Reliability of fMRI motor tasks in structures of the corticostriatal circuitry: implications for future studies and circuit function.

The corticostriatal circuits are important information processing networks. There is evidence that these circuits may be dysfunctional in a variety of neuropsychiatric conditions ranging from Parkinson's disease to bipolar disorder. Cross-sectional fMRI studies may clarify normal circuit function, and longitudinal studies may provide information on changes related to age in control subjects, as well as illness progression and treatment response in patient groups. In this paper, we report a comprehensive analysis of the utility of several motor tasks as cross-sectional and longitudinal probes of corticostriatal function in terms of their activation strength and reliability. Our findings suggest that the motor tasks studied can be useful probes of corticostriatal function for studies utilizing group comparisons. However, longitudinal clinical studies in which individual results are important will need to take into account wide variation in individual activation and reliability. For example, measures of activation strength and reliability based on percent signal change display a dichotomy between simple motor tasks, which have high reliability and low activation, and complex tasks, which have lower reliability and higher activation. Size and overlap ratios calculated from activation maps produced a different view of reliability than intraclass correlation coefficients (ICC) based on percent signal change. Finally, these results suggest that the corticostriatal circuitry exhibit individualized responses to motor adaptation.

An fMRI motor activation paradigm demonstrates abnormalities of putamen activation in females with panic disorder.

BACKGROUND: The neurobiology of panic disorder is incompletely understood. The aim of this study was to determine if functional abnormalities of the putamen occur in panic disorder. METHODS: Activation patterns of 12 female subjects with panic disorder were compared to 18 female healthy controls using functional MRI at 3 T. A motor activation paradigm was used to probe putamen function. RESULTS: A complex motor activation paradigm for the non-dominant hand revealed decreased activation of the bilateral putamen among subjects with panic disorder. LIMITATIONS: The sample size was a relatively small cohort of non-depressed females. Further, some panic disorder subjects were taking medications and/or had comorbid conditions. However, second-level regression analyses did not reveal any correlations between medication use or comorbidity and activation patterns demonstrated by the non-dominant hand complex task. Finally, we used a post-hoc approach to determine the magnitude of global fMRI signal as a surrogate index of the global cerebral blood flow as a means of controlling for possible confounds from reduction of BOLD signal secondary to cerebral vasoconstriction resulting from possible hyperventilation among panic subjects. A more compelling approach would have been to record the respiratory data from subjects during scanning. CONCLUSIONS: Our findings suggest that putamen dysfunction occurs in at least some cases of panic disorder. We also provide preliminary evidence that a complex motor task for the non-dominant hand is a useful probe of putamen function in this disorder.

Putamen coactivation during motor task execution.

Models of corticostriatal motor circuitry have focused on the role of the circuit in the hemisphere of the motor cortex providing primary control (contralateral to the movement). We used functional magnetic resonance imaging and functional connectivity analyses to study circuit function in both the controlling and noncontrolling hemispheres. During the completion of a unilateral motor task with either hand, each putamen nucleus demonstrated strong coactivation with structures in both hemispheres. The putamen in the noncontrolling hemisphere (ipsilateral to the movement) coactivated more strongly with the controlling motor cortex than with the noncontrolling cortex. These findings suggest that the two corticostriatal circuits are functionally integrated. New circuit models based on functional connectivity may need to be developed.

Motor deactivation in the human cortex and basal ganglia.

We used a functional magnetic resonance imaging motor activation paradigm for both hands and functional connectivity analyses to investigate motor deactivation. These analyses revealed ipsilateral (to the task) postcentral gyrus connectivity with the ipsilateral primary motor cortex as well as contralateral cerebellum for both hands. Analyses using default-mode network nodes as seed regions revealed connectivity patterns similar to previous studies of the default network and therefore provide evidence that this network is demonstrable using a synchronized motor activation paradigm. We did not find evidence suggesting that motor deactivation represents modulation of the default mode network. Therefore, motor deactivation is likely a motor-specific process. Finally, we found no evidence of basal ganglia circuit deactivation, which suggests that the two-pathway hypothesis of frontal-subcortical circuit function may be incomplete.

Clinical characteristics and health service use of veterans with comorbid bipolar disorder and PTSD.

OBJECTIVE: This study aimed to increase the understanding of the clinical characteristics and utilization of health services among veterans with comorbid bipolar disorder and posttraumatic stress disorder (PTSD). METHODS: A retrospective chart review was conducted that examined the clinical and health service use data of 139 male veterans with bipolar disorder (N=49), PTSD (N=49), or comorbid bipolar disorder and PTSD (N=41) who obtained services over two years from the Department of Veterans Affairs Salt Lake City Health Care System. RESULTS: Compared with patients with bipolar disorder or those with PTSD alone, those with both conditions had significantly higher mean Clinical Global Impression-Severity scores and required more frequent inpatient psychiatric treatment. Patients with both conditions and those with bipolar disorder were significantly less likely to have received psychotherapy and antidepressant pharmacotherapy than patients with PTSD. CONCLUSIONS: Patients with both conditions have a more severe illness course than those with bipolar disorder alone. Psychotherapy and antidepressant pharmacotherapy may be underutilized among patients with comorbid bipolar disorder and PTSD.