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Brain Imaging and Behavior

Springer Science and Business Media LLC

Preprints posted in the last 30 days, ranked by how well they match Brain Imaging and Behavior's content profile, based on 14 papers previously published here. The average preprint has a 0.01% match score for this journal, so anything above that is already an above-average fit.

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Regional distribution of white matter hyperintensity burden in coronary artery disease and links with coronary revascularization procedure

Potvin-Jutras, Z.; Tremblay, S. A.; Rezaei, A.; Sanami, S.; Sabra, D.; Intzandt, B.; Wright, L.; Gagnon, C.; Mainville-Berthiaume, A.; Parent, O.; Dadar, M.; Iglesies-Grau, J.; Steele, C. J.; Gayda, M.; Nigam, A.; Bherer, L.; Gauthier, C. J.

2026-05-15 neuroscience 10.64898/2026.05.12.724587 medRxiv
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IntroductionCoronary artery disease (CAD) increases the risk of cerebrovascular events, yet early brain injury in this population remains poorly characterized. White matter hyperintensities (WMHs), a biomarker of cerebrovascular lesions, are prevalent in CAD and are linked to risk of stroke. Beyond total burden, spatial distribution of WMHs carries pathological significance and is critical for understanding CAD-related injury. While clinical outcomes including coronary revascularization procedure and myocardial infarction influence CAD prognosis, their impact on WMH burden remains unclear. MethodsThis study investigated regional WMH burden in CAD and its relationship with clinical characteristics. 82 adults over 50 years participated, including 44 individuals with CAD and 38 controls. WMHs were segmented from fluid attenuated inversion recovery and T1-weighted MRI and categorized as total, periventricular, deep, and superficial regions. History of myocardial infarction and coronary revascularization (coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)), was obtained from medical files. ResultsIndividuals with CAD exhibited higher total, periventricular, and deep WMH volumes than controls. Participants who underwent CABG had higher superficial WMH volumes than those with PCI, suggesting greater disease severity influences WMH burden. ConclusionCAD is characterized by a distinct pattern of cerebrovascular vulnerability, with revascularization procedures influencing WMH burden

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Associations between brain structure and both language proficiency and language balance in early bilinguals

Coutinho, M. R.; Eden, G. F.; Brignoni-Perez, E.; Jamal, N. I.

2026-05-15 neuroscience 10.64898/2026.05.14.725184 medRxiv
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Prior studies in bilinguals have reported relationships between brain structure and the dimensions of (i) language proficiency or (ii) language balance (the discrepancy between a bilinguals two proficiencies), but rarely both, even though they are highly related. These studies were often conducted in late bilinguals and the analyses limited to regions of interest. Here, we tested for relationships between brain structure and these two dimensions in 46 early cultural Spanish-English bilinguals (mean age = 16.7 years) at the level of the whole brain for gray matter volume (GMV) and cortical thickness (CT). Results revealed a positive association between GMV and proficiency in the weaker language in the right angular gyrus (AG; BA 39) extending into the superior temporal gyrus (BA 22). More balanced bilingualism was also associated with more GMV in the AG (BA 39), in addition to less GMV in left postcentral gyrus (BA 1), right cerebellum lobule IX and right superior occipital gyrus (BA 18). However, these relationships between GMV and balance disappeared after controlling for language proficiency. No significant associations were observed for CT and these two dimensions of language. Our findings suggest that relationships between GMV and balance are driven by language proficiency, and that the relationship between GMV and language proficiency likely does not involve language-specific mechanisms, given the location of the association is in the right inferior parietal cortex. Together, this study separates the neuroanatomical bases of these two language dimensions and places them in brain regions outside those usually targeted in prior studies. HighlightsO_LINeuroanatomy was correlated with proficiencies in early Spanish-English bilinguals C_LIO_LIRight angular gyrus gray matter volume (GMV) was positively related to proficiency C_LIO_LIGMV was positively related to balance, but not after controlling for proficiency C_LIO_LIRelations with these language dimensions are located outside of language cortex C_LIO_LINo significant associations were observed for cortical thickness C_LI

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Fronto-limbic and Thalamocortical Network Alterations after COVID-19 Recovery: a Multimodal MRI Study

Mishra, S. S.; Misra, R.; Douaud, G.; Biswal, B.; Gandhi, T.

2026-05-22 radiology and imaging 10.64898/2026.05.19.26353613 medRxiv
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Background: Persistent neurological and cognitive symptoms following SARS-CoV-2 infection point to long-term alterations in brain structure and function. The thalamus, orbitofrontal cortex, and limbic networks are particularly susceptible to inflammatory and neurovascular stressors. However, the relationship between cortical, white-matter, and thalamocortical alterations in post-COVID syndrome remains unclear. Methods: 76 COVID-19 recovered participants (CRPs) and 51 healthy controls (HCs) underwent multimodal MRI comprising T1-weighted structural, diffusion, and resting-state functional acquisitions. Grey-matter morphology was assessed using voxel-based morphometry (VBM), white-matter microstructure using tract-based spatial statistics (TBSS), and thalamocortical functional connectivity (TC-FC) using seed-based analyses from major thalamic nuclei. Results were evaluated both across the groups (HC vs. CRP) and after stratifying CRPs by hospitalisation status (HC vs. Non-hospitalized patients (NHPs) vs. Hospitalized patients (HPs)). Results: No group-level grey-matter differences were observed between HCs and CRPs; however, HPs showed localized volume loss in the orbitofrontal and frontal-pole cortices (pFWE < 0.05). TBSS revealed widespread microstructural abnormalities, including reduced fractional anisotropy and mean diffusivity across association and commissural tracts (pcorr < 0.05), with regional increases in mode of anisotropy indicating selective loss of crossing fibres (pcorr < 0.05). Resting-state analyses revealed increased TC-FC from the mediodorsal thalamic nucleus to anterior cingulate, parietal, and occipital cortices (pcorr < 0.05), while differences in pulvinar and ventrolateral nuclei were not significant (pcorr > 0.05). Conclusions: Our findings indicate that COVID-19 recovery is associated with enduring alterations in fronto-limbic and thalamo-cortical circuits, most prominently in individuals with severe infection. Convergent structural and functional changes involving the orbitofrontal cortex and mediodorsal thalamus suggest network-specific reorganisation that may underpin persistent cognitive and affective symptoms of post-COVID syndrome.

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Are executive function and neuroanatomy in ADHD modulated by bilingualism?

Oak, A.; Gutierrez-Schieferl, I. S.; Eden, G. F.

2026-05-14 neuroscience 10.64898/2026.05.13.724877 medRxiv
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It has been proposed that bilinguals have better executive function (EF) arising from the constant selection of one language while inhibiting the other, and gray matter has been found to differ in bilinguals in regions linked to EF (frontal-parietal and subcortical structures). Attention Deficit Hyperactivity Disorder (ADHD) is associated with poorer EF and neuroanatomical differences underlying EF. Given the EF advantage in bilinguals, we investigated whether a bilingual experience affects EF performance and brain structure differentially in those with ADHD. Using the Adolescent Brain and Cognitive Development Study, we compared early Spanish-English bilinguals and English-speaking monolinguals with and without ADHD. ANOVAs for the Flanker, Working Memory, and Card Sort Tasks revealed no main effects of Language Experience (Bilingual versus Monolingual), a main effect of Diagnostic Group for Card Sort (ADHD worse than Controls), and no interaction effects on performance for any task. ANOVAs for gray matter volume (GMV) revealed a main effect of Language Experience in many regions, a main effect of Diagnostic Group in some regions, but no interactions. GMV in left thalamus was affected by both ADHD and bilingualism, but the effect of ADHD was not significantly diminished or enhanced by the dual-language experience. For cortical thickness, there was a main effect of Language Experience in several regions, no main effect of Diagnostic Group, and no interactions. Taken together, bilingualism has some impact on EF performance, a strong impact on neuroanatomy, but there was no disproportionate impact by bilingualism on the differences caused by ADHD for any measure. Research HighlightsExecutive function and brain structure differ in ADHD and in bilinguals, prompting the need to investigate interactive effects. Bilingualism did not disproportionately affect performance differences in ADHD for executive function, nor for gray matter volume or for cortical thickness differences in ADHD. Gray matter volume was less in ADHD than non-ADHD, as well as greater in bilinguals than monolinguals in the left thalamus, but without interaction effect. These independent effects indicate that the brain basis of ADHD is not impacted by a dual-language experience.

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Naturalistic acceptance-based emotion regulation in adolescents with NSSI: altered prefrontal activation and amygdala-prefrontal connectivity

Jiang, H.; He, J.; Li, L.; Guo, Y.; Gan, X.; Fan, X.; Wang, X.; Ferraro, S.; Vatansever, D.; Kendrick, K. M.; Keysers, C.; Gazzola, V.; Zhou, B.; Becker, B.

2026-05-04 radiology and imaging 10.64898/2026.05.03.26352312 medRxiv
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BackgroundNon-suicidal self-injury (NSSI) represents a growing public health concern, particularly in adolescents. Emotion dysregulation is central to prevailing NSSI models, yet it remains unclear whether acceptance-based emotion regulation (ER) and its underlying neural processes are disrupted in naturalistic, dynamic contexts. MethodsPre-registered neuroimaging trial in recently diagnosed and treatment-naive adolescents with NSSI (n=25) and healthy controls (n=25) using an ER paradigm with dynamic video clips and concomitant functional magnetic resonance imaging. Behavioral, neural activity, and connectivity indices during emotion reactivity and acceptance-based regulation were compared between groups. ResultsAdolescents with NSSI experienced elevated negative feelings during neutral clips, reflecting heightened baseline negativity. In comparison to controls, they displayed reduced temporal and ventrolateral prefrontal engagement during emotional reactivity, but increased engagement of regions implicated in both emotion reactivity (right amygdala, insula) and ER (right dlPFC, dmPFC, vlPFC) when utilizing acceptance. Higher activation in the right dlPFC was positively associated with difficulties in accessing ER strategies in everyday life. Adolescents with NSSI showed reduced functional connectivity between the right amygdala and left dlPFC. ConclusionsAdolescents with NSSI exhibited a baseline negativity bias and altered neural engagement during both negative emotional reactivity and acceptance-based regulation, characterized by increased activation and reduced amygdala-dlPFC connectivity. These findings highlight atypical emotion processing in real-life contexts in individuals with NSSI. Targeting acceptance-based regulation and prefrontal-limbic circuitry may represent a promising intervention approach for adolescents with NSSI.

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Conserved fiber topography of the anterior limb of the internal capsule in treatment-resistant psychiatric patients

El Jammal, R.; Suzuki, H.; Mattar, L. S.; Hamre, T.; Soubra, S.; Ryan, M. A.; Mathura, R. K.; Mathew, S. J.; Allawala, A.; Storch, E. A.; Vanegas Arroyave, N.; Banks, G. P.; Pouratian, N.; Patriat, R.; Goodman, W. K.; Provenza, N. R.; Sheth, S. A.; Bartoli, E.; Heilbronner, S. R.

2026-05-15 neuroscience 10.64898/2026.05.11.724148 medRxiv
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IntroductionThe anterior limb of the internal capsule (ALIC) is a major white matter highway connecting prefrontal cortical (PFC) regions to the thalamus, brainstem, and subthalamic nucleus. Structural and functional abnormalities within the ALIC circuit have been associated with many neuropsychiatric disorders, including obsessive-compulsive disorder (OCD) and depression, and deep brain stimulation (DBS) may provide effective treatment to some of these patients. However, it remains unclear whether the well-characterized topographic organization of the ALIC observed in healthy individuals and preclinical models is preserved in treatment-resistant psychiatric populations. MethodsWe first used diffusion tractography to evaluate the topography of PFC and subcortical fibers through the ALIC in patients with treatment-resistant OCD (n=18) and depression (n=5). In depression patients, we also evaluated ALIC topography using cerebro-cerebral evoked potentials (CCEPs) elicited by single-pulse electrical stimulation (SPES) of DBS leads in the ALIC and recordings in the ventral PFC (vPFC). ResultsThe topographic organization of PFC and subcortical projections is preserved in the ALIC among treatment-resistant psychiatric patients, consistent with patterns observed in healthy individuals and preclinical models. CCEP recordings in the ventral PFC showed a ventral ALIC to medial vPFC/dorsal ALIC to lateral vPFC response pattern in the left hemisphere, but not in the right. ConclusionOur findings confirm that topographic patterns within the ALIC previously identified using preclinical models and healthy controls are preserved in treatment-resistant psychiatric patients. Furthermore, by linking white matter topography to stimulation effects, this work supports more precise and individualized neuromodulatory strategies for neuropsychiatric disorders.

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Microscopic fractional anisotropy MRI differences in genetic frontotemporal dementia

So, I.; Rios-Carrillo, R.; Coleman, K. K. L.; Finger, E. C.; Baron, C. A.

2026-05-26 neurology 10.64898/2026.05.25.26354046 medRxiv
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ABSTRACT INTRODUCTION: Microscopic fractional anisotropy ({micro}FA), an emerging diffusion MRI metric, may be more sensitive than conventional metrics to gray matter microstructural changes in neurodegeneration. This pilot study compared {micro}FA, mean diffusivity (MD), and volume between genetic frontotemporal dementia (FTD) variant carriers and non-carriers in the insula, frontal pole, and medial orbitofrontal cortex (mOFC). METHODS: Carriers and familial non-carriers of FTD variants in C9orf72, GRN, or MAPT were scanned between October 2024-December 2025. Non-parametric aligned rank transform ANCOVAs were computed to analyze between-group differences in {micro}FA, MD, and volume while controlling for age. RESULTS: Carriers (n=12) exhibited lower insula {micro}FA than non-carriers (n=8): F(1,19)=5.89, 95% CI [-10.7,-0.75], p=0.027, 2p=0.26. No group-differences were observed in other metrics, including MD and volume. DISCUSSION: Reduced {micro}FA in the insula, a region vulnerable to early atrophy in FTD, may be more sensitive to early microstructural changes in genetic FTD than traditional diffusivity measures.

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Regional reconfiguration of functional brain networks during childhood and adolescence: evaluating age and sex effect

Fang, C. Z.; Nakua, H.; Ma, X.; Zhang, A.; Lee, S.

2026-05-22 neuroscience 10.64898/2026.05.21.726818 medRxiv
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IntroductionWhile global topological properties of brain networks reach relative maturity early in development, functional reconfigurations at the regional level continue throughout adolescence to support cognitive maturation. However, regional age and sex-specific developmental patterns of functional reconfiguration remain incompletely understood. MethodsWe analyzed resting-state fMRI data from 528 participants aged 5-21 years from the Human Connectome Project in Development. Three regional graph-theory metrics (betweenness centrality, hub score, and local efficiency) were computed for each individuals functional network. Cognition was measured using NIH toolbox. Parallel factor analysis was employed to decompose an individual x region x metric array into factors representing distinct developmental properties in the full sample and separately for males and females. Brain-cognition associations were examined in developmental subgroups (<13, 13-18, >18 years). ResultsThree factors emerged, characterizing visual, multimodal integration, and higher-order factors. Across development, metrics capturing network integration (betweenness centrality and hubness) showed general stability, while metrics capturing segregation (local efficiency) presented distinct peaks, particularly in the visual factor. Females showed earlier peaks and declines in higher-order factor, while males exhibited greater variability and protracted maturation in multimodal and higher-order factors. Brain-cognition associations were modest with early childhood and crystallized cognition composites showed small negative correlations with hub score in entire sample (r=-0.212) and local efficiency in males aged <13 years (r=-0.215). ConclusionFindings highlight nonlinear, sex-specific functional reconfiguration at region-level during childhood and adolescence, underscoring the importance of sex-stratified analyses in developmental and providing a crucial foundation for future investigations of developmental disorders.

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Retest Reliability of Task-related fMRI BOLD Signals during Sequential Decision Making

Stege, N. L.; Pekar, J.; Jackson, M. S.; Niemann, F.; Grundei, M.; Graur, I.-M.; Shi, Y.; Li, S.-C.

2026-05-14 neuroscience 10.64898/2026.05.11.724283 medRxiv
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IntroductionFunctional magnetic resonance imaging (fMRI) is widely used to study neural processes of behavior, but evaluations of test-retest reliability (TRR) of task-related blood-oxygen-level-dependent (BOLD) responses are scarce for many cognitive tasks. Such information is particularly important for longitudinal and intervention research. The ability to learn associations between choices and outcomes across decision stages is crucial for daily behavior. We assessed the measurement reliability of behavioral performance and fMRI BOLD signals during value-based sequential decision making to evaluate the TRR of task-relevant regions for future research on non-invasive brain stimulations. MethodsTwenty healthy adults (22 to 40 years) completed two task-fMRI sessions that were at least 2 weeks apart. During scanning, participants performed two variants of a three-stage Markov decision task with conditions varied in temporal contingency (immediate vs. delayed) and magnitude of choice outcomes (high vs. low). Both sessions were conducted under sham tDCS via a focal 3 x 1 montage targeting left dorsolateral prefrontal cortex (DLPFC). The TRR was assessed using intraclass correlation coefficients (ICC) with a two-way mixed-effects consistency model for decision performance and task-related fMRI signals at voxel-wise level and summarized in key regions defined by the extended Human Connectome Project atlas (HCPex). ResultsDecision performance was lower with delayed than immediate outcomes (p < 0.001). Higher outcome magnitude improved performance (p < 0.001). Decision performance increased across learning bins (p < 0.001). The behavioral TRR was in the moderate to good level (ICC(3,1) = 0.742 for accuracy; ICC(3,1) = 0.801 for reaction time). At the whole-brain level, contrasting brain activities in delayed with immediate condition revealed suprathreshold cluster peaks in several frontal-parietal (e.g., bilateral orbitofrontal, bilateral dorsolateral prefrontal, and medial parietal cortices) and striatal regions (e.g., bilateral putamen). Voxel-wise ICCs revealed variable but partly good-to-excellent TRR across task-relevant regions, with stronger reliability in several striatal, orbitofrontal, and left dorsolateral prefrontal parcels, and more variable reliability across anterior cingulate and medial prefrontal parcels. ConclusionThese results from a 2-session tDCS sham-sham stimulation study establish the validity of using the three-stage Markov decision task in future studies about intervention effects on the frontal-parietal-striatal network.

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Functional connectivity correlates of the hierarchical p-factor model in youth at neurodevelopmental risk

Ianov Vitanov, R. A.; Akarca, D.; CALM Team, ; Morgan, S. E.; Jones, J. S.

2026-05-04 neuroscience 10.64898/2026.05.03.722505 medRxiv
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BackgroundEmotional and cognitive difficulties often co-occur in neurodevelopmental conditions. While transdiagnostic, dimensional approaches offer a more precise framework for understanding mental health than diagnostic categories, their neural correlates in youth with learning difficulties remain poorly understood. This study investigates associations between transdiagnostic mental health dimensions and resting-state functional connectivity in struggling learners. MethodsCross-sectional behavioural data from the Centre for Attention, Learning and Memory (CALM) for struggling learners (N = 378) was used to replicate a hierarchical model of mental health from the Conners Parent Rating Short Form, the Revised Childrens Anxiety and Depression Scale and the Strengths and Difficulties Questionnaire. Functional connectomes were derived from resting-state fMRI data (N = 67), and partial least squares regression related mental health dimensions to connectivity within and between large-scale brain networks. ResultsThe replicated model comprised a general p-factor, two broad domains (internalising and externalising), and three specific dimensions (specific internalising, neurodevelopmental and social maladjustment). Symptom severity was associated with two connectivity patterns: greater default mode network coupling to frontoparietal and attention networks, and reduced connectivity between visual and somatomotor systems. These effects were strongest for the neurodevelopmental and social maladjustment dimensions, respectively. ConclusionsThese findings align with population-level evidence linking mental health dimensions to brain network organization, extending it to struggling learners and offering new insight into the neural basis of mental health vulnerability in neurodevelopmentally at-risk youth.

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Higher PVS volume in adults born very preterm

Huerter, N. M.; Schmenger, V. S.; Barda, T.; Thalhammer, M.; Schmitz-Koep, B. M.; Menegaux, A.; Daamen, M.; Priller, J.; Decker, A.; Deike, K.; Zimmer, C.; Bartmann, P.; Wolke, D.; Zott, B.; Sorg, C.; Hedderich, D. M.

2026-05-25 radiology and imaging 10.64898/2026.05.23.26353943 medRxiv
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Abstract: BACKGROUND: Perivascular spaces (PVS), visible on brain MRI, contribute to the brain clearance system and are associated with age and neurodegenerative disorders. While lower volumes of PVS in the forebrains white matter and basal ganglia have been also demonstrated in preterm-born neonates, the long-term trajectory of PVS after premature birth remains unclear. This study tests for altered PVS volumes in very preterm/very low birthweight-born (VP/VLBW) adults compared to full-term controls and explores potential associations with cognitive performance. METHODS: PVS were assessed on T2-weighted MRI from 97 VP/VLBW and 89 full-term (FT) subjects at 26 years from the prospective, population-based Bavarian Longitudinal Study. PVS volume and count was based on automated nnU-Net-based segmentation. Regional PVS volumes were normalized by corresponding regional parenchyma volumes. Cognitive performance was assessed by the Wechsler Adult Intelligence Scale. MANCOVA was used for PVS group comparisons, Spearman rank correlations for testing PVS relationships with birth variables and cognitive scores. RESULTS: VP/VLBW-born adults showed significantly higher normalized PVS volumes in bilateral basal ganglia (p < 0.001, partial eta-squared = 0.096) and insula-related white matter (p = 0.001, partial eta-squared = 0.057). In the basal ganglia, higher PVS volumes were negatively correlated with gestational age (rho = -0.223, p = 0.030) and positively correlated with the Intensity of Neonatal Treatment Index (rho = 0.222, p = 0.030) in the VP/VLBW group. PVS volume was not associated with IQ scores. CONCLUSION: We demonstrate region-specific alterations of perivascular spaces in VP/VLBW-born adults. Data suggest that prematurity has lasting impact on the PVS.

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Therapist-Delivered Video CBT for Hoarding Disorder: A Retrospective Observational Study of Clinical Outcomes from a Large Real-World Sample of Adults

Beatty, C.; Feusner, J. D.; McGrath, P. B.; Farrell, N. R.; Nunez, M.; Lume, N.; Trusky, L.; Smith, S. M.; Rhode, A.

2026-05-19 psychiatry and clinical psychology 10.64898/2026.05.14.26353262 medRxiv
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Hoarding disorder (HD) affects approximately 2-3% of adults and is associated with substantial functional disability and limited access to evidence-based care. The aim of the current analysis was to examine the naturalistic effectiveness of therapist-delivered video cognitive-behavioral therapy (CBT) for HD in a large real-world sample, and to characterize individual-level treatment response, time-to-response, and moderators of outcome. This retrospective, observational analysis examined clinical data from 305 adults diagnosed with HD who received therapist-delivered video CBT through an online specialty therapy platform between September 2021 and February 2026. Hoarding symptom severity was assessed using the Hoarding Rating Scale-Self Report (HRS-SR). Linear mixed models examined symptom change from baseline to three timepoints: session 10, session 20, and each patient's final session. HRS-SR scores decreased from M = 22.4 (SD = 7.6) at baseline to M = 16.4 (SD = 8.2) at final session (Hedges' g = 0.81, 95% CI: 0.68-0.94). By the final session, median percent improvement was 25.0% [IQR: 3.0-46.7%]. A total of 39.3% of patients achieved [&ge;]35% HRS-SR reduction, 27.4% of patients who began above the clinical threshold achieved remission, 36.4% demonstrated reliable improvement, and 22.9% of eligible patients achieved clinically significant change. Among patients who achieved and maintained [&ge;]35% reduction through their final session (n = 120), median time to first response was session 9, with 54.2% responding within 10 sessions. Analyses of secondary outcomes showed significant improvements in clutter severity, depressive and anxiety symptoms, stress, quality of life, and functional disability (Hedges' g = 0.21-0.47). Greater baseline severity, more sessions, and longer treatment duration significantly moderated outcomes; prior OCD treatment history did not. Findings suggest that therapist-delivered video CBT for HD, delivered remotely in a real-world setting, produces outcomes consistent with controlled trials and may be a clinically effective and scalable approach for a condition historically underserved by mental health systems.

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Distinct neural substrates of affective distress and communicative disability in head and neck cancer: a cross-sectional 18F-FDG PET study

Tsionis, A.; Kyrodimos, E.; Chatziioannou, S.; Papageorgiou, C. C.

2026-05-08 psychiatry and clinical psychology 10.64898/2026.05.07.26352637 medRxiv
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BackgroundHead and neck cancer (HNC) uniquely threatens communication through its impact on voice and speech. The neural systems linking depressive symptoms with perceived voice handicap remain poorly characterized. We examined whether these symptom domains show dissociable associations with regional brain glucose metabolism. MethodsWe conducted a cross-sectional 18FFDG-PET study in 63 HNC patients following diagnosis. Regional cerebral glucose metabolism (standardized uptake value ratios) was quantified in five a priori regions of interest: Brocas area, Wernickes area, bilateral insula, and bilateral hippocampus. Depressive symptoms (Zung Self-Rating Depression Scale, SDS) and perceived voice handicap (Voice Handicap Index, VHI) were assessed. Spearman correlations with false discovery rate correction, partial correlations, and unique variance analyses were performed. Brain-behavior associations were examined using Spearman correlations with FDR correction. ResultsDepression and perceived voice handicap were strongly correlated ({rho} = 0.64, p < 0.001) and exhibited partially dissociable metabolic correlates. Depressive symptom severity was associated with reduced metabolism in Brocas area ({rho} = -0.31, p_FDR = 0.041) and higher metabolism in the left insula ({rho} = 0.36, p_FDR = 0.039), with graded insular elevation in moderate-severe depression (+14%, p = 0.008). Voice handicap was associated with reduced hippocampal metabolism ({rho} = -0.34, p = 0.016 after covariate adjustment) in exploratory analyses. ConclusionsDepression and voice handicap in HNC arise from partially independent neurobiological processes despite their clinical co-occurrence. This dissociation supports parallel rather than hierarchical supportive care pathways. Routine clinical imaging can be leveraged to generate testable hypotheses for psychosomatic and rehabilitation research. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=170 SRC="FIGDIR/small/26352637v1_ufig1.gif" ALT="Figure 1"> View larger version (32K): org.highwire.dtl.DTLVardef@174642org.highwire.dtl.DTLVardef@5c750org.highwire.dtl.DTLVardef@1607b27org.highwire.dtl.DTLVardef@1355ef9_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphical abstractC_FLOATNO Depressive symptoms were associated with reduced Brocas area metabolism and elevated left insula metabolism, consistent with limbic-cortical dysregulation. Perceived voice handicap was uniquely associated with reduced bilateral hippocampal metabolism, implicating contextual memory and adaptation processes. Arrows indicate direction of association. C_FIG

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Tobacco Use is Related to Parietal-Hippocampal Connectivity in People at Clinical High Risk for Psychosis

Bai, Y.; Roeske, M. J.; Beermann, A.; Addington, J.; Bearden, C. E.; Cadenhead, K.; Cannon, T. D.; Carrion, R. E.; Cornblatt, B.; Keshavan, M.; Mathalon, D. H.; Perkins, D. O.; Seidman, L.; Stone, W. S.; Tsuang, M. T.; Walker, E. F.; Woods, S. W.; Brady, R. O.; Ward, H. B.

2026-05-28 psychiatry and clinical psychology 10.64898/2026.05.26.26354136 medRxiv
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Background: Tobacco use is prevalent in clinical high risk for psychosis (CHR-P) population and has widespread negative health consequences, but understanding of its neural substrates is limited. Abnormal default mode network (DMN) may underlie tobacco dependence in CHR-P. We investigated how tobacco use relates to DMN connectivity and how CHR-P status impacts this relationship. Methods: We used baseline substance use and resting-state functional magnetic resonance imaging data from the North American Prodrome Longitudinal Study (NAPLS2; CHR-P: n=211, mean age 19.2, 37.9% female; healthy control: n=132, mean age 19.9, 47.7% female). Voxel-wise connectivity was calculated from the left lateral parietal (LLP) node of the DMN to the rest of the brain. We regressed LLP-brainwide connectivity against tobacco use frequency in the past month to generate a spatial map of how connectivity relates to current tobacco use. Results: Brainwide connectivity analysis identified two clusters in R hippocampus (peak voxel at MNI [+30,-12,-27]) and in L parahippocampus (peak voxel at MNI [-27,-27,-27]), where higher LLP-cluster connectivity was associated with more frequent tobacco use. LLP - R hippocampus connectivity was higher in current tobacco users compared to non-tobacco users (t=-3.5466, df=101.88, p=0.0006), and higher in CHR-P than controls (t=-2.8651, df=279.47, p=0.0049). Among current tobacco users, there was a significant tobacco-by-diagnosis interaction on LLP - R hippocampus connectivity (estimate=0.306, SE=0.149, t=2.051, p=0.045) such that heavier tobacco use predicted hyperconnectivity only in CHR. Conclusions: More frequent tobacco use was associated with higher DMN-hippocampal connectivity in both CHR-P and controls. CHR-P diagnosis enhanced this relationship.

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Acute inflammation-mediated attenuation of behavioural sensitization in methamphetamine-sensitized mice via distinct COX-2 and TNF-α pathways

Shinohara, R. C.; Ishikawa, S.; Matsumoto, R.; Ito, K.; Tonosaki, M.; Matsuyama, S.; Ohgidani, M.; Koga, M.; Hashimoto, N.; Kusumi, I.; Takahiro, K. A.

2026-05-12 pharmacology and toxicology 10.64898/2026.05.08.723429 medRxiv
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Background and PurposeWhile inflammation has been generally considered to exacerbate symptoms of schizophrenia, some clinical observations suggest that acute inflammation may alleviate positive symptoms. However, animal models often use excessive inflammatory stimuli, and the effects of acute inflammation--comparable to levels observed in patients--remain unknown. Experimental ApproachTo address this, we examined whether acute inflammation induced under relatively mild, clinically relevant conditions suppresses behavioural sensitization in methamphetamine (METH)-sensitized mice, a model of psychostimulant-induced psychosis with relevance to certain aspects of positive symptoms of schizophrenia. We used a repeated METH (1 mg/kg) sensitized model to evaluate the effects of acute inflammation on behavioural sensitization. Acute inflammation was induced via two methods using either lipopolysaccharides (LPS; 1 g/kg) to mimic peripheral immune activation or restraint stress (RS; single 2-h exposure) to model the neuroinflammation induced by psychological stress. LPS doses were adjusted with reference to the magnitude of peripheral cytokine elevation reported in patients, and RS was applied in short single sessions to avoid excessive inflammation. Key ResultsBoth LPS and RS significantly suppressed behavioural sensitization, without inducing other behavioural abnormalities. This suppression was dependent on toll-like receptor-4 activation. LPS-mediated suppression involved cyclooxygenase-2, whereas RS-mediated suppression was linked to the microglia-derived tumour necrosis factor-. LPS did not alter, whereas RS significantly reduced the striatal extracellular dopamine levels. Conclusion and ImplicationsThese findings suggest that acute inflammation suppresses behavioural sensitization through distinct mechanisms depending on the inflammatory trigger, providing a framework for understanding how inflammation may influence psychosis-related processes, with potential relevance to schizophrenia.

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Gene-Set Based Rare Variant Association Analysis of Whole Genome Sequencing Data in the Portuguese Island Collection for Schizophrenia and Bipolar Disorder

Kazemi, H.; Drake, J.; Bigdeli, T.; Bacanu, S.; Nguyen, T. H.; Benke, K.; Maher, B.; Knowles, J.; McCarroll, S.; Carvalho, C.; Medeiros, H.; Ferreira, R.; Pato, M.; Pato, C.; Vladimirov, V.; Fanous, A.

2026-06-01 genetic and genomic medicine 10.64898/2026.05.28.26354351 medRxiv
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Abstract Schizophrenia (SCZ) and bipolar disorder (BPD) are highly heritable psychiatric disorders with complex polygenic architectures. Genome-wide association studies (GWASs) have identified numerous common variant associations, but rarer variants detectable through whole-genome sequencing (WGS) remain underexplored. We conducted rare variant association analysis using WGS data from the Portuguese Island Collection (PIC), including 28 families with SCZ (n = 53) and 41 families with BPD (n = 83) cases, and population controls (n = 62). Following ANNOVAR and CADD annotation, burden analysis of deleterious variants showed that both affected and unaffected family members from SCZ and BPD pedigrees had significantly higher burdens of rare deleterious variants compared to controls (p < 0.0001), with no significant differences observed between affected and unaffected relatives, consistent with shared familial genetic liability. Polygenic Risk Score (PRS) analysis confirmed significant genetic contributions to both disorders within PIC. Association analyses were subsequently performed using SAIGE-GENE+ identifying 483 and 583 nominally significant (suggestive associations) gene sets (p-value [&le;] 0.05; FDR > 0.05) for SCZ and BPD, respectively, including gene sets related to neurotransmission, synaptic function and structure, neurodevelopment, and neuroinflammation as well as major signaling pathways. Cross disorder overlaps also identified shared suggestive enrichment of GABA and glutamate signaling, synaptic signaling, and Wnt signaling gene sets in both SCZ and BPD. These findings support shared rare variant burden within multiplex psychiatric families and highlight the role of gene-set based rare variant analysis in identifying neurobiological pathways relevant to SCZ and BPD. Keywords: WGS, Rare Variants, Schizophrenia, Bipolar Disorder

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Effects of theta burst stimulation on neural connectivity and visual perception following attention modification of own-face viewing in body dysmorphic disorder

Diaz-Fong, J. P.; Peel, H. J.; Zhang, K.; Qian, J.; Lewis, M.; Wong, W.-W.; Leuchter, A. F.; Tadayonnejad, R.; Voineskos, D.; Konstantinou, G.; Lam, E.; Blumberger, D. M.; Feusner, J. D.

2026-05-26 psychiatry and clinical psychology 10.64898/2026.05.25.26354053 medRxiv
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Background: Individuals with body dysmorphic disorder misperceive defects of their physical appearance. Current evidence suggests that visual processing abnormalities may underlie this core symptom. Separate pre-clinical studies testing perceptual and attentional interventions and non-invasive neuromodulation suggest that these visual processing abnormalities may be modifiable, but their combined effects on neural connectivity and perceptual processing remain unclear. Methods: Thirty-nine unmedicated men and women with body dysmorphic disorder or subclinical body dysmorphic disorder received intermittent theta burst stimulation and continuous theta burst stimulation targeting the lateral parietal cortex combined with a visual attention modification paradigm during functional magnetic resonance imaging, in a crossover design. Dynamic effective connectivity within dorsal and ventral visual stream pathways was calculated, and global visual processing biases were assessed using the face inversion effect before and after stimulation plus attention modification. Results: Intermittent theta burst stimulation resulted in increased connectivity in higher-level dorsal visual stream pathways during naturalistic viewing following attention modification, whereas continuous theta burst stimulation was associated with reduced connectivity in lower-level dorsal pathways and increased connectivity in ventral stream pathways. These changes were accompanied by differential effects on global visual processing, with stimulation type modulating the magnitude of the face inversion effect. Conclusions: Combined neuromodulation and visual attention modification modulate visual system connectivity and perceptual processing in individuals with body dysmorphic disorder symptoms. These findings support a mechanistic link between dorsal-ventral stream dynamics and perceptual biases. Integrating neuromodulation with perceptual retraining may represent a viable approach for targeting core symptoms of distorted appearance perception.

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The Associations of Cerebral Blood Flow and White Matter Hyperintensities with Tau and Amyloid-beta Across the Alzheimer's Disease Spectrum

Lin, K.; Sachdev, P.; Jiang, J.; Alzheimer's Disease Neuroimaging Initiative,

2026-05-27 neurology 10.64898/2026.05.25.26354067 medRxiv
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Although the associations between cerebrovascular dysfunctions and Alzheimer's disease are increasingly appreciated, the relationship of cerebral blood flow and white matter hyperintensities with tau and amyloid-{beta} pathology remains unclear, particularly in the longitudinal context. This study investigated cross-sectional and longitudinal associations of cerebral blood flow and white matter hyperintensities with tau and amyloid-{beta} pathology using multimodal imaging and blood biomarkers in 179 participants from the ADNI3 cohort. Participants underwent structural (T1-weighted, T2-weighted FLAIR) and arterial spin labelling perfusion MRI, tau and amyloid-{beta} PET, and plasma assay tests for amyloid-{beta} 42, amyloid-{beta} 40, and phosphorylated tau-217. Tau from PET was negatively associated with cerebral blood flow both cross-sectionally and longitudinally in the posterior brain, independent of amyloid-{beta} quantified from PET. Higher white matter hyperintensities volumes were associated with higher levels of tau and amyloid-{beta} at baseline, but the associations were significantly attenuated after further adjusting for amyloid-{beta} and tau, respectively. Plasma amyloid-{beta} 42/40 ratio was negatively associated with white matter hyperintensity volumes both cross-sectionally and longitudinally. In conclusion, tau pathology showed spatially specific associations with cerebral hypoperfusion, independent of amyloid-{beta}, particularly in posterior regions. The attenuation of associations of white matter hyperintensities with amyloid-{beta} and tau after adjustment may reflect shared disease-related variance rather than distinct independent effects. Keywords: Alzheimer's disease, Cerebral blood flow, White matter hyperintensities, Tau pathology, Amyloid-{beta}.

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Effects of NMDA antagonists on social behaviour: a systematic review and meta-analysis of preclinical studies

Gallas-Lopes, M.; Abreu, M. B.; Andrades, M.; Arbo, B. D.; Bastos, L. M.; Caetano, T. C.; Muller, D. V.; Patelli-Alves, A.; Rosa, D. A.; Stein, D. J.; Herrmann, A. P.

2026-05-15 pharmacology and toxicology 10.64898/2026.05.13.724847 medRxiv
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Social withdrawal is a key component of the negative symptom domain of schizophrenia, and pharmacological blockade of the N-methyl-D-aspartate receptor (NMDAR) is widely used to model schizophrenia-relevant phenotypes in animals. However, findings on social behaviour are inconsistent across paradigms and laboratories. We therefore conducted a systematic review and meta-analysis to synthesise the effects of dizocilpine, ketamine, and phencyclidine on social interaction and social preference, to evaluate whether clinically approved antipsychotics modify these outcomes, and to examine locomotor activity measured within the same social tests to aid interpretation. We searched Embase, PubMed and Web of Science without language or date restrictions. Controlled in vivo studies in laboratory animals administering an eligible NMDAR antagonist and reporting social interaction and/or social preference outcomes were included. Two reviewers independently screened records, extracted data and assessed risk of bias. Effect sizes were computed as standardised mean differences and synthesised using correlated multilevel random-effects models with cluster-robust variance estimation. In total, 264 studies met the inclusion criteria. Overall, NMDAR antagonists were associated with reduced social interaction and reduced social preference relative to controls, although the social preference literature appeared vulnerable to small-study effects and imprecision. Locomotor activity measured during social interaction tests tended to be higher following NMDAR antagonists, whereas during social preference no consistent overall change was observed. In animals exposed to NMDAR antagonists, antipsychotics increased social behaviour, but these changes commonly co-occurred with reduced locomotion during social interaction tests, suggesting that improvements in social measures may partly reflect altered behavioural competition and time allocation rather than selective restoration of social functioning. Taken together, the evidence supports an overall link between NMDAR antagonism and reduced social behaviour, but the strength and interpretability of this signal depend on the paradigm and are constrained by heterogeneity and limitations in reporting.

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7 Tesla MRI links poorer cognitive function to higher perivascular space burden in neuroPASC

Herb, M. T.; Becker, J. H.; OConnor, D.; Perez, M. R.; Saju, S.; Zhu, Y.; Verma, G.; Jette, N.; Delman, B. N.; Balchandani, P.; Seifert, A. C.

2026-05-04 neurology 10.64898/2026.05.01.26352247 medRxiv
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PurposePost-acute sequalae of SARS-CoV-2 (PASC) are associated with persistent neurological symptoms (neuroPASC). Perivascular spaces (PVS) in the brain may enlarge in the context of inflammation and vascular dysfunction, reflecting impaired glymphatic clearance, and have been linked to cognitive decline. SARS-CoV-2 may disrupt the blood-brain barrier and impair glymphatic function, contributing to PVS burden. This study used 7 Tesla MRI to segment and quantify PVS in neuroPASC participants and uninfected comparators and examined associations with cognitive performance. MethodsAdult participants (36 neuroPASC (44.3 {+/-} 12.7 years) and 33 comparators (38.4 {+/-} 13.0 years)) underwent a 7 Tesla MRI scan. White matter masks of the whole brain and four lobes were segmented, and semi-automated segmentation was used to quantify PVS count and volume. All participants completed cognitive testing including Trails A and B sequencing tasks; neuroPASC participants also self-reported brain fog, fatigue, anxiety, and depression. PVS count, PVS volume, and total white matter volume (WMV) between groups were compared and associations between PVS metrics and cognitive function were assessed controlling for age, sex, and intracranial volume and corrected for multiple comparisons. ResultsAmong neuroPASC participants, those reporting anxiety (p =0.009) and depression (p =0.01) had higher WMV than those without. Greater PVS burden was associated with worse cognitive performance in PASC, particularly processing speed (Trails A) and executive function (Trails B). Specifically, processing speed was negatively associated with whole-brain PVS count (p-FDR = 0.008, R2 = 0.27), frontal PVS count (p-FDR = 0.03, R2 = 0.25), and frontal PVS volume (p-FDR = 0.04, R2 = 0.23). Trails B was also negatively associated with whole-brain PVS count (p-FDR = 0.005, R2 = 0.26). In comparators, higher PVS burden (volume and count) across multiple lobes was associated with worse semantic fluency (Animal Naming). There were no other significant associations between PVS measures and neuropsychiatric tests among participants within any of the subgroups to report. ConclusionAlthough group-level differences in PVS were not observed, PVS burden was meaningfully negatively associated with cognitive performance in neuroPASC, with the strongest effects in frontal regions. These findings suggest that microvascular and glymphatic alterations may contribute to the characteristic processing speed and executive dysfunction seen in neuroPASC. Elevated WMV in those with anxiety and depression may reflect heightened inflammatory vulnerability. PVS may serve as a sensitive imaging marker of glymphatic dysfunction and neuroinflammation in neuroPASC, offering insight into the mechanisms underlying cognitive impairment and potential intervention targets.