Zusammenfassung
Funktionelle Bildgebung ist die in-vivo-bildliche Darstellung von Hirnaktivität. Die direkten Methoden wie Elektroenzephalografie (EEG) und Magnetenzephalografie (MEG) messen die elektrischen bzw. magnetischen Feldänderungen, die durch simultane Entladungen von Gruppen von Neuronen hervorgerufen werden. Die indirekten Methoden, wie funktionelle Magnetresonanztomografie (fMRT) und Positronenemissionstomografie (PET) messen die regionalen Änderungen im Blutfluss als Maß für die neuronale Aktivität. Gemeinsam haben die direkten und indirekten Methoden, dass Änderungen der Hirnaktivität unter experimentellen Bedingungen mit einem Ausgangswert verglichen werden und so die lokale Beteiligung von einem oder mehreren Hirnarealen an einer Aufgabe nachgewiesen werden kann. Die gemessenen Änderungen werden zur Lokalisation auf anatomische Aufnahmen (in der Regel dreidimensionale kernspintomografische Aufnahmen) des Gehirns projiziert. Die ersten indirekten Methoden wurden mit PET gemacht, aber wegen der größeren Zugänglichkeit des MRT, der fehlenden Strahlenbelastung und der geringeren Kosten wird zurzeit für fast alle Studien das fMRT genutzt. MEG und EEG haben v. a. einen Vorteil in der hohen zeitlichen Auflösung, die mit dem fMRT als indirekte Methode wohl nie erreicht werden kann. Das MRT hat aber den großen Vorteil, dass Aktivierungen anatomisch genau zugeordnet werden können. Zusätzlich können mit der voxelbasierten Morphometrie (VBM) lokale anatomische Unterschiede gemessen werden, mit dem Diffusion-Tensor Imaging (DTI) wird der Faserverlauf in der weißen Substanz untersucht. Allerdings werden diese zwei Methoden aufgrund der individuellen Unterschiede der Hirnanatomie in der Regel nur in Gruppenstudien angewandt, nur in Ausnahme bei individuellen Patienten. Diese zwei anatomischen Methoden werden aber auch zu der funktionellen Bildgebung gerechnet, weil sie die gleichen Fragen beantworten können.
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Rijntjes, M., Weiller, C. (2018). Funktionelle Bildgebung in der neurologischen Diagnostik. In: Berlit, P. (eds) Klinische Neurologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44768-0_25-1
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