This document discusses various neuroimaging techniques used in psychiatry. It begins with a brief history of neuroimaging, including early techniques like ventriculography and CT scans, as well as key developments in MRI, PET, SPECT, and other modalities. The document then explains several common neuroimaging techniques in more detail, such as CT, MRI sequences (T1WI, T2WI, FLAIR, DWI), and MRS. It provides information on the principles, applications, and appearance of structures on different sequences. In summary, neuroimaging allows measurement of brain structure, function and chemistry, and has provided useful insights into psychiatric pathophysiology that could aid diagnosis and treatment development.
This document provides an overview of neuroimaging in psychiatry. It discusses the historical milestones of neuroimaging techniques such as CT, MRI, PET and SPECT. It explains the basic principles and types of structural and functional neuroimaging. The document summarizes the significance of neuroimaging in understanding specific psychiatric disorders and its role in diagnosis, prognosis and treatment development. Neuroimaging techniques can help identify neural abnormalities in psychiatry and aid in better classification of mental illnesses.
The document provides an overview of neuroimaging techniques used in psychiatry such as MRI, CT, PET, SPECT, fMRI, DTI, and MRS. It discusses the basic principles, milestones in development, and applications of these techniques. Specifically, it summarizes research using these neuroimaging methods that have found abnormalities in brain structure and function in patients with obsessive-compulsive disorder (OCD), such as reduced serotonin transporter binding in fronto-striatal circuits and differences in brain activity in regions like the thalamus and orbitofrontal cortex.
Significance of Brain imaging in Psychiatry. Most of the major Psychiatric disorders are associated with statistically significant differences on various Neuroimaging measures, when comparing groups of patients and controls.
This document provides an overview of neuroimaging techniques used in psychiatry. It discusses various structural and functional neuroimaging methods including CT, MRI, fMRI, SPECT, PET, DTI, and MRS. CT and MRI provide structural images while fMRI, SPECT, PET, and MRS assess brain function by measuring activity, blood flow, and metabolite levels. Neuroimaging has improved understanding of psychiatric conditions and informed research on the pathophysiology of disorders.
Neuroimaging and its implications in psychiatryRupinder Oberoi
This document discusses various neuroimaging techniques used to study the structure and function of the living human brain, including their applications and limitations. It describes computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), functional MRI (fMRI), and single photon emission computed tomography (SPECT). CT and MRI are used to examine brain structure, while fMRI, MRS and SPECT provide insights into brain function by detecting changes in blood flow, metabolism or radiotracer distribution associated with neuronal activity. These techniques have advanced understanding of neurological and psychiatric disorders but each has specific strengths and weaknesses for clinical or research applications.
The document provides an overview of functional neuroimaging techniques used in psychiatry, including their principles, applications, and future trends. It discusses various imaging modalities such as MRI, fMRI, MRS, PET, SPECT, and diffusion tensor imaging. It describes how these techniques are used to study structural and functional correlates of psychiatric disorders and examine areas of the brain involved in conditions like schizophrenia, depression, addiction, and dementia. The document also outlines how neuroimaging is enhancing our understanding of psychopathology and treatment responses in these illnesses.
This document discusses novel neurotransmitters beyond the classical ones. It describes nitric oxide, carbon monoxide, hydrogen sulfide, endocannabinoids, eicosanoids, and neurosteroids. Nitric oxide is produced in neurons from arginine and acts through cGMP. It is involved in long term potentiation and erectile function. Carbon monoxide regulates olfaction and vasodilation. Hydrogen sulfide is produced from cysteine and acts as a gaseous messenger. Endocannabinoids like anandamide signal retrogradely through CB1 receptors. Eicosanoids are derived from arachidonic acid. Neurosteroids are synthesized in the brain from cholesterol and include allopregn
This document provides information on various brain stimulation therapies, including electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). It discusses the history, procedures, indications, side effects, and mechanisms of action for each therapy. ECT involves inducing seizures with electricity to treat conditions like depression. VNS uses electrical pulses to the vagus nerve to treat epilepsy and depression. TMS uses magnetic pulses to target specific brain regions without surgery. These non-pharmacological therapies can be effective options for treating neuropsychiatric illnesses.
This document provides an overview of neuroimaging in psychiatry. It discusses the historical milestones of neuroimaging techniques such as CT, MRI, PET and SPECT. It explains the basic principles and types of structural and functional neuroimaging. The document summarizes the significance of neuroimaging in understanding specific psychiatric disorders and its role in diagnosis, prognosis and treatment development. Neuroimaging techniques can help identify neural abnormalities in psychiatry and aid in better classification of mental illnesses.
The document provides an overview of neuroimaging techniques used in psychiatry such as MRI, CT, PET, SPECT, fMRI, DTI, and MRS. It discusses the basic principles, milestones in development, and applications of these techniques. Specifically, it summarizes research using these neuroimaging methods that have found abnormalities in brain structure and function in patients with obsessive-compulsive disorder (OCD), such as reduced serotonin transporter binding in fronto-striatal circuits and differences in brain activity in regions like the thalamus and orbitofrontal cortex.
Significance of Brain imaging in Psychiatry. Most of the major Psychiatric disorders are associated with statistically significant differences on various Neuroimaging measures, when comparing groups of patients and controls.
This document provides an overview of neuroimaging techniques used in psychiatry. It discusses various structural and functional neuroimaging methods including CT, MRI, fMRI, SPECT, PET, DTI, and MRS. CT and MRI provide structural images while fMRI, SPECT, PET, and MRS assess brain function by measuring activity, blood flow, and metabolite levels. Neuroimaging has improved understanding of psychiatric conditions and informed research on the pathophysiology of disorders.
Neuroimaging and its implications in psychiatryRupinder Oberoi
This document discusses various neuroimaging techniques used to study the structure and function of the living human brain, including their applications and limitations. It describes computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), functional MRI (fMRI), and single photon emission computed tomography (SPECT). CT and MRI are used to examine brain structure, while fMRI, MRS and SPECT provide insights into brain function by detecting changes in blood flow, metabolism or radiotracer distribution associated with neuronal activity. These techniques have advanced understanding of neurological and psychiatric disorders but each has specific strengths and weaknesses for clinical or research applications.
The document provides an overview of functional neuroimaging techniques used in psychiatry, including their principles, applications, and future trends. It discusses various imaging modalities such as MRI, fMRI, MRS, PET, SPECT, and diffusion tensor imaging. It describes how these techniques are used to study structural and functional correlates of psychiatric disorders and examine areas of the brain involved in conditions like schizophrenia, depression, addiction, and dementia. The document also outlines how neuroimaging is enhancing our understanding of psychopathology and treatment responses in these illnesses.
This document discusses novel neurotransmitters beyond the classical ones. It describes nitric oxide, carbon monoxide, hydrogen sulfide, endocannabinoids, eicosanoids, and neurosteroids. Nitric oxide is produced in neurons from arginine and acts through cGMP. It is involved in long term potentiation and erectile function. Carbon monoxide regulates olfaction and vasodilation. Hydrogen sulfide is produced from cysteine and acts as a gaseous messenger. Endocannabinoids like anandamide signal retrogradely through CB1 receptors. Eicosanoids are derived from arachidonic acid. Neurosteroids are synthesized in the brain from cholesterol and include allopregn
This document provides information on various brain stimulation therapies, including electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). It discusses the history, procedures, indications, side effects, and mechanisms of action for each therapy. ECT involves inducing seizures with electricity to treat conditions like depression. VNS uses electrical pulses to the vagus nerve to treat epilepsy and depression. TMS uses magnetic pulses to target specific brain regions without surgery. These non-pharmacological therapies can be effective options for treating neuropsychiatric illnesses.
Neurobiology of consciousness and its disordersNeurologyKota
1. Consciousness involves wakefulness, awareness of self and environment, and depends on complex interactions between brainstem, subcortical and cortical regions.
2. States of impaired consciousness include coma, vegetative state, minimally conscious state, and locked-in syndrome. Clinical assessment involves detailed history, examination, and tools like CRS-R to characterize awareness and functioning.
3. Imaging and electrophysiological techniques provide objective measures of brain activity, while sensory stimulation and pharmacologic agents may improve arousal or awareness in some patients. Prognosis depends on etiology, duration of impairment, and age.
This document discusses the history and modern practice of surgery for psychiatric disorders. It begins by covering the early history of psychosurgery dating back to the 1930s. It then discusses the development of stereotactic surgery and various ablative psychosurgical procedures used in the 1940s-1950s such as prefrontal leucotomy. The introduction of psychotropic drugs in the 1950s reduced the use of ablative psychosurgery. Modern techniques discussed include cingulotomy, anterior capsulotomy, limbic leucotomy, vagus nerve stimulation, and deep brain stimulation. Specific applications to disorders like obsessive-compulsive disorder, depression, and Tourette's syndrome are also summarized.
The document provides an overview of frontal lobe disorders, including:
- The functional anatomy and neurotransmitters of the frontal lobes.
- Frontotemporal dementia, which selectively attacks the frontal and temporal lobes.
- Frontal lobe syndromes, which can cause changes in personality and behavior.
- Frontal lobe epilepsy, characterized by seizures arising from the frontal lobes.
- The relationship between the frontal lobes and schizophrenia, depression, and other conditions.
The temporal lobe is involved in processing sensory input, memory formation, language comprehension, and emotional processing. It contains structures like the hippocampus and amygdala that are important for memory and emotional associations. Disorders of the temporal lobe can cause problems like epilepsy, memory deficits, language issues like aphasia, and behavioral changes. Temporal lobe epilepsy is a common type of seizure originating in structures of the anteromedial temporal lobe. Bilateral damage to the amygdala and inferior temporal cortex can cause Klüver-Bucy syndrome characterized by changes in behavior and cognition. The temporal lobe also plays a key role in conditions like Alzheimer's disease, frontotemporal dementia, and traumatic brain injury.
The temporal lobe plays important roles in processing sensory input such as auditory and visual information. It is involved in functions such as memory formation, emotion processing, and language comprehension. Damage to temporal lobe structures can cause symptoms like auditory or visual processing issues, memory impairments, and changes in emotional behavior or personality. The superior, middle, and inferior temporal gyri and medial temporal structures each contribute to these various temporal lobe functions.
Limbic system and psychiatric disordersKarrar Husain
The limbic system is a set of brain structures located in the medial temporal lobe and midbrain that are involved in emotion, behavior, motivation, long-term memory, and olfaction. It includes structures like the hippocampus, amygdala, hypothalamus, and others. In the 1930s, James Papez proposed a neural circuit involving limbic structures that was important for emotional experiences. Later work expanded understanding of the limbic system's role in additional functions like regulating autonomic and endocrine systems, sleep-wake cycles, sexual behavior, and reward processing.
Trans cranial magnetic stimulation - Diagnostic & Therapeutic applicationNeurologyKota
Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses electromagnetic induction to stimulate neural tissue without causing pain. TMS can have acute effects like activating neural circuits or disrupting speech, as well as prolonged effects like changing synaptic strength and modulating cortical excitability. TMS has diagnostic applications like measuring motor thresholds and central motor conduction time to evaluate motor pathways, and therapeutic applications for treating depression, Parkinson's disease, neuropathic pain, and more. Common TMS protocols include single pulse, paired pulse, and repetitive TMS with low or high frequency stimulation. TMS is generally safe but can infrequently cause minor side effects like headaches.
This document provides an agenda and background information for a seminar on amnesia. It discusses various types of amnesia including transient amnesic syndromes, persistent amnesic disorders, and organic amnesia. It describes different causes of amnesia including thiamine deficiency, head injuries, seizures, infections like herpes simplex virus, and surgical procedures. It compares classifications of amnesia in DSM-IV and DSM-5. References are also provided.
The document discusses the parietal lobe of the brain. The parietal lobe is located towards the top and middle of the brain. It is involved in processing sensory information like touch, pressure, temperature, and pain. The document also likely discusses how the parietal lobe is evaluated through neurological exams and imaging tests.
Neuromodulation therapies like TMS and ECT allow targeted delivery of electrical or magnetic signals to specific areas of the nervous system to improve neural function. TMS uses magnetic pulses to induce currents in the brain non-invasively, while ECT induces seizures via electrodes. Both can have antidepressant effects by modifying neurotransmitter systems and inducing neuroplasticity. Ongoing research aims to better understand mechanisms of action, optimize dosing parameters, and expand indications to other psychiatric conditions.
The document discusses neurobiology of memory, including:
1. It describes the anatomical and functional organization of memory, focusing on the hippocampus formation, its afferents and efferents, and its role in learning and memory.
2. It discusses the different types of memory including explicit and implicit memory, and the cellular and molecular processes underlying short-term and long-term memory formation.
3. It explains mechanisms of memory formation and consolidation at the synaptic level, including the roles of proteins like CaMKII and CREB.
The document discusses the anatomy and functions of different areas of the frontal lobe. It describes the primary motor cortex (area 4), premotor cortex (area 6), supplementary motor area (medial area 6), frontal eye fields (area 8), Broca's speech area (areas 44 and 45), orbital prefrontal cortex (areas 10 and 11), dorsomedial prefrontal cortex, and dorsolateral prefrontal cortex (areas 9, 10, 46). It provides details on the connections, functions, and effects of lesions for each area. Bedside tests are also described to assess functions localized to different frontal lobe regions.
The parietal lobe is located at the top of the brain and is involved in processing somatosensory information, spatial awareness, and language comprehension. It contains the primary somatosensory cortex and association areas important for functions like tactile perception, discrimination, localization, and stereognosis. Injuries or lesions to different areas of the parietal lobe can cause syndromes like Gerstmann's syndrome involving acalculia, finger agnosia, and right-left disorientation if the angular gyrus is affected. The supramarginal gyrus is involved in tasks like praxis, repetition, and constructional abilities.
The document discusses various neuroimaging techniques used to study the brain, including their basic principles and psychiatric applications. It describes CT, MRI, MRS, fMRI, and SPECT, explaining what each measures, how they work, and what tissues appear as on the images. It provides examples of structural images and contrasts the advantages and disadvantages of the different modalities. It also outlines specific indications for neuroimaging in clinical practice and research into psychiatric disorders.
Neuropsychiatric aspects of traumatic brain injuryAzfer Ibrahim
1) Traumatic brain injury (TBI) can cause various neuropsychiatric issues including mood disorders, cognitive deficits, and behavioral changes.
2) Common mood disorders after TBI include depression in 25-50% of patients in the first year, as well as increased risks of mania/hypomania and anxiety disorders.
3) Frequent cognitive deficits involve problems with memory, attention, concentration, language, and executive functioning that can cause long-term impairment.
Neuroimaging or brain imaging is the use of various techniques to either directly or indirectly image the structure, function, or pharmacology of the nervous system. It is a relatively new discipline within medicine, neuroscience, and psychology
This document summarizes research on cognitive remediation therapy (CRT) for various mental health conditions. It discusses CRT approaches for schizophrenia, including evidence that CRT improves cognitive functioning and psychosocial outcomes. It also explores using CRT for other disorders like bipolar disorder, depression, Alzheimer's, and ADHD. For many conditions, initial studies show benefits of CRT for cognition, symptoms, and functioning, though more research is still needed.
DISORDER CONTENTOF THOUGHT -DELUSION
BY DR.WASIM
UNDER GUIDANCE OF
DR.SANJAY.JAIN
Definition of delusion:
Delusions are categorized into four different groups
THERE ARE 2 TYPES OF DISORDERS OF THOUGHT CONTENT
1.DELUSION
2.OVERVALUED IDEAS
DISTINGUISED
DELUSION
OTHER MEMBERS OF THE CULTURE DONOT SHARE THE BELIEF.
NEED NOT BE ASSOCIATED WITH AFFECT.
FIRMLY SUSTAINED BELIEF.
CONVINCED THAT DELUSION IS REAL.
RECOGNIZED AS ABSURED.
CANNOT BE ACCEPTED.
OCCUR IN MENTALLY ILL PATIENTS.
OVERVALUED IDEAS
OTHER MEMBERS OF THE CULTURE SHARE THE BELIEF.
ASSOCIATED WITH VERY STRONG AFFECT.
NOT HELD FIRMLY.
ATLEAST SOME LEVEL OF DOUBT AS TO ITS TRUTHFULNESS.
NOT RECOGNIZED AS ABSURED.
ACCEPTABLE.
CAN OCCUR IN BOTH HEALTHY AND MENTALLY ILL PATIENTS.
KENDLER’S VECTORS FOR DELUSION:
five stages in the development of delusion(FISH & CONRAD)
FACTORS CONCERNED WITH GENERATION OF DELUSIONS
PATHPOPHYSIOLOGY OF DELUSIONS
PRIMARY DELUSIONS
SECONDARY DELUSIONS
SYSTEMATIZATION
DELUSIONS ON THE BASIS OF CONTENT OF DELUSIONS
THANK YOU
This document summarizes research on the course and outcome of schizophrenia. It discusses several landmark studies including the International Pilot Study of Schizophrenia, Determinants of Outcome of Severe Mental Disorder study, and International Study of Schizophrenia. Overall, the studies found that outcomes tended to be better in developing countries compared to developed countries. Within developing countries, outcomes were particularly good in India, with studies in Agra and Chandigarh finding high rates of remission. Acute onset, good premorbid adjustment, younger age, and shorter duration of initial psychotic episode predicted better long-term prognosis.
This document provides an overview of neuroimaging techniques used in psychiatry. It discusses the types and principles of structural neuroimaging like CT and MRI. CT provides visualization of brain morphology while MRI also allows evaluation of biochemical processes through techniques like fMRI. The document outlines indications for neuroimaging in psychiatric evaluation and research to study clinically defined patient groups and brain activity during tasks. It provides details on the basic principles and anatomical images of CT and MRI to interpret neuroimaging findings.
1. MRI uses magnetic fields and radio waves to produce detailed images of the internal structures of the body without using ionizing radiation. It is useful for evaluating abnormalities in the brain such as tumors, infections, hemorrhages, and more.
2. Different MRI sequences such as T1-weighted, T2-weighted, and FLAIR provide contrast between tissues that is useful for identifying various pathologies. T1-weighted images show good anatomical detail while T2-weighted and FLAIR images are better for detecting pathologies.
3. MRI of the brain can be obtained in axial, sagittal, and coronal planes to visualize structures from different orientations without moving the patient. Key anatomical
Neurobiology of consciousness and its disordersNeurologyKota
1. Consciousness involves wakefulness, awareness of self and environment, and depends on complex interactions between brainstem, subcortical and cortical regions.
2. States of impaired consciousness include coma, vegetative state, minimally conscious state, and locked-in syndrome. Clinical assessment involves detailed history, examination, and tools like CRS-R to characterize awareness and functioning.
3. Imaging and electrophysiological techniques provide objective measures of brain activity, while sensory stimulation and pharmacologic agents may improve arousal or awareness in some patients. Prognosis depends on etiology, duration of impairment, and age.
This document discusses the history and modern practice of surgery for psychiatric disorders. It begins by covering the early history of psychosurgery dating back to the 1930s. It then discusses the development of stereotactic surgery and various ablative psychosurgical procedures used in the 1940s-1950s such as prefrontal leucotomy. The introduction of psychotropic drugs in the 1950s reduced the use of ablative psychosurgery. Modern techniques discussed include cingulotomy, anterior capsulotomy, limbic leucotomy, vagus nerve stimulation, and deep brain stimulation. Specific applications to disorders like obsessive-compulsive disorder, depression, and Tourette's syndrome are also summarized.
The document provides an overview of frontal lobe disorders, including:
- The functional anatomy and neurotransmitters of the frontal lobes.
- Frontotemporal dementia, which selectively attacks the frontal and temporal lobes.
- Frontal lobe syndromes, which can cause changes in personality and behavior.
- Frontal lobe epilepsy, characterized by seizures arising from the frontal lobes.
- The relationship between the frontal lobes and schizophrenia, depression, and other conditions.
The temporal lobe is involved in processing sensory input, memory formation, language comprehension, and emotional processing. It contains structures like the hippocampus and amygdala that are important for memory and emotional associations. Disorders of the temporal lobe can cause problems like epilepsy, memory deficits, language issues like aphasia, and behavioral changes. Temporal lobe epilepsy is a common type of seizure originating in structures of the anteromedial temporal lobe. Bilateral damage to the amygdala and inferior temporal cortex can cause Klüver-Bucy syndrome characterized by changes in behavior and cognition. The temporal lobe also plays a key role in conditions like Alzheimer's disease, frontotemporal dementia, and traumatic brain injury.
The temporal lobe plays important roles in processing sensory input such as auditory and visual information. It is involved in functions such as memory formation, emotion processing, and language comprehension. Damage to temporal lobe structures can cause symptoms like auditory or visual processing issues, memory impairments, and changes in emotional behavior or personality. The superior, middle, and inferior temporal gyri and medial temporal structures each contribute to these various temporal lobe functions.
Limbic system and psychiatric disordersKarrar Husain
The limbic system is a set of brain structures located in the medial temporal lobe and midbrain that are involved in emotion, behavior, motivation, long-term memory, and olfaction. It includes structures like the hippocampus, amygdala, hypothalamus, and others. In the 1930s, James Papez proposed a neural circuit involving limbic structures that was important for emotional experiences. Later work expanded understanding of the limbic system's role in additional functions like regulating autonomic and endocrine systems, sleep-wake cycles, sexual behavior, and reward processing.
Trans cranial magnetic stimulation - Diagnostic & Therapeutic applicationNeurologyKota
Transcranial magnetic stimulation (TMS) is a non-invasive technique that uses electromagnetic induction to stimulate neural tissue without causing pain. TMS can have acute effects like activating neural circuits or disrupting speech, as well as prolonged effects like changing synaptic strength and modulating cortical excitability. TMS has diagnostic applications like measuring motor thresholds and central motor conduction time to evaluate motor pathways, and therapeutic applications for treating depression, Parkinson's disease, neuropathic pain, and more. Common TMS protocols include single pulse, paired pulse, and repetitive TMS with low or high frequency stimulation. TMS is generally safe but can infrequently cause minor side effects like headaches.
This document provides an agenda and background information for a seminar on amnesia. It discusses various types of amnesia including transient amnesic syndromes, persistent amnesic disorders, and organic amnesia. It describes different causes of amnesia including thiamine deficiency, head injuries, seizures, infections like herpes simplex virus, and surgical procedures. It compares classifications of amnesia in DSM-IV and DSM-5. References are also provided.
The document discusses the parietal lobe of the brain. The parietal lobe is located towards the top and middle of the brain. It is involved in processing sensory information like touch, pressure, temperature, and pain. The document also likely discusses how the parietal lobe is evaluated through neurological exams and imaging tests.
Neuromodulation therapies like TMS and ECT allow targeted delivery of electrical or magnetic signals to specific areas of the nervous system to improve neural function. TMS uses magnetic pulses to induce currents in the brain non-invasively, while ECT induces seizures via electrodes. Both can have antidepressant effects by modifying neurotransmitter systems and inducing neuroplasticity. Ongoing research aims to better understand mechanisms of action, optimize dosing parameters, and expand indications to other psychiatric conditions.
The document discusses neurobiology of memory, including:
1. It describes the anatomical and functional organization of memory, focusing on the hippocampus formation, its afferents and efferents, and its role in learning and memory.
2. It discusses the different types of memory including explicit and implicit memory, and the cellular and molecular processes underlying short-term and long-term memory formation.
3. It explains mechanisms of memory formation and consolidation at the synaptic level, including the roles of proteins like CaMKII and CREB.
The document discusses the anatomy and functions of different areas of the frontal lobe. It describes the primary motor cortex (area 4), premotor cortex (area 6), supplementary motor area (medial area 6), frontal eye fields (area 8), Broca's speech area (areas 44 and 45), orbital prefrontal cortex (areas 10 and 11), dorsomedial prefrontal cortex, and dorsolateral prefrontal cortex (areas 9, 10, 46). It provides details on the connections, functions, and effects of lesions for each area. Bedside tests are also described to assess functions localized to different frontal lobe regions.
The parietal lobe is located at the top of the brain and is involved in processing somatosensory information, spatial awareness, and language comprehension. It contains the primary somatosensory cortex and association areas important for functions like tactile perception, discrimination, localization, and stereognosis. Injuries or lesions to different areas of the parietal lobe can cause syndromes like Gerstmann's syndrome involving acalculia, finger agnosia, and right-left disorientation if the angular gyrus is affected. The supramarginal gyrus is involved in tasks like praxis, repetition, and constructional abilities.
The document discusses various neuroimaging techniques used to study the brain, including their basic principles and psychiatric applications. It describes CT, MRI, MRS, fMRI, and SPECT, explaining what each measures, how they work, and what tissues appear as on the images. It provides examples of structural images and contrasts the advantages and disadvantages of the different modalities. It also outlines specific indications for neuroimaging in clinical practice and research into psychiatric disorders.
Neuropsychiatric aspects of traumatic brain injuryAzfer Ibrahim
1) Traumatic brain injury (TBI) can cause various neuropsychiatric issues including mood disorders, cognitive deficits, and behavioral changes.
2) Common mood disorders after TBI include depression in 25-50% of patients in the first year, as well as increased risks of mania/hypomania and anxiety disorders.
3) Frequent cognitive deficits involve problems with memory, attention, concentration, language, and executive functioning that can cause long-term impairment.
Neuroimaging or brain imaging is the use of various techniques to either directly or indirectly image the structure, function, or pharmacology of the nervous system. It is a relatively new discipline within medicine, neuroscience, and psychology
This document summarizes research on cognitive remediation therapy (CRT) for various mental health conditions. It discusses CRT approaches for schizophrenia, including evidence that CRT improves cognitive functioning and psychosocial outcomes. It also explores using CRT for other disorders like bipolar disorder, depression, Alzheimer's, and ADHD. For many conditions, initial studies show benefits of CRT for cognition, symptoms, and functioning, though more research is still needed.
DISORDER CONTENTOF THOUGHT -DELUSION
BY DR.WASIM
UNDER GUIDANCE OF
DR.SANJAY.JAIN
Definition of delusion:
Delusions are categorized into four different groups
THERE ARE 2 TYPES OF DISORDERS OF THOUGHT CONTENT
1.DELUSION
2.OVERVALUED IDEAS
DISTINGUISED
DELUSION
OTHER MEMBERS OF THE CULTURE DONOT SHARE THE BELIEF.
NEED NOT BE ASSOCIATED WITH AFFECT.
FIRMLY SUSTAINED BELIEF.
CONVINCED THAT DELUSION IS REAL.
RECOGNIZED AS ABSURED.
CANNOT BE ACCEPTED.
OCCUR IN MENTALLY ILL PATIENTS.
OVERVALUED IDEAS
OTHER MEMBERS OF THE CULTURE SHARE THE BELIEF.
ASSOCIATED WITH VERY STRONG AFFECT.
NOT HELD FIRMLY.
ATLEAST SOME LEVEL OF DOUBT AS TO ITS TRUTHFULNESS.
NOT RECOGNIZED AS ABSURED.
ACCEPTABLE.
CAN OCCUR IN BOTH HEALTHY AND MENTALLY ILL PATIENTS.
KENDLER’S VECTORS FOR DELUSION:
five stages in the development of delusion(FISH & CONRAD)
FACTORS CONCERNED WITH GENERATION OF DELUSIONS
PATHPOPHYSIOLOGY OF DELUSIONS
PRIMARY DELUSIONS
SECONDARY DELUSIONS
SYSTEMATIZATION
DELUSIONS ON THE BASIS OF CONTENT OF DELUSIONS
THANK YOU
This document summarizes research on the course and outcome of schizophrenia. It discusses several landmark studies including the International Pilot Study of Schizophrenia, Determinants of Outcome of Severe Mental Disorder study, and International Study of Schizophrenia. Overall, the studies found that outcomes tended to be better in developing countries compared to developed countries. Within developing countries, outcomes were particularly good in India, with studies in Agra and Chandigarh finding high rates of remission. Acute onset, good premorbid adjustment, younger age, and shorter duration of initial psychotic episode predicted better long-term prognosis.
This document provides an overview of neuroimaging techniques used in psychiatry. It discusses the types and principles of structural neuroimaging like CT and MRI. CT provides visualization of brain morphology while MRI also allows evaluation of biochemical processes through techniques like fMRI. The document outlines indications for neuroimaging in psychiatric evaluation and research to study clinically defined patient groups and brain activity during tasks. It provides details on the basic principles and anatomical images of CT and MRI to interpret neuroimaging findings.
1. MRI uses magnetic fields and radio waves to produce detailed images of the internal structures of the body without using ionizing radiation. It is useful for evaluating abnormalities in the brain such as tumors, infections, hemorrhages, and more.
2. Different MRI sequences such as T1-weighted, T2-weighted, and FLAIR provide contrast between tissues that is useful for identifying various pathologies. T1-weighted images show good anatomical detail while T2-weighted and FLAIR images are better for detecting pathologies.
3. MRI of the brain can be obtained in axial, sagittal, and coronal planes to visualize structures from different orientations without moving the patient. Key anatomical
This is a slideshow made essentially for undergraduate MBBS students to have a working knowledge about CT scan of brain in diagnosing common medical and surgical conditions. It includes detection of major anatomical structures in CT and prompt diagnosis of emergency conditions like head trauma and cerebrovascular accident. Last but not the least, I have also touched the areas where CT scan is not the first mode of diagnosis (like diagnosis of brain tumor and evaluation of headache).
This document provides an overview of neuroimaging techniques used in psychiatry, including their principles and clinical applications. It discusses several structural neuroimaging methods like CT scans and MRI, as well as functional techniques including fMRI, PET, SPECT, and MRS. CT scans provide images of brain tissue density but expose patients to radiation. MRI utilizes magnetic fields and radio waves to generate detailed images of brain structure and pathology without radiation. Functional neuroimaging methods allow observation of the living brain in action.
This document provides an overview of neuroimaging techniques used in psychiatry, including their principles and clinical applications. It discusses several structural neuroimaging methods like CT scans and MRI, as well as functional techniques including fMRI, PET, SPECT, and MRS. CT scans provide bone detail but less contrast between brain tissues, while MRI generates high-resolution images of brain structure and pathology without radiation. Neuroimaging is increasingly being used to better understand the pathophysiology of psychiatric disorders and aid diagnosis.
This document provides an overview of MRI brain imaging. It begins with the anatomy of the brain and basic MRI principles. It then covers indications for brain MRI, patient preparation including positioning in the scanner, and common sequences used. T1-weighted, T2-weighted, FLAIR and diffusion-weighted sequences are described in terms of their characteristics. Contrast agents, safety procedures, and specialized protocols for conditions like epilepsy are also summarized. The document aims to inform about all aspects of performing and interpreting a brain MRI exam.
NEUROIMAGING IN PSYCHIATRY777777777777.pptxssuser7567ef
This document provides an overview of various neuroimaging techniques used in psychiatry, including their principles, applications, and advantages/disadvantages. It discusses structural neuroimaging methods like CT and MRI, as well as functional techniques including fMRI, PET, and SPECT. CT and MRI provide high-resolution images of brain structure. Functional methods like fMRI, PET, and SPECT allow measurement of brain activity by detecting changes in blood flow and glucose metabolism associated with neuronal activation. Together, these neuroimaging modalities have improved understanding of psychiatric pathophysiology and have diagnostic and research applications in conditions such as dementia, psychosis, and mood disorders.
This document provides an overview of medical imaging modalities used to image the central nervous system. It discusses the anatomy of the brain and spinal cord and indications for imaging. Imaging modalities covered include plain x-rays, fluoroscopy, ventriculography, arteriography, myelography, computed tomography, magnetic resonance imaging, ultrasound, and nuclear medicine techniques. Each modality is described along with examples of images and its risks and applications in evaluating conditions like trauma, tumors, infections and other neurological disorders.
The document provides information about different MRI sequences and their applications:
- FLAIR sequences suppress the signal from cerebrospinal fluid, highlighting hyperintense lesions near CSF-containing spaces. This makes FLAIR useful for evaluating conditions like multiple sclerosis.
- STIR sequences suppress the signal from fat, making it useful for detecting bone marrow edema which can indicate occult fractures.
- T1-weighted images provide good anatomical details and are best for viewing subacute hemorrhages and fat-containing structures.
CT imaging of Brain in Clinical Practice by Dr. Vaibhav Yawalkarvaibhavyawalkar
Cranial CT is a useful diagnostic tool in the emergency room that physicians need to be able to accurately interpret without specialist assistance. CT imaging works by passing collimated X-rays through the patient which are detected on the other side and assembled into cross-sectional images. Different tissues absorb X-rays to different degrees, appearing as different shades of grey on the image. The "blood can be very bad" mnemonic directs physicians to examine the blood, cisterns, brain, ventricles, and bone for abnormalities such as hemorrhage, increased intracranial pressure, infarcts, and space-occupying lesions. Contrast injection helps identify enhancing lesions including tumors, abscesses, and infections
CT scans of the brain can identify several abnormalities. Non-contrast CT scans can detect hemorrhages and infarcts, while contrast CT scans can better identify tumors and sites of infection. Interpretation of CT scans requires understanding Hounsfield units to characterize lesions as hyperdense or hypodense compared to brain tissue. Physicians must also be familiar with the vascular supply of different brain regions to localize lesions.
This document provides an overview of MRI brain imaging, including:
1) It describes the physics behind MRI, how hydrogen atoms generate signals in magnetic fields, and how pulse sequences produce different tissue contrasts.
2) It lists the benefits of MRI for neurological imaging, such as having better resolution than CT for visualizing soft tissues and not using ionizing radiation.
3) It discusses various MRI techniques including T1/T2 weighting, FLAIR, diffusion MRI, DTI, MRA, fMRI, and MRS.
4) It also covers MRI safety considerations and contrast agents.
1. The document discusses the basics of neuroimaging using CT and MRI. It provides information on the appearance of different tissues on CT and MRI scans and describes normalization CT findings.
2. It outlines a systematic approach to interpreting head CT scans and examines cross-sectional anatomy seen on various brain slices. Color images are used to identify different brain lobes.
3. The principles of MRI are described including relaxation times, T1-weighted, T2-weighted, and FLAIR sequences. Example MRI images are presented and labeled to illustrate anatomy at different brain levels.
1. The document discusses the basics of neuroimaging using CT and MRI. It explains how different tissues appear on CT and MRI scans and provides examples of normal anatomy.
2. It then covers the systematic approach to interpreting head CT scans and provides various cross-sectional anatomy examples.
3. The document also discusses the physics behind MRI and how tissues appear differently on T1-weighted, T2-weighted, and FLAIR sequences. It includes many labeled MRI images as examples.
1. The document discusses the basics of neuroimaging using CT and MRI. It explains how different tissues appear on CT and MRI scans and provides examples of normal anatomy.
2. It then covers the systematic approach to interpreting head CT scans and analyzing different areas of the brain. Examples of cross-sectional anatomy at different brain levels are shown on CT scans.
3. The document also discusses the physics behind MRI and how tissues appear differently on T1-weighted, T2-weighted, and FLAIR sequences. Multiple images demonstrate normal brain anatomy on post-contrast MRI scans.
The document discusses the radiological anatomy of a normal CT brain scan. It begins by describing the lobes of the brain and surfaces visible on CT. It then discusses the history and technique of CT scanning, describing how different tissues appear in varying shades of gray. Common artifacts are also reviewed. Key features of a normal CT brain include symmetric ventricles and sulci, with intact skull and no masses or fluid collections seen.
CNS RADIOLOGY FOR RADIATION ONCOLOGISTSKanhu Charan
This document provides an overview of radiology for brain and spine imaging for radiation oncologists. It discusses various imaging modalities including CT, MRI, nuclear imaging and angiography. It describes key anatomical structures of the brain such as the meninges, ventricles, sulci and gyri, lobes, basal ganglia and cerebellum. Different MRI sequences are outlined including T1, T2, FLAIR, DWI and perfusion. Spine imaging including sequences for T1, T2, STIR and post-contrast are also reviewed. Important considerations for planning MRI such as field of view and disease-specific sequences are highlighted.
Neurocognition, social cognition, rehabilitation in schizophreniaEnoch R G
This document discusses neurocognition, social cognition, and rehabilitation in schizophrenia. It covers the introduction, history, neurobiology, cognitive domains, and relationship to symptoms and treatment. The key points are:
- Neurocognitive impairment in schizophrenia is profound and impacts domains like memory, attention, problem solving, and social cognition. Deficits are present prior to treatment and not caused by symptoms.
- Cognitive deficits are stable over time, persist even when symptoms remit, and are better predictors of functional impairment than symptoms. Neurocognition is now a primary treatment target.
- Tests are used to assess specific cognitive domains like attention, verbal learning and memory, visual learning and memory, executive function/problem solving
This case report describes a 13-year-old girl who presented with repeated episodes of vomiting, palpitations, tremors, fearfulness, sweating, and loss of awareness. Investigations including blood tests, CT brain scan, and EEG were normal except for EEG spikes in the occipital lobes. She was diagnosed with Panayiotopoulos syndrome, a rare idiopathic focal seizure disorder occurring in childhood, and treated successfully with antiepileptic medications.
This document provides an introduction to psychiatry, including definitions of key terms like mental illness, psychology, psychotherapy, and psychoanalysis. It discusses the etiology (causes) of mental illness, which can include biological factors like genetics and brain damage, as well as psychological and social factors like childhood experiences, relationships, and poverty. It also describes features of mental illness, classifications of mental disorders, and the roles of professionals on the mental health team.
Treatment resistant schizophrenia & Treatment resistant depressionEnoch R G
This document discusses treatment resistant schizophrenia and provides guidelines for its management. It defines treatment resistance and outlines criteria from Kane and others. Factors associated with poor outcomes are biological, symptomatic, environmental, illness-related and pharmacological. The neurobiology of treatment resistant schizophrenia involves dopamine, glutamate, genetics and neuroanatomy. Management guidelines are provided from NICE and involve trials of clozapine as the gold standard treatment. Clozapine details include pharmacology, dosage, side effects, monitoring and predictors of response. Studies demonstrate clozapine's superior efficacy over other antipsychotics for treatment resistant schizophrenia.
The document discusses various treatment modalities in psychiatry including somatic (physical) therapies like psychopharmacology, electroconvulsive therapy, and psychosurgery. It provides details on specific psychotropic drugs like antipsychotics, antidepressants, mood stabilizers, anxiolytics, and their indications, mechanisms of action, dosages, side effects and the nurse's role in administering them. Electroconvulsive therapy is described as the artificial induction of seizures through electrical stimulation to treat severe depression, catatonia and psychosis.
This document discusses various psychiatric emergencies and their management. It describes conditions like suicidal threats, violence, panic attacks, catatonia, hysteria, transient situational disturbances, delirium tremens, epileptic furor, acute drug-induced movement disorders, and drug toxicity. For each condition, it outlines signs, potential causes, and recommended emergency treatment approaches such as reassurance, sedation, monitoring safety, fluid replacement, and stopping causative medications. The overall goal of management is to stabilize the patient, prevent harm, and address the underlying psychiatric condition.
Specific learning disorder - reading disorder, mathematics disorder, and disorder of written expression and learning disorder NOS .
neurodevelopmental disorder produced by the interactions of genetic and environmental factors that influence the brain's ability to perceive or process verbal and nonverbal information efficiently.
CBT in Clozapine resistant schizophrenia - Journal reviewEnoch R G
This document summarizes a randomized controlled trial that examined the effectiveness of cognitive behavioral therapy (CBT) for individuals with clozapine-resistant schizophrenia. The trial compared CBT plus treatment as usual to treatment as usual alone over a 21-month period. It was hypothesized that CBT would reduce symptoms of schizophrenia, improve quality of life, and improve user-defined recovery compared to treatment as usual alone. The trial recruited participants through inpatient mental health services in five sites in the UK and was approved by the National Research Ethics Committee.
Autism spectrum disorder is a neurodevelopmental condition characterized by impairments in social communication and restricted, repetitive behaviors. It is a highly heritable and heterogeneous condition. The document discusses the history of autism, epidemiology, etiology including genetic and environmental factors, clinical features, diagnosis, and treatment. Autism is typically diagnosed by age 2 and is more common in boys than girls. While the exact causes are unknown, both genetic and environmental factors are thought to play a role in its development.
Classification of sleep disorders and parasomniasEnoch R G
Sleep is made up of two physiological states: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. There are several brain regions and neurotransmitters that regulate the sleep-wake cycle, including serotonin, norepinephrine, acetylcholine, melatonin, and dopamine. Sleep disorders are classified in the DSM-5 and ICSD-2 and include insomnia, sleep-related breathing disorders, hypersomnias, circadian rhythm sleep-wake disorders, parasomnias, and other sleep-related movement disorders.
This document discusses disorders of self and provides information on key concepts related to self, including:
1. It defines self and discusses levels of self-awareness, self-concept, body image, and theories of self such as self-awareness theory and self-discrepancy theory.
2. It explores the history of perspectives on individual identity versus community and discusses how mirrors encouraged greater self-inspection.
3. It examines the brain regions involved in self-referential processing and the role of serotonin in regulating self-esteem.
Cluster B personality disorders are characterized by dramatic, emotional or erratic behaviors. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder. Biological factors like genetics and hormones play a role in etiology. Psychological factors during development like attachment issues and maladaptive defenses also contribute to Cluster B personalities. Antisocial personality disorder specifically involves a persistent disregard for social norms with impulsive and aggressive tendencies, affecting mostly males.
The document provides an overview of psychiatric classification systems. It discusses the definition and advantages of classification, as well as key terms and historical approaches including etiological, descriptive, categorical, and dimensional.
It then describes the development of major classification systems including the DSM and ICD. The DSM is the diagnostic manual published by the American Psychiatric Association while the ICD is published by the World Health Organization. The document outlines the various editions of the DSM from DSM-I to the current DSM-5. It also discusses other classification systems and tools used in psychiatry such as the Chinese Classification of Mental Disorders and the Research Domain Criteria.
The basal ganglia are large masses of gray matter located in the cerebral hemispheres. They are comprised of the caudate nucleus, lentiform nucleus (putamen and globus pallidus), amygdaloid nuclear complex, and claustrum. The basal ganglia receive input from the cerebral cortex and thalamus and output mainly to the globus pallidus and substantia nigra. They are involved in motor control and planning through direct and indirect pathways that facilitate or inhibit motor activity. Disorders like Parkinson's and Huntington's result from disruptions to these circuits.
Emotion is a complex phenomenon influenced by physiological and cognitive factors. It arises from both physical reactions in the body as well as conscious experiences. The document discusses several theories of emotion:
1. James-Lange theory proposes that emotional experience arises from physiological arousal.
2. Cannon-Bard theory argues that physiological and emotional experiences occur simultaneously rather than one causing the other.
3. Schachter-Singer theory suggests emotion results from physiological arousal combined with cognitive interpretation of the arousal.
4. Cognitive theories like Lazarus' emphasize that appraisal and evaluation of situations determine emotional responses.
No single theory comprehensively explains emotions, but most agree both biological and environmental factors interact to
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
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2. • Introduction
• History
• Imaging techniques
• Neuroimaging in specific psychiatric disorders
• Important signs
• Conclusion
3. INTRODUCTION
• Psychiatric diseases are mainly diagnosed by their symptoms, with little contribution from
observable signs and none from biological markers so far. This places psychiatry in a unique
position compared to other medical disciplines. The defining symptoms will ultimately have to be
investigated in humans with the diverse techniques of neuroimaging.
• Neuroimaging methodologies allow measurement of the structure, function, and chemistry of
the living human brain.
• Have provided information about the pathophysiology of psychiatric disorders that may be useful
for diagnosing illness and for developing new treatments.
4. HISTORY
• 1918 – the American neurosurgeon Walter dandy introduced the technique of Ventriculography by injection of filtered air directly into one
or both lateral ventricles of the brain.
• 1927 – Egas Moniz introduced cerebral angiography
• 1946 – MR phenomenon explained by Bloch & Purcell [1952 – Nobel prize]
• 1963 – 1st instance of SPECT – Kuhn & Edwards
• 1972 – Computerized tomography [Godfrey Hounsfield, Alan Mcleod Cormack, 1979 – Nobel prize]
• 1983 – Compton Camera for SPECT – Manbir Singh & David Doria
• 1985 – DTI – Le Bihan D & Breton E
• 1987 – MR Angiography – Dumoulin
• 1992 – Functional MRI By Richard R. Ernst
9. • Takes a series of head X-ray pictures from all
vantage points, 360 degrees around a patient's
head.
• Patient is placed on the CT table in a supine
position and the tube rotates around the patient
in the gantry.
• Head CTs are performed at an angle parallel to
the base of the skull, to prevent unnecessary
irradiation of the orbits
• Slice thickness - between 5 and 10 mm for a
routine Head CT.
10. • The amount of radiation that passes through
each angle is digitized and entered into a
computer.
• The image is a digital image and consists of a
square matrix of elements (pixel), each of
which represents a voxel (volume element)
of the tissue of the patient.
• The attenuation coefficient is measured in
terms of hounsefield units.
11. • Hounsefield units for
Air = -1000
Fat = -60 to -120
Water = 0
compact bone = +1000
• Density
1.Hypodense - CSF ,air, Fat. - BLACK
2.Isodense - Brain tissue - GREY
3.Hyperdense - Bone - WHITE
12. CONTRAST CT
•IV infusion of iodine-containing contrast agents increases the appreciation of tumors and areas of
inflammation.
•The blood-brain barrier, normally prevents the passage of contrast agents. But in the presence of
inflammation or tumors, the blood-brain barrier breaks down and allows accumulation of contrast
agents. These sites appear whiter than the surrounding brain.
•CAUTION – Allergy
•The only component better seen on CT scan is calcification, which may be invisible on MRI.
13.
14. Imaging Plane:
•CT images are acquired only in the axial plane.
Windows:
•Images can be "windowed" to bring out different
structures, which is a post processing step.
•"brain window" for neuroimaging to look at the
parenchyma and ventricular system.
•bone window to evaluate the osseous structures and
paranasal sinuses.
15. ABOVE THE LEVEL OF FORAMEN MAGNUM
A. Frontal Lobe
C. Dorsum Sellae
E. Temporal
Lobe
B. Frontal Bone (Superior Surface of Orbital
Part)
D. Basilar Artery
F. Mastoid Air CellsG. Cerebellar Hemisphere
16. AT THE LEVEL OF FOURTH VENTRICLE
A. Frontal Lobe
C. Temporal
Lobe
E. Midbrain
B. Sylvian Fissure (divides frontal, parietal from
temporal)
D. Suprasellar Cistern
F. Fourth VentricleG. Cerebellar Hemisphere
17. ABOVE THE LEVEL OF FOURTH VENTRICLE
A. Falx Cerebri B. Frontal Lobe
C. Anterior Horn of Lateral
Ventricle
E. Quadrigeminal Plate Cistern
D. Third
Ventricle
F. Cerebellum
18. AT THE THIRD VENTRICULAR LEVEL
A. Anterior Horn of the Lateral Ventricle
C. Anterior Limb of the Internal Capsule
E. Posterior Limb of the Internal Capsule
G. Quadrigeminal Plate Cistern
B. Caudate Nucleus (BG)
D. Putamen and Globus Pallidus (BG)
F. Third Ventricle
H. Cerebellar Vermis
19. AT THE LATERAL VENTRICULAR LEVEL
B. Anterior Horn of the Lateral
Ventricle
D. Thalamus
F. Choroid Plexus
A. Genu of the Corpus Callosum
C. Internal Capsule
E. Pineal Gland
G. Straight Sinus
20. ABOVE THE VENTRICULAR LEVEL
B. Frontal Lobe
D. Splenium of the Corpus Callosum
F. Occipital Lobe
A. Falx Cerebri
C. Body of the Lateral
Ventricle
E. Parietal Lobe
23. • The principle of MRI is that the nuclei of all atoms are thought to spin about an axis, which is
randomly oriented in space.
• When atoms are placed in a magnetic field, the axes of all odd-numbered nuclei align with the
magnetic field.
• Most abundant odd-numbered nucleus in the brain - hydrogen.
• The axis of a nucleus deviates away from the magnetic field when exposed to a pulse of
radiofrequency electromagnetic radiation oriented at 90 or 180 degrees to the magnetic field.
• When the pulse terminates, the axis of the spinning nucleus realigns itself with the magnetic
field, and during this realignment, it emits its own radiofrequency signal.
24.
25.
26. • MRI scanners collect the emissions of individual realigning nuclei and use computer analysis to
generate a series of two-dimensional images.
• MRI make use of a mathematical operation called a Fourier transform
• By varying the sequence of RF pulses applied & collected, different types of images are created.
• The images can be in the axial, coronal, or sagittal planes.
27. Parameters
• TE (echo time) : time interval in which signals are measured after RF excitation
• TR (repetition time) : the time between two RF excitations is called repetition time
• By varying the TR and TE one can obtain T1WI and T2WI
• In general a short TR (<1000ms) and short TE (<45 ms) scan is T1WI
• Long TR (>2000ms) and long TE (>45ms) scan is T2WI
28. T1WI
• Closely resembles that of CT scan
• Best for visualizing normal neuroanatomy
• Sharp boundaries between grey matter, white matter,
and CSF
• Useful in evaluation of CP angle, cistern& pituitary fossa
• T1 - only sequence that allows contrast enhancement
with gadoliniumdiethylenetriamine pentaacetic acid
(gadolinium-DTPA).
• Gadolinium remains excluded from the brain by the
blood-brain barrier, except in areas where this barrier
breaks down, such as inflammation or tumor - appear
white.
29.
30. T2WI
• T2 pulses last four times as long as T1 pulses, and
the collection times are also extended to
emphasize the signal from hydrogen nuclei
surrounded by water.
• Brain tissue is dark, and CSF is white
• T2 images reveal brain pathology most clearly.
• Less distinct boundaries between white and grey
matter
• Areas within the brain tissue that have
abnormally high water content, such as tumors,
inflammation, or strokes, appear brighter on T2
images
31. INTENSITY
•high signal intensity = white - HYPERINTENSE
•intermediate signal intensity = grey - ISOINTENSE
•low signal intensity = black - HYPOINTENSE
32. FLAIR (Fluid-attenuated inversion recovery)
• FLAIR images are T2-weighted with the CSF signal
suppressed.
• In this method, the T1 image is inverted and added to the
T2 image to double the contrast between gray matter and
white matter.
• Useful for
• imaging cerebral oedema,
• sclerosis of the hippocampus caused by temporal lobe epilepsy and
• for localizing areas of abnormal metabolism in degenerative
neurological disorders.
33. • CSF signal is removed on FLAIR which has two advantages:
1.First, periventricular lesions are better differentiated from CSF
2.Second , infectious exudates may replace CSF in the sulci to appear
hyperintense on FLAIR images
34. TISSUE T1-WEIGHTED T2-WEIGHTED FLAIR
CSF Dark Bright Dark
WHITE MATTER Bright Dark Gray Dark Gray
GREY MATTER Dark Gray Light Gray Light Gray
35. DIFFUSION WEIGHTED IMAGING (DWI)
• The diffusivity of water can provide a mechanism of contrast for MRI.
• Signal in each image pixel is altered based on the diffusivity of water.
• Movement of water molecules is significantly restricted in the intracellular space - this results in
an extremely bright signal on DWI.
• Diffusion, rapidly become restricted in ischemic brain tissue. Visualizes area of ischemic stroke in
1st few hours- earliest to detect ischemia.
• DWI can reveal abnormalities in otherwise normal-appearing tissue, as in regions of edema that
surround a cerebral infarct. Regions with edema show greater signal reductions, because water
can diffuse more readily.
36. • Principle application is in the imaging of white matter where the location, orientation, and
anisotropy of the tracts can be measured
• The architecture of the axons in parallel bundles, facilitate the diffusion of the water molecules
preferentially along their main direction. Such preferentially oriented diffusion is called
anisotrophic diffusion.
• The fiber tracts that run in the same direction as the diffusion gradient of water will show a
greater signal reduction than fibers that run perpendicular.
• DTIs are also used to track fibers. Fiber tracking allows detailed analyses of anatomic
connectivity.
37.
38. PROPERTIES MRI CT
Resolution Higher Lesser
Soft tissue contrast Greater detail Lesser
Bony structures Less detailed More clear and
detailed
S/E Nil Radiation
Claustrophobia Present Absent
Duration of
procedure
Longer Quick
Cost Higher Less expensive
With pacemakers and
metal implants
C / I Can be performed
IMAGING PLANE Any Only axial
Arifacts from bone Absent Present
39. Magnetic Resonance Spectroscopy
• Spectroscopy is the determination of the chemical composition of a substance by observing the
spectrum of electromagnetic energy emerging from it.
• Whereas routine MRI detects hydrogen nuclei to determine brain structure, magnetic resonance
spectroscopy (MRS) can detect several odd-numbered nuclei.
• Hence allows the use of the technique to study many metabolic processes.
• The most commonly used nuclei have been 1H, 31P, and 13C.
40. • The readout of an MRS device is usually in the
form of a spectrum - can also be converted into a
pictorial image of the brain.
• The height of the peak indicates the amount of
the molecule present. Using MRS, the more
metabolite that is present, the taller the peak or
greater the area under the peak.
• The multiple peaks for each nucleus reflect that
the same nucleus is exposed to different electron
environments in different molecules. Thus, the
position in the spectrum indicates the identity of
the molecule in which the nuclei are present.
41. ….MRS
• This technique provides data regarding the levels of
N-acetyl aspartate (NAA, a marker of neuronal density and integrity),
choline (Cho, a marker of cellular density and precursor of neurotransmitter acetyl Choline),
creatine (Cr, a marker of cellular energy),
myo-inositol (mI, a marker of membrane turnover and myelination), and
the complex named Glx formed by Glu and glutamine; both of them are involved in the
synthesis of GABA.
42. NUCLEI USED IN MRS & THEIR USES IN PSYCHIATRY
NUCLEUS CLINICAL USES
1H MRI
19F Measurement of p02, glucose metabolism, and
pH
7Li Pharmacokinetics
23Na MRI
31P Measurement of pH and the concentrations of
ATP and GTP
14N Measurement of glutamate, urea, ammonia
13C Analysis of metabolite turnover rate,
Pharmacokinetics
17O Measurement of metabolic rate
2H Measurement of perfusion
43. Functional MRI
• A new sequence is the T2 or blood oxygen level-dependent (BOLD) sequence, which detects levels
of oxygenated hemoglobin in the blood.
• Neuronal activity - local increase in blood flow, which in turn increases the local oxygenated
hemoglobin concentration.
• This change can be detected essentially in real time with the T2 sequence, which thus detects the
functionally active brain regions. This process is the basis for the technique of fMRI.
44.
45.
46. • fMRI is useful to localize neuronal activity to a particular lobe or subcortical nucleus or even to a
single gyrus.
• fMRI detect tissue perfusion not the neuronal metabolism.
• First, a routine T 1 MRI image is obtained; then the T2 images are superimposed to allow more
precise localization.
Advantages
• Possible to study both cerebral anatomy & Functional Neurophysiology using a single technique
• No radioactive isotopes used, a great advantage over PET and SPECT.
• Used in criminal psychiatry or federal investigations as a lie detector
…fMRI
47. Limitations
1.The volume of brain in which blood flow increases exceeds the volume of activated neurons by
about 1 to 2 cm and limits the resolution of the technique. Sensitivity & resolution can be improved
by using iron oxide particles.
2.Two tasks that activates neurons 5 mm apart will yield overlapping signals on fMRI & thus are
indistinguishable by this technique.
3.Procedure takes 20 Minutes to 3 hours, during which the subject’s head must remain in exactly
the same position.
…fMRI
48. SPECT
• Manufactured radioactive isotopes are used to study regional differences in cerebral blood flow
within the brain.
• radioactive isotopes emit single gamma ray.
• the pattern of photon emission is recorded according to the level of perfusion in different regions
of the brain.
• As with fMRI, it provides information on the cerebral blood flow, which is highly correlated with
the rate of glucose metabolism, but does not measure neuronal metabolism directly.
• SPECT uses compounds labelled with single photon-emitting isotopes:
1. iodine- 123,
2. technetium-99m, and
3. xenon- 133.
49. 1. Xenon- 133 is a noble gas that is inhaled directly and quickly enters the blood and is distributed
to areas of the brain as a function of regional blood flow – but can measure blood flow only on
the surface of the brain, which is an important limitation.
2. Assessment of blood flow over the whole brain with SPECT requires the injectable tracers,
technetium-99m-D,L-hexamethylpropyleneamineoxime (HMPAO) or iodoamphetamine. These
isotopes are attached to molecules that are highly lipophilic and rapidly cross the blood-brain
barrier and enter cells. Thus, over time, the tracers are concentrated in areas of relatively
higher blood flow.
3. Iodine- 123-labeled ligands can be used to study muscarinic, dopaminergic, and serotonergic
receptors
…SPECT
50. PET
• The isotopes used in PET decay by emitting positrons
• The positrons bind with and annihilate electrons, thereby
giving off photons that travel in 180-degree opposite
directions.
• the resolution of the PET image is higher - 3 mm, which is
the distance positrons move before colliding with an
electron.
• Relatively few PET scanners are available because they
require an onsite cyclotron to make the isotopes.
• The most commonly used isotopes in PET are
• fluorine- 18 (18F),
• nitrogen- 13 , and
• oxygen- 15.
51. • These isotopes are usually linked to another molecule, except in the case of oxygen- 15. The
most commonly reported ligand has been [18F]fluorodeoxyglucose (FDG), an analogue of
glucose that the brain cannot metabolize.
• Use of glucose is a highly sensitive indicator of the rate of brain metabolism.
• The brain regions with the highest metabolic rate and the highest blood flow take up the most
FDG but cannot metabolize and excrete the usual metabolic products. The concentration of
FDG builds up in these neurons and is detected by the PET camera.
1. Water- 15 and nitrogen - 13 are used to measure blood flow, and
2. 15O can be used to determine the metabolic rate.
3. 18F-labeled 3 ,4-dihydroxyphenylalanine (DOPA), the fluorinated precursor to dopamine,
has been used to localize dopaminergic neurons.
• PET has been used increasingly to study normal brain development and function as well as to
study neuropsychiatric disorders.
52.
53. PET SPECT
Emits positron Emits gamma radiation
Higher spatial resolution 3-5 mm Lower 7-10 mm
Costly Economical
Limited half life Longer half life of isotopes
Not easily available Easily available
56. SCHIZOPHRENIA
CT/MRI
•Consistent lateral and third ventricular enlargement - most replicated finding in schizophrenia
•Reduced volumes of cortical gray matter - during the earliest stages of the disease.
•Frontal lobe abnormalities in prefrontal gray matter and orbitofrontal regions.
•Parietal lobe abnormalities, particularly of the inferior parietal lobule
•Reduced symmetry in several brain areas in schizophrenia, including the temporal, frontal, and
occipital lobes. This reduced symmetry originate during fetal life and to be indicative of a disruption
in brain lateralization during neurodevelopment.
57.
58. • The second most replicated finding, is medial
temporal lobe involvement
• decrease in the size of the region, including
the amygdala, the hippocampus, and the
parahippocampal gyrus and superior
temporal gyrus (STG).
• Hippocampus is not only smaller in size but
also functionally abnormal (disturbed
glutamate transmission in functional scans)
• Positive symptoms - decreased volume of
superior temporal gyrus
• Negative symptoms - enlarged lateral
ventricle & decreased volume of medial
temporal lobe structures
• All these structural abnormalities may be
static or progressive.
SCHIZOPHRENIA
59. MRS
•NAA levels were lower in hippocampus and frontal lobes
DTI
•DTI to investigate white matter pathology particularly in frontotemporal tracts. the frontotemporal
connections investigated in schizophrenia are
• uncinate fasciculus (UF),
• cingulum bundle (CB),
• the arcuate fasciculus (AF)
• inferior longitudinal fasciculus (ILF)
•A number of studies have shown reduced anisotropy in patients
compared with controls
SCHIZOPHRENIA
60. fMRI/PET
•Hypofrontality
•With memory and executive tasks – abnormal activations in temporal lobe,
prefrontal cortices, and limbic structures
•On emotional stimulus – consistent diminished activation in limbic and
paralimbic regions, especially the amygdala.
•Functional scans have also revealed lower levels of phosphomonoester &
inorganic phosphate and higher levels of phophodiester.
SCHIZOPHRENIA
61. MOOD DISORDERS
CT/MRI
•Most consistent abnormality in depression – increased frequency of abnormal hyperintensities in
subcortical regions, such as periventricular regions, the basal ganglia, and the thalamus.
•Also present in bipolar I disorder, these hyperintensities appear to reflect the deleterious
Neurodegenerative effects of recurrent affective episodes.
•Ventricular enlargement, cortical atrophy, and sulcal widening also have been
•Reduced hippocampal or caudate nucleus volumes, or both
•Diffuse and focal areas of atrophy have been associated with increased illness severity, and
bipolarity.
63. DEPRESSION
fMRI
•Normal sadness is associated with an increase in
blood flow and neuronal activity in the thalamus
and medial PFC
•More specific activation is seen in the left
amygdala, hippocampal formation, and
parahippocampal gyrus
64. • Inactivation of left prefrontal cortex in depressed
• During inhibition task - greater activation in frontal and anterior temporal areas in MDD
65. PET
•The most widely replicated PET finding in depression is decreased anterior brain metabolism, which is
generally more pronounced on the left side.
•Relative increase in nondominant hemispheric activity.
DEPRESSION
66. • Shifts from depression into hypomania – causes a reversal of hypofrontality, such that greater left
hemisphere reductions are seen in depression compared with greater right hemisphere reductions in mania.
• Other studies - reductions of cerebral blood flow or metabolism, or both, in the dopaminergically innervated
tracts of the mesocortical and mesolimbic systems in depression.
• Antidepressants partially normalize these changes.
• Increased glucose metabolism has also been observed in several limbic regions, particularly among severe
recurrent depression and a family history of mood disorder.
• Increased glucose metabolism is correlated with intrusive ruminations.
67. SPECT
•Baseline cerebral blood flow is lower in frontal cortex and sub-cortical nuclei bilaterally.
•Medication response – normalization of cerebral blood flow deficit.
DEPRESSION
68. OCD
CT/MRI
•Bilaterally smaller caudate in OCD pts.
•Significantly more cerebral grey matter & less white matter volume than normal controls.
•Decreased volume of left orbital frontal cortex.
•Abnormality in length of corpus callosum.
•Abnormality in pituitary volume may also be noted.
•Larger anterior cingulate volumes - increased ocd symptom severity
69. OCD
• Increased grey matter in lenticular nuclei
• Decreased grey matter in anterior
cingulate gyri
70. OCD - MRS
•Reduction in NAA levels in various regions of brain involved in CSTC circuitry including corpus
striatum, thalamus, basal ganglia, and anterior cingulate cortex.
•Similarly, studies also suggest higher levels of Glx in caudate nucleus and anterior cingulate cortex
(hyperglutaminergic state)
71. OCD
DTI
•Drug naive OCD patients showed significant increase in fractional anisotropy (FA) in the Corpus
callosum, Internal capsule, white matter in the area to the right caudate.
72. PET - OCD
•Increased metabolism in the the orbitofrontal
cortex, caudate nucleus, anterior cingulate cortex,
thalamus, and parietal cortex.
•Cortico-striatal-thalamic-cortical (CSTC) circuitry
plays a important role in mediating the compulsive
and impulsive features of OCDs - Increased activity
in these circuits both at rest, and on exposure to
feared stimuli.
•Pharmacological and behavioral treatments
reportedly reverse these abnormalities.
73. ANXIETY DISORDERS
• Volumetric MRI studies of panic disorder – smaller OFC, putamen, and temporal lobe volume,
and lower gray matter density in parahippocampal cortex
• Intrinsically exaggerated amygdala hyperresponsivity and abnormal structure or function in the
mPFC and hippocampus.
• Both PET and fMRI studies have identified altered resting-state regional cerebral blood flow
(rCBF). Specifically, patients show altered function in parahippocampal gyrus, hippocampus,
superior temporal gyrus.
74. MRS studies demonstrated that in
comparison with healthy controls,
participants with panic disorder showed
a significantly greater rise in brain lactate
in response to the same level of
hyperventilation.
PANIC DISORDER - MRS
75. • The first reported structural abnormality in PTSD was a reduced left hippocampal volume in Vietnam
veterans with PTSD.
• Numerous studies subsequently reported left, right, or bilateral hippocampal volume reduction in PTSD.
Volume reductions were associated with severity of combat exposure.
• Evidence for smaller left amygdala volumes in adults with PTSD
• Several studies have pointed to abnormal structural characteristics in the anterior cingulate cortex (ACC)
PTSD
76. • fMRI studies have found increased activity in
amygdala, a brain region associated with fear.
78. ALZHEIMER'S DISEASE
CT
•Cerebral atrophy (typical dilatation of
lateral ventricles & widening of cortical
sulci) particularly in posterior temporal
& parietal regions
79. • Change in global (whole brain and
ventricles) and regional (entorhinal
cortex, hippocampus, corpus callosum)
volumes
• MRI evidence of medial temporal lobe
(MTL) atrophy appears to be most
closely associated with the disorder.
• MTL atrophy is often observed even in
the early stages of mild cognitive
impairment (MCI), making it potentially
useful as a prognostic tool.
ALZHEIMER’S - MRI
80. fMRI
•During the encoding of new memories, decreased fMRI activation in the hippocampus and related
structures within the medial temporal lobe
MRS
•There is decreased levels of NAA and increased levels of myo-inositol compared to those of age-
matched comparison subjects.
ALZHEIMER
• related to the loss of neurons and an
increase in gliosis.
• Few studies suggest glutamate and
glutamine can be found in subjects with
MCI impairment and AD - reflect a
combination of ongoing metabolic
dysfunction and increased gliosis.
81. DTI
•Significant frontal, temporal, and parietal white
matter diffusion tensor changes in MCI and
Alzheimer's disease that correlate with cognitive
functioning.
PET/ SPECT
•Reduced blood flow and metabolism in parietal,
posterior temporal, and posterior cingulate cortices,
with variable reductions in other cortical regions.
ALZHEIMER
82. • Recent development of PET imaging is with the Aβ-binding agent Pittsburgh Compound B (PIB-PET).
• In contrast to PET or SPECT, the PIB-PET has the potential to demonstrate qualitative differences between
Alzheimer's disease and cognitively intact elderly individuals.
• PIB-PET may also detect the presence of Aβ deposition in mild cognitive impairment – can be used to
detect preclinical Alzheimer's disease.
ALZHEIMER
PIB-PET
AD
MCI
FTD
85. • PET or SPECT in FTD selective frontal and/or anterior temporal reduction in blood flow or metabolism.
• Alzheimer's disease - reductions in blood flow and metabolism in posterior temporal and parietal regions.
86. DEMENTIA WITH LEWY BODIES
• Greater hypoperfusion with FDG-PET in occipital regions than Alzheimer's disease.
87. • Imaging the presynaptic dopaminergic
terminals using 123I-FP-CIT SPECT ( 123I-N-3-
fluoropropyl-2beta-carbomethoxy-3beta-4-
iodophenyl tropane ) [ DATSCAN ] - reveals a
marked loss of presynaptic dopaminergic
terminals in the corpus striata in DLB,
whereas there is no change in these
terminals in normal individuals and in
patients with Alzheimer's disease
123I-FP-CIT SPECT
88. CT/ MRI
•Increased total brain volume < 4 years of age in ASD
whose neonatal head circumferences were normal
•At 5 years - 15 to 20 percent of children developed
macrocephaly.
•Size of the amygdala increase in the first few years
of life, followed by a decrease in size over time.
•The size of the striatum has also been found in
several studies to be enlarged
•Positive correlation of striatal size with frequency of
repetitive behaviors.
AUTISM SPECTRUM DISORDER
89. AUTISM - fMRI
fMRI studies have provided evidence - they focus more on
the mouth region of the face rather than on the eye region
rather than scanning entire face, they focus more on
individual features of the face.
In response to socially relevant stimuli, they have greater
amygdala hyperarousal.
In terms of "theory of mind," that is, the ability to attribute
emotional states of others, right temporal lobe become
activated in controls but not in autism. This difference is due
to dysfunction of the mirror neuron system (MNS).
90. During face processing tasks - Atypical
pattern of frontal lobe activation
During memory and language-based tasks -
decreased activation in the left frontal
regions – so they utilized more visual
strategies during language processing.
AUTISM - fMRI
91. ADHD
MRI
•Shows no consistent findings.
•Increased cortical grey & white matter volumes from 5 yrs of age with peak at 12-15 yrs of age.
•Decrease in the volume of posterior inferior cerebellar vermis may be noted.(region involved in
attention processing)
92. ADHD - PET
•PET scans have also shown that female adolescents with ADHD have globally lower glucose metabolism
than both control female and male adolescents.
White, Red, Orange = higher glucose metabolism
Blue, Green, Purple = lower glucose metabolism
93. • Pet scan has also shown lower CBF and metabolic rates in the frontal lobes of children with ADHD.
• Less striatal activation during cognition inhibition tasks.
ADHD - PET
95. HUMMING BIRD SIGN / PENGUIN SIGN
• Seen in Progressive Supranuclear palsy (PSP)
• significant midbrain atrophy with sparing of pons known as “hummingbird” sign.
96. MICKEY MOUSE/MORNING GLORY SIGN
• Classically seen in PSP
• selective atrophy of the midbrain tegmentum with relative preservation of tectum and cerebral peduncles
resembling the head of a Mickey Mouse
• lateral margin of midbrain tegmentum - abnormal concavity - resembles morning glory.
97. EYE OF TIGER APPEARANCE
• Seen in Hallervorden-Spatz disease/ NBIA.
• Hyperintense area in Globus Pallidus surrounded by hypointense area
• Central high signal – due to gliosis and neuronal loss
• Surrounding Low signal – due to excessive iron accumulation
98. HOT-CROSS-BUN SIGN
• Seen in Multiple System Atrophy
• Crucifrom hyperintensities in Pons
• selective degeneration of pontocerebellar tracts
99. FACE OF GIANT PANDA
• Seen in Wilson’s disease.
• High signal intensity in the Midbrain tegmentum sparing the red nucleus (forms eyes)
• Preservation of signal intensity of the lateral portion of the pars reticulata of the substantia nigra makes up the ears.
• Hypointensity of the superior colliculus makes up the chin/mouth
• Similar changes when seen in Pons – Face of Miniature Panda / panda Cub Sign
• Together called as – Double Panda Sign.
108. Summary
• A CT scan takes a series of head X-ray pictures around a patient's head.
• MRI scanners use strong magnetic fields, and RF waves to alter the H2 atom and generate images of the organs in
the body.
• DTI uses the diffusion of water molecules to generate contrast in MR images
• fMRI measures brain activity by detecting blood oxygen level–dependent (BOLD) changes
• MR Spectroscopy is the determination of the chemical composition of a substance by observing the spectrum of
electromagnetic energy emerging from it.
• SPECT uses radioactive isotopes that emit single gamma ray to study cerebral blood flow within the brain.
• PET uses isotopes that decay by emitting positrons which emit a pair of photons
109. CONCLUSION
• Functional and structural neuroimaging are key techniques of modern brain research and play a
major role in the quest for biological markers of mental disorders.
• They have already contributed greatly to the pathophysiology of mental disorders, their clinical
applications in diagnosis or treatment monitoring are under reseaech.
• Neuroimaging could also monitor and compare the brain effects of different psychiatric and
psychological treatments, and eventually aid in the development of new interventions in future.
110. REFERENCES
1. Kaplan and Sadocks Comprehensive textbook of Psychiatry – 9, 10th Edition
2. Kaplan and Sadocks Synopsis of Psychiatry – 11th Edition
3. Postgraduate Textbook of Psychiatry – Neeraj Ahuja, 3rd Edition
4. Neuroradiology Signs - Mai-Lan Ho
5. Journals