Advances in Brain Imaging Review of Psychiatry Series John M. Oldham, M.D. Michelle B. Riba, M.D., M.S. Series Editors No. 4 Washington, DC London, England Advances in Brain Imaging EDITED BY John M. Morihisa, M.D. Note: The authors have worked to ensure that all information in this book concerning drug dosages, schedules, and routes of administration is accurate as of the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice advance, however, therapeutic standards may change. For this reason and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of a physician who is directly involved in their care or the care of a member of their family. A product’s current package insert should be consulted for full prescribing and safety information. Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association. Copyright © 2001 American Psychiatric Publishing, Inc. 04 03 02 01 4 3 2 1 ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper First Edition American Psychiatric Publishing, Inc. 1400 K Street, NW Washington, DC 20005 www.appi.org The correct citation for this book is Morihisa JM (editor): Advances in Brain Imaging (Review of Psychiatry Series, Volume 20, Number 4; Oldham JM and Riba MB, series editors). Washington, DC, American Psychiatric Publishing, 2001 Library of Congress Cataloging-in-Publication Data Advances in brain imaging / edited by John M. Morihisa. p. ; cm. — (Review of psychiatry ; v. 20, no. 4) Includes bibliographical references and index. ISBN 1-58562-028-9 (alk. paper) 1. Brain—Imaging. 2. Mental illness—Diagnosis. I. Morihisa, John M., 1951– II. Review of psychiatry series ; v. 20, 4. [DNLM: 1. Mental Disorders—diagnosis. 2. Brain—physiopathology. 3. Brain Mapping—methods. 4. Diagnostic Imaging—methods. 5. Psychiatry—methods. WM 141 A2445 2001] RC473.B7 A35 2001 616.89′075—dc21 2001016043 British Library Cataloguing in Publication Data A CIP record is available from the British Library. Cover photograph: Copyright © 2001 Custom Medical Stock Photo, Inc. Contents Contributors ix Introduction to the Review of Psychiatry Series xi John M. Oldham, M.D., and Michelle B. Riba, M.D., M.S., Series Editors Foreword xv John M. Morihisa, M.D. Chapter 1 Functional Brain Imaging in Psychiatry: The Next Wave 1 Joseph H. Callicott, M.D. Functional Magnetic Resonance Imaging (fMRI) in Psychiatry 3 A Dynamic Approach to Brain Mapping in Psychiatry 8 Magnetic Resonance and Genetic Susceptibility 15 Conclusions 17 References 18 Chapter 2 Cognitive Neuroscience: The New Neuroscience of the Mind and Its Implications for Psychiatry 25 Cameron S. Carter, M.D. Executive Functions and the Brain 27 ACC and Performance Monitoring 29 DLPFC and Top-Down Control 32 Impaired Executive Functions in Schizophrenia: Role of DLPFC and ACC 36 DLPFC and Impaired Executive Functions in Schizophrenia 38 ACC and Impaired Performance Monitoring in Schizophrenia 41 Overcontrol and Dysfunctional Performance Monitoring in OCD: Role of the ACC 43 Conclusions 45 References 47 Chapter 3 Functional Magnetic Resonance Imaging in Children and Adolescents: Implications for Research on Emotion 53 Daniel S. Pine, M.D. Developmental Psychopathology Perspectives Applied to Mood and Anxiety Disorders 55 Data Implicating Neural Circuits in Pediatric Mood and Anxiety Disorders 59 Using fMRI to Probe Developmental Dysfunction in Neural Circuits 66 Conclusions 74 References 75 Chapter 4 Brain Structure and Function in Late-Life Depression 83 Harold A. Sackeim, Ph.D. Brain Structural Abnormalities: Encephalomalacia 84 Etiology of Encephalomalacia 91 Pathophysiology of Encephalomalacia 94 Volumetric Brain Structural Abnormalities 97 Functional Brain Abnormalities 105 Treatment and Recovery Effects in Late-Life Depression 110 Conclusions 113 References 115 Chapter 5 Neuroimaging Studies of Major Depression 123 Wayne C. Drevets, M.D. Overview of the Imaging Research Program 124 Neurophysiological Imaging Studies of Major Depression 127 Functional Anatomical Correlates of Depression 138 Anatomic Circuits Implicated in MDD 153 Histopathological Findings in the L-T-C and L-C-S-P-T Circuits 154 Clinical Implications and Directions for Future Studies 158 References 159 Afterword 171 John M. Morihisa, M.D. Index 175 Contributors ix Contributors Joseph H. Callicott, M.D. Chief, Unit on Functional MRI, Clinical Brain Disorders Branch, National Institute of Mental Health/National Institutes of Health, Bethesda, Maryland Cameron S. Carter, M.D. Associate Professor, Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania Wayne C. Drevets, M.D. Chief, Mood and Anxiety Disorders Section, NIMH, Bethesda, Maryland; Associate Professor, Departments of Psychiatry and Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania John M. Morihisa, M.D. Professor, Department of Psychiatry, Albany Medical College; Capital District Psychiatric Center, Albany, New York John M. Oldham, M.D. Dollard Professor and Acting Chairman, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York Daniel S. Pine, M.D. Head of Developmental Studies, Program on Mood and Anxiety, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland Michelle B. Riba, M.D., M.S. Associate Chair for Education and Academic Affairs, Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan Harold A. Sackeim, Ph.D. Chief, Department of Biological Psychiatry, New York State Psychiatric Institute; Professor, Departments of Psychiatry and Radiology, College of Physicians and Surgeons of Columbia University, New York [...]... reveal brain structure and function in great detail is remarkable Yet in many ways these techniques still elude clinical application, since they are expensive and increasingly complex to administer and interpret John Morihisa has gathered a group of our best experts to discuss the latest developments in Advances in Brain Imaging, and the shift toward xii ADVANCES IN BRAIN IMAGING greater clinical utility... Carter goes on to describe fascinating developments in cognitive xvi ADVANCES IN BRAIN IMAGING neuroscience that are important to the field of brain imaging Neuroimaging researchers have been able to build upon the basic work of cognitive neuroscience to assist in the interpretation of functional brain imaging findings Carter then emphasizes that when taken together, the work in these two fields of science... that abnormal brain images actually correlate with brain pathology In addition to emphasizing the therapeutic implications of brain- imaging findings, Callicott also suggests that this field may achieve its greatest utility in the search for the genetic bases of psychiatric disorders Indeed, Callicott’s most exciting theme is the future application of brain imaging in concert with genetic findings He gives... scientific advances When taken together, moreover, they begin to inspire one of the most valuable emotions that can be felt by researchers or clinicians in our field: hope for advancement in therapeutic interventions for our patients xviii ADVANCES IN BRAIN IMAGING Chapter 1 Functional Brain Imaging in Psychiatry The Next Wave Joseph H Callicott, M.D Early failure to identify brain lesions in psychiatric... psychiatric help xiv ADVANCES IN BRAIN IMAGING Foreword John M Morihisa, M.D In this new century the field of brain imaging will evolve and grow to fulfill the bright promise it has showed from its beginning over a generation ago This book includes the work of five scientists who are contributing to that growth by investigating a spectrum of psychopathologies using a variety of imaging approaches All have... Resonance Imaging (fMRI) in Psychiatry Advantages such as minimal invasiveness, no radioactivity, widespread availability, and virtually unlimited study repetitions make fMRI ideally suited to the study of in vivo brain function in psychiatry (Levin et al 1995) Before proceeding to the findings themselves, however, it is important to be mindful of the continued limitations of fMRI brain mapping (Weinberger... Nowhere in the field of medicine is technology advancing more rapidly than in brain imaging, generating a level of excitement that surely surpasses the historical moment when the discovery of the X ray first allowed us to noninvasively see into the living human body The new imaging methods, fortunately, do not involve the risk of radiation exposure, and the capacity of the newest imaging machines to... altering the way we conceptualize these illnesses In Chapter 4, Sackeim presents both structural and functional brain imaging findings in patients with late-life depression He reports that there is growing evidence suggesting that patients with this disorder demonstrate an excess of hyperintensities on Foreword xvii magnetic resonance imaging (MRI) Further, Sackeim discusses findings of decreased brain. .. approximately 21% increase in neuronal density (decrease in neuropil) The original intent of in vivo functional brain imaging was to illuminate the underlying physiological disturbances that lead to manifest illness Based on the neurological tradition, alterations in cerebral blood flow or metabolic rate were presumed to mark the brain lesions underlying loss of function However, no independent measures... like schizophrenia In addition, we will examine the use of proton magnetic resonance spectroscopic imaging ( 1H-MRSI) as a method for connecting functional findings with neuronal pathology Finally, in contrast to previous attempts to construe functional imaging findings as diagnostically relevant, we will discuss the use of such findings to guide the search for the genetic underpinnings of neuropsychiatric . Advances in Brain Imaging Review of Psychiatry Series John M. Oldham, M.D. Michelle B. Riba, M.D., M.S. Series Editors No. 4 Washington, DC London, England Advances in Brain Imaging EDITED. 1 Functional Brain Imaging in Psychiatry: The Next Wave 1 Joseph H. Callicott, M.D. Functional Magnetic Resonance Imaging (fMRI) in Psychiatry 3 A Dynamic Approach to Brain Mapping in Psychiatry. GREDEN, M.D. • Advances in Brain Imaging E DITED BY JOHN M. MORIHISA, M.D. In today’s rapidly changing world, the dissemination of infor- mation is one of its rapidly changing elements. Information