1. FUNCTIONAL
NEUROANATOMY OF
BRAIN
Presented by: Dr. Karrar Husain
Moderator: Dr Piyush P Singh

2. • The brain, and the brain alone, is the source of our pleasures,
joys, laughter, and amusement, as well as our sorrow, pain,
grief, and tears.
Hippocrates, ca.
400

3. HUMAN BRAIN
• Human brain  substantially greater in size (350g vs 1200g).
• The prefrontal cortex  3.5 % of the total cortical volume in
cats and 11.5% in monkeys but close to 30 % in humans brain.
• Relative representation of other regions is decreased in the
human brain; (primary visual cortex 1.5 percent of the total area
in humans but its close to 17% in monkeys.

5. CELLS
• Human brain  1011 nerve cells
• Neurons  four morphologically identified regions
• 1) The cell body, or soma containing the nucleus; considered the
metabolic center of the neuron.
• 2) The dendrites, processes arising from the cell body, branch
extensively; serve as the major recipient zones of input.

6. • 3) The axon, a single process that arises from a specialized
portion of the cell body (the axon hillock) and conveys
information to other neurons
• 4) The axon terminals, fine branches near the end of the axon
that form contacts (synapses).

8. THE CEREBRUM

9. Cerebrum -The largest division of the brain. It
is divided into two hemispheres, each of which is
divided into four lobes.
Cerebru
m
Cerebrum
Cerebellum

10. Cerebral cortex
• Cerebral Cortex - The outermost layer of gray matter
making up the superficial aspect of the cerebrum.
• cerebral cortex, several millimeters thick, covers the
cerebral hemispheres 22.5 billion neurons 165 trillion
synapses
• 90 percent of the total cortical area neocortex, which has
a six-layered structure
• Rest is allocortex and consists of the paleocortex and the
archicortex, regions that are restricted to the base of the
telencephalon and the hippocampal formation,
respectively.

11. Cerebral Cortex
Cerebral
Cortex

12. Cerebral Features:
• Sulci – Small grooves dividing the gyri
– Central Sulcus – Divides the Frontal Lobe from the Parietal
Lobe
• Fissures – Deep grooves, generally dividing large
regions/lobes of the brain
– Longitudinal Fissure – Divides the two Cerebral Hemispheres
– Transverse Fissure – Separates the Cerebrum from the
Cerebellum
– Sylvian/Lateral Fissure – Divides the Temporal Lobe from the
Frontal and Parietal Lobes
• Gyri – Elevated ridges “winding” around the brain.

14. Gyri (ridge)
Fissure
(deep groove)
Sulci
(groove)

15. Longitudinal
Fissure
Transverse
Fissure
Sylvian/Latera
l Fissure
Central Sulcus
Specific
Sulci/Fissures:

16. Lobes of the Brain
•Frontal
•Parietal
•Occipital
•Temporal
* Note: Occasionally, the Insula is considered the fifth lobe. It is
located deep to the Temporal Lobe.

17. Lobes of the Brain - Frontal
• The Frontal Lobe of the brain is located deep to the
Frontal Bone of the skull.
• It plays an integral role in the following
functions/actions:- Memory Formation
- Emotions
- Decision Making/Reasoning
- Personality

18. Frontal Lobe - Cortical Regions
• Orbitofrontal Cortex – Site of Frontal Lobotomies
• Primary Motor Cortex (Precentral Gyrus) – Cortical site involved with
controlling movements of the body.
• Broca’s Area – Controls facial neurons, speech, and language comprehension.
Located on Left Frontal Lobe.
– Broca’s Aphasia – Results in the ability to comprehend
speech, but the decreased motor ability (or inability) to speak
and form words.
• Olfactory Bulb - Cranial Nerve I, Responsible for sensation of
Smell
* Desired Effects:
- Diminished Rage
- Decreased
Aggression
- Poor Emotional
Responses
* Possible Side Effects:
- Epilepsy
- Poor Emotional Responses
- Perseveration (Uncontrolled,
repetitive actions, gestures, or
words)

19. Primary Motor
Cortex/ Precentral
Gyrus
Broca’s Area
Orbitofrontal
Cortex
Olfactory Bulb

20. Lobes of the Brain - Parietal Lobe
• The Parietal Lobe of the brain is located deep to
the Parietal Bone of the skull.
• It plays a major role in the following
functions/actions:
- Senses and integrates sensation(s)
- Spatial awareness and perception
(Proprioception - Awareness of
body/ body parts in space and
in relation to each other)

21. Parietal Lobe - Cortical Regions
• Primary Somatosensory Cortex (Postcentral
Gyrus) – Site involved with processing of tactile
and proprioceptive information.
• Somatosensory Association Cortex - Assists with the
integration and interpretation of sensations relative to body position
and orientation in space. May assist with visuo-motor coordination.
• Primary Gustatory Cortex – Primary site involved with the
interpretation of the sensation of Taste.

22. Primary
Somatosensory
Cortex/ Postcentral
Gyrus
Primary Gustatory
Cortex
Somatosensory
Association Cortex

23. Lobes of the Brain – Occipital Lobe
• The Occipital Lobe of the
Brain is located deep to the
Occipital Bone of the Skull.
• Its primary function is the
processing, integration,
interpretation, etc. of VISION
and visual stimuli.

24. Occipital Lobe – Cortical Regions
• Primary Visual Cortex – This is the primary area of the
brain responsible for sight -recognition of size, color, light,
motion, dimensions, etc.
• Visual Association Area – Interprets
information acquired through the primary
visual cortex.

25. Primary Visual
Cortex
Visual Association
Area

26. Lobes of the Brain – Temporal Lobe
• The Temporal Lobes are located on the sides of
the brain, deep to the Temporal Bones of the skull.
• They play an integral
role in the following
functions:- Hearing
- Organization/Comprehension of
language
- Information
Retrieval (Memory and
Memory Formation)

27. Temporal Lobe – Cortical Regions
• Primary Auditory Cortex – Responsible for hearing
• Primary Olfactory Cortex – Interprets the
sense of smell once it reaches the cortex via the
olfactory bulbs. (Not visible on the superficial cortex)
• Wernicke’s Area – Language comprehension.
Located on the Left Temporal Lobe.
- Wernicke’s Aphasia – Language
comprehension is inhibited. Words and sentences are
not clearly understood, and sentence formation may
be inhibited or non-sensical.

28. Primary Auditory
Cortex
Wernike’s Area
Primary Olfactory
Cortex (Deep)
Conducted from Olfactory
Bulb

29. • Arcuate Fasciculus - A white matter tract that connects Broca’s
Area and Wernicke’s Area through the Temporal, Parietal and Frontal
Lobes. Allows for coordinated, comprehensible speech. Damage
may result in:
- Conduction Aphasia - Where auditory comprehension and speech
articulation are preserved, but people find it difficult to repeat heard
speech.

30. Click the Region to see its
Name

31. Lobes and Structures of the Brain
B.
A.
C.
D.
E.
F.
G.

32. Lobes and Structures of the Brain
B.
A. (groove)
C. (groove)
D. E.
F.
G.
B. Frontal Lobe
G. Parietal Lobe
F. Occipital Lobe
D. Temporal Lobe
A. Central Sulcus
(groove)
E. Transverse Fissure
C. Sylvian/Lateral Fissure

33. Cortical Regions
A.
B.
C.
D.
E. F.
G.
H.
I.
J.
K.

34. Cortical
Regions
A.
B.
C.
D.
E. F.
G.
H.
I.
J.
K.
A. Primary Motor Cortex/ Precentral Gyrus
B. Broca’s Area
C. Orbitofrontal Cortex
K. Primary
Somatosensory Cortex/
Postcentral Gyrus
I. Primary Gustatory Cortex
J. Somatosensory
Association Cortex
G. Primary Visual Cortex
H. Visual
Association Area
E. Primary Auditory Cortex
F. Wernike’s Area
D. Primary Olfactory Cortex (Deep)

35. A: Primary Motor Cortex
* This graphic representation of the regions of the Primary Motor Cortex
and Primary Sensory Cortex is one example of a HOMUNCULUS:

36. Q: What do you notice about the proportions depicted in
the aforementioned homunculus?
Q: What is meant by depicting these body
parts in such outrageous proportions?
A: They are not depicted in the same scale representative of the human
body.
A: These outrageous proportions depict the cortical area devoted to
each structure.
- Ex: Your hands require many intricate movements and sensations to
function properly. This requires a great deal of cortical surface area to
control these detailed actions. Your back is quite the opposite, requiring
limited cortical area to carry out its actions and functions, or detect
sensation.
* Note: Homunculus literally means “little person,” and may refer to one whose body shape
is governed by the cortical area devoted to that body region.

37. Further Investigation
Phineas Gage: Phineas Gage was a railroad worker in the 19th century living
in Cavendish, Vermont. One of his jobs was to set off explosive charges in
large rock in order to break them into smaller pieces. On one of these
instances, the detonation occurred prior to his expectations, resulting in a 42
inch long, 1.2 inch wide, metal rod to be blown right up through his skull and
out the top. The rod entered his skull below his left cheek bone and exited
after passing through the anterior frontal lobe of his brain.

38. Remarkably, Gage never lost consciousness, or quickly regained it (there is
still some debate), suffered little to no pain, and was awake and alert when he
reached a doctor approximately 45 minutes later. He had a normal pulse and
normal vision, and following a short period of rest, returned to work several
days later. However, he was not unaffected by this accident.

39.  Gage’s personality, reasoning, and capacity to
understand and follow social norms had been
diminished or destroyed. He illustrated little to no
interest in hobbies or other involvements that at one
time he cared for greatly. ‘After the accident, Gage
became a nasty, vulgar, irresponsible vagrant. His
former employer, who regarded him as "the most
efficient and capable foreman in their employ
previous to his injury," refused to rehire him because
he was so different.’

40. FUNCTIONAL BRAIN SYSTEMS
• The relations between the organizational principles and
the structural components of the human brain are
illustrated in three functional systems:
the thalamocortical,
basal ganglia, and
limbic systems

41. Thalamocortical Systems
• Thalamus: Group of nuclei located medial to the basal
ganglia that serves as the major synaptic relay station for
the information reaching the cerebral cortex
• the thalamic nuclei can be divided into six groups:
anterior, medial, lateral, reticular, intralaminar, and midline
nuclei

43. BASAL GANGLIA
• Basal ganglia are a collection of nuclei that have been
grouped together on the basis of their interconnections
• play an important role in regulating movement and in
certain disorders of movement eg chorea
,dyskinesia,athetosis,tremors
• include the caudate nucleus, the putamen, the globus
pallidus (referred to as the paleostriatum or pallidum), the
subthalamic nucleus, and the substantia nigra

45. • striatum ->caudate nucleus + the putamen together;
• corpus striatum -> caudate nucleus +putamen + globus
pallidus;
• lentiform nucleus-> putamen + globus pallidus

46. FUNCTIONAL CIRCUITS OF BASAL
GANGLIA
• INPUTS:
• The striatum is the major recipient of the inputs to the basal
ganglia. Three major afferent systems are known to terminate in
the striatum: the corticostriatal, nigrostriatal, and
thalamostriatal afferents.
• Disruption of the input pathways of the basal ganglia has been
associated with some movement disorders, such as Parkinson's
disease

48. INTERNAL
PROCESSING

49. • The intrinsic circuitry of the basal ganglia is disrupted by a
severe loss of neurons in the striatum in Huntington's disease.
This autosomal-dominant disorder is characterized by
progressive chorea and dementia

50. OUTPUTS

51. • globus palllidus provides a projection to the ventral lateral and
ventral anterior nuclei of the thalamus and to the intralaminar
thalamic nuclei, particularly the central median nucleus
• The pars reticulata of the substantia nigra also provides a
projection to the ventral anterior and ventral lateral thalamic
nuclei.
• the basal ganglia are able to indirectly influence the output of
the primary motor cortex through thalamic nuclei.

53. • Functions of basal ganglia:
• important in the control of movement
• recent studies of the connections of the basal ganglia in
nonhuman primates also support a role for these structures in
cognitive functions.

54. LIMBIC SYSTEM
• the cingulate and parahippocampal gyri (limbic cortex),
• the hippocampal formation,(dentate gyrus, the hippocampus,
and the subicular complex)
• the amygdala,
• the septal area, the hypothalamus, and
• related thalamic and cortical areas.

55. FUNCTIONS OF LIMBIC SYSTEM
• Integration of olfactory, visceral, somatic impulses
• Control of activities necessary for survival of animal
• Control of activities necessary survival of species
• Emotional behaviour
• Retention of recent memory

56. • In 1937, James Papez postulated, primarily on the basis
of anatomical data, that these cortical regions were linked
to the hippocampus, mammillary body, and anterior
thalamus in a circuit that mediated emotional behavior

57. neural circuit for emotion as originally proposed by
James Papez

58. • However, over the last 40 years, it has become clear that
some limbic structures (for example, the hippocampus)
are also involved in other complex brain processes, such
as memory
• Other cognitive processes with the hypothalamus and its
output pathways that control autonomic, somatic, and
endocrine functions

59. • LIMBIC CORTEX
• composed of two general regions, the cingulate gyrus and
the parahippocampal gyrus
• ENTORHINAL CORTEX
(Brodmann’s area no 28)
• Receive projections from olfactory bulb

60. • HIPPOCAMPAL FORMATION
• Three distinct zones—the dentate gyrus, the
hippocampus, and the subicular complex—constitute the
hippocampal formation, which is located in the floor of the
temporal horn of the lateral ventricle
• These zones are composed of adjacent strips of cortical
tissue
• On the basis of differences in the cytoarchitecture and
connectivity, the hippocampus can be divided into three
distinct fields, which have been labeled CA3, CA2, and
CA1.

61. • The major input to the hippocampal formation arises from
neurons in layers II and III of the entorhinal cortex
• The major input to the hippocampal formation arises from
neurons in layers II and III of the entorhinal cortex

63. FUNCTIONS OF HIPPOCAMPUS
• Retention of short term memory – long term
declarative memory

64. AMYGDALA
• Almond
• Involved in Central regulation of ANS connection to
hypothalamus
• Controls survival fight-or-flight response of ANS
• Emotional & visceral responses

65. AMYGDALA
• Several group of nucleus
• B/w inferior horn of lateral ventricle & lentiform
nucleus
• Two divisions :-
-dorsomedial
-ventrolateral – Basolateral
- central

66. • Functional Circuits of limbic systemThe major structures of
the limbic system are interconnected with each other and with
other components of the nervous system in a variety of ways..
highly processed sensory information from the cingulate, the
orbital and temporal cortices, and the amygdala is transmitted
to the entorhinal cortex of the parahippocampal gyrus and then
to the hippocampal formation. After traversing the intrinsic
circuitry of the hippocampal formation, information is projected
through the fornix either to the anterior thalamus, which, in turn,
projects to the limbic cortex, or to the septal area and the
hypothalamus. These latter two regions provide feedback to
the hippocampal formation through the fornix. In addition, the
mammillary bodies of the hypothalamus project to the anterior
thalamus. Finally, the hypothalamus and the septal area project
to the brainstem and the spinal cord

68. • Highly processed sensoryinformation, primarily from the
association regions of the prefrontal and temporal
cortices, projects to the amygdala. Output from the
amygdala is conducted through two main pathways (Fig.
1.2-37). A dorsal route, the stria terminalis, accompanies
the caudate nucleus in an arch around the temporal lobe
and contains axons that project primarily to the septal
area and the hypothalamus. The second major output
route, the ventral amygdalofugal pathway, passes below
the lenticular nucleus and contains fibers that terminate in
a number of regions, including the septal area, the
hypothalamus, and the medial dorsal thalamic nucleus.
The medial dorsal nucleus, in turn, projects heavily to
prefrontal and some temporal cortical regions.

70. • Both of these pathways reveal how the limbic system is
able to integrate the highly processed sensory and
cognitive information content of the cerebral cortical
circuitry with the hypothalamic pathways that control
autonomic and endocrine systems

71. • the ventral amygdalofugal pathway also projects to the
nucleus accumbens (ventral striatum), the area where the
head of the caudate nucleus fuses with the putamen (Fig.
This region sends efferents to the ventral palladium, an
extension of the globus pallidus. This area, in turn,
projects to the medial dorsal thalamic nucleus. The
pathway indicates that the functions of the basal ganglia
extend beyond the regulation of motor activities and
shows the necessity of considering the function or
dysfunction of particular brain regions in the context of all
aspects of their circuitry.

73. FUNCTIONAL ANATOMY OF BRAIN IN
RELATION TO PSYCHIATRIC DISORDER

74. schizophrenia
• Reduced nmda glutamate receptors causing cognitive symptoms
• Responsible for negative symptoms
• Anatomical abnormality of prefrontal cortex
• Mri & pet shows functional difference in brain activity in
frontal lobe,hippocampus,temporal lobe
• Pet shows less frontal activity during working memory related
to neurocognitive defects

75. • Latera land third ventricular enlargement
• Reduced volumes of cortical gray matter
• reduced symmetry in thetemporal,frontal,and occipital
lobes
• decrease inthe size the amygdala, the hippocampus,and
the parahippocampal gyrus.
• functionallyabnormal hippocampus as indicated by
disturbances in glutamate transmis-sion. D

76. • Anatomical abnormalitiesin the prefrontal cortex in
schizophrenia
• volume shrinkage or neuronal loss in thalamus , in
particular subnuclei

77. Mood disorders
• The most consistent abnormality observed in the
depressive disorders is increased frequency of abnormal
hyperintensities in subcortical regions such as
periventricular regions, the basal ganglia, and the
thalamus
• reduced hippocampal or caudate nucleus volumes
• increase in blood flow and neuronal activity in the
thalamus and medial PFC.
• decreased anterior brain metabolism, which is generally
more pronounced on the left side

78. • global reduction of anterior cerebral metabolism,
increased glucose metabolism has been observed in
several limbic regions, particularly among patients with
relatively severe recurrent depression and a family history
of mood disorder

79. ANXIETY DISORDERS
• icreasedactivityintheseptohippocampalpathway, which may lead to
anxiety, and the cingulate gyrus, which hasbeen implicated
particularly in the pathophysiology of ocd.
altered function in neuro circuit
increased blood flow&metabolism in frontal lobe
compulsive hoarding:compulsive hoarding or pathological
hoarding or disposophobia is the excessive acquisition of possessions,
even if the items are worthless, hazardous, or unsanitary.
damage to rt medial prefrontal cortex cause HOARDING

80. ADHD GENERAL REDUCTION OF BRAIN VOLUME ,BUT
PROPORTIONALLY GREAT REDUCTION OF LT PREFRONTAL
CORTEX
 RECENT RESEARCH SHOWS FOLLOWING FOUR CONNECTED
FRONTOSTRIATAL REGIONS PLAY A ROLE IN ADHD-lateral
prefrontal cortex ,Dorsal anterior cingulate,caudate,Putamen
 DELAYED DEVELOPMENT OF FRONTAL CORTEX,TAMPORAL
LOBE&FAST MATURITY OF MOTOR CORTEX SEEN
 THIS CONTRIBUTES SLOW BEHAVIOURAL CONTROL &ADVANCED
MOTOR DEVELOPMENT LEADS TO FIDGETINESS,THAT IS
CHARACTERISTIC OF ADHD
 PET SHOS LOW PERFUSION AND METABOLISM OF FRONTAL
AREA

81. APPLIED ANATOMY BASAL GAGLIA
• MOVEMENT DISORDER
1- athetosis: lesion of globus pallidus
2- hemiballismus: lesion of subthalamic nuclei
3-chorea: multiple small lesion in putamen
4-parkinsonism disease: destruction of substantia
nigra
5 hutingtons disease: loss of cell bodies of GABA
secreting neurons in caudate nucleus and putamen

82. • NEUROPSYCHIATRIC DISORDER
• Impairment in cognition
• Depression
• Personality changes
• Poor judgment
• Impaired concentration
• Social withdrawl
• Agitation

83. APPLIED ANATOMY OF LIMBIC
SYSTEM
• Kluver Bucy
syndrome
-complete removal of both
temporal lobes
-amygdaloid body,
hippocampal formation
-docility, lack of emotional
responses, increased
sexual activity (perverted),
visual agnosia
-Amygdaloid body lesion
-Lesion of hippocampi

84. •Anxiety states
-Inappropriate activity of amygdala
-Panic attacks of excessive activity of sympathetic
nervous system, subjective feeling of worry
-Treatment – anxiolytic drugs

85. • Schizophrenia
-anatomical measurements reduced in size
-antipsychotics antagonise action of dopamine
-parkinsonism
-tardive dyskinesia

86. •Memory disorders
-consolidation of new short term memory
-arterial occlusion – infarction – loss of
hippocampal function
-transient global amnesia
-head injury –damage to hippocampus –
hemorrhage – anterograde amnesia

87. - B/l hippocampal lesion – major circuit of hippocampus
- B/l transaction of fornix – severe amnesia
•Alzheimer’s disease –
- loss of cholinergic neurons of substantia innominata
which project to hippocampus
-ass. with degenerative changes in entorhinal cortex,
hippocampus, extensive neocortical atrophy
-amnesia for recently occurred events as mechanism for
retention of new memory not operating

88. FUNCTION ALASSESSMENT OF
BRAIN(NEURO-
PSYCHOLOGICAL ASSESMENT)

89. • Neuropsychological Assessment provides an objective
evaluation of cognitive and structural functioning
• Areas of neurological assessment:
• Abstract reasoning/compensation(e.g. problem solving,
executive functions)
• Activities of daily living(e.g toiletting, dressing,feeeding)
• Attention
• Emotional/psychological distress(depression, impusivity)

90. • Language skills
• Motor
• Orientation
• Sensation/perception
• Visuospatial

91. Neuropsychological tests
• Intelligence
• Ammons Quick Test
• National Adult Reading Test (NART)
• Wechsler Adult Intelligence Scale (WAIS)
• Wechsler Intelligence Scale for Children (WISC)
• Wechsler Preschool and Primary Scale of Intelligence
(WPPSI)
• Wechsler Test of Adult Reading (WTAR)

92. • Memory
• California Verbal Learning Test
• Cambridge Prospective Memory Test (CAMPROMPT)
• Doors and People
• MCI Screen
• Memory Assessment Scales (MAS)
• Rey Auditory Verbal Learning Test
• Rivermead Behavioural Memory Test
• Test of Memory and Learning (TOMAL)
• Wechsler Memory Scale (WMS)
• Test of Memory Malingering (TOMM)
•

93. • Language
• Boston Diagnostic Aphasia Examination
• Boston Naming Test
• Comprehensive Aphasia Test (CAT)
• Lexical decision task
• Multilingual Aphasia Examination

94. • Executive function
• Behavioural Assessment of Dysexecutive Syndrome (BADS)
• CogScreen: Aeromedical Edition
• Continuous Performance Task (CPT)
• Controlled Oral Word Association Test (COWAT)
• d2 Test of Attention
• Delis-Kaplan Executive Function System (D-KEFS)
• Digit Vigilance Test
• Figural Fluency Test
• Halstead Category Test
• Hayling and Brixton tests
• Iowa gambling task
• Kaplan Baycrest Neurocognitive Assessment (KBNA)
• Kaufman Short Neuropsychological Assessment
• Paced Auditory Serial Addition Test (PASAT)
• Pediatric Attention Disorders Diagnostic Screener (PADDS)
• Rey-Osterrieth Complex Figure
• Ruff Figural Fluency Test
• Stroop task
• Test of Variables of Attention (T.O.V.A.)
• Tower of London Test
• Trail-Making Test (TMT) or Trails A & B
• Wisconsin Card Sorting Test (WCST)
• Symbol Digit Modalities Test
• Test of Everyday Attention (TEA)

95. • Visuospatial[edit]
• Neuropsychological tests of visuospatial function should
cover the areas of visual perception, visual construction
and visual integration.[9] Though not their only functions,
these tasks are to a large degree carried out by areas of
the parietal lobe.[10]
• Clock Test
• Hooper Visual Organisation Task (VOT)
• Rey-Osterrieth Complex Figure

96. Batteries assessing multiple
neuropsychological functions
• There are some test batteries which combine a range of
tests to provide an overview of cognitive skills.
• These are usually good early tests to rule out problems in
certain functions and provide an indication of functions
which may need to be tested more specifically.

99. Goals of Neuropsychological Assessment
• Diagnose the presence of cortical damage and
localize it if possible
• Facilitate patient care
• Identify mild disturbances
• Identify unusual brain organization
• Identify the cause of disorders
• Rehabilitation
• Help the patient and their family understand the
disorder

100. PRIMITIVE REFLEXES
These are newborn reflexes disappear or inhibited by Frontal lobe
during normal development,which are not being suppressed in
frontal lobe injury causes frontal release signs.
WALKING/STEPPING REFLEX
ROOTING REFLEX
SUCKING REFLEX
TONIC NECK REFLEX
PALMAR GRASP REFLEX
PLANTAR REFLEX
GALANT REFLEX
SWIMMING REFLEX
BABKIN REFLEX

101. FUNCTIONAL NEUROIMAGING
OF BRAIN IN RELATION TO
MENTAL IN ILLNESS

102. Neuroimaging and Mental Illness
Structural
– Computerized Tomography (CT)
– Magnetic Resonance Imaging (MRI)
Functional
– Positron Emission Tomography (PET)
– Single Photon Emission CT (SPECT)
– functional MRI (fMRI)
– MR spectroscopy
– EEG & Event-Related Potentials (ERP)
– Magnetoencephalography (MEG)
– near infrared spectroscopy (NIRS)

103. Neuroimaging and Mental Illness
Structural
– Computerized Tomography (CT)
– Magnetic Resonance Imaging (MRI)
Functional
– Positron Emission Tomography (PET)
– Single Photon Emission CT (SPECT)
– functional MRI (fMRI)
– MR spectroscopy
– EEG & Event-Related Potentials (ERP)
– Magnetoencephalography (MEG)
– near infrared spectroscopy (NIRS)

104. Functional MRI (fMRI)
• Observation of active brain areas at a given time
• Blood-oxygen-level dependent or BOLD fMRI
• Increased blood flow releases oxygen to active neurons at a greater
rate than to inactive neurons
• Increased blood flow to active areas creates the magnetic signal
variation that can be detected by an MRI
• Comparisons can be made of brain activity
• during rest
• scripted thoughts
• patterned actions
• controlled experiences

105. Advantages of fMRI
Noninvasively record brain signals without risks of radiation
It can record on a spatial resolution in the region of 3-6 millimeters.
Disadvantages of fMRI
BOLD signal is an indirect measure of neural activity
It is susceptible to influence by non-neural changes in the body
BOLD signals are most strongly associated with the input to a given
area rather than with the output.
The temporal response of the blood supply is poor relative to the
electrical signals that define neuronal communication.

106. Motor
Working
memory/
Executive
functions
Speech
production
Emotions Memory
Vision
Motor/sequencing
Audition / speech
perception
Attention
Sensory
Assumption in
fMRI-BOLD imaging
studies is a
”cognitive map”

107. Depression group
Healthy Controls

108. Schizophrenia group
fMRIHealthy Controls

109. Copyright restrictions may apply.
Psychotherapy vs Drug Treatment
In Depression
Interpersonal psychotherapy
Venlafaxine

110. Positron Emission Tomography
• A PET scan is a radionuclide scan that produces a 3-D image or map of
functional processes such as blood flow, oxygen use and blood sugar
(glucose) metabolism.
• Glucose is often combined with a radioactive substance (radiotracer)
fluorodeoxyglucose (FDG), that's injected into the patient
• PET tracer emits positrons which annihilate with electrons up to a few
millimeters away, causing two gamma photons to be emitted in opposite
directions. A PET scanner detects these emissions as "coincident" in time
• Different tissues in your body take up different radionuclides at different
rates.
• The number of positrons emitted by an organ or area of tissue indicates the
amount of radioactive substance
• Intense color = high uptake = hot spots
• Less intense color = low uptake of radioactive substance = cold spots.

111. PET Radiotracers
• Dopamine
• Benzodiazepine
• Serotonin
• Histamine
• Muscarinic cholinergic
• Amyloid
• Protein kinase C
• Monoamine oxidase

112. PET
scan
Increased loss of gray
matter in adolescence
between the ages of
12-16 compared to
healthy adolescence.
Red—Gray Matter Gain
Blue—Gray Matter Loss

113. PET scan of Schizophrenics participating
in the Wisconsin card sorting task

114. PET Scan
Obsessive Compulsive Disorder

115. DepressedNot Depressed

117. PET scans of a 45 year old woman
with recurrent depression
pre and post treatment.

118. PET Scan
ADHD vs. Normal
White, Red, Orange = higher glucose metabolism
Blue, Green, Purple = lower glucose metabolism
ADHD Normal

119. Single photon emission computed
tomography (SPECT)
• SPECT is very similar to PET
• Uses a radioactive tracer material and detects gamma
rays.
• In contrast with PET, the tracer used emits gamma
radiation that is measured directly.
• SPECT have lower resolution than a PET scan.
• SPECT scans are significantly less expensive.

120. SPECT Images
Depressed
Not Depressed

121. How Radiology Can Aid Psychiatry
• Structural brain changes can be seen on CT
• MRI studies in patients can confirm significant differences in
brain volume and structure
• Functional chemical changes can be seen on PET, SPECT
and fMRI
• altered blood flow and metabolism
• PET and SPECT studies have demonstrated treatment
receptor occupancy and treatment progression
• Radiological studies of psychiatric populations add to
available knowledge on the biological aspects of psychiatry.

122. Thank you