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Chapter 36 - Psychiatric and neurodegenerative disease

overview

from Section 6 - Psychiatric and neurodegenerative diseases

Published online by Cambridge University Press:  05 March 2013

By
Adam D. Waldman
Edited by
Jonathan H. Gillard ,
Adam D. Waldman  and
Peter B. Barker
Jonathan H. Gillard
Affiliation:
University of Cambridge
Adam D. Waldman
Affiliation:
Imperial College London
Peter B. Barker
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

Introduction

The advent of neuroimaging techniques that yield physiological in addition to structural information are of particular interest in the scientific and clinical investigations of neurodegenerative and psychiatric disorders. These are groups of conditions where any structural changes that are evident on anatomical imaging sequences generally correlate poorly with clinical diagnostic categories, underlying pathophysiology, and disease severity.

The T1- and T2-dependent MR sequences, on which most routine clinical neuroimaging relies, are frequently insensitive to the underlying pathological processes in these diseases. Focal or global atrophy from associated neuronal loss is also frequently subtle or absent, particularly early in the course of disease. As a result, clinical brain imaging using standard techniques is frequently normal, or non-specifically abnormal.

Physiological imaging can be considered to have two main purposes in this context. The first is clinical: to provide diagnostic information which augments that available from clinical examination, laboratory tests, and conventional structural brain imaging. The aim here is to increase the sensitivity and/or specificity of the imaging examination as a whole and to improve diagnostic confidence, which will ultimately guide clinical management. In this context, the technique must provide a surrogate marker of disease that is of predictive value in diagnosis or prognosis for an individual patient.

Type
Chapter
Information
Clinical MR Neuroimaging
Physiological and Functional Techniques
 , pp. 561 - 565
Publisher: Cambridge University Press
Print publication year: 2009

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