Faculty Bibliography

The Covid-19 pandemic upended the country, with enormous economic and social shifts. Given the increased contact from families living in virtual confinement coupled with massive economic disarray, the Covid-19 pandemic may have created the ideal conditions to witness a rise in children's experience of abuse and neglect. Yet such a rise will be difficult to calculate given the drop in official mechanisms to track its incidence. The current investigation utilized two studies conducted early in the pandemic to evaluate maltreatment risk. In the first cross-sectional study, parents (n = 405) reported increased physical and verbal conflict and neglect which were associated with their perceived stress and loneliness. In the second study, parents (n = 106) enrolled in a longitudinal study reported increased parent-child conflict, which was associated with concurrent child abuse risk, with several links to employment loss, food insecurity, and loneliness; findings also demonstrated increases in abuse risk and psychological aggression relative to pre-pandemic levels. Findings are discussed in the context of a reactive welfare system rather than a pro-active public-health oriented approach to child maltreatment, connecting with families through multiple avenues. Innovative approaches will be needed to reach children faced with maltreatment to gauge its scope and impact in the pandemic's aftermath.

Infants who experience sensitive caregiving are at lower risk for numerous adverse outcomes. This is especially true for infants born preterm, leading them to be more susceptible to risks associated with poorer quality caregiving. Some research suggests that preterm and full-term infants differ on temperament, which may contribute to these findings. This study aimed to investigate associations between infant temperament (negative emotionality, positive affectivity/surgency, and orienting/regulatory capacity) and maternal sensitivity among infants born preterm (M = 30.2 weeks) and full term. It was hypothesized that mothers of infants born preterm and mothers of infants with more difficult temperaments would display lower sensitivity, indicated by lower responsiveness to nondistress, lower positive regard, and higher intrusiveness. Videotaped play interactions and a measure of temperament (Infant Behavior Questionnaire) were coded for 18 preterm and 44 full-term infants at 9 months (corrected) age. Results suggest that mothers of preterm and full-term infants differed significantly in responding to their infants, but these results cannot be explained by infant temperament. Preterm status and sociodemographic risk emerged as correlates of maternal behavior, such that mothers of infants born preterm and mothers with greater sociodemographic risk displayed lower levels of maternal sensitivity.

Glutamatergic hilar mossy cells (MCs) have axons that terminate both near and far from their cell body but stay within the DG, making synapses primarily in the molecular layer. The long-range axons are considered the primary projection, and extend throughout the DG ipsilateral to the soma, and project to the contralateral DG. The specificity of MC axons for the inner molecular layer (IML) has been considered to be a key characteristic of the DG. In the present study, we made the surprising finding that dorsal MC axons are an exception to this rule. We used two mouse lines that allow for Cre-dependent viral labeling of MCs and their axons: dopamine receptor D2 (Drd2-Cre) and calcitonin receptor-like receptor (Crlr-Cre). A single viral injection into the dorsal DG to label dorsal MCs resulted in labeling of MC axons in both the IML and middle molecular layer (MML). Interestingly, this broad termination of dorsal MC axons occurred throughout the septotemporal DG. In contrast, long-range axons of ventral MCs terminated in the IML, consistent with the literature. Taken together, these results suggest that dorsal and ventral MCs differ significantly in their axonal projections. Since MC projections in the ML are thought to terminate primarily on GCs, the results suggest a dorsal-ventral difference in MC activation of GCs. The surprising difference in dorsal and ventral MC projections should therefore be considered when evaluating dorsal-ventral differences in DG function.

BACKGROUND:Deep transcranial magnetic stimulation (dTMS) with the H7-coil was FDA cleared for obsessive-compulsive disorder (OCD) in August 2018 based on multicenter sham-controlled studies. Here we look at the efficacy of dTMS for OCD in real world practices. METHODS:All dTMS clinics were asked to supply their data on treatment details and outcome measures. The primary outcome measure was response, defined by at least a 30% reduction in the Yale Brown Obsessive Compulsive Scale (YBOCS) score from baseline to endpoint. Secondary outcome measures included first response, defined as the first time the YBOCS score has met response criteria, and at least one-month sustained response. Analyses included response rate at the endpoint (after 29 dTMS sessions), number of sessions and days required to reach first response and sustained response. RESULTS:Twenty-two clinical sites with H7-coils provided data on details of treatment and outcome (YBOCS) measures from a total of 219 patients. One-hundred-sixty-seven patients who had at least one post-baseline YBOCS measure were included in the main analyses. Overall first and sustained response rates were 72.6% and 52.4%, respectively. The response rate was 57.9% in patients who had YBOCS scores after 29 dTMS sessions. First response was achieved in average after 18.5 sessions (SD = 9.4) or 31.6 days (SD = 25.2). Onset of sustained one-month response was achieved in average after 20 sessions (SD = 9.8) or 32.1 days (SD = 20.5). Average YBOCS scores demonstrated continuous reduction with increasing numbers of dTMS sessions. CONCLUSIONS:In real-world clinical practice, the majority of OCD patients benefitted from dTMS, and the onset of improvement usually occurs within 20 sessions. Extending the treatment course beyond 29 sessions results in continued reduction of OCD symptoms, raising the prospect of value for extended treatment protocols in non-responders.

BACKGROUND:This study examined trauma screening and behavioral health linkage rates in school-based health centers (SBHCs). METHODS:Participants included 4161 English- and Spanish-speaking patients between the ages of 12 and 22 across 8 urban SBHCs 2 years. Screening rates at medical visits and linkage to additional behavioral health screening and services were assessed via electronic medical records and a chart audit. RESULTS:Medical providers administered the Primary Care-PTSD screen to 66.3% of patients in year 1 and 46.7% of patients in year 2. Rates of positive trauma screens were 27.5% and 32.1%, respectively, with more girls screening positive than boys. Few (year 1; 8.1%; year 2: 9.6%) adolescents received additional trauma screening by a behavioral health clinician. However, the majority were linked to services (year 1: 66%; year 2: 74%). Lack of documentation (year 1: 24%; year 2: 33%) was a common gap in the charts of patients who did not receive a second stage trauma screening. Demographic differences in screening rates were minimal. CONCLUSION/CONCLUSIONS:The current study supports the feasibility of traumatic stress screening and linkage within an integrated care setting. Process improvement efforts should, however, address communication gaps around trauma assessment and its integration into ongoing care.

The everyday world is populated with artifacts that require specific motor actions to use objects as their designers intended. But researchers know little about how children learn to use everyday artifacts. We encouraged forty-four 12- to 60-month-old children to unzip a vinyl pouch during a single 60-s trial. Although unzipping a pouch may seem simple, it is not. Unzipping requires precise role-differentiated bimanual actions-one hand must stabilize the pouch while the other hand applies a pulling force on the tab. Moreover, kinematic data from six adults showed that the tolerance limits for applying the forces are relatively narrow (pulling the tab within 63° of the zipper teeth while stabilizing the pouch within 4 cm of the slider). Children showed an age-related progression for the unzipping action. The youngest children did not display the designed pulling action; children at intermediate ages pulled the tab but applied forces outside the tolerance limits (pulled in the wrong direction, failed to stabilize the pouch in the correct location), and the oldest children successfully implemented the designed action. Findings highlight the perceptual-motor requirements in children's discovery and implementation of the hidden affordances of everyday artifacts.

Trait impulsivity is a multifaceted personality characteristic that contributes to maladaptive life outcomes. Although a growing body of neuroimaging studies have investigated the structural correlates of trait impulsivity, the findings remain highly inconsistent and heterogeneous. Herein, we performed a systematic review to depict an integrated delineation of gray matter (GM) substrates of trait impulsivity and a meta-analysis to examine concurrence across previous whole-brain voxel-based morphometry studies. The systematic review summarized the diverse findings in GM morphometry in the past literature, and the quantitative meta-analysis revealed impulsivity-related volumetric GM alterations in prefrontal, temporal, and parietal cortices. In addition, we identified the modulatory effects of age and gender in impulsivity-GM volume associations. The present study advances understanding of brain GM morphometry features underlying trait impulsivity. The findings may have practical implications in the clinical diagnosis of and intervention for impulsivity-related disorders.

Cerebrovascular reactivity (CVR) is of great significance for the treatment and prevention of cerebrovascular diseases. CVR can be mapped using the blood oxygenation level-dependent (BOLD) signal of fMRI. Breath holding (BH) is a reliable method to produce the desired increase in arterial CO₂, while its application in clinical research is limited due to subject's compliance and variability. BH task with variable respiratory rates could allow more flexibility in clinical populations. In this study, 50 healthy volunteers were scanned for end-inspiration BH tasks with three different respiration rates. For the three respiratory rates BH tasks, the CVR was estimated based on the BOLD signal and general linear model (GLM) separately. Specifically, the extra time delay was considered for the hemodynamic response function, and the optimal delay was estimated for each voxel. To measure CVR in grey matter, BOLD signals of end-inspiration BH were used as regressors in general linear models to quantify their impact on CVR. This was performed for regions and voxels. Systematic differences were observed between the three end-inspiratory breathing rates. The greatest increase in activation intensity was found in fast breathing followed by self-paced and slow breathing. We conclude that the BH task of variable respiratory rates allows for CVR measurement, making breath-holding challenges more flexible and appropriate for routine practice.

Interval timing, the ability to encode and retrieve the memory of intervals from seconds to minutes, guides fundamental animal behaviors across the phylogenetic tree. In Pavlovian fear conditioning, an initially neutral stimulus (conditioned stimulus, CS) predicts the arrival of an aversive unconditioned stimulus (US, generally a mild foot-shock) at a fixed time interval. Although some studies showed that temporal relations between CS and US events are learned from the outset of conditioning, the question of the memory of time and its underlying neural network in fear conditioning is still poorly understood. The aim of the present study was to investigate the role of the dorsal striatum in timing intervals in odor fear conditioning in male rats. To assess the animal's interval timing ability in this paradigm, we used the respiratory frequency. This enabled us to detect the emergence of temporal patterns related to the odor-shock time interval from the early stage of learning, confirming that rats are able to encode the odor-shock time interval after few training trials. We carried out reversible inactivation of the dorsal striatum before the acquisition session and before a shift in the learned time interval, and measured the effects of this treatment on the temporal pattern of the respiratory rate. In addition, using intracerebral microdialysis, we monitored extracellular dopamine level in the dorsal striatum throughout odor-shock conditioning and in response to a shift of the odor-shock time interval. Contrary to our initial predictions based on the existing literature on interval timing, we found evidence suggesting that transient inactivation of the dorsal striatum may favor a more precocious buildup of the respiratory frequency's temporal pattern during the odor-shock interval in a manner that reflected the duration of the interval. Our data further suggest that the conditioning and the learning of a novel time interval were associated with a decrease in dopamine level in the dorsal striatum, but not in the nucleus accumbens. These findings prompt a reassessment of the role of the striatum and striatal dopamine in interval timing, at least when considering Pavlovian aversive conditioning.