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  • 1. David Linden School of Psychology, University of Wales, Bangor North West Wales NHS Trust North Wales Brain Injury Service Research Development Group „Neuroimaging“ A round peg in a square hole? It did fit in the end… Neuroimaging in psychiatry? Filley & Kleinschmidt-DeMasters, West J Med, 1995 56 year old female patient with 3year history of apathy, social withdrawal, poor self care; Admitted for depression Why to use structural neuroimaging in psychiatry? • Rule our other (treatable) causes of psychopathology • Understand biological basis of mental disorders and brain effects of environmental stressors • Do structural changes in specific brain areas or pathways correlate with symptoms? • Longitudinal studies, e.g. predictive value in prodromal schizophrenia or Mild Cognitive Impairment, assessment of neurodegeneration • Changes in high-risk groups: endophenotypes? Why to use functional MRI (and other measures of brain activation) in psychiatry? • Human neuroimaging/ neurophysiology needed for biological basis of mental diseases • Structural imaging alone: often no clear correlates of psychopathology/ deficit • Longitudinal studies possible because of non- invasive nature, e.g. treatment monitoring • Particular activation patterns associated with genetic markers: endophenotypes? • Brain activation-aided psychological interventions?
  • 2. Structural imaging: schizophrenia Reduced asymmetry between brain hemispheres in schizophrenia Oertel et al., submitted DTI of the anatomical network of auditory hallucinations Rotarska-Jagiela et al., submitted fMRI of psychopathology: schizophrenia Linden et al., Neuron (1999) Activation of temporal cortex during auditory hallucinations FMRI reveals activity in Heschl’s gyrus a: auditory hallucinations b: auditory stimulation EEG of cognition: schizophrenia
  • 3. Visual WM in patients with EOS: ERP effects at encoding Haenschel et al., Arch Gen Psych 2007 Functional imaging of treatment effects: psychotherapy “… all our provisional ideas in psychology will presumably one day be based on an organic substructure.” Sigmund Freud Effects of hypnosis • Dissociation (“out of body experience”) induced by hypnosis: • Attenuation of pain perception and reduced activity in SI and amygdala SI AMY Röder, Michal, Overbeck, Van de Ven, Linden, Psychotherapy & Psychosomatics 2007 Intervention studies: spider phobia • Paquette et al. (Neuroimage, 2003) – symptom provocation with film sequences of spiders in captivity: decrease of BOLD signal in parahippocampal gyrus and PFC after successful CBT • Straube et al. (Neuroimage, 2005) – activity reduction in ACC and insula after CBT Functional imaging and new interventions A new treatment approach for MDD based on neurobiological findings & theories Electrode placement just below subgenual cingulate for DBS Baseline PET: hyperactivity in BA 25, increase after DBS in Responders; opposite pattern in DLPFC Mayberg et al., Neuron, 2005
  • 4. Neurofeedback with fMRI • Modulation of brain activity in a particular area by the subject herself • Training based on real-time feedback of fMRI time course Weiskopf et al., Neuroimage 2003; J. Physiol. Paris 2004 Self-regulation of emotion networks Johnston et al., submitted PPurpose of RDG • Inaugural meeting in Bangor, 11 June 2009 • Further meetings to link in with MHRN-C and Neurodem Cymru conferences • Prepare joint grant proposals • Exchange of ideas, skills, techniques, people • Educational opportunities (including NHS, service user and carer groups) • Recruitment and management of multi-centre imaging studies • Link with voluntary sector