The Brain Connectome for Clinical Neuroscience.

In this chapter, we introduce the topic of the brain connectome, consisting of the complete set of both the structural and functional connections of the brain. Connectomic information and the large-scale network architecture of the brain provide an improved understanding of the organization and functional relevance of human cortical and subcortical anatomy. We discuss various analytical methods to both identify and interpret structural and functional connectivity data.

Improvements in Sleep Quality in Patients With Major Depressive and Generalized Anxiety Disorders Treated With Individualized, Parcel-Guided Transcranial Magnetic Stimulation.

Introduction: Poor quality sleep has often been cited as a cause of lowered quality of life in patients with affective disorders such as major depressive disorder (MDD) and generalized anxiety disorder (GAD). As sleep and affective disorders are affected by multi-network interactions, we hypothesize that the modulation of the central executive network (CEN), salience, and default mode networks (DMNs) through individualized repetitive transcranial magnetic stimulation (rTMS) may improve sleep and quality of life.

Methods: A retrospective analysis from 2020 to 2023 was conducted in patients with affective disorders at Cingulum Health.

Discernible interindividual patterns of global efficiency decline during theoretical brain surgery.

The concept of functional localization within the brain and the associated risk of resecting these areas during removal of infiltrating tumors, such as diffuse gliomas, are well established in neurosurgery. Global efficiency (GE) is a graph theory concept that can be used to simulate connectome disruption following tumor resection. Structural connectivity graphs were created from diffusion tractography obtained from the brains of 80 healthy adults.

Application of individual brain connectome in chronic ischemia: mapping symptoms before and after reperfusion.

How brain functions in the distorted ischemic state before and after reperfusion is unclear. It is also uncertain whether there are any indicators within ischemic brain that could predict surgical outcomes. To alleviate these issues, we applied individual brain connectome in chronic steno-occlusive vasculopathy (CSOV) to map both ischemic symptoms and their postbypass changes.

Simpson's Grading Scale for WHO Grade I Meningioma Resection in the Modern Neurosurgical Era: Are We Really Asking the Right Question?

The Simpson grading scale for the classification of the extent of meningioma resection provided a tremendous movement forward in 1957 suggesting increasing the extent of resection improves recurrence rates. However, equal, if not greater, movements forward have been made in the neurosurgical community over the last half a century owing to improvements in neuroimaging capabilities, microsurgical techniques, and radiotherapeutic strategies. Sughrue et al proposed the idea that these advancements have altered what a "recurrence" and "subtotal resection" truly means in modern neurosurgery compared with Simpson's era, and that a mandated use of the Simpson Scale is likely less clinically relevant today.

Functional connectivity in ADHD children doing Go/No-Go tasks: An fMRI systematic review and meta-analysis.

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders diagnosed in childhood. Two common features of ADHD are impaired behavioural inhibition and sustained attention. The Go/No-Go experimental paradigm with concurrent functional magnetic resonance imaging (fMRI) scanning has previously revealed important neurobiological correlates of ADHD such as the supplementary motor area and the prefrontal cortex.

A parcellation-based connectomic model of hemispatial neglect.

Background And Purpose: Hemispatial neglect is characterized by a reduced awareness to stimuli on the contralateral side. Current literature suggesting that damage to the right parietal lobe and attention networks may cause hemispatial neglect is conflicting and can be improved by investigating a connectomic model of the "neglect system" and the anatomical specificity of regions involved in it.

Methods: A meta-analysis of voxel-based morphometry magnetic resonance imaging (MRI) studies of hemispatial neglect was used to identify regions associated with neglect.

Personalized, parcel-guided rTMS for the treatment of major depressive disorder: Safety and proof of concept.

Background: Not all patients with major depressive disorder (MDD) benefit from the US Food and Drug Administration-approved use of repetitive transcranial magnetic stimulation (rTMS) at the dorsolateral prefrontal cortex. We may be undertreating depression with this one-size-fits-all rTMS strategy.

Methods: We present a retrospective review of targeted and connectome-guided rTMS in 26 patients from Cingulum Health from 2020 to 2023 with MDD or MDD with associated symptoms.

Parcellation-Based Connectivity Model of the Judgement Core.

Judgement is a higher-order brain function utilized in the evaluation process of problem solving. However, heterogeneity in the task methodology based on the many definitions of judgement and its expansive and nuanced applications have prevented the identification of a unified cortical model at a level of granularity necessary for clinical translation. Forty-six task-based fMRI studies were used to generate activation-likelihood estimations (ALE) across moral, social, risky, and interpersonal judgement paradigms.

Connectomic insight into unique stroke patient recovery after rTMS treatment.

An improved understanding of the neuroplastic potential of the brain has allowed advancements in neuromodulatory treatments for acute stroke patients. However, there remains a poor understanding of individual differences in treatment-induced recovery. Individualized information on connectivity disturbances may help predict differences in treatment response and recovery phenotypes.

Deconvoluting human Brodmann area 8 based on its unique structural and functional connectivity.

Brodmann area 8 (BA8) is traditionally defined as the prefrontal region of the human cerebrum just anterior to the premotor cortices and enveloping most of the superior frontal gyrus. Early studies have suggested the frontal eye fields are situated at its most caudal aspect, causing many to consider BA8 as primarily an ocular center which controls contralateral gaze and attention. However, years of refinement in cytoarchitectural studies have challenged this traditional anatomical definition, providing a refined definition of its boundaries with neighboring cortical areas and the presence of meaningful subdivisions.

The functional role of the precuneus.

Recent advancements in computational approaches and neuroimaging techniques have refined our understanding of the precuneus. While previously believed to be largely a visual processing region, the importance of the precuneus in complex cognitive functions has been previously less familiar due to a lack of focal lesions in this deeply seated region, but also a poor understanding of its true underlying anatomy. Fortunately, recent studies have revealed significant information on the structural and functional connectivity of this region, and this data has provided a more detailed mechanistic understanding of the importance of the precuneus in healthy and pathologic states.

Functional connectivity of the language area in migraine: a preliminary classification model.

Background: Migraine is a complex disorder characterized by debilitating headaches. Despite its prevalence, its pathophysiology remains unknown, with subsequent gaps in diagnosis and treatment. We combined machine learning with connectivity analysis and applied a whole-brain network approach to identify potential targets for migraine diagnosis and treatment.

Functional connectivity reveals different brain networks underlying the idiopathic foreign accent syndrome.

Foreign accent syndrome (FAS) is characterized by new onset speech that is perceived as foreign. Available data from acquired cases suggests focal brain damage in language and sensorimotor brain networks, but little remains known about abnormal functional connectivity in idiopathic cases of FAS without structural damage. Here, connectomic analyses were completed on three patients with idiopathic FAS to investigate unique functional connectivity abnormalities underlying accent change for the first time.

Real world demonstration of hand motor mapping using the structural connectivity atlas.

Background: Locating the hand-motor-cortex (HMC) is an essential component within many neurosurgeries. Despite advancements in these localization methods there are still downfalls for each. Additionally, the importance of presurgical planning calls for increasingly accurate and efficient methods of locating specific cortical regions.

An agile, data-driven approach for target selection in rTMS therapy for anxiety symptoms: Proof of concept and preliminary data for two novel targets.

Introduction: Data-driven approaches to transcranial magnetic stimulation (TMS) might yield more consistent and symptom-specific results based on individualized functional connectivity analyses compared to previous traditional approaches due to more precise targeting. We provide a proof of concept for an agile target selection paradigm based on using connectomic methods that can be used to detect patient-specific abnormal functional connectivity, guide treatment aimed at the most abnormal regions, and optimize the rapid development of new hypotheses for future study.

Methods: We used the resting-state functional MRI data of 28 patients with medically refractory generalized anxiety disorder to perform agile target selection based on abnormal functional connectivity patterns between the Default Mode Network (DMN) and Central Executive Network (CEN).

Topology of the lateral visual system: The fundus of the superior temporal sulcus and parietal area H connect nonvisual cerebrum to the lateral occipital lobe.

Background And Purpose: Mapping the topology of the visual system is critical for understanding how complex cognitive processes like reading can occur. We aim to describe the connectivity of the visual system to understand how the cerebrum accesses visual information in the lateral occipital lobe.

Methods: Using meta-analytic software focused on task-based functional MRI studies, an activation likelihood estimation (ALE) of the visual network was created.

Symptom-circuit mappings of the schizophrenia connectome.

Objective: This paper aims to model the anatomical circuits underlying schizophrenia symptoms, and to explore patterns of abnormal connectivity among brain networks affected by psychopathology.

Methods: T1 magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), and resting-state functional MRI (rsfMRI) were obtained from a total of 126 patients with schizophrenia who were recruited for the study. The images were processed using the Omniscient software (https://www.

Connectomics underlying motor functional outcomes in the acute period following stroke.

Objective: Stroke remains the number one cause of morbidity in many developing countries, and while effective neurorehabilitation strategies exist, it remains difficult to predict the individual trajectories of patients in the acute period, making personalized therapies difficult. Sophisticated and data-driven methods are necessary to identify markers of functional outcomes.

Methods: Baseline anatomical T1 magnetic resonance imaging (MRI), resting-state functional MRI (rsfMRI), and diffusion weighted scans were obtained from 79 patients following stroke.

Functional connectivity analysis of the depression connectome provides potential markers and targets for transcranial magnetic stimulation.

Background: Despite efforts to improve targeting accuracy of the dorsolateral prefrontal cortex (DLPFC) as a repetitive transcranial magnetic stimulation (rTMS) target for Major Depressive Disorder (MDD), the heterogeneity in clinical response remains unexplained.

Objective: We sought to compare the patterns of functional connectivity from the DLPFC treatment site in patients with MDD who were TMS responders to those who were TMS non-responders.

Methods: Baseline anatomical T1 magnetic resonance imaging (MRI), resting-state functional MRI, and diffusion weighted imaging scans were obtained from 37 participants before they underwent a course of rTMS to left Brodmann area 46.

Delayed, Progressive Multivessel Occlusion After Resection of a Recurrent Glioma.

Glioblastoma multiforme (GBM) is one of the most common primary brain tumors with an aggressive natural history consistent with a median survival of less than two years. Most clinical research has primarily focused on improving overall survival through aggressive cytoreductive surgery and adjuvant radiochemotherapy. However, far less clinical guidance has been given for unexpected instances of neurologic decline following safe glioma resection in the setting of vascular etiology.

Graph Theory Measures and Their Application to Neurosurgical Eloquence.

Improving patient safety and preserving eloquent brain are crucial in neurosurgery. Since there is significant clinical variability in post-operative lesions suffered by patients who undergo surgery in the same areas deemed compensable, there is an unknown degree of inter-individual variability in brain 'eloquence'. Advances in connectomic mapping efforts through diffusion tractography allow for utilization of non-invasive imaging and statistical modeling to graphically represent the brain.