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Neurotherapeutics: The Journal of the American Society for Experimental NeuroTherapeutics
Neuroimaging in Psychiatric Disorders
Joseph C. Masdeu
Section on Integrative Neuroimaging, Intramural Research Program, National Institutes of Health (NIH/NIMHCBDB), 9000 Rockville Pike, Building 10, Room 3C111, Bethesda, Maryland 20892-1365
Summary: In psychiatry, neuroimaging facilitates the diagnosis of psychiatric disorders and the development of new medications. It is used to detect structural lesions causing psychosis and to differentiate depression from neurodegenerative disorders or brain tumors. Functional neuroimaging, mostly in the form of molecular neuroimaging with positron emission tomography or single
photon emission tomography, facilitates the identication of therapeutic targets, the determination of the dose of a new drug needed to occupy its target in the brain, and the selection of patients for clinical trials. Key Words: Magnetic resonance imaging, Positron emission tomography, Single photon emission tomography, Depression, Schizophrenia, Drug development.
INTRODUCTION
Unlike many neurological disorders, psychiatric disorders do not cause changes visible to the naked eye in the neuroimaging study of the individual patient [1]. They are, however, amenable to investigation by recent neuroimaging modalities, particularly quantitative structural imaging, as exemplied by voxel-based morphometry, and functional neuroimaging, using magnetic resonance imaging (MRI) techniques, positron emission tomography (PET), and single photon emission tomography (SPECT). Additionally, in the last few years psychiatric neuroimaging has benetted from its interaction with genetics (imaging genetics). In such studies, neuroimaging ndings in two or more genetic variants of the population are compared in order to discover imaging endophenotypes that may be amenable to measurement, and, therefore, useful as biomarkers in therapeutic discovery [2]. By relating neural structures to specic genes, imaging genetics is also likely to reveal the molecular underpinning of the organization and function of the various brain structures [2].
In this article I will review rst the use of neuroimaging in the diagnosis of psychiatric disorders and then its use in the development of drugs to treat these disorders.
NEUROIMAGING IN THE DIFFERENTIAL DIAGNOSIS OF NEUROPSYCHIATRIC
SYNDROMES
Neuroimaging may help arrive at the correct diagnosis in a patient presenting with psychiatric symptoms. Such symptoms may be caused by neurological diseases masking as psychiatric disorders or by disorders currently considered to be primarily psychiatric in nature.
Neuroimaging to diagnose neurological diseases masquerading as psychiatric disorders
Neuroimaging is routinely used in the...