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Functional MRI: Applications in Clinical Neurology and Psychiatry

2006 Edition, April 13, 2006

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Active, Most Current

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ISBN: 978-0-203-09044-2
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Product Details:

  • Revision: 2006 Edition, April 13, 2006
  • Published Date: April 13, 2006
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 226
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Almost 15 years have passed since functional MRI (fMRI) was introduced as a new method for the non-invasive study of human brain function. The impact it had on the disciplines of neuroscience and psychology was immediate. Scientists investigating neural mechanisms underlying sensory, motor, and cognitive processes in humans with other methods – such as neuropsychological studies of patients with brain dysfunction or eventrelated potential recording – were presented with a new tool that had the potential to provide converging evidence to support their hypotheses. Importantly, the introduction of fMRI did not replace other neuroscientific methods for studying human brain function, instead, it provided a new and different way of examining brain-behavior relationships, and with superb temporal and spatial resolution. The success of fMRI has led to an exponential increase over the past five years in its use to study the brain function. A bibliographic search for the term ‘fMRI' in MEDLINE in the year 2004 leads to almost 5000 citations. The results of this search also reveal that fMRI studies are being published in a wide range of journals across many disciplines. Advances in fMRI methods in both data acquisition and data analysis are occurring at a rapid pace, which will likely fuel even more widespread use of this tool in the future.

The clinical utility of fMRI has been slower to materialize when compared to the impact fMRI has had on basic neuroscience applications. There are probably many reasons for this observation. First, it will most likely take substantial experience and validation of fMRI methods before it replaces trusted and reliable diagnostic tools used by neurologists and psychiatrists, such as the Wada test or EEG. However, as reviewed in this book, many such fMRI methods are currently being developed and validated and are beginning to gain acceptance for clinical use. For example, there are several different fMRI language mapping protocols that provide information comparable to that provided by the Wada test. A second likely reason that clinical applications of fMRI have been slower to develop is that fMRI data collected from patients with neurological and psychiatric disorders are more difficult to interpret, compared with data collected from individuals with a healthy brain. Most often, fMRI data is treated as a ‘brain map' in a qualitative fashion with attempts to interpret patterns of activity. To be clinically useful, methods for analyzing fMRI will also have to take a quantitative approach. Moreover, it will be imperative that any clinician who uses this method understands exactly what is being measured with fMRI. The first two chapters of this book provide an overview of how fMRI compares with other functional neuroimaging methods such as positron emission tomography (PET), and describe the basic underlying concepts and principles of fMRI, as well as approaches in its use for studying brain function.

Although we have less experience with ‘clinical' fMRI data, there is significant momentum in the use of fMRI as a clinical tool, and numerous clinical fMRI studies are being published. In this book, we present a collection of chapters that highlight its application in neurological and psychiatric disorders. Prior to fMRI, PET was the predominant functional neuroimaging method for studying human brain function, thus, each chapter also reviews the relevant literature using this method. This book was not meant to be an exhaustive review of all of the clinical uses of fMRI, instead, I have chosen selective examples of clinical conditions where I believe fMRI has made significant progress. I am confident that in the not too distant future, the number and range of clinical conditions that can be studied using fMRI will greatly expand.

After reading this book it should be clear that there are many different ways that fMRI could aid the clinician in the diagnosis or treatment of a neurological or psychiatric disorder. One way would be for it to develop as a reliable and valid diagnostic tool. For example, it may be capable of providing biomarkers that predict the development of neurodegenerative disorders such as Alzheimer's disease before the onset of symptoms, or guide a neurosurgeon's decisions prior to epilepsy or brain tumor surgery. Development of such biomarkers may help predict which patients may benefit from rehabilitation interventions or aid in the monitoring of therapeutic interventions. Another important contribution of fMRI would be for it to provide a better understanding of the pathophysiology underlying neurological and psychiatric disorders. As we review in this book, fMRI studies of clinical conditions have begun to provide insight into neurological disorders such as stroke, traumatic brain injury and neurodegenerative disease; psychiatric disorders such as schizophrenia, depression and anxiety; developmental disorders such as dyslexia; and other important clinical conditions such as pain and drug addiction. Thus, it is clear that fMRI has enormous potential for studying brain function and is poised to have a tremendous impact on many aspects of clinical neurology and psychiatry. For these reasons, I hope that trainees and clinicians that diagnose and care for patients with neurological and psychiatric disorders find the information provided in this book valuable.