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1. Attention and motor profiles in children with developmental coordination disorder: A neuropsychological and neuroimaging investigation

Author

Bonthrone, AF, Green, D, Morgan, AT, Mankad, K, Clark, CA, Liegeois, FJ, Bonthrone, AF, Green, D, Morgan, AT, Mankad, K, Clark, CA, and Liegeois, FJ

Abstract

Aim: This study aimed to (1) quantify attention and executive functioning in chil-dren with developmental coordination disorder (DCD), (2) assess whether some chil-dren with DCD are more likely to show attention difficulties, and (3) characterizebrain correlates of motor and attention deficits.Method: Fifty-three children (36 with DCD and 17 without) aged 8 to 10 years un-derwent T1-weighted and diffusion-weighted magnetic resonance imaging, andstandardized attention and motor assessments. Parents completed questionnaires ofexecutive functioning and symptoms of inattention and hyperactivity. We assessedregional cortical thickness and surface area, and cerebellar, callosal, and primarymotor tract structure.Results: Analyses of covariance and one-sample t-tests identified impaired atten-tion, non-motor processing speed, and executive functioning in children with DCD,yet partial Spearman's rank correlation coefficients revealed these were unrelatedto one another or the type or severity of the motor deficit. Robust regression analy-ses revealed that cortical morphology in the posterior cingulate was associated withboth gross motor skills and inattentive symptoms in children with DCD, while grossmotor skills were also associated with left corticospinal tract (CST) morphology.Interpretation: Children with DCD may benefit from routine attention and hyper-activity assessments. Alterations in the posterior cingulate and CST may be linkedto impaired forward modelling during movements in children with DCD. Overall,alterations in these regions may explain the high rate of non-motor impairments inchildren with DCD.

Published
2024

2. Retrospective Evaluation of the Perioperative Management of Patients Undergoing Total Pancreatectomy With Islet Autotransplantation

Author

McSwain, Skorke Ca, Nykamp M, Clark Ca, Wolf Bj, and McMurray Jd

Subjects
Adult, Male, medicine.medical_specialty, Total pancreatectomy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Islets of Langerhans Transplantation, Hemoglobin levels, Transplantation, Autologous, Article, Perioperative Care, 03 medical and health sciences, Pancreatectomy, Postoperative Complications, 0302 clinical medicine, Endocrinology, Blood loss, Pancreatitis, Chronic, Internal Medicine, Humans, Medicine, Single institution, Retrospective Studies, geography, geography.geographical_feature_category, Hepatology, Perioperative management, business.industry, Data Collection, Middle Aged, Islet, Autotransplantation, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Procedure Duration, Female, 030211 gastroenterology & hepatology, business
Abstract

OBJECTIVE: The aim of this retrospective descriptive study was to examine associations with the perioperative management of patients undergoing total pancreatectomy with islet autotransplantation, which may impact complication rate and hospital length of stay. METHODS: We retrospectively collected data on 165 patients, and 161 patients were included in the final analysis. Data collected included preoperative, intraoperative, and postoperative patient and procedural characteristics. RESULTS: Approximately 46.6% of patients experienced 1 or more complications. The occurrence of complications was associated with postoperative day 1 hemoglobin levels, use of intraoperative goal-directed therapy, estimated intraoperative blood loss, and total amount of intraoperative insulin given. Hospital length of stay was significantly associated with number of complications, use of goal-directed therapy, procedure duration, and postoperative day 1 hemoglobin levels. CONCLUSIONS: Overall, our retrospective descriptive study adds to the emerging body of literature determining optimal perioperative management of patients undergoing total pancreatectomy with islet autotransplantation.

Published
2019
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4. Tractography dissection variability: What happens when 42 groups dissect 14 white matter bundles on the same dataset?

Author

Schilling, KG, Rheault, F, Petit, L, Hansen, CB, Nath, V, Yeh, F-C, Girard, G, Barakovic, M, Rafael-Patino, J, Yu, T, Fischi-Gomez, E, Pizzolato, M, Ocampo-Pineda, M, Schiavi, S, Canales-Rodriguez, EJ, Daducci, A, Granziera, C, Innocenti, G, Thiran, J-P, Mancini, L, Wastling, S, Cocozza, S, Petracca, M, Pontillo, G, Mancini, M, Vos, SB, Vakharia, VN, Duncan, JS, Melero, H, Manzanedo, L, Sanz-Morales, E, Pena-Melian, A, Calamante, F, Attye, A, Cabeen, RP, Korobova, L, Toga, AW, Vijayakumari, AA, Parker, D, Verma, R, Radwan, A, Sunaert, S, Emsell, L, De Luca, A, Leemans, A, Bajada, CJ, Haroon, H, Azadbakht, H, Chamberland, M, Genc, S, Tax, CMW, Yeh, P-H, Srikanchana, R, Mcknight, CD, Yang, JY-M, Chen, J, Kelly, CE, Yeh, C-H, Cochereau, J, Maller, JJ, Welton, T, Almairac, F, Seunarine, KK, Clark, CA, Zhang, F, Makris, N, Golby, A, Rathi, Y, O'Donnell, LJ, Xia, Y, Aydogan, DB, Shi, Y, Fernandes, FG, Raemaekers, M, Warrington, S, Michielse, S, Ramirez-Manzanares, A, Concha, L, Aranda, R, Meraz, MR, Lerma-Usabiaga, G, Roitman, L, Fekonja, LS, Calarco, N, Joseph, M, Nakua, H, Voineskos, AN, Karan, P, Grenier, G, Legarreta, JH, Adluru, N, Nair, VA, Prabhakaran, V, Alexander, AL, Kamagata, K, Saito, Y, Uchida, W, Andica, C, Abe, M, Bayrak, RG, Wheeler-Kingshott, CAMG, D'Angelo, E, Palesi, F, Savini, G, Rolandi, N, Guevara, P, Houenou, J, Lopez-Lopez, N, Mangin, J-F, Poupon, C, Roman, C, Vazquez, A, Maffei, C, Arantes, M, Andrade, JP, Silva, SM, Calhoun, VD, Caverzasi, E, Sacco, S, Lauricella, M, Pestilli, F, Bullock, D, Zhan, Y, Brignoni-Perez, E, Lebel, C, Reynolds, JE, Nestrasil, I, Labounek, R, Lenglet, C, Paulson, A, Aulicka, S, Heilbronner, SR, Heuer, K, Chandio, BQ, Guaje, J, Tang, W, Garyfallidis, E, Raja, R, Anderson, AW, Landman, BA, Descoteaux, M, Schilling, KG, Rheault, F, Petit, L, Hansen, CB, Nath, V, Yeh, F-C, Girard, G, Barakovic, M, Rafael-Patino, J, Yu, T, Fischi-Gomez, E, Pizzolato, M, Ocampo-Pineda, M, Schiavi, S, Canales-Rodriguez, EJ, Daducci, A, Granziera, C, Innocenti, G, Thiran, J-P, Mancini, L, Wastling, S, Cocozza, S, Petracca, M, Pontillo, G, Mancini, M, Vos, SB, Vakharia, VN, Duncan, JS, Melero, H, Manzanedo, L, Sanz-Morales, E, Pena-Melian, A, Calamante, F, Attye, A, Cabeen, RP, Korobova, L, Toga, AW, Vijayakumari, AA, Parker, D, Verma, R, Radwan, A, Sunaert, S, Emsell, L, De Luca, A, Leemans, A, Bajada, CJ, Haroon, H, Azadbakht, H, Chamberland, M, Genc, S, Tax, CMW, Yeh, P-H, Srikanchana, R, Mcknight, CD, Yang, JY-M, Chen, J, Kelly, CE, Yeh, C-H, Cochereau, J, Maller, JJ, Welton, T, Almairac, F, Seunarine, KK, Clark, CA, Zhang, F, Makris, N, Golby, A, Rathi, Y, O'Donnell, LJ, Xia, Y, Aydogan, DB, Shi, Y, Fernandes, FG, Raemaekers, M, Warrington, S, Michielse, S, Ramirez-Manzanares, A, Concha, L, Aranda, R, Meraz, MR, Lerma-Usabiaga, G, Roitman, L, Fekonja, LS, Calarco, N, Joseph, M, Nakua, H, Voineskos, AN, Karan, P, Grenier, G, Legarreta, JH, Adluru, N, Nair, VA, Prabhakaran, V, Alexander, AL, Kamagata, K, Saito, Y, Uchida, W, Andica, C, Abe, M, Bayrak, RG, Wheeler-Kingshott, CAMG, D'Angelo, E, Palesi, F, Savini, G, Rolandi, N, Guevara, P, Houenou, J, Lopez-Lopez, N, Mangin, J-F, Poupon, C, Roman, C, Vazquez, A, Maffei, C, Arantes, M, Andrade, JP, Silva, SM, Calhoun, VD, Caverzasi, E, Sacco, S, Lauricella, M, Pestilli, F, Bullock, D, Zhan, Y, Brignoni-Perez, E, Lebel, C, Reynolds, JE, Nestrasil, I, Labounek, R, Lenglet, C, Paulson, A, Aulicka, S, Heilbronner, SR, Heuer, K, Chandio, BQ, Guaje, J, Tang, W, Garyfallidis, E, Raja, R, Anderson, AW, Landman, BA, and Descoteaux, M

Abstract

White matter bundle segmentation using diffusion MRI fiber tractography has become the method of choice to identify white matter fiber pathways in vivo in human brains. However, like other analyses of complex data, there is considerable variability in segmentation protocols and techniques. This can result in different reconstructions of the same intended white matter pathways, which directly affects tractography results, quantification, and interpretation. In this study, we aim to evaluate and quantify the variability that arises from different protocols for bundle segmentation. Through an open call to users of fiber tractography, including anatomists, clinicians, and algorithm developers, 42 independent teams were given processed sets of human whole-brain streamlines and asked to segment 14 white matter fascicles on six subjects. In total, we received 57 different bundle segmentation protocols, which enabled detailed volume-based and streamline-based analyses of agreement and disagreement among protocols for each fiber pathway. Results show that even when given the exact same sets of underlying streamlines, the variability across protocols for bundle segmentation is greater than all other sources of variability in the virtual dissection process, including variability within protocols and variability across subjects. In order to foster the use of tractography bundle dissection in routine clinical settings, and as a fundamental analytical tool, future endeavors must aim to resolve and reduce this heterogeneity. Although external validation is needed to verify the anatomical accuracy of bundle dissections, reducing heterogeneity is a step towards reproducible research and may be achieved through the use of standard nomenclature and definitions of white matter bundles and well-chosen constraints and decisions in the dissection process.

Published
2021

6. Extrastriate projections in human optic radiation revealed by fMRI-informed tractography

Author

Alvarez, I, Schwarzkopf, DS, and Clark, CA

Subjects
Adult, Male, Brain Mapping, Histology, Extrastriate, Neuroscience(all), fMRI, Magnetic Resonance Imaging, Radiography, Young Adult, Diffusion tensor imaging, Nerve Fibers, Image Processing, Computer-Assisted, Optic radiation, Animals, Humans, Original Article, Female, Visual Pathways, Occipital Lobe, Anatomy, Tractography, Visual Cortex
Abstract

The human optic radiation (OR) is the main pathway for conveying visual input to occipital cortex, but it is unclear whether it projects beyond primary visual cortex (V1). In this study, we used functional MRI mapping to delineate early visual areas in 30 healthy volunteers and determined the termination area of the OR as reconstructed with diffusion tractography. Direct thalamo-cortical projections to areas V2 and V3 were found in all hemispheres tested, with a distinct anatomical arrangement of superior–inferior fiber placement for dorsal and ventral projections, respectively, and a medio-lateral nesting arrangement for projections to V1, V2 and V3. Finally, segment-specific microstructure was examined, revealing sub-fascicular information. This is to date the first in vivo demonstration of direct extrastriate projections of the OR in humans.

Published
2014

7. ImmunoglobuliN in the Treatment of Encephalitis (IgNiTE): protocol for a multicentre randomised controlled trial

Author

Iro, MA, Sadarangani, M, Absoud, M, Chong, WK, Clark, CA, Easton, A, Gray, V, Kneen, R, Lim, M, Pike, M, Solomon, T, Vincent, A, Willis, L, Yu, LM, and Pollard, A

Abstract

INTRODUCTION: Infectious and immune-mediated encephalitides are important but under-recognised causes of morbidity and mortality in childhood, with a 7% death rate and up to 50% morbidity after prolonged follow-up. There is a theoretical basis for ameliorating the immune response with intravenous immunoglobulin (IVIG), which is supported by empirical evidence of a beneficial response following its use in the treatment of viral and autoimmune encephalitis. In immune-mediated encephalitis, IVIG is often used after a delay (by weeks in some cases), while diagnosis is confirmed. Wider use of IVIG in infectious encephalitis and earlier use in immune-mediated encephalitis could improve outcomes for these conditions. We describe the protocol for the first ever randomised control trial of IVIG treatment for children with all-cause encephalitis. METHODS AND ANALYSIS: 308 children (6 months to 16 years) with a diagnosis of acute/subacute encephalitis will be recruited in ∼30 UK hospitals and randomised to receive 2 doses (1 g/kg/dose) of either IVIG or matching placebo, in addition to standard treatment. Recruitment will be over a 42-month period and follow-up of each participant will be for 12 months post randomisation. The primary outcome is 'good recovery' (score of 2 or lower on the Glasgow Outcome Score Extended-paediatric version), at 12 months after randomisation. Additional secondary neurological measures will be collected at 4-6 weeks after discharge from acute care and at 6 and 12 months after randomisation. Safety, radiological, other autoimmune and tertiary outcomes will also be assessed. ETHICS AND DISSEMINATION: This trial has been approved by the UK National Research Ethics committee (South Central-Oxford A; REC 14/SC/1416). Current protocol: V4.0 (10/03/2016). The findings will be presented at national and international meetings and conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBERS: NCT02308982, EudraCT201400299735 and ISRCTN15791925; Pre-results.

Published
2016
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10. Endnotes

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

11. Bibliography

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

19. Introduction

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

20. Acknowledgments

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

21. Back Cover

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

23. Cover

Author

Clark, Orlo H. and Clark, Carol Z.

Published
2011

28. A Digital Program (Hope) for People Living With Cancer During the COVID-19 Pandemic: Protocol for a Feasibility Randomized Controlled Trial

Author

Wright, Hayley, Martin, Faith, Clyne, Wendy, Clark, Cain C T, McGillion, Michael, Matouskova, Gabriela, and Turner, Andrew

Subjects
Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract

BackgroundDuring the COVID-19 lockdown period in the United Kingdom that began on March 23, 2020, more than a quarter of a million people with cancer reported worsening mental health. Help to Overcome Problems Effectively (Hope) is a self-management program for people with cancer, designed to provide support for distress, unmet needs, and poor psychological health. In light of social distancing during the COVID-19 pandemic, digital delivery of the Hope Programme has become ever more vital for people with cancer. Previous pre-post studies of the digital Hope Programme have found reduced anxiety and depression and improved well-being for people with cancer. However, evaluation of this evidence has been limited by the lack of a control group in these previous studies. ObjectiveWe now present a protocol for a feasibility randomized controlled trial of the digital Hope Programme for people with cancer during the COVID-19 pandemic. Primary outcomes will be recruitment, dropout, and adherence rates, and estimations of sample and effect size. To detect signals of efficacy, secondary outcomes will be participant mental health and well-being. MethodsParticipants will be recruited by Macmillan Cancer Support (MCS) through their social media networks. The study will employ a feasibility wait-list randomized controlled trial (RCT) design, with people with cancer being randomized to join the digital Hope Programme immediately (intervention group [IG]) or join a 6-week waiting list (wait-list control group [WLCG]) with a 1:1 allocation ratio. Participants will complete digital measures of depression, anxiety, mental well-being, and confidence in managing their own health. Online questionnaires will be administered preprogram and 6 weeks postprogram. ResultsAll people who had requested access to the Hope Programme from MCS (N=61) will be invited to participate in the trial. Baseline data collection commenced in April 2020, and the Hope Programme began for the IG in May 2020 and for the WLCG in June 2020. Postprogram data collection was completed by the end of August 2020. ConclusionsThis feasibility study will provide data to inform the design of a future definitive trial. Wider-scale provision of the digital Hope Programme has potential to improve the lives of thousands of people with cancer and reduce the burden on health care providers during these unprecedented times. Trial RegistrationISRCTN Registry ISRCTN79623250; http://www.isrctn.com/ISRCTN79623250 International Registered Report Identifier (IRRID)DERR1-10.2196/24264

Published
2020
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36. Neonatal white matter abnormalities predict global executive function impairment in children born very preterm.

Author

Woodward LJ, Clark CA, Pritchard VE, Anderson PJ, and Inder TE

Abstract

Using prospective longitudinal data from 110 very preterm and 113 full term children, this article describes the executive functioning abilities of very preterm children at age 4, and examines relations between the extent of white matter abnormality on neonatal magnetic resonance imaging (MRI) and later executive function outcomes. Very preterm children performed less well than full term children on measures of planning ability, cognitive flexibility, selective attention, and inhibitory control. Executive impairments at age 4 were confined to preterm children with mild or moderate-severe white matter abnormalities on MRI. Findings support the importance of cerebral white matter integrity for later executive function. [ABSTRACT FROM AUTHOR]

Published
2011

43. Stability and change in personality pathology: revelations of three longitudinal studies.

Author

Clark CA

Abstract

Three major longitudinal studies of personality disorder jointly provide new insights into the nature of stability and change in this important domain of psychopathology. This commentary highlights some of the many convergent results, which indicate robust findings that can be considered 'established,' and also differences in the studies' purposes and methods that permit each study to make unique contributions. One of the most important findings across the studies is that DSM- diagnosed personality disorder is not as stable as the characteristic traits that underlie personality pathology, leading to the insight that DSM personality disorders are hybrids of more acute, 'Axis I-like' symptoms that resolve more quickly and longer lasting affective, cognitive, and behavioral personality dysfunctions. Implications for future research are considered. [ABSTRACT FROM AUTHOR]

Published
2005
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