Faculty Bibliography

BACKGROUND:Children born very preterm (VPT) are at high risk for attention problems. This study's purpose was to describe the Conners Kiddie Continuous Performance Test (K-CPT) assessment in children born VPT, including rates of clinically elevated scores, change over time, and associations between K-CPT scores and parent reported attention problems. METHODS:We studied 305 children from a multi-site study of children born VPT who completed at least one K-CPT assessment at age 5, 6, and/or 7 years. Parent-reported ADHD symptoms and diagnosis were also collected. We calculated K-CPT completion rates, mean scores, and rates of clinically elevated scores at each timepoint. Linear mixed models examined change over time in K-CPT scores. Correlations and generalized linear models investigated associations between K-CPT scores and ADHD symptoms and diagnoses. RESULTS:K-CPT scores showed expected age-related improvements from age 5-7, with significant intra- and inter-individual variability. Up to 1/3 of children had clinically elevated attention problems and another 1/3 had subclinical elevations. K-CPT scores were modestly correlated with parent-rated ADHD symptoms and children with a parent-reported ADHD diagnosis performed worse on nearly all K-CPT metrics. CONCLUSION/CONCLUSIONS:Performance-based measures like the K-CPT can be useful for research and clinical practice in VPT populations. IMPACT/CONCLUSIONS:Attention problems are a specific area of weakness for children born very preterm. Performance-based tests of attention have benefits and drawbacks compared to parent report measures yet are understudied in this population. We examined one performance-based measure (the Conners Kiddie Continuous Performance Test [K-CPT]) in 305 children born very preterm. We observed improving task scores from age 5-7 years with significant intra- and inter-individual variability, a sizable proportion of children with clinically and subclinically elevated scores, and modest associations between K-CPT scores and parent reported attention problems. The K-CPT could be a useful clinical and research tool in this population.

We often exert greater cognitive resources (i.e., listening effort) to understand speech under challenging acoustic conditions. This mechanism can be overwhelmed in those with hearing loss, resulting in cognitive fatigue in adults and potentially impeding language acquisition in children. However, the neural mechanisms that support listening effort are uncertain. Evidence from human studies suggests that the cingulate cortex is engaged under difficult listening conditions and may exert top-down modulation of the auditory cortex (AC). Here, we asked whether the gerbil cingulate cortex (Cg) sends anatomical projections to the AC that facilitate perceptual performance. To model challenging listening conditions, we used a sound discrimination task in which stimulus parameters were presented in either "Easy" or "Hard" blocks (i.e., long or short stimulus duration, respectively). Gerbils achieved statistically identical psychometric performance in Easy and Hard blocks. Anatomical tracing experiments revealed a strong, descending projection from layer 2/3 of the Cg1 subregion of the cingulate cortex to superficial and deep layers of the primary and dorsal AC. To determine whether Cg improves task performance under challenging conditions, we bilaterally infused muscimol to inactivate Cg1 and found that psychometric thresholds were degraded for only Hard blocks. To test whether the Cg-to-AC projection facilitates task performance, we chemogenetically inactivated these inputs and found that performance was only degraded during Hard blocks. Taken together, the results reveal a descending cortical pathway that facilitates perceptual performance during challenging listening conditions.

PURPOSE/UNASSIGNED:Urine calcium excretion is greater after dinner and urine volumes are lower. The result is higher urine calcium concentrations, which may confer greater risk of stone formation, at night. We considered whether night-time administration - as compared with daytime administration - of thiazides would be more effective for stone prevention. MATERIALS AND METHODS/UNASSIGNED:We performed 12-hour urine collections in 7 patients taking 25 mg of chlorthalidone (CTD) and 10 patients taking 25 mg of hydrochlorothiazide (HCTZ). Participants completed urine collections at baseline, again after a week of morning medication administration, and again after a week of evening administration, all on repeated self-selected diets. RESULTS/UNASSIGNED:Chlorthalidone reduced urine calcium excretion for both 12-hour periods whether administered in the morning or in the evening: morning dosing lowered urine calcium from 130±70 mg/gram Cr at baseline, to 76±52 mg/gram Cr (P<0.02); evening dosing lowered it to 87±51 mg/gram Cr, which was not significant. On the other hand, HCTZ did not reduce urine calcium excretion regardless of the time of administration: mean 24-hour urine calcium excretion (UCa) was 124±38 mg/gram Cr at baseline and 106±40 mg/gram Cr when HCTZ was given in AM, and 117±54 mg/gram Cr when given in PM. CONCLUSION/UNASSIGNED:We conclude that the long-acting and more effective CTD is a preferable agent for stone prevention. Time of administration does not appear to be important, although morning administration may more effectively address higher post-dinner calcium excretion. The most commonly used thiazide (HCTZ) is shorter acting, frequently dosed once per day, but does not appear to reduce urine calcium excretion at this dose.

OBJECTIVES/OBJECTIVE:Magnetization-prepared rapid gradient-echo (MP-RAGE) sequences are routinely acquired for brain exams, providing high conspicuity for enhancing lesions. Vessels, however, also appear bright, which can complicate the detection of small lesions. T1RESS (T1 relaxation-enhanced steady-state) sequences have been proposed as an alternative to MP-RAGE, offering improved lesion conspicuity and suppression of blood vessels. This work aims to evaluate the performance of radial T1RESS variants for motion-robust contrast-enhanced brain MRI. MATERIALS AND METHODS/METHODS:Radial stack-of-stars sampling was implemented for steady-state free-precession-based rapid T1RESS acquisition with saturation recovery preparation. Three variants were developed using a balanced steady-state free-precession readout (bT1RESS), an unbalanced fast imaging steady precession (FISP) readout (uT1RESS-FISP), and an unbalanced reversed FISP readout (uT1RESS-PSIF). Image contrast was evaluated in numerical simulations and phantom experiments. The motion robustness of radial T1RESS was demonstrated with a motion phantom. Four patients and six healthy volunteers were scanned at 3 T and 0.55 T. Extensions were developed combining T1RESS with GRASP for dynamic imaging, with GRAPPA for accelerated scans, and with Dixon for fat/water separation. RESULTS:In simulations and phantom scans, uT1RESS-FISP provided higher signal intensity for regions with lower T1 values (<500 ms) compared with MP-RAGE. In motion experiments, radial uT1RESS-FISP showed fewer artifacts than MP-RAGE and Cartesian uT1RESS-FISP. In patients, both unbalanced uT1RESS variants provided higher lesion conspicuity than MP-RAGE. Blood vessels appeared bright with MP-RAGE, gray with uT1RESS-FISP, and dark with uT1RESS-PSIF. At 0.55 T, bT1RESS provided high signal-to-noise ratio T1-weighted images without banding artifacts. Lastly, dynamic T1RESS images with a temporal resolution of 10.14 seconds/frame were generated using the GRASP algorithm. CONCLUSIONS:Radial T1RESS sequences offer improved lesion conspicuity and motion robustness and enable dynamic imaging for contrast-enhanced brain MRI. Both uT1RESS variants showed higher tumor-to-brain contrast than MP-RAGE and may find application as alternative techniques for imaging uncooperative patients with small brain lesions.

Most offspring are born helpless, requiring intense caregiving from parents especially during the first few days of neonatal life. For many species, infant cries are a primary signal used by parents to provide caregiving. Previously we and others documented how maternal left auditory cortex rapidly becomes sensitized to pup calls over hours of parental experience, enabled by oxytocin. The speed and robustness of this maternal plasticity suggests cortical pre-tuning or initial bias for pup call stimulus features. Here we examine the circuit basis of left-lateralized tuning to vocalization features with whole-cell recordings in brain slices. We found that layer 2/3 pyramidal cells of female left auditory cortex show selective suppression of inhibitory inputs with repeated stimulation at the fundamental pup call rate (inter-stimulus interval ∼150 msec) in pup-naïve females and expanded with maternal experience. However, optogenetic stimulation of cortical inhibitory cells showed that inputs from somatostatin-positive and oxytocin-receptor-expressing interneurons were less suppressed at these rates. This suggested that disynaptic inhibition rather than monosynaptic depression was a major mechanism underlying pre-tuning of cortical excitatory neurons, confirmed with simulations. Thus cortical interneuron specializations can augment neuroplasticity mechanisms to ensure fast appropriate caregiving in response to infant cries.

High-density microelectrode arrays have opened new possibilities for systems neuroscience, but brain motion relative to the array poses challenges for downstream analyses. We introduce DREDge (Decentralized Registration of Electrophysiology Data), a robust algorithm for the registration of noisy, nonstationary extracellular electrophysiology recordings. In addition to estimating motion from action potential data, DREDge enables automated, high-temporal-resolution motion tracking in local field potential data. In human intraoperative recordings, DREDge's local field potential-based tracking reliably recovered evoked potentials and single-unit spike sorting. In recordings of deep probe insertions in nonhuman primates, DREDge tracked motion across centimeters of tissue and several brain regions while mapping single-unit electrophysiological features. DREDge reliably improved motion correction in acute mouse recordings, especially in those made with a recent ultrahigh-density probe. Applying DREDge to recordings from chronic implantations in mice yielded stable motion tracking despite changes in neural activity between experimental sessions. These advances enable automated, scalable registration of electrophysiological data across species, probes and drift types, providing a foundation for downstream analyses of these rich datasets.

Our brains integrate sensory, cognitive and internal state information with memories to extract behavioral relevance. Cortico-hippocampal interactions likely mediate this interplay, but underlying circuit mechanisms remain elusive. Unlike the entorhinal cortex-to-hippocampus pathway, we know little about the organization and function of the hippocampus-to-cortex feedback circuit. Here we report in mice, two functionally distinct parallel hippocampus-to-entorhinal cortex feedback pathways: the canonical disynaptic route via layer 5 and a novel monosynaptic input to layer 2/3. Circuit mapping reveals that hippocampal input predominantly drives excitation in layer 5 but feed-forward inhibition in layer 2/3. Upon repetitive pairing with cortical layer 1 inputs, hippocampal inputs undergo homosynaptic potentiation in layer 5, but induce heterosynaptic plasticity and spike output in layer 2/3. Behaviorally, hippocampal inputs to layer 5 and layer 2/3 support object memory encoding versus recall, respectively. Two-photon imaging during navigation reveals hippocampal suppression reduces spatially tuned cortical axonal activity. We present a model, where hippocampal feedback could iteratively shape ongoing cortical processing.