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9 results

  • Chapter Six - Images of the Suicidal Brain

  • Kees van Heeringen
  • Book:
    The Neuroscience of Suicidal Behavior
    Published online:
    22 May 2019
    Print publication:
    23 August 2018, pp 102-124

  • Summary

    In addition to neurocognitive studies, neuroimaging techniques provide a unique opportunity to study brain characteristics. Structural imaging studies clearly demonstrate volumetric differences in particular brain areas between individuals with a history of nonfatal suicidal behavior and those without such a history. Functional imaging studies show a reduced prefrontal perfusion or metabolism and a blunted increase in activation when challenged in the brains of individuals with a history of suicide attempts. Moreover, impairment of the prefrontal serotonergic system in association with suicidal behavior is demonstrated in a number of studies. Recent structural and functional imaging studies show changes in cortical and subcortical areas and their connections in association with suicidal behavior and risk factors such as mental pain, hopelessness, and impulsivity. The global picture that emerges from these studies reflects the involvement of a particular circuit in the development of suicidal behavior, the so-called frontothalamic network.

  • Temporo-parietal Brain Activity as a Longitudinal Predictor of Response to Educational Interventions among Middle School Struggling Readers

  • Roozbeh Rezaie, Panagiotis G. Simos, Jack M. Fletcher, Paul T. Cirino, Sharon Vaughn, Andrew C. Papanicolaou
  • Journal:
    Journal of the International Neuropsychological Society / Volume 17 / Issue 5 / September 2011
    Published online by Cambridge University Press:
    11 July 2011, pp. 875-885

  • Spatiotemporal brain activation profiles were obtained from 27 middle school students experiencing difficulties in reading comprehension as well as word-level skills (RD) and 23 age- and IQ-matched non-reading impaired students during performance of an oral pseudoword reading task using Magnetoencephalography (MEG). Based on their scores on standardized reading fluency tests 1 year later, students with RD who showed significant improvement were classified as Adequate Responders (AR) whereas those not demonstrating such gains were classified as Inadequate Responders (IR). At baseline, activation profiles of the AR group featured increased activity in the left supramarginal and angular gyri, as well as in the superior and middle temporal gyri, bilaterally compared to IR. The degree of activity in these regions was a significant predictor of the amount of subsequent gains in reading fluency. These results extend previous functional brain imaging findings of beginning readers, suggesting that recruitment of brain areas that typically serve as key components of the brain circuit for reading is an important factor in determining response to intervention in older struggling readers. (JINS, 2011, 17, 875–885)

  • Chapter 11 - Cortical and subcortical disorders

  • from Section 3 - Specific conditions
  • Edited by Clare J. Fowler, Jalesh N. Panicker, Anton Emmanuel, University College London
  • Book:
    Pelvic Organ Dysfunction in Neurological Disease
    Published online:
    06 December 2010
    Print publication:
    04 November 2010, pp 167-186

  • Summary

    Based on observations under laboratory conditions of over 300 couples, Masters and Johnson identified four discrete phases of the human sexual response as arousal (excitement), plateau, orgasm and satisfaction. This sequence was subsequently modified to include the phase of sexual drive: Kaplan proposed a triphasic response model, each phase with a distinct underlying neurophysiological basis. Libido is defined as the biological need for sexual activity (sex drive) and depends upon hypothalamic and temporal lobe functioning. This chapter outlines the roles of the subcortical and cortical regions, spinal connections and peripheral innervation involved in the phases of the human sexual cycle, with reference to the experimental animal literature and mention of the dysfunctions that can result from neurological disease at each level. Findings from recent functional imaging experiments are discussed in the context of the role of the cortical regions in human neurological control of sexual function.

  • Frontostriatal activation in patients with obsessive–compulsive disorder before and after cognitive behavioral therapy

  • T. Freyer, S. Klöppel, O. Tüscher, A. Kordon, B. Zurowski, A.-K. Kuelz, O. Speck, V. Glauche, U. Voderholzer
  • Journal:
    Psychological Medicine / Volume 41 / Issue 1 / January 2011
    Published online by Cambridge University Press:
    18 March 2010, pp. 207-216
  • Background

    Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the psychotherapeutic treatment of choice for obsessive–compulsive disorder (OCD). However, little is known about the impact of CBT on frontostriatal dysfunctioning, known to be the neuronal correlate of OCD.

    Method

    A probabilistic reversal learning (RL) task probing adaptive strategy switching capabilities was used in 10 unmedicated patients with OCD and 10 healthy controls during an event-related functional magnetic resonance imaging (fMRI) experiment. Patients were scanned before and after intensive CBT, controls twice at comparable intervals.

    Results

    Strategy change within the RL task involved activity in a broad frontal network in patients and controls. No significant differences between the groups or in group by time interactions were detected in a whole-brain analysis corrected for multiple comparisons. However, a reanalysis with a more lenient threshold revealed decreased responsiveness of the orbitofrontal cortex and right putamen during strategy change before treatment in patients compared with healthy subjects. A group by time effect was found in the caudate nucleus, demonstrating increased activity for patients over the course of time. Patients with greater clinical improvement, reflected by greater reductions in Yale–Brown Obsessive Compulsive Scale (YBOCS) scores, showed more stable activation in the pallidum.

    Conclusions

    Although these findings are preliminary and need to be replicated in larger samples, they indicate a possible influence of psychotherapy on brain activity in core regions that have been shown to be directly involved both in acquisition of behavioral rules and stereotypes and in the pathophysiology of OCD, the caudate nucleus and the pallidum.

  • Functional Brain Imaging as a Surrogate Marker in Vascular Cognitive Impairment

  • Etsuro Mori
  • Journal:
    International Psychogeriatrics / Volume 15 / Issue S1 / July 2003
    Published online by Cambridge University Press:
    10 January 2005, pp. 267-272

  • Functional brain imaging represents cerebrovascular status, neuronal status, and neuronetwork status, and plays an increasingly important role in the evaluation of vascular cognitive impairment or vascular dementia. In this article, the roles of functional brain imaging are discussed in evaluation of subcortical lesions disrupting cortico-subcortical circuits and in the study of white-matter changes in dementia. Also mentioned is an ongoing clinical trial of extracranial-intracranial artery bypass surgery for hemispheric hemodynamic misery perfusion where single-photon emission tomography is used as a surrogate measure.

  • 6 - Structural and functional brain imaging in treatment-resistant depression

  • from Part II - Biological basis
  • Edited by Jay D. Amsterdam, University of Pennsylvania, Mady Hornig, University of California, Irvine, Andrew A. Nierenberg
  • Book:
    Treatment-Resistant Mood Disorders
    Published online:
    25 March 2010
    Print publication:
    28 June 2001, pp 111-141

  • Summary

    This chapter shows that structural and functional brain imaging methods have offered into the neural substrates of affective processes as well as the current and possible future utility of these methods in the evaluation and management of patients with treatment-resistant mood disorders. Neuroanatomic models of the substrates of affective processes were originally derived from non-human animal studies in addition to postmortem and in vivo studies of humans with brain trauma, neurologic, and psychiatric disorders. The chapter reviews brain imaging studies in mood disorders, which in many cases demonstrate disruptions in anterior paralimbic structures and anterior basal ganglia-thalamocortical circuits. Many of these studies involved treatment-resistant patients or patients in tertiary care institutions and thus may be particularly indicative of the neurobiology of treatment-resistant mood disorders. Thus, a useful initial approach to the treatment-resistant mood disorder patient is to reassess whether the disorder is primary or secondary.

  • 1 - Functional brain imaging with PET and SPECT

  • from Part 1 - Techniques of functional neuroimaging
  • Edited by Monique Ernst, National Institutes of Health, Baltimore, Judith M. Rumsey, National Institute of Mental Health, Bethesda, Maryland
  • Foreword by Joseph T. Coyle
  • Book:
    Functional Neuroimaging in Child Psychiatry
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 3-26

  • Summary

    Two nuclear medicine-based approaches to functional brain imaging can be used to study the pediatric population, positron emission tomography (PET) and single-photon emission computed tomography (SPECT). This chapter talks about PET instrumentation, positron-emitting radiotracers, and radiotracer modeling. It describes the PET methods used to measure cerebral blood flow (rCBF) and cerebral blood volume (rCBV) and glucose and oxygen metabolism. Measurements of CBF glucose metabolism are widely used as indices of neuronal activity. The radionuclides used in SPECT decay by emitting a single photon or gamma ray from their nucleus; radioactivity distribution is estimated by detection of gamma rays. To interpret changes in PET and SPECT studies, it is necessary to understand the relationships among CBF, metabolism, and local neuronal activity. Radiation exposure in the context of PET and SPECT is an important consideration when they are used for research rather than diagnostic purposes.

  • 11 - Functional imaging in childhood-onset schizophrenia

  • from Part 4 - Psychiatric disorders
  • Edited by Monique Ernst, National Institutes of Health, Baltimore, Judith M. Rumsey, National Institute of Mental Health, Bethesda, Maryland
  • Foreword by Joseph T. Coyle
  • Book:
    Functional Neuroimaging in Child Psychiatry
    Published online:
    06 January 2010
    Print publication:
    12 October 2000, pp 189-204

  • Summary

    This chapter deals with the developmental theories of schizophrenia to provide a foundation for a discussion of functional brain imaging studies of childhood-onset schizophrenia. Neurochemical brain imaging methodologies have permitted testing of the dopamine hypothesis of schizophrenia. Clinical studies have demonstrated prominent premorbid developmental delays in childhood-onset schizophrenia, especially in the areas of speech and language. Neurobiologic studies of the NIMH childhood-onset schizophrenia sample have generally supported neurobiologic continuity between childhood- and adult-onset schizophrenia. Very few functional brain imaging studies have been conducted in patients with childhood-onset schizophrenia. The only study of cerebral glucose metabolism in childhood-onset schizophrenia has been conducted with a subset of the National Institute of Mental Health (NIMH) childhood-onset schizophrenia sample. The finding of cerebellar hypermetabolism in childhood-onset schizophrenia, seen with both data analytic approaches, is notable in light of recent evidence implicating the cerebellum in higher cortical processes.

  • Practitioner Review: Routes from Research to Clinical Practice in Child Psychiatry: Retrospect and Prospect

  • Michael Rutter
  • Journal:
    The Journal of Child Psychology and Psychiatry and Allied Disciplines / Volume 39 / Issue 6 / September 1998
    Published online by Cambridge University Press:
    01 September 1998, pp. 805-816
    Print publication:
    September 1998

  • The last 40 years has seen a virtual revolution in both medical research and medical practice. Child psychiatry has been part of that revolution. The situation in the 1950s is briefly noted and seven examples are used to illustrate how causal research in the past has led to changes in clinical practice. The areas used as examples comprise: autism, hyperactivity/attention deficit syndromes, conduct disorders, depressive conditions, genetic research, organic brain dysfunction, and psychosocial risk processes. Prospects for the future with respect to the impact of research on clinical practice are discussed in relation to molecular genetics, environmental risks, cognitive and affective processing of experiences, links across the lifespan, and functional brain imaging. Attention is drawn to implications for training as well as for practice.