared to a 7.0T 3D T1-GRE sequence (voxel size = 0.4 x 0.4 x 0.8 mm3, single-dose Gd-DOTA) in four patients after a 5 minute delay. The number of contrast-enhancing metastases in MPRAGE images was compared in each patient by two radiologists in consensus. We measured contrast ratio of enhancing brain metastases and white matter in 1.5T and 7.0T. RESULTS: In all four patients 7.0T 3D T1-GRE images after single-dose Gd-DOTA and 1.5T after double-dose Gd-DOTA depicted 11 brain metastases equally. In the quantitative analysis of contrast ratios of enhancing brain metastases and white matter, the 1.5T 3D T1-GRE after double-dose showed an increased contrast ratio compared to 7.0T 3D T1-GRE after single-dose (0.961 +/- 0.571 versus 0.885 +/- 0.494; n = 11 metastases). But this difference was not statistically significant (P = 0.711). CONCLUSION: Our preliminary results indicate that 7.0T single-dose Gd-enhanced images were not different to 1.5T double-dose Gd-enhanced images for the detection of brain metastases.

A Case Report of Preoperative and Postoperative 7.0T Brain MRI in a Patient with a Small Cell Glioblastoma

A 45-yr-old female patient was admitted with one-month history of headache and progressive left hemiparesis. Brain magnetic resonance imaging (MRI) demonstrated a mass lesion in her right frontal lobe. Her brain tumor was confirmed as a small cell glioblastoma. Her follow-up brain MRI, taken at 8 months after her initial surgery demonstrated tumor recurrence in the right frontal lobe. Contrast-enhanced 7.0T brain magnetic resonance imaging (MRI) was safely performed before surgery and at the time of recurrence. Compared with 1.5T and 3.0T brain MRI, 7.0T MRI showed sharpened images of the brain tumor contexture with detailed anatomical information. The fused images of 7.0T and 1.5T brain MRI taken at the time of recurrence demonstrated no significant discrepancy in the positions of the anterior and the posterior commissures. It is suggested that 7.0T MRI can be safely utilized for better images of the maligant gliomas before and after surgery.

Early Experience of Pre- and Post-Contrast 7.0T MRI in Brain Tumors

We investigated the safety and clinical applicability of 7.0 Tesla (T) brain magnetic resonance imaging (MRI) in patients with brain tumors. Twenty-four patients with intraaxial or extraaxial brain tumors were enrolled in this study. 7.0T MRIs of T2*-weighted axial and T1-weighted coronal or sagittal images were obtained and compared with 1.5T brain MRIs. The T2*-weighted images from 7.0T brain MRI revealed detailed microvasculature and the internal contents of supratentorial brain tumors better than that of 1.5T brain MRI. For brain tumors located in parasellar areas or areas adjacent to major cerebral vessels, flow-related artifacts were exaggerated in the 7.0T brain MRIs. For brain tumors adjacent to the skull base, susceptibility artifacts in the interfacing areas of the paranasal sinus and skull base hampered the aquisition of detailed images and information on brain tumors in the 7.0T brain MRIs. This study shows that 7.0T brain MRI can provide detailed information on the intratumoral components and margins in supratentorial brain tumors. Further studies are needed to develop refined MRI protocols for better images of brain tumors located in the skull base, parasellar, and adjacent major cerebrovascular structures.

Magnetic Resonance Imaging Compatibility of the Polymer-based Cochlear Implant

OBJECTIVES: In this study, we compared the magnetic resonance (MR) image artifacts caused by a conventional metal-based cochlear implant and a newly developed liquid crystal polymer (LCP)-based device. METHODS: The metal-based cochlear implant system (Nurobiosys Co.) was attached to side of the head of a subject and the LCP-based device was attached to opposite side. In both devices, alignment magnets were removed for safety. Magnetic resonance imaging (MRI) was performed on a widely used 3.0 T and an ultra-high 7.0 T MRI machine. 3.0 and 7.0 T MR images were acquired using T1- and T2*-weighted gradient echo sequences, respectively. RESULTS: In the 3.0 T images, the metal-based device on the left side generated the significant amount of artifacts. The MR images in the proximity of the metal package were obscured by the artifacts in both axial and sagittal views. On the other hand, the MR images near the LCP-based device were relatively free from the artifacts and clearly showed the brain structures. 7.0 T MR images showed the more severe distortion in the both sides but the metal-based cochlear implant system caused a much larger obscure area than the LCP-based system. CONCLUSION: The novel LCP-based cochlear implant provides a good MRI compatibility beyond present-day cochlear implants. Thus, MR images can be obtained from the subjects even with the implanted LCP-based neural prosthetic systems providing useful diagnostic information. Furthermore, it will be also useful for functional MRI studies of the auditory perception mechanism after cochlear implantations as well as for positron emission tomography-MRI hybrid imaging.

Clinical Application of 7.0 T Magnetic Resonance Images in Gamma Knife Radiosurgery for a Patient with Brain Metastases

In the study we assessed the distortion of 7.0 T magnetic resonance (MR) images in reference to 1.5 T MR images in the radiosurgery of metastatic brain tumors. Radiosurgery with Gamma Knife Perfexion(R) was performed for the treatment of a 54-yr-old female patient with multiple brain metastases by the co-registered images of the 7.0 T and 1.5 T magnetic resonance images (MRI). There was no significant discrepancy in the positions of anterior and posterior commissures as well as the locations of four metastatic brain tumors in the co-registered images between 7.0 T and 1.5 T MRI with better visualization of the anatomical details in 7.0 T MR images. This study demonstrates for the first time that 7.0 T MR images can be safely utilized in Perfexion(R) Gamma Knife radiosurgery for the treatment of metastatic brain tumors. Furthermore 7.0 T MR images provide better visualization of brain tumors without image distortion in comparison to 1.5 T MR images.

Diurnal Variation of Blood Pressure; the Difference between before and after Removal of Pheochromocytoma: Evaluation by Ambulatory Blood Pressure Monitoring

Ambulatory BP monitoring was performed in a patients with pheochromocytoma before and after removal of the tumor. Before surgery, it did not show any significant diurnal variation. But, after surgery the diurnal variation was restored.