23 - Functional neuroimaging in child psychiatry: future directions

Summary

Introduction

The future of functional neuroimaging in child psychiatry is bound not only to technologic progress but also to the refinement of our skills in exploiting these techniques to answer the ultimate questions of why and how symptoms occur. These skills require a clear understanding of the physiologic meaning of the signals recorded by the various neuroimaging techniques, the formulation of rational models of normal and deviant processes that can be evaluated systematically in a logical and stepwise fashion, and the intimately interactive and synergistic collaboration with other disciplines. Indeed, clinical taxonomy, psychopharmacology, molecular genetics, and basic neuroscience all provide critical clues for understanding the mechanisms underlying psychiatric disorders.

Ultimately, hypothesis generation and the interpretation of functional neuroimaging findings in child psychiatry will rely heavily upon the synthesis of scientific evidence originating from neuroscience and clinical research. The impact of brain maturation and brain plasticity lies at the forefront of the understanding of brain imaging findings in children and adolescents. How one approaches questions depends on one's theoretical assumptions concerning the extent of the brain's capacity for plasticity, the regional convergence and divergence of inputs, and the degree of equipotency of brain regions for adaptation. Functional neuroimaging can serve to bridge clinical science and basic neuroscience and, in doing so, realize its potential for translating advances in neuroscience into clinical applications.