Xinnan Li1, Daisuke Sawamura2, Hiroyuki Hamaguchi1, Yuta Urushibata3, Thorsten Feiweier4, Keita Ogawa5, and Khin Khin Tha1,6
1Department of Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, Sapporo, Japan, 2Department of Functioning and Disability, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan, 3Siemens Healthcare K.K., Tokyo, Japan, 4Siemens Healthcare GmbH, Erlangen, Germany, 5Department of Rehabilitation, Hokkaido University Hospital, Sapporo, Japan, 6Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan
Synopsis
A
four-week neurocognitive training of spatial attention and working memory was
conducted in 21 volunteers. A change in tissue microstructure was tested by
using double diffusion encoding MRI, which revealed a decrease in μFA in the
left middle frontal gyrus. This decrease showed a significant negative
correlation with the changes in the response time as assessed by the orienting
attention network test.
Introduction
Improved
cognitive performance by neurocognitive training has been reported in both
normal and cognitively impaired individuals. This improvement has been thought
of as due to neuroplastic changes1. Structural and functional MRI
techniques are often applied as attempts to visualize these changes
noninvasively and in vivo. So far, functional connectivity (FC) by
resting-state functional MRI (rsfMRI) and fractional anisotropy (FA) by
diffusion tensor imaging (DTI) have shown promising results1-3. Nevertheless, FA extracted by DTI has certain technical issues, such as failure
to resolve fiber crossings.
Double
diffusion encoding (DDE) MRI is a recently developed MRI technique that employs
multiple diffusion encoding schemes to map microscopic diffusion anisotropy
without the conflating effects of orientation dispersion at the voxel scale4.
The superiority of its major index - microscopic fractional anisotropy (μFA), over FA, in detecting age-related
changes has been reported5.
This
prospective study aimed to evaluate if μFA can map the neuroplastic changes
following a four-week neurocognitive training of spatial attention and working
memory.Methods
A local institutional review board approved this
study. Written informed consent was obtained from all participants. Twenty-one
healthy subjects (12 men and 9 women; mean age= 27.7±6.0 years) were
recruited to undergo a 4-week neurocognitive training of spatial attention
(30-minute long attention network training task each day and 5 days/week) and
working memory (another 30-minute dual N-back task each day and 5 days/week)2.
The neurocognitive performance was evaluated twice before and after the
training, using a set of neuropsychological tests. The brain MRI, including DDE
MRI (prototype spin-echo EPI sequence, TR/TE=7000/84 ms, δ=12.2 ms, Δ=13.7 ms,
b=800 s/mm2, number of diffusion directions=72, voxel size=1.5×1.5×4
mm3) and 3D-MPRAGE, was acquired using a 3T scanner (MAGNETOM
Prisma, Siemens Healthcare, Erlangen, Germany) and a 64-channel head coil, at
the timing of neuropsychological tests. Another eight healthy subjects who were
age, gender, and education level-matched to the training group were also
recruited to serve as the control. These subjects also underwent
neuropsychological tests and MRI of the brain twice at an interval of 4-week
but did not receive neurocognitive training. μFA, FA, and ADC maps were calculated from the DDE MRI data, and were
further processed as detailed in Fig 1 to evaluate the training and
time-related changes of these indices. A 2×2 mixed-design ANOVA was used for
this purpose, and statistical significance was set as uncorrected P<0.001
for clusters>50 voxels. Statistically significant voxels, if any, were
tested for correlation with changes in neurocognitive performance. For this
purpose, Pearson’s product moment correlation analyses were used to determine
significance at P<0.05. For all comparisons, age, gender, years of
education, and the cerebrospinal fluid volume were taken as covariates.Results
The 2×2
mixed-design ANOVA revealed training and time-related change in μFA (F(4,50)=5.459, uncorrected P<0.001), which turned out
on post-hoc analysis as a decrease in μFA in the left middle frontal gyrus (53 voxels; MNI coordinates: X=-36,
Y=54, Z=-6) upon the training (Fig 2). FA and ADC did not show any
statistically significant difference (Fig 3). This decrease in μFA showed significant negative correlation with the changes in the
response time as assessed by the orienting attention network test - a neuropsychological test (r=-0.508, P=0.037) (Fig 4).Discussion
Our observation of μFA decrease in the left middle frontal
gyrus upon neurocognitive training is thought to be due to axonal and dendritic
pruning, a neurological regulatory process that facilitates changes in neural
structure by reducing the overall number of neurons and synapses, leaving more
efficient synaptic configurations6. Such pruning is known to occur,
not only in children and adolescence, but also in adults. Lack of change in FA and
ADC may imply that these indices are not as sensitive as μFA to detect these minute changes.
The
left middle frontal gyrus is a part of prefrontal cortex, which plays an
important role in modulation of attention7. Our observation of the
correlation between μFA of this region and the response time
of the orienting attention network test is in agreement with previous reports
which document structure-functional correlation between FA of white matter
tracts and attention network test results8.Conclusions
μFA by DDE MRI can become a sensitive
marker to evaluate neuronal changes due to neurocognitive training.Acknowledgements
This study was
supported by (i) the Global Institution for Collaborative Research and
Education, Hokkaido University, Japan and (ii) the Grant-in-Aid for scientific
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