James H. Fallon

Reproducibility of Quantitative Tractography Methods Applied to Cerebral White Matter

Tractography based on diffusion tensor imaging (DTI) allows visualization of white matter tracts. In this study, protocols to reconstruct eleven major white matter tracts are described. The protocols were refined by several iterations of intra- and inter-rater measurements and identification of sources of variability. Reproducibility of the established protocols was then tested by raters who did not have previous experience in tractography. The protocols were applied to a DTI database of adult normal subjects to study size, fractional anisotropy (FA), and T2 of individual white matter tracts. Distinctive features in FA and T2 were found for the corticospinal tract and callosal fibers. Hemispheric asymmetry was observed for the size of white matter tracts projecting to the temporal lobe. This protocol provides guidelines for reproducible DTI-based tract-specific quantification.

Fluoro-gold: a new fluorescent retrograde axonal tracer with numerous unique properties

A new fluorescent dye, Fluoro-Gold, has been demonstrated to undergo retrograde axonal transport. Its properties include intense fluorescence, extensive filling of dendrites, high resistance to fading, no uptake by intact undamaged fibers of passage, no diffusion from labeled cells, consistent and pure commercial source, wide latitude of survival times and compatibility with all other tested neuro-histochemical techniques.

A phase 1 clinical trial of nerve growth factor gene therapy for Alzheimer disease

Cholinergic neuron loss is a cardinal feature of Alzheimer disease. Nerve growth factor (NGF) stimulates cholinergic function, improves memory and prevents cholinergic degeneration in animal models of injury, amyloid overexpression and aging. We performed a phase 1 trial of ex vivo NGF gene delivery in eight individuals with mild Alzheimer disease, implanting autologous fibroblasts genetically modified to express human NGF into the forebrain. After mean follow-up of 22 months in six subjects, no long-term adverse effects of NGF occurred. Evaluation of the Mini-Mental Status Examination and Alzheimer Disease Assessment Scale-Cognitive subcomponent suggested improvement in the rate of cognitive decline. Serial PET scans showed significant (P < 0.05) increases in cortical 18-fluorodeoxyglucose after treatment. Brain autopsy from one subject suggested robust growth responses to NGF. Additional clinical trials of NGF for Alzheimer disease are warranted.

MRI white matter diffusion anisotropy and PET metabolic rate in schizophrenia

A disturbance in the frontal–striatal–thalamic circuitry has been proposed for schizophrenia, but this concept has been based primarily on indirect evidence from psychopharmacology and analogies with animal research. Diffusion tensor imaging, a new MRI technique that permits direct assessment of the large axon masses stretching from the prefrontal cortex to the striatum, was used to study white matter axon bundles. Diffusion tensor images, high-resolution structural MRI and positron emission tomography scans with 18-fluorodexoyglucose were obtained on five patients with schizophrenia and six age- and sex-matched normal controls. Significantly lower diffusion anisotropy in the white matter of the prefrontal cortex in schizophrenic patients than in normal controls was observed in statistical probability maps. Co-registered PET scans revealed significantly lower correlation coefficients between metabolic rates in the prefrontal cortex and striatum in patients than in controls. These twin findings provide convergent evidence for diminished fronto–striatal connectivity in schizophrenia.

Hippocampal Atrophy as a Quantitative Trait in a Genome-Wide Association Study Identifying Novel Susceptibility Genes for Alzheimer's Disease

Background With the exception of APOE ε4 allele, the common genetic risk factors for sporadic Alzheimers Disease (AD) are unknown. Methods and Findings We completed a genome-wide association study on 381 participants in the ADNI (Alzheimers Disease Neuroimaging Initiative) study. Samples were genotyped using the Illumina Human610-Quad BeadChip. 516,645 unique Single Nucleotide Polymorphisms (SNPs) were included in the analysis following quality control measures. The genotype data and raw genetic data are freely available for download (LONI, http://www.loni.ucla.edu/ADNI/Data/). Two analyses were completed: a standard case-control analysis, and a novel approach using hippocampal atrophy measured on MRI as an objectively defined, quantitative phenotype. A General Linear Model was applied to identify SNPs for which there was an interaction between the genotype and diagnosis on the quantitative trait. The case-control analysis identified APOE and a new risk gene, TOMM40 (translocase of outer mitochondrial membrane 40), at a genome-wide significance level of≤10−6 (10−11 for a haplotype). TOMM40 risk alleles were approximately twice as frequent in AD subjects as controls. The quantitative trait analysis identified 21 genes or chromosomal areas with at least one SNP with a p-value≤10−6, which can be considered potential “new” candidate loci to explore in the etiology of sporadic AD. These candidates included EFNA5, CAND1, MAGI2, ARSB, and PRUNE2, genes involved in the regulation of protein degradation, apoptosis, neuronal loss and neurodevelopment. Thus, we identified common genetic variants associated with the increased risk of developing AD in the ADNI cohort, and present publicly available genome-wide data. Supportive evidence based on case-control studies and biological plausibility by gene annotation is provided. Currently no available sample with both imaging and genetic data is available for replication. Conclusions Using hippocampal atrophy as a quantitative phenotype in a genome-wide scan, we have identified candidate risk genes for sporadic Alzheimers disease that merit further investigation.

Functional Brain Imaging during Anesthesia in Humans Effects of Halothane on Global and Regional Cerebral Glucose Metabolism

BACKGROUND Propofol and isoflurane anesthesia were studied previously with functional brain imaging in humans to begin identifying key brain areas involved with mediating anesthetic-induced unconsciousness. The authors describe an additional positron emission tomography study of halothanes in vivo cerebral metabolic effects. METHODS Five male volunteers each underwent two positron emission tomography scans. One scan assessed awake-baseline metabolism, and the other scan assessed metabolism during halothane anesthesia titrated to the point of unresponsiveness (mean +/- SD, expired = 0.7+/-0.2%). Scans were obtained using a GE2048 scanner and the F-18 fluorodeoxyglucose technique. Regions of interest were analyzed for changes in both absolute and relative glucose metabolism. In addition, relative changes in metabolism were evaluated using statistical parametric mapping. RESULTS Awake whole-brain metabolism averaged 6.3+/-1.2 mg x 100 g(-1) x min(-1) (mean +/- SD). Halothane reduced metabolism 40+/-9% to 3.7+/-0.6 mg x 100 g(-1) x min(-1) (P< or =0.005). Regional metabolism did not increase in any brain areas for any volunteer. The statistical parametric mapping analysis revealed significantly less relative metabolism in the basal forebrain, thalamus, limbic system, cerebellum, and occiput during halothane anesthesia. CONCLUSIONS Halothane caused a global whole-brain metabolic reduction with significant shifts in regional metabolism. Comparisons with previous studies reveal similar absolute and relative metabolic effects for halothane and isoflurane. Propofol, however, was associated with larger absolute metabolic reductions, suppression of relative cortical metabolism more than either inhalational agent, and significantly less suppression of relative basal ganglia and midbrain metabolism.

A Genome-Wide Association Study of Schizophrenia Using Brain Activation as a Quantitative Phenotype

BACKGROUND Genome-wide association studies (GWASs) are increasingly used to identify risk genes for complex illnesses including schizophrenia. These studies may require thousands of subjects to obtain sufficient power. We present an alternative strategy with increased statistical power over a case-control study that uses brain imaging as a quantitative trait (QT) in the context of a GWAS in schizophrenia. METHODS Sixty-four subjects with chronic schizophrenia and 74 matched controls were recruited from the Functional Biomedical Informatics Research Network (FBIRN) consortium. Subjects were genotyped using the Illumina HumanHap300 BeadArray and were scanned while performing a Sternberg Item Recognition Paradigm in which they learned and then recognized target sets of digits in an functional magnetic resonance imaging protocol. The QT was the mean blood oxygen level-dependent signal in the dorsolateral prefrontal cortex during the probe condition for a memory load of 3 items. RESULTS Three genes or chromosomal regions were identified by having 2 single-nucleotide polymorphisms (SNPs) each significant at P < 10(-6) for the interaction between the imaging QT and the diagnosis (ROBO1-ROBO2, TNIK, and CTXN3-SLC12A2). Three other genes had a significant SNP at <10(-6) (POU3F2, TRAF, and GPC1). Together, these 6 genes/regions identified pathways involved in neurodevelopment and response to stress. CONCLUSION Combining imaging and genetic data from a GWAS identified genes related to forebrain development and stress response, already implicated in schizophrenic dysfunction, as affecting prefrontal efficiency. Although the identified genes require confirmation in an independent sample, our approach is a screening method over the whole genome to identify novel SNPs related to risk for schizophrenia.

Monoamine innervation of the forebrain: Collateralization

The forebrain is characterized by a dense, localized dopamine (DA) innervation pattern, a diffuse, widespread norepinephrine (NE) innervation pattern, and a serotonin (5-HT) innervation intermediate between the DA and NE patterns. These innervation patterns have implied that basic differences exist in the way DA, NE and 5-HT axons collateralize to different brain structures; that is, DA axons are thought to be poorly collateralized and NE and 5-HT axons are presumed to be more highly collateralized. In the present study, we used injections of retrograde labeling fluorescent dyes into various forebrain regions in order to determine axonal branching patterns from nuclei that contain DA, NE and 5-HT neurons, namely the substantia nigra-ventral tegmental area (SN-VTA), locus coeruleus (LC) and raphe nuclei (DR-MR). The results suggest that at least two subpopulations of neurons can be defined in each monoamine nucleus with respect to the way their axons collateralize. Each area contains a centrally located nuclear area with highly collateralized neurons, and more peripherally situated areas with less highly collateralized neurons. Thus, previous suppositions of the branching of monoamine axons must be revised to account for the existence of cells exhibiting totally different collateralization patterns within each monoamine nucleus.

Monoamine Innervation of Cerebral Cortex and a Theory of the Role of Monoamines in Cerebral Cortex and Basal Ganglia

The historical development of interest in the monoamine innervation of cerebral cortex is highlighted by several key discoveries that have changed our perspectives on cortical function specifically, and brain function in general. The dogma until the early 1960s was that the cortex receives input directly from the thalamus but not from the brain stem. Thus, ascending sensory and nonspecific “activating” neural activity generated in the brain stem was thought to have an obligatory synaptic relay in the thalamus before being sent on to cerebral cortex (Moruzzi and Magoun, 1949; Lorente de No, 1949, Scheibel and Scheibel, 1958; Nauta and Kuypers, 1958). In the early 1960s the fluorescence technique for the visualization of monoamines (Falck et al. 1962) led to the discovery that monoamine cell bodies are present in the brain-stem reticular formation and monoamine fibers are present in cerebral cortex (Dahlstrom and Fuxe, 1964; Fuxe, 1965). Anden et al. (1965), therefore, postulated that these brain-stem norepinephrine-and serotonin-containing neurons in the reticular formation give rise to a direct innervation of cerebral cortex. Moore and Heller (1967) were later able to show biochemically that lesions of the medial forebrain bundle, which contains the ascending monoamine fibers, led to a decrease of serotonin and norepinephrine in cortex. However, because such lesions failed to produce visibly degenerating axons in cortex with silver degeneration methods, it was not clear if the decrease of cortical monoamines was merely a result of a transsynaptic effect induced by the lesions.

Locus coeruleus projections to cortex: Topography, morphology and collateralization

The relationship between individual cells of origin within the nucleus locus coeruleus (LC) and the geometry and distribution of terminal fields in cortex was examined in the albino rat. Computer-assisted 3-dimensional reconstructions of the Nissl-stained LC allowed the characterization of the spatial distribution of LC cells. Similar reconstructions of the distributions of labelled cells following cortical injections of horseradish peroxidase were created. Comparisons of such reconstructions revealed that LC cells projecting to cortex were distributed throughout the compact dorsal LC. These cells were predominantly medium sized multipolar cells. Significant labelling of other morphological sub-populations of LC did not occur following cortical injections. Simultaneous injections of multiple fluorescent retrograde tracers into different cortical regions allowed the characterization of LC axon collateralization in cortex. Individual LC cells innervate functionally and cytoarchitectonically distinct cortical regions simultaneously. LC cells arborize more extensively in the anterior-to-posterior axis of cortex and exhibit relatively minimal medial-to-lateral collateralization. Individual LC cells were also shown to innervate both superficial and deep layers of a cortical region.