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Role of Imaging Techniques in Discerning Neurobehavioral Changes in Ischemic, Neurodegenerative and Demyelinating Disorders

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The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes

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Abstract

Magnetic resonance imaging (MRI) is the most important paraclinical measure for assessing and monitoring the pathologic changes implicated in the onset and progression of demyelinating and ischemic disorders. Conventional MRI sequences, such as T2-weighted imaging are unable to provide full details about the degree of inflammation and underlying neu- rodegenerative changes. Newer non-conventional MRI techniques have the potential to detect clinical impairment, disease progression, accumulation of disability, and the neuroprotective effects of treatment. The measurement of brain atrophy seems to be of growing clinical relevance as a biomarker of the disease process. Atrophy should now be included as a secondary end- point in trials of therapies aimed at limiting disease progression. Magnetization transfer imaging is increasingly used to characterize the evolution of lesions and normal-appearing brain tissue. Magnetic resonance spec-troscopy, which provides details on tissue biochemistry, metabolism, and function, also has the capacity to reveal neurodegeneration and neuroprotective mechanisms. By measuring the motion of water, diffusion imaging can provide information about the orientation, size, and geometry of tissue damage in white and gray matter. Functional MRI and other nuclear functional techniques may help clarify the brain's plasticity- and receptor-dependent compensatory mechanisms in patients with a variety of neurologic disorders. New techniques that might bring new information to the field include studies of microglial activation and studies using multiple single photon emission computed tomography (SPECT) and positron emission tomography (PET) tracers. All these techniques are useful in establishing diagnosis, monitoring disease activity, measuring therapeutic effect and explaining the development of disability in the short-and long-term. The role of these techniques in discerning neurobehavioral and neuropsychiatric symptoms in neurodegenerative (emphasizing Parkinson's Disease and Dementia with Lewy Bodies), ischemic and demyelinating disorders will be discussed.

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Authors and Affiliations

  1. Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA

    Turi O. Dalaker M.D., Milena Stosic M.D. (Stosic) & Robert Zivadinov M.D., Ph.D.

  2. Department of Radiology, Stavanger University Hospital, Stavanger, Norway

    Turi O. Dalaker M.D. & Mona K. Beyer M.D., Ph.D.

  3. The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway

    Turi O. Dalaker M.D. & Mona K. Beyer M.D., Ph.D.

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  1. Israel Institute of Technology, Haifa

    Michael S. Ritsner M.D., Ph.D. (Associate Professor of Psychiatry, the Rappaport Faculty of Medicine Technion) (Associate Professor of Psychiatry, the Rappaport Faculty of Medicine Technion)

  2. Sha'ar Menashe Mental Health Center, Hadera, Israel

    Michael S. Ritsner M.D., Ph.D. (Associate Professor of Psychiatry, the Rappaport Faculty of Medicine Technion) (Associate Professor of Psychiatry, the Rappaport Faculty of Medicine Technion)

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Dalaker, T.O., Beyer, M.K., Stosic, M., Zivadinov, R. (2009). Role of Imaging Techniques in Discerning Neurobehavioral Changes in Ischemic, Neurodegenerative and Demyelinating Disorders. In: Ritsner, M.S. (eds) The Handbook of Neuropsychiatric Biomarkers, Endophenotypes and Genes. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-9831-4_2

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