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La investigación para el conocimiento del cerebro es una ciencia joven, su inicio se remonta a Santiago Ramón y Cajal en 1888. Desde esta fecha a nuestro tiempo la neurociencia ha avanzado mucho en el desarrollo de técnicas que permiten su estudio. Desde la neurociencia cognitiva hoy se explican muchos modelos que nos permiten acercar a nuestro entendimiento a capacidades cognitivas complejas. Aun así hablamos de una ciencia casi en pañales que tiene un lago recorrido por delante. Una de las claves del éxito en los estudios de la función cerebral ha sido convertirse en una disciplina que combina conocimientos de diversas áreas: de la física, de las matemáticas, de la estadística y de la psicología. Esta es la razón por la que a lo largo de este trabajo se entremezclan conceptos de diferentes campos con el objetivo de avanzar en el conocimiento de un tema tan complejo como el que nos ocupa: el entendimiento de la mente humana. Concretamente, esta tesis ha estado dirigida a la integración multimodal de la magnetoencefalografía (MEG) y la resonancia magnética ponderada en difusión (dMRI). Estas técnicas son sensibles, respectivamente, a los campos magnéticos emitidos por las corrientes neuronales, y a la microestructura de la materia blanca cerebral. A lo largo de este trabajo hemos visto que la combinación de estas técnicas permiten descubrir sinergias estructurofuncionales en el procesamiento de la información en el cerebro sano y en el curso de patologías neurológicas. Más específicamente en este trabajo se ha estudiado la relación entre la conectividad funcional y estructural y en cómo fusionarlas. Para ello, se ha cuantificado la conectividad funcional mediante el estudio de la sincronización de fase o la correlación de amplitudes entre series temporales, de esta forma se ha conseguido un índice que mide la similitud entre grupos neuronales o regiones cerebrales. Adicionalmente, la cuantificación de la conectividad estructural a partir de imágenes de resonancia magnética ponderadas en difusión, ha permitido hallar índices de la integridad de materia blanca o de la fuerza de las conexiones estructurales entre regiones. Estas medidas fueron combinadas en los capítulos 3, 4 y 5 de este trabajo siguiendo tres aproximaciones que iban desde el nivel más bajo al más alto de integración. Finalmente se utilizó la información fusionada de MEG y dMRI para la caracterización de grupos de sujetos con deterioro cognitivo leve, la detección de esta patología resulta relevante en la identificación precoz de la enfermedad de Alzheimer. Esta tesis está dividida en seis capítulos. En el capítulos 1 se establece un contexto para la introducción de la connectómica dentro de los campos de la neuroimagen y la neurociencia. Posteriormente en este capítulo se describen los objetivos de la tesis, y los objetivos específicos de cada una de las publicaciones científicas que resultaron de este trabajo. En el capítulo 2 se describen los métodos para cada técnica que fue empleada: conectividad estructural, conectividad funcional en resting state, redes cerebrales complejas y teoría de grafos y finalmente se describe la condición de deterioro cognitivo leve y el estado actual en la búsqueda de nuevos biomarcadores diagnósticos. En los capítulos 3, 4 y 5 se han incluido los artículos científicos que fueron producidos a lo largo de esta tesis. Estos han sido incluidos en el formato de la revista en que fueron publicados, estando divididos en introducción, materiales y métodos, resultados y discusión. Todos los métodos que fueron empleados en los artículos están descritos en el capítulo 2 de la tesis. Finalmente, en el capítulo 6 se concluyen los resultados generales de la tesis y se discuten de forma específica los resultados de cada artículo. ABSTRACT In this thesis I apply concepts from mathematics, physics and statistics to the neurosciences. This field benefits from the collaborative work of multidisciplinary teams where physicians, psychologists, engineers and other specialists fight for a common well: the understanding of the brain. Research on this field is still in its early years, being its birth attributed to the neuronal theory of Santiago Ramo´n y Cajal in 1888. In more than one hundred years only a very little percentage of the brain functioning has been discovered, and still much more needs to be explored. Isolated techniques aim at unraveling the system that supports our cognition, nevertheless in order to provide solid evidence in such a field multimodal techniques have arisen, with them we will be able to improve current knowledge about human cognition. Here we focus on the multimodal integration of magnetoencephalography (MEG) and diffusion weighted magnetic resonance imaging. These techniques are sensitive to the magnetic fields emitted by the neuronal currents and to the white matter microstructure, respectively. The combination of such techniques could bring up evidences about structural-functional synergies in the brain information processing and which part of this synergy fails in specific neurological pathologies. In particular, we are interested in the relationship between functional and structural connectivity, and how two integrate this information. We quantify the functional connectivity by studying the phase synchronization or the amplitude correlation between time series obtained by MEG, and so we get an index indicating similarity between neuronal entities, i.e. brain regions. In addition we quantify structural connectivity by performing diffusion tensor estimation from the diffusion weighted images, thus obtaining an indicator of the integrity of the white matter or, if preferred, the strength of the structural connections between regions. These quantifications are then combined following three different approaches, from the lowest to the highest level of integration, in chapters 3, 4 and 5. We finally apply the fused information to the characterization or prediction of mild cognitive impairment, a clinical entity which is considered as an early step in the continuum pathological process of dementia. The dissertation is divided in six chapters. In chapter 1 I introduce connectomics within the fields of neuroimaging and neuroscience. Later in this chapter we describe the objectives of this thesis, and the specific objectives of each of the scientific publications that were produced as result of this work. In chapter 2 I describe the methods for each of the techniques that were employed, namely structural connectivity, resting state functional connectivity, complex brain networks and graph theory, and finally, I describe the clinical condition of mild cognitive impairment and the current state of the art in the search for early biomarkers. In chapters 3, 4 and 5 I have included the scientific publications that were generated along this work. They have been included in in their original format and they contain introduction, materials and methods, results and discussion. All methods that were employed in these papers have been described in chapter 2. Finally, in chapter 6 I summarize all the results from this thesis, both locally for each of the scientific publications and globally for the whole work.

Neuroimaging research involves analyses of huge amounts of biological data that might or might not be related with cognition. This relationship is usually approached using univariate methods, and, therefore, correction methods are mandatory for reducing false positives. Nevertheless, the probability of false negatives is also increased. Multivariate frameworks have been proposed for helping to alleviate this balance. Here we apply multivariate distance matrix regression for the simultaneous analysis of biological and cognitive data, namely, structural connections among 82 brain regions and several latent factors estimating cognitive performance. We tested whether cognitive differences predict distances among individuals regarding their connectivity pattern. Beginning with 3,321 connections among regions, the 36 edges better predicted by the individuals' cognitive scores were selected. Cognitive scores were related to connectivity distances in both the full (3,321) and reduced (36) connectivity patterns. The selected edges connect regions distributed across the entire brain and the network defined by these edges supports high-order cognitive processes such as (a) (fluid) executive control, (b) (crystallized) recognition, learning, and language processing, and (c) visuospatial processing. This multivariate study suggests that one widespread, but limited number, of regions in the human brain, supports high-level cognitive ability differences. Hum Brain Mapp, 2016. © 2016 Wiley Periodicals, Inc. PSI2010-20364 PSI2015-65557-P PSI2013-44300-P BES-2011-043527 AP2008-00433 4.927 JCR (2017) Q1, 48/261 Neurosciences, 2/14 Neuroimaging, 16/128 Radiology, Nuclear Medicine and Medical Imaging UEM

Motor tremor-related syndromes like essential tremor (ET) and Parkinson?s disease (PD) have a common symptomatology in early stages: the presence of tremor. Even when both diseases have a different aetiology and, thus, different prognosis and treatment, the symptoms in early stages are quite similar. This usually leads to misdiagnosis, with the associated risks and limitations. A PD patient with an ET treatment will continue developing the disease, loosing an important window of action. On the other hand, an ET patient with a PD treatment will suffer strong side effects. A correct diagnosis is in both cases mandatory for the well-being of the patients. In this experiment we tried to find a biomarker based in magneto-physiological data that allows clinicians a faster and easier diagnosis of ET and PD patients, saving time and money to both patients and hospitals.

To determine whether functional connectivity patterns, as an index of synaptic dysfunction, associate with cerebrospinal fluid (CSF) biomarkers (i.e., phospho-tau and amyloid beta -A 42- levels) in patients with Mild Cognitive Impairment due to Alzheimer?s disease. We also assessed orrelations of aberrant functional connections with structural connectivity abnormalities and with cognitive deficits

Whole brain resting state connectivity is a promising biomarker that might help to obtain an early diagnosis in many neurological diseases, such as dementia. Inferring resting-state connectivity is often based on correlations, which are sensitive to indirect connections, leading to an inaccurate representation of the real backbone of the network. The precision matrix is a better representation for whole brain connectivity, as it considers only direct connections. The network structure can be estimated using the graphical lasso (GL), which achieves sparsity through l1-regularization on the precision matrix. In this paper, we propose a structural connectivity adaptive version of the GL, where weaker anatomical connections are represented as stronger penalties on the corre- sponding functional connections. We applied beamformer source reconstruction to the resting state MEG record- ings of 81 subjects, where 29 were healthy controls, 22 were single-domain amnestic Mild Cognitive Impaired (MCI), and 30 were multiple-domain amnestic MCI. An atlas-based anatomical parcellation of 66 regions was ob- tained for each subject, and time series were assigned to each of the regions. The fiber densities between the re- gions, obtained with deterministic tractography from diffusion-weighted MRI, were used to define the anatomical connectivity. Precision matrices were obtained with the region specific time series in five different frequency bands. We compared our method with the traditional GL and a functional adaptive version of the GL, in terms of log-likelihood and classification accuracies between the three groups. We conclude that introduc- ing an anatomical prior improves the expressivity of the model and, in most cases, leads to a better classification between groups.

Anatomical 3D T1 weighted images have been widely used to assess the volume of subcortical structures. It has been demonstrated that volume loss of hippocampi, entorhinal cortex and amygdala are early biomarkers for the diagnosis of cognitive impairments and AD1. In this work, we investigate AD biomarkers based on brain connectivity. SC-FC differences have been reported between controls and patients at risk for AD2. We will try to anticipate to MCI or AD diagnoses by differentiating in a sample of healthy subjects, i.e. with no cognitive impairment, other than related to ageing, using as criterion of separation the normalized hippocampal volume (NHV). The sample is formed by volunteers in the Valleca?s Initiative, a longitudinal study evaluating normal ageing in a cohort of more than 600 healthy elder people (70-85 years). The prevalence of AD in people older than 65 years is 13%3 suggesting that a certain number of those subjects will develop AD in the next years. The subjects with lower NHV are more prone to have AD than subjects with higher NHV. Thus they are more likely to manifest connectivity patterns that can be considered as AD biomarkers.

Many studies have assessed the characterization of anatomical or functional connectivity in mild cognitive impairment (MCI), however it is still unknown how they are related in the course of the pathology. Here we integrate the analysis of magnetoencephalographic (MEG) data with white matter (WM) integrity quantification from diffusion weighted imaging (DWI), to asses whether the damage in the WM tracts disrupt the organization of the functional networks.

There are several studies focused on comparing rsFC networks with their structural substrate \cite{hagmann2008, honey2010}. However an accurate description of how anatomo-­functional connections are organized, both at physical and topological levels, is still to be defined. Here we present an approach to quantify the anatomo-functional organization and discuss its consistency.

Fixation-off sensitivity (FOS) denotes the forms of epilepsy elicited by elimination of fixation. FOS-IGE patients are rare cases [1]. In a previous work [2] we showed that two FOS-IGE patients had different altered EEG rhythms when closing eyes; only beta band was altered in patient 1 while theta, alpha and beta were altered in patient 2. In the present work, we explain the relationship between the altered brain rhythms in these patients and the disruption in functional brain networks.

In this work, we describe hubs organization within the olfactory network with Functional Magnetic Resonance Imaging (fMRI). Granger causality analyses were applied in the supposed regions of interest (ROIs) involved in olfactory tasks, as described in [1]. We aim to get deeper knowledge about the hierarchy of the regions within the olfactory network and to describe which of these regions, in terms of strength of the connectivity, impair in different types of anosmia.

This contribution reviews the current state of art comprising the application of Complex Networks Theory to the analysis of functional brain networks. We briefly overview the main advances in this field during the last decade and we explain how graph analysis has increased our knowledge about how the brain behaves when performing a specific task or how it fails when a certain pathology arises. We also show the limitations of this kind of analysis, which have been a source of confusion and misunderstanding when interpreting the results obtained. Finally, we discuss about a possible direction to follow in the next years.

Introduction: Therapeutic strategies targeting protein aggregations are ready for clinical trials in atypical parkinsonian disorders. Therefore, there is an urgent need for neuroimaging biomarkers to help with the early detection of neurodegenerative processes, the early differentiation of the underlying pathology, and the objective assessment of disease progression. However, there currently is not yet a consensus in the field on how to describe utility of biomarkers for clinical trials in atypical parkinsonian disorders. Methods: To promote standardized use of neuroimaging biomarkers for clinical trials, we aimed to develop a conceptual framework to characterize in more detail the kind of neuroimaging biomarkers needed in atypical parkinsonian disorders, identify the current challenges in ascribing utility of these biomarkers, and propose criteria for a system that may guide future studies. Results: As a consensus outcome, we describe the main challenges in ascribing utility of neuroimaging biomarkers in atypical parkinsonian disorders, and we propose a conceptual framework that includes a graded system for the description of utility of a specific neuroimaging measure. We included separate categories for the ability to accurately identify an intention-to-treat patient population early in the disease (Early), to accurately detect a specific underlying pathology (Specific), and the ability to monitor disease progression (Progression). Discussion: We suggest that the advancement of standardized neuroimaging in the field of atypical parkinsonian disorders will be furthered by a well-defined reference frame for the utility of biomarkers. The proposed utility system allows a detailed and graded description of the respective strengths of neuroimaging biomarkers in the currently most relevant areas of application in clinical trials.

INTRODUCTION: Therapeutic strategies targeting protein aggregations are ready for clinical trials in atypical parkinsonian disorders. Therefore, there is an urgent need for neuroimaging biomarkers to help with the early detection of neurodegenerative processes, the early differentiation of the underlying pathology, and the objective assessment of disease progression. However, there currently is not yet a consensus in the field on how to describe utility of biomarkers for clinical trials in atypical parkinsonian disorders. METHODS: To promote standardized use of neuroimaging biomarkers for clinical trials, we aimed to develop a conceptual framework to characterize in more detail the kind of neuroimaging biomarkers needed in atypical parkinsonian disorders, identify the current challenges in ascribing utility of these biomarkers, and propose criteria for a system that may guide future studies. RESULTS: As a consensus outcome, we describe the main challenges in ascribing utility of neuroimaging biomarkers in atypical parkinsonian disorders, and we propose a conceptual framework that includes a graded system for the description of utility of a specific neuroimaging measure. We included separate categories for the ability to accurately identify an intention-to-treat patient population early in the disease (Early), to accurately detect a specific underlying pathology (Specific), and the ability to monitor disease progression (Progression). DISCUSSION: We suggest that the advancement of standardized neuroimaging in the field of atypical parkinsonian disorders will be furthered by a well-defined reference frame for the utility of biomarkers. The proposed utility system allows a detailed and graded description of the respective strengths of neuroimaging biomarkers in the currently most relevant areas of application in clinical trials.

(SPA)La enfermedad del Parkinson es una enfermedad neurodegenerativa que afecta al sistema motor provocando los temblores característicos en los pacientes. El proyecto abarca la obtención y la evaluación de biomarcadores para la enfermedad del Parkinson. Los biomarcadores son obtenidos mediante imágenes de resonancia magnética sensibles a la neuromelanina. Todas las imágenes de los pacientes se registran de manera afín en el espacio de un sujeto, llamado sujeto estándar. De esta manera los resultados del volumen de las estructuras tomadas como posibles biomarcadores está normalizado. La obtención de resultados se realizó de dos formas, manual y automática. Durante el estudio, se observó una pérdida de neuromelanina en la sustancia nigra de manera manual y automática, sin embargo, en la estructura del locus ceroleus, de forma automática no se observó la pérdida de neuromelanina. Los resultados del volumen de la sustancia nigra, como biomarcador, son mejores que para el volumen del locus ceroleus. Lo que se debe al reducido tamaño del locus ceroleus y a la baja resolución de las imágenes disponibles. Para determinar la calidad de los biomarcadores se evaluaron mediante el análisis de varianza (ANOVA) y el análisis de validación cruzada dejando uno fuera (LOO). Además, a partir del LOO se obtiene el rendimiento del biomarcador mediante el área bajo la curva y sus características operativas (ROC). (ENG)Parkinson's disease is a neurodegenerative disease that affects the motor system causing characteristic tremors in patients. The project includes obtaining and evaluation biomarkers for Parkinson's disease. Biomarkers are obtained by magnetic resonance imaging sensitive to neuromelanin. All patient's images are registered by afin register in the space of a subject, called standard subject. In this way the results of the volume of the structures taken as possible biomarkers is normalized. The results were obtained of two ways, manual and automatic. During the study, a loss of neuromelanin in the substantia nigra was observed manually and automatically. However, in the structure of the locus ceroleus, the loss of neuromelanin was not observed in the automatic method. The results of the volume of the substantia nigra, as a biomarker, are better than the volume of the locus ceroleus. That which is due to the small size of the locus ceroleus and the low resolution of the available images. To determine the quality of the biomarkers were evaluated by analysis of variance (ANOVA) and cross-validation analysis leaving one out (LOO). In addition, the biomarker performance is obtained from the LOO through the area under the curve and its operational characteristics (ROC).