brain anatomy and function

1. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Brain Anatomy and
Function

2. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Anatomy of the Brain
• Separated into right
and left halves by the
Interhemispheric
Fissure
• The Central Sulcus
runs down &
forward
• The Lateral Fissure
runs backward & up

3. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
• Thought
• Voluntary
movement
• Speech motor
• Covers 1/3rd of
area of the brain
Frontal and Temporal Lobes
• Memory
• Auditory function
Frontal Temporal

4. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
• Sensation
• Touch
• Pressure
• Pain
• Temperature
• Texture
• Position/spatial
orientation
Parietal and Occipital Lobes
• Vision
• Visual
processes
• Reading
Parietal Occipital

5. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
• Large Muscle
Coordination
• Balance
 Walking,
Writing
Medulla Oblongata,
Cerebellum, and Pons
• Relay between
the cerebral
hemispheres
and the
cerebellum
• Respiration
• Heart rate
• Continuous
with the
spinal cord
(2.5 cm)
Cerebellum
Medulla
Oblongata
Pons

6. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Basal Ganglia and Thalamus
“The Brakes”
• Modifies movement
on a minute-to-
minute basis
• Inhibits Movement
• Coordination
• Cortical relay

7. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
• Attention
• Sensory gateway
• Memory processing
• Rage
• Aggression
• Sexuality
• Appetite/Thirst
Limbic System

8. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
The Nerve Cell
Synaptic junction

9. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Neurotransmitters
• Serotonin – major – emotions,
judgment, eating and sleep
disorders (associated with
frontotemporal disorder)
• Glutamate/GABA - Widespread,
anxiety, sleep, (Valium targets this)
• Dopamine – memory, mood,
movement, Parkinson's Disease,
psychiatric problems
• Endorphins – relief of pain,
(Morphine targets this)
Lichtman, J., et al Washington University 2002

10. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Serotonin
Normal functions
 Emotions
 Judgment
 Sleep
Imbalances
 Depression
 Suicidal behavior
 Anxiety
 Impulsive behavior
 Eating disorders
Glutamate/GABA
Normal functions
• Involved in most facets of
brain function
Imbalances
 Memory disturbances
 Sleep disturbances
 Anxiety

11. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Dopamine
Normal functions
 Mood
 Movement
 Memory
Imbalances
 Movement disorders
 Schizophrenia
 Addiction
Endorphins
Normal functions
• Relieve pain
• Induce euphoria

12. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Normal Aging Brain
• Brain weight and
volume decrease
• Grooves widen
• Surface smoothes
• Neurofibrillary tangles
increase
• Understanding
normal variation is
key to interpretation

13. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Brain Glucose Metabolism –
Normal
• Normal brain tissue actively metabolizes glucose
and its analogue (F-18 FDG)
• Glucose metabolism provides 95% of the energy
required for brain function
• FDG is irreversibly trapped within brain cells in
proportion to its use because it cannot be broken
down or stored unlike glucose

14. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
FDG-PET Normal Brain Metabolism

15. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
FDG-PET Abnormal Brain
Imaging
• Dementia
 Memory loss
 Cognitive Decline
• Epilepsy
 Localization of a seizure focus
• Tumor Assessment
 Radiation Necrosis vs Tumor
 Grade
• Objective Imaging Diagnosis of Movement Disorders
 Huntington’s Disease
 Parkinson’s Disease

16. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Dementia Diagnosis:
Current Methods
• History and physical examination
 Neurologist (Sens. = 50-80%)
 Neuropsychologist / Neuropsychiatrist
• Neuropsychological testing
• MRI / CT
• Blood testing
• Functional Neuroimaging (SPECT/ PET/MR)
• Sens.=80-90%

17. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Summary
• Normal Brain Anatomy
• Normal Brain Function
• Current PET Brain Applications:
 Diagnosis of Dementia
 Seizure Localization
 Tumor Assessment
 Objective Imaging Diagnosis of Movement
Disorders (not CMS approved)

18. © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Contributors
• Rebecca Trunnell Hyman
• Coordinator of PET Services
• Clinical PET of West County - Creve
Coeur, MO
• Kevin L. Berger, M.D.
• Assistant Professor of Radiology
• Director of PET Imaging
• Michigan State University – East
Lansing, MI