Author name cluster

E. van Dellen

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8 papers

1 author row

YNICL Journal 2023 Journal Article

fMRI connectivity as a biomarker of antipsychotic treatment response: A systematic review

L.S. Dominicus
L. van Rijn
J. van der A
R. van der Spek
D. Podzimek
M. Begemann
L. de Haan
M. van der Pluijm

BACKGROUND: Antipsychotic drugs are the first-choice therapy for psychotic episodes, but antipsychotic treatment response (AP-R) is unpredictable and only becomes clear after weeks of therapy. A biomarker for AP-R is currently unavailable. We reviewed the evidence for the hypothesis that functional magnetic resonance imaging functional connectivity (fMRI-FC) is a predictor of AP-R or could serve as a biomarker for AP-R in psychosis. METHOD: A systematic review of longitudinal fMRI studies examining the predictive performance and relationship between FC and AP-R was performed following PRISMA guidelines. Technical and clinical aspects were critically assessed for the retrieved studies. We addressed three questions: Q1) is baseline fMRI-FC related to subsequent AP-R; Q2) is AP-R related to a change in fMRI-FC; and Q3) can baseline fMRI-FC predict subsequent AP-R? RESULTS: In total, 28 articles were included. Most studies were of good quality. fMRI-FC analysis pipelines included seed-based-, independent component- / canonical correlation analysis, network-based statistics, and graph-theoretical approaches. We found high heterogeneity in methodological approaches and results. For Q1 (N = 17) and Q2 (N = 18), the most consistent evidence was found for FC between the striatum and ventral attention network as a potential biomarker of AP-R. For Q3 (N = 9) accuracy's varied form 50 till 93%, and prediction models were based on FC between various brain regions. CONCLUSION: The current fMRI-FC literature on AP-R is hampered by heterogeneity of methodological approaches. Methodological uniformity and further improvement of the reliability and validity of fMRI connectivity analysis is needed before fMRI-FC analysis can have a place in clinical applications of antipsychotic treatment.

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YNICL Journal 2020 Journal Article

fMRI network correlates of predisposing risk factors for delirium: A cross-sectional study

S.J.T. van Montfort
A.J.C. Slooter
I.M.J. Kant
R.R. van der Leur
C. Spies
J. de Bresser
T.D. Witkamp
J. Hendrikse

Delirium, the clinical expression of acute encephalopathy, is a common neuropsychiatric syndrome that is related to poor outcomes, such as long-term cognitive impairment. Disturbances of functional brain networks are hypothesized to predispose for delirium. The aim of this study in non-delirious elderly individuals was to investigate whether predisposing risk factors for delirium are associated with fMRI network characteristics that have been observed during delirium. As predisposing risk factors, we studied age, alcohol misuse, cognitive impairment, depression, functional impairment, history of transient ischemic attack or stroke, and physical status. In this multicenter study, we included 554 subjects and analyzed resting-state fMRI data from 222 elderly subjects (63% male, age range: 65-85 year) after rigorous motion correction. Functional network characteristics were analyzed and based on the minimum spanning tree (MST). Global functional connectivity strength, network efficiency (MST diameter) and network integration (MST leaf fraction) were analyzed, as these measures were altered during delirium in previous studies. Linear regression analyses were used to investigate the relation between predisposing delirium risk factors and delirium-related fMRI characteristics, adjusted for confounding and multiple testing. Predisposing risk factors for delirium were not associated with delirium-related fMRI network characteristics. Older age within our elderly cohort was related to global functional connectivity strength (β = 0.182, p < 0.05), but in the opposite direction than hypothesized. Delirium-related functional network impairments can therefore not be considered as the common mechanism for predisposition for delirium.

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YNICL Journal 2019 Journal Article

Brain network disintegration as a final common pathway for delirium: a systematic review and qualitative meta-analysis

S.J.T. van Montfort
E. van Dellen
C.J. Stam
A.H. Ahmad
L.J. Mentink
C.W. Kraan
A. Zalesky
A.J.C. Slooter

Delirium is an acute neuropsychiatric syndrome characterized by altered levels of attention and awareness with cognitive deficits. It is most prevalent in elderly hospitalized patients and related to poor outcomes. Predisposing risk factors, such as older age, determine the baseline vulnerability for delirium, while precipitating factors, such as use of sedatives, trigger the syndrome. Risk factors are heterogeneous and the underlying biological mechanisms leading to vulnerability for delirium are poorly understood. We tested the hypothesis that delirium and its risk factors are associated with consistent brain network changes. We performed a systematic review and qualitative meta-analysis and included 126 brain network publications on delirium and its risk factors. Findings were evaluated after an assessment of methodological quality, providing N=99 studies of good or excellent quality on predisposing risk factors, N=10 on precipitation risk factors and N=7 on delirium. Delirium was consistently associated with functional network disruptions, including lower EEG connectivity strength and decreased fMRI network integration. Risk factors for delirium were associated with lower structural connectivity strength and less efficient structural network organization. Decreased connectivity strength and efficiency appear to characterize structural brain networks of patients at risk for delirium, possibly impairing the functional network, while functional network disintegration seems to be a final common pathway for the syndrome.

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YNIMG Journal 2015 Journal Article

The minimum spanning tree: An unbiased method for brain network analysis

P. Tewarie
E. van Dellen
A. Hillebrand
C.J. Stam

The brain is increasingly studied with graph theoretical approaches, which can be used to characterize network topology. However, studies on brain networks have reported contradictory findings, and do not easily converge to a clear concept of the structural and functional network organization of the brain. It has recently been suggested that the minimum spanning tree (MST) may help to increase comparability between studies. The MST is an acyclic sub-network that connects all nodes and may solve several methodological limitations of previous work, such as sensitivity to alterations in connection strength (for weighted networks) or link density (for unweighted networks), which may occur concomitantly with alterations in network topology under empirical conditions. If analysis of MSTs avoids these methodological limitations, understanding the relationship between MST characteristics and conventional network measures is crucial for interpreting MST brain network studies. Here, we firstly demonstrated that the MST is insensitive to alterations in connection strength or link density. We then explored the behavior of MST and conventional network-characteristics for simulated regular and scale-free networks that were gradually rewired to random networks. Surprisingly, although most connections are discarded during construction of the MST, MST characteristics were equally sensitive to alterations in network topology as the conventional graph theoretical measures. The MST characteristics diameter and leaf fraction were very strongly related to changes in the characteristic path length when the network changed from a regular to a random configuration. Similarly, MST degree, diameter, and leaf fraction were very strongly related to the degree of scale-free networks that were rewired to random networks. Analysis of the MST is especially suitable for the comparison of brain networks, as it avoids methodological biases. Even though the MST does not utilize all the connections in the network, it still provides a, mathematically defined and unbiased, sub-network with characteristics that can provide similar information about network topology as conventional graph measures.

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YNIMG Journal 2014 Journal Article

Structural degree predicts functional network connectivity: A multimodal resting-state fMRI and MEG study

P. Tewarie
A. Hillebrand
E. van Dellen
M.M. Schoonheim
F. Barkhof
C.H. Polman
C. Beaulieu
G. Gong

Communication between neuronal populations in the human brain is characterized by complex functional interactions across time and space. Recent studies have demonstrated that these functional interactions depend on the underlying structural connections at an aggregate level. Multiple imaging modalities can be used to investigate the relation between the structural connections between brain regions and their functional interactions at multiple timescales. We investigated if consistent modality-independent functional interactions take place between brain regions, and whether these can be accounted for by underlying structural properties. We used functional MRI (fMRI) and magnetoencephalography (MEG) recordings from a population of healthy adults together with a previously described structural network. A high overlap in resting-state functional networks was found in fMRI and especially alpha band MEG recordings. This overlap was characterized by a strongly interconnected functional core network in temporo-posterior brain regions. Anatomically realistically coupled neural mass models revealed that this strongly interconnected functional network emerges near the threshold for global synchronization. Most importantly, this functional core network could be explained by a trade-off between the product of the degrees of structurally-connected regions and the Euclidean distance between them. For both fMRI and MEG, the product of the degrees of connected regions was the most important predictor for functional network connectivity. Therefore, irrespective of the modality, these results indicate that a functional core network in the human brain is especially shaped by communication between high degree nodes of the structural network.

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YNICL Journal 2013 Journal Article

Connectivity in MEG resting-state networks increases after resective surgery for low-grade glioma and correlates with improved cognitive performance

E. van Dellen
P.C. de Witt Hamer
L. Douw
M. Klein
J.J. Heimans
C.J. Stam
J.C. Reijneveld
A. Hillebrand

PURPOSE: Low-grade glioma (LGG) patients often have cognitive deficits. Several disease- and treatment related factors affect cognitive processing. Cognitive outcome of resective surgery is unpredictable, both for improvement and deterioration, especially for complex domains such as attention and executive functioning. MEG analysis of resting-state networks (RSNs) is a good candidate for presurgical prediction of cognitive outcome. In this study, we explore the relation between alterations in connectivity of RSNs and changes in cognitive processing after resective surgery, as a stepping stone to ultimately predict postsurgical cognitive outcome. METHODS: Ten patients with LGG were included, who had no adjuvant therapy. MEG recording and neuropsychological assessment were obtained before and after resective surgery. MEG data were recorded during a no-task eyes-closed condition, and projected to the anatomical space of the AAL atlas. Alterations in functional connectivity, as characterized by the phase lag index (PLI), within the default mode network (DMN), executive control network (ECN), and left- and right-sided frontoparietal networks (FPN) were compared to cognitive changes. RESULTS: Lower alpha band DMN connectivity was increased after surgery, and this increase was related to improved verbal memory functioning. Similarly, right FPN connectivity was increased after resection in the upper alpha band, which correlated with improved attention, working memory and executive functioning. DISCUSSION: Increased alpha band RSN functional connectivity in MEG recordings correlates with improved cognitive outcome after resective surgery. The mechanisms resulting in functional connectivity alterations after resection remain to be elucidated. Importantly, our findings indicate that connectivity of MEG RSNs may be used for presurgical prediction of cognitive outcome in future studies.

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YNIMG Journal 2013 Journal Article

Local MEG networks: The missing link between protein expression and epilepsy in glioma patients?

L. Douw
M. de Groot
E. van Dellen
E. Aronica
J.J. Heimans
M. Klein
C.J. Stam
J.C. Reijneveld

Connectivity and network analysis in neuroscience has been applied to multiple spatial scales, but the links between these different scales have rarely been investigated. In tumor-related epilepsy, altered network topology is related to behavior, but the molecular basis of these observations is unknown. We elucidate the associations between microscopic features of brain tumors, local network topology, and functional patient status. We hypothesize that expression of proteins related to tumor-related epilepsy is directly correlated with network characteristics of the tumor area. Glioma patients underwent magnetoencephalography, and functional network topology of the tumor area was used to predict tissue protein expression patterns of tumor tissue collected during neurosurgery. Protein expression and network topology were interdependent; in particular between-module connectivity was selectively associated with two epilepsy-related proteins. Total number of seizures was related to both the role of the tumor area in the functional network and to protein expression. Importantly, classification of protein expression was predicted by between-module connectivity with up to 100% accuracy. Thus, network topology may serve as an intermediate level between molecular features of tumor tissue and symptomatology in brain tumor patients, and can potentially be used as a non-invasive marker for microscopic tissue characteristics.

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YNIMG Journal 2013 Journal Article

Local polymorphic delta activity in cortical lesions causes global decreases in functional connectivity

E. van Dellen
A. Hillebrand
L. Douw
J.J. Heimans
J.C. Reijneveld
C.J. Stam

Increasing evidence from neuroimaging and modeling studies suggests that local lesions can give rise to global network changes in the human brain. These changes are often attributed to the disconnection of the lesioned areas. However, damaged brain areas may still be active, although the activity is altered. Here, we hypothesize that empirically observed global decreases in functional connectivity in patients with brain lesions can be explained by specific alterations of local neural activity that are the result of damaged tissue. We simulated local polymorphic delta activity (PDA), which typically characterizes EEG/MEG recordings of patients with cerebral lesions, in a realistic model of human brain activity. 78 neural masses were coupled according to the human structural brain network. Lesions were created by altering the parameters of individual neural masses in order to create PDA (i. e. simulating acute focal brain damage); combining this PDA with weakening of structural connections (i. e. simulating brain tumors), and fully deleting structural connections (i. e. simulating a full resection). Not only structural disconnection but also PDA in itself caused a global decrease in functional connectivity, similar to the observed alterations in MEG recordings of patients with PDA due to brain lesions. Interestingly, connectivity between regions that were not lesioned directly also changed. The impact of PDA depended on the network characteristics of the lesioned region in the structural connectome. This study shows for the first time that locally disturbed neural activity, i. e. PDA, may explain altered functional connectivity between remote areas, even when structural connections are unaffected. We suggest that focal brain lesions and the corresponding altered neural activity should be considered in the framework of the full functionally interacting brain network, implying that the impact of lesions reaches far beyond focal damage.

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