Neuroimage: Reports

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.

Two decades of research have provided evidence for gray matter volume (GMV) differences in developmental dyslexia (or reading disability, RD) in the left perisylvian cortex. However, there are concerns about result inconsistencies, likely attributable to small sample sizes, lenient statistical thresholds, and insufficient accounting for demographic variables and global GMV (Ramus et al., 2018). To address these concerns, we conducted a Discovery and Replication Study (N=262) using data from the Adolescent Brain Cognitive Development Study. We found GMV differences between the RD and Control Groups did not replicate across the Discovery and Replication Studies using voxel-based morphometry (VBM) in Statistical Parametric Mapping (SPM), and that a more conservative threshold yielded far fewer results. We then conducted Reproducibility Studies and first found that when using surface-based morphometry in FreeSurfer instead of VBM, the Discovery and the Replication Study results again failed to converge. Second, we combined all groups in a factorial VBM/SPM analysis and the interaction analysis provided quantitative confirmation for diverging between-group difference results across the two studies. Third, we tested for the role of covariates of no interest and found that when total GMV is not controlled for, this divergence dissipates and group differences in RD (main effect of Reading Ability) are amplified. In conclusion, replication of GMV differences in RD is low, even when using large, well-matched groups, and analyses approaches play a modulating role. As such, results from prior studies using lenient statistical thresholds and not accounting for total GMV should therefore be viewed with caution.

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.

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.

BackgroundNeuronavigation based on the standard MNI template (MNI-protocol) offers a cost-effective alternative to the gold-standard individualized T1-weighted MRI approach (T1-protocol). However, it remains unclear whether the reduced anatomical precision of the MNI-protocol compromises its functional efficacy, creating a critical need to verify protocol interchangeability. ObjectiveWe aimed to determine whether the MNI-protocol yields targeting efficacy comparable to the T1-protocol by specifically testing their functional and biophysical equivalence. MethodsWe employed a novel tri-level within-subject framework. The behavioral level assessed functional efficacy via the size congruity effect (SCE) during TMS to the right intraparietal sulcus (IPS). Anatomical accuracy (coil-to-cortex distances) and electromagnetic efficacy (E-field simulations) were evaluated across three distinct regions (right IPS, left dorsolateral prefrontal cortex, and left primary motor cortex) to assess regional generalizability. ResultsThe MNI-protocol demonstrated functional similarity to the T1-protocol, yielding behavioral outcomes that were statistically indistinguishable. This functional equivalence was corroborated by electromagnetic analyses, which revealed nearly identical induced E-field magnitudes and spatial distributions across all three target regions. Although the T1-protocol achieved significantly shorter coil-to-cortex distances, this anatomical advantage did not confer any measurable functional benefit. ConclusionThe MNI-protocol produced behavioral and electromagnetic outcomes equivalent to the T1-protocol. These findings validate the MNI-protocol as a scientifically sound and scalable alternative to individualized MRI-guided targeting, supporting its broader application in diverse research and clinical settings. HighlightsO_LIFunctional equivalence of MNI-vs. T1-guided TMS was systematically tested. C_LIO_LIA novel tri-level framework compared behavioral, anatomical, and E-field metrics. C_LIO_LIMNI- and T1-guided targeting yielded comparable behavioral and E-field outcomes. C_LIO_LIAnatomical proximity does not ensure better behavior or stronger E-field strength. C_LIO_LIMNI-guided targeting offers a robust, practical alternative to individual MRI. C_LI

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.

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

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.

BackgroundAttention-deficit/hyperactivity disorder (ADHD) has traditionally been conceptualized categorically, with efforts to identify disorder-specific neurobiological endophenotypes. However, dimensional models suggest that brain-behavior organization may follow developmental axes that cut across diagnostic boundaries. We tested whether neural dynamics and cortical excitability differentiate those with ADHD diagnoses from typically developing (TD) peers, and whether brain-behavior covariance aligns with diagnostic or developmental dimensions. MethodsWe studied 84 participants aged 8-17 years (51 ADHD, 33 TD). High-density electrophysiological (hdEEG) measures included task-free source-resolved data used to derive mean global brain fluidity (variance of dynamic functional connectivity) and region-specific cortical excitability. Behavioural measures included self- and parent-report questionnaires, cognitive control (CC) tasks, and neuropsychological tests. Partial least squares (PLS) assessed multivariate brain-behavior associations including age, followed by clustering based on latent component scores. ResultsGroup differences emerged in parent-report questionnaires and CC tasks, but not in neuropsychological measures. ADHD individuals showed higher mean global brain fluidity and increased cortical excitability. The excitability-fluidity relationship was network-dependent: higher excitability predicted higher fluidity in task-positive networks and lower fluidity in default-mode and salience networks, with no group effects. PLS identified a latent dimension linking neural metrics with age, verbal fluency, inhibitory control, and positive affect, but it did not distinguish ADHD from TD. Clustering revealed two neurodevelopmental profiles spanning both groups. ConclusionsWhile ADHD is associated with mean-level differences in neural dynamics, brain-behaviour organization follows a developmental neurocognitive-affective axis that transcends the diagnostic boundary. These findings support a dimensional framework for understanding neurobiological variation in neurodevelopmental conditions.

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

Apathy is characterized by reduced motivation for goal-directed behaviour and may emerge following brain injury. Currently, little is known about apathy in children and adolescents with neurodevelopmental disorders (NDDs) exposed to repetitive head impacts. This exploratory study investigated associations between apathy, repetitive head-banging behaviour, and substantia nigra neuromelanin-sensitive MRI (NM-MRI) signal in youth with NDDs. Forty-seven participants (14 typically developing; 33 ADHD/ASD) completed Behaviour Assessment System for Children (BASC-3) measures, from which apathy-related items were harmonized across developmental forms and subjected to principal component analysis. A one-component solution explained 47.3% of variance and was used to derive apathy scores. Although head-banging severity and NM-MRI signal were not independently associated with apathy, a significant interaction emerged, whereby greater head-banging severity strengthened the relationship between apathy and substantia nigra NM-MRI signal. These preliminary findings suggest repetitive self-injurious head impacts may influence dopaminergic systems linked to motivational dysfunction in youth with NDDs.

Prior studies have reported inconsistent results for neuroanatomical differences between early bilinguals and monolinguals. These studies primarily measured gray matter volume (GMV), involved small samples, and prioritized adults. Few studies of early bilinguals have measured cortical thickness (CT), which offers more anatomical specificity. It remains unclear whether results derived from differing metrics and approaches (e.g., vertex-versus parcel-wise analyses) converge. Using data from the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study, we compared neuroanatomy between large groups of early cultural Spanish-English bilingual and English monolingual children (N = 1,209) matched on age, pubertal status, sex, handedness, socioeconomic status (SES), and nonverbal reasoning. Whole-brain voxel-based morphometry revealed areas of greater and of lesser GMV in bilinguals than monolinguals across all lobes. Vertex-wise CT analyses similarly identified widespread differences, with bilinguals showing areas of both thicker and thinner cortex. We contextualized these findings with parcel-wise CT analyses (average CT values), utilizing two atlases of differing spatial granularity. Parcel-wise results showed good correspondence with vertex-wise findings when implementing the more fine-grained atlas (Destrieux), but use of the coarser atlas (Desikan-Killiany) provided results that led to different conclusions. Finally, we tested for interaction effects between bilingualism and SES on CT and found several regions where differences between bilinguals and monolinguals in CT were modulated by SES. Together, these findings indicate that early bilingualism is associated with extensive neuroanatomical differences relative to monolinguals during childhood, and that these results can vary as a function of neuroanatomical metric, analysis approach, atlas granularity, and SES. Research HighlightsEarly Spanish-English bilingual and monolingual children differ in gray matter volume and cortical thickness across multiple brain regions. Cortical thickness differences between bilinguals and monolinguals cannot be firmly attributed to adaptations associated with language or executive control. Socioeconomic status modulates cortical differences between early bilinguals and monolinguals, revealing unique thickness patterns for those with lower versus higher SES backgrounds. Parcel-wise between-group cortical thickness results are affected by atlas choice and can influence the interpretation of the findings.

Much of a typical individuals mental life is characterized by spontaneous thoughts that occur independently of external stimuli. In prior studies, ongoing mental experiences and their neural correlates have been captured using thought probes presented at random intervals during functional Magnetic Resonance Imaging (fMRI). However, this approach results in temporally imprecise estimates of brain activity relative to the arising of mental experience. In this preregistered, proof-of-concept study, we aimed to improve temporal precision using a novel method termed real-time fMRI-triggered experience-sampling (rt-fMRI-ES). We analyzed blood-oxygenation-level-dependent signals in real time during a wakeful resting state (n=60) to trigger thought probes from spontaneous activations within two regions: the dorsal anterior insular cortex (daIC; a key region within salience network) and posteromedial cortex (PMC; a key region within default mode network). We tested two preregistered hypotheses: (H1) Ratings of arousal time-locked to daIC-activation trials are higher than ratings time-locked to non-daIC-activation trials; (H2) Ratings of external-attention time-locked to PMC-activation trials are lower than ratings time-locked to non-PMC-activation trials. After applying preregistered exclusion criteria, 42 participants (1243 trials) and 49 participants (1429 trials) were included in H1 and H2 analyses, respectively. We did not find evidence in support of H1, but we did find evidence in support of H2, as external-attention ratings were significantly lower for trials triggered by PMC activation compared to other trial types. Taken together, we successfully developed and validated the rt-fMRI-ES method, offering a novel technique to efficiently capture spontaneous thoughts based on ongoing neural activity. Preregistered Stage 1 Recommendationhttps://osf.io/sd4hu (Date of in-principle acceptance: 07/24/2024; under temporary private embargo)

The persistence of a left-handed minority of slightly over 10% of the population is enigmatic because it is associated with stigma, increased psychopathology, and cognitive deficits. In a community sample of 9,352 individuals (age range 8-21 years) with neurobehavioral assessments, left-handers (N=1,281, 673 male) indeed showed greater psychopathology and performed more poorly than right-handers (N=8,076, 3,839 male) on tests of executive function, memory, complex cognition, and social cognition, while excelling in motor speed. Furthermore, the variance was higher and within-individual variability (WIV) - the extent to which scores in the different domains varied within individuals - was higher in left-handers. Since low WIV indicates even distribution of abilities while high WIV reflects specialization in circumscribed areas, the finding indicates that left-handers are "neurocognitive specialists". This combination of behavioral traits could confer resilience against natural selection pressures and help explain preponderance of left-handers in highly specialized professions requiring specific talents. Our findings encourage more research on left-handers, who are currently excluded from multiple brain behavior studies.

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.

Importance: Leukodystrophies are a heterogeneous group of genetic disorders affecting the white matter of the brain, often presenting with overlapping clinical features but differing in neuroanatomical involvement. There is a critical need for quantitative tools to characterize disease burden and support diagnosis, severity stratification, and clinical trial readiness. Objective: To characterize shared and distinct neuroanatomical patterns across six genetically confirmed leukodystrophies using anatomical MRI-derived phenotypes benchmarked against brain growth charts, and to assess the utility of this methodological approach for identifying imaging biomarkers of disease severity. Design, Setting, and Participants: Cross-sectional neuroimaging study using retrospective clinical MRI data. Setting: Multicenter study incorporating data from the Global Leukodystrophy Initiative Clinical Trials Network (GLIA-CTN) and control data from the Childrens Hospital of Philadelphia. Participants: The study included 434 MRI scan sessions from 274 patients with genetically confirmed leukodystrophies (Pelizaeus-Merzbacher disease, Metachromatic leukodystrophy, Alexander disease, Aicardi-Goutieres syndrome, TUBB4A-related leukodystrophies, and POLR3-related leukodystrophy). Control MRI data (7628 scans from 7205 subjects) were drawn from the Scans with Limited Imaging Pathology cohort at the Children's Hospital of Philadelphia. Exposures: All MRI scans underwent automated segmentation using deep learning segmentation tools to derive global and regional brain volumes. Normative models of brain development ("brain growth charts") were generated for the control cohort using generalized additive models for location, scale, and shape. Centile scores were then calculated for leukodystrophy subjects to quantify deviations from typical development. Main Outcomes and Measures: Centile scores for global and regional brain volumes were compared across leukodystrophy subtypes to identify disease-specific neuroanatomical patterns and to evaluate their potential utility for severity stratification. Results: Distinct patterns of neuroanatomical deviation were observed across leukodystrophy subtypes. Certain leukodystrophies showed preferential involvement of specific cortical or subcortical regions, while others displayed more diffuse volume loss. Centile scores demonstrated potential for differentiating disease subtypes and stratifying individuals by severity. Preliminary longitudinal data suggest centile scores may also track progression over time. Conclusions and Relevance:This study demonstrates the feasibility and utility of MRI profiling of individuals with leukodystrophy using anatomical MRI-derived phenotypes benchmarked against brain growth charts. The approach enables data-driven, quantitative characterization of structural brain abnormalities, offering a scalable method for phenotyping, diagnosis, and future use in clinical trials.

PurposeTo examine speech iconicity for shape in aphasia, we compared iconicity ratings from people with aphasia to those from neurologically intact individuals and evaluated how iconicity relates to phonological and semantic processing profiles in aphasia. MethodEleven people with aphasia and 11 age- and gender-matched neurologically intact participants rated how rounded or pointed 50 auditory pseudowords sounded using a 5-point scale. Ratings from participants with aphasia were compared to predicted iconicity ratings derived from reference ratings from prior work and to ratings from neurologically intact participants. For each participant with aphasia, correlations between individual ratings and predicted ratings were related to measures of phonological and semantic processing. ResultsRatings from people with aphasia were significantly correlated with both the predicted ratings and the ratings from neurologically intact participants. The strength of the correlation between individual ratings and predicted ratings did not differ significantly between groups, although there was a trend toward weaker correlations in the aphasia group. There were indications that greater language impairment was associated with greater disruption of iconicity ratings; in particular, deficits in phonological segmentation and semantic processing were associated with reduced sensitivity to shape iconicity. ConclusionThese findings suggest that sensitivity to shape iconicity is preserved in individuals with aphasia to varying degrees. The specific nature of language impairment appears to play an important role in determining iconicity processing in aphasia.

Resting state networks RSNs measured through functional connectivity FC emerge in utero and are detectable within hours of birth. Although neonatal growth metrics predict later neurodevelopmental outcomes and structural brain maturation their relationship to early functional network organization remains poorly understood. We examined associations between anthropometric growth metrics and resting state FC in a cohort of healthy near term and term born neonates using functional near infrared spectroscopy fNIRS acquired during the first few days of life. Task free fNIRS data were recorded in 121 neonates 67 males 55 percent mean postnatal age equals 25.6 hours mean gestational age equals 38.63 weeks. Based on birthweight percentiles 12 9 percent newborns were small for gestational age SGA and 13 11 percent were large for gestational age LGA. Growth metrics included birth weight for gestational age z score BGZ head circumference for gestational age z score HGZ birth weight for length z score BLZ and z scored Ponderal Index PIz. Whole brain FC was calculated as the mean Fisher Z transformed correlation across valid channel pairs. Channel wise associations were examined using general linear and linear mixed effects models controlling for gestational age postnatal age and sex. Linear and quadratic terms were tested and multiple comparisons were controlled using the false discovery rate. None of the anthropometric measures were associated with global FC however significant nonlinear quadratic relationships emerged at the channel pair level. BGZ B range equals negative 0.102 to negative 0.074 FDR corrected p less than 0.005 and PIz B range equals negative 0.088 to negative 0.074 FDR corrected p less than 0.001 demonstrated negative quadratic associations with inter and intra hemispheric connectivity such that newborns with both lower SGA and higher LGA growth values showed reduced FC relative to those with average growth. In contrast HGZ demonstrated positive quadratic associations B range equals 0.051 to 0.074 FDR corrected p less than 0.001 with infants at the lower and higher ends of the head size distribution exhibiting increased FC relative to infants near the mean. BLZ showed no significant associations after correction. Results indicate that early somatic growth is reflected in the organization of neonatal functional brain networks and that deviations from average growth whether smaller or larger are associated with altered regional connectivity. Findings suggest that neonatal growth metrics may provide an accessible marker of early brain health reflected in regionally specific functional connectivity patterns.

Subthreshold depression is associated with significant functional impairment and elevated risk of major depressive disorder. A negative self-concept may disrupt the implicit positive association evoked by ones own face, impairing incidental encoding of self-relevant information. Whether subthreshold depression involves a selective deficit in encoding self-face identity remains unclear. The attribute amnesia paradigm is well suited to address this question because it can dissociate attentional selection from working memory encoding. Using this paradigm, we examined the issue across two experiments. Experiment 1 employed nonsocial stimuli (animal drawings) and confirmed an intact attribute amnesia effect in subthreshold depression (n = 30) comparable to healthy controls (n = 30), ruling out a generalized encoding deficit. Experiment 2 replaced targets with faces (self or other) and revealed a selective enhancement of the attribute amnesia effect for self-face identity in subthreshold depression. Specifically, on the surprise trial, accuracy for self-face identity dropped to near-chance levels in the subthreshold depression group, whereas no such deficit emerged for other-faces or in controls. Encoding recovered rapidly once explicit memory expectations were introduced, indicating intact basic encoding capacity. These findings suggest that subthreshold depression is associated with a specific impairment in incidentally encoding self-face identity. This impairment likely stems from a negative self-concept that weakens self-face salience under incidental encoding conditions. By capturing this selective encoding failure, the present study reveals that the self-processing deficit in subthreshold depression can arise at the gating stage between attention and working memory consolidation.

ObjectiveDirect cortical stimulation (DCS) is the gold standard for language mapping during SEEG but is prone to false negatives and false positives that may contribute to post-operative dysphasia or else overly conservative resections. Task-induced high-frequency activity (HFA, 30-200Hz) is an emerging functional biomarker that may augment DCS, but its clinical utility remains uncertain. We aimed to quantify HFAs diagnostic concordance with DCS, assessing its potential as both a surrogate marker and a screening tool. MethodsIn this single-centre prospective study, 23 adults undergoing SEEG completed language mapping with DCS and HFA. HFA was mapped using auditory and visual naming tasks (ANT/VNT), quantified via Morlet wavelet transforms with baseline-normalised z-scores. DCS-positive channels were those where 50Hz stimulation elicited language disruption. HFA distribution was examined independently of DCS. HFA-DCS concordance was assessed for individual and combined (ANT+VNT; maximal HFA across tasks) conditions at channel and sublobar levels across two thresholds: a specificity-optimized stringent threshold (Z>0.8) to examine HFA as a surrogate for DCS, and a sensitivity-optimized permissive threshold (Z>0.3) to evaluate its potential as a screening tool. ResultsTwelve (52%) participants were female, and 17 (74%) were MRI-negative. HFA patterns differed by task: VNT produced greater HFA magnitude in the dominant frontal lobe (p=0.0498), while ANT produced greater magnitude and activation rate in the non-dominant temporal lobe (p=0.015; p=0.0189), highest in the non-dominant superior temporal gyrus. In the combined condition, concordance with DCS was low at the stringent threshold (channel-wise sensitivity/specificity=0.24/0.88; region-wise=0.43/0.77). Sensitivity improved at the permissive threshold (channel-wise 0.56, NPV=0.96), with region-wise sensitivity of 0.75, specificity=0.45, and NPV=0.94. SignificanceRegion-level HFA at a permissive threshold is useful for identifying language-negative regions and prioritising DCS testing. Poor concordance at a stringent threshold suggests HFA and DCS index distinct functional properties and are not interchangeable. Anatomically plausible HFA localisation supports the need for further multimodal validation to clarify its role in presurgical mapping. Key PointsO_LIHFA and DCS show threshold- and scale-dependent diagnostic concordance for language mapping during SEEG C_LIO_LISensitivity-optimized sublobar HFA shows high negative predictive value and moderate sensitivity for DCS-positive language sites C_LIO_LIThese metrics support sublobar HFA as a screening tool to exclude non-eloquent regions and streamline DCS language mapping C_LIO_LISpecificity-optimized HFA concords poorly with DCS, indicating these markers index distinct properties and are not interchangeable C_LIO_LICombined HFA/DCS profiles may help stratify surgical risk: HFA-/DCS-regions as low risk, while HFA+/DCS+ sites denote high risk C_LI