Imaging of the Brain in Psychiatry and Related Fields

361 Pages·1993·13.247 MB·English

by  T. J. Crow (auth.), Konrad Maurer M.D. (eds.)

Konrad Maurer (Ed.)
Imaging of the Brain
in Psychiatry
and Related Fields
With 101 Figures, 15 in Color
Springer-Verlag
Berlin Heidelberg New York
London Paris Tokyo
Hong Kong Barcelona
Budapest
Konrad Maurer, M.D.
Professor of Psychiatry,
Neurology, Psychotherapy
Department of Psychiatry
University of Wiirzburg
Fiichsleinstr. 15
W-S700 Wiirzburg, FRG
ISBN-I 3: 978-3-642-77089-0 e-ISBN-13: 978-3-642-77087-6
001: 10.1007/978-3-642-77087-6
Library of Congress Cataloging-in-Publication Data. Imaging of the brain in psychiatry and
related fields 1 Konrad Maurer (ed.). p. em. Includes bibliographical references and index.
l. Brain - Imaging. 2.
Brain - Pathophysiology. 3. Schizophrenia - Pathophysiology. J. Maurer, Konrad, 1943-
[DNLM: l. Brain - physiopathology. 2. Brain - radio nuclide imaging. 3. Diagnostic
Imaging - methods. 4. Electroencephalography. 5. Mental Disorders - diagnosis. 6. Psy
chiatry methods. WM 141 131J RC386.6.D52I4 1992 616.8'04754 - dc20 DNLMIDLC
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Softeover reprint of the hard cover I st edition 1993
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Preface
In the last two decades imaging of the brain, or neuroimaging, has
become an integral part of clinical and research psychiatry. This is
due to recent advances in computer technology, which has made it
relatively easy to generate brain images representing structure and
function of the central nervous system.
Currently used clinical diagnostic imaging modalities, such as
X-ray computed tomography (CT) and magnetic resonance imaging
(MRI) , provide predominantly anatomic information. CT images
reflect X-ray attenuation distribution within the brain, whereas MRI
signals depend primarily on proton sensitivity and tissue relaxivity.
The chapter "Structural Imaging Methods" reviews CT and
MRI studies on schizophrenic and affective disorders and degenera
tive central nervous system diseases. The impact of fast three
dimensional (3-0) imaging and the automatic transfer from 3-D
elements in the brain to artificial diagrams based on this information
is considered.
Since the original report of the findings of Ingvar and Franzen
in 1974 and the introduction of regional cerebral blood flow (rCBF)
measurements, single photon emission computed tomography
(SPECT) has been gaining acceptance as one of the major imaging
techniques, and it is available in most nuclear medicine depart
ments. The section "Functional Imaging Methods (Cerebral Blood
Flow - CBF, Single Photon Emission Computerized Tomography -
SPECT)" describes rCBF studies with the 133Xe inhalation method
utilizing a 254 detector system and rCBF images measured by
SPECT using the tracer 99mTc-HMPAO. The authors provide a
comprehensive account of this technique, including a brief summary
of the basic principles, various methods of application, and recent
findings in most psychiatric disorders. Analogies to its "aristocratic
cousin" positron emission tomography (PET) are presented to
emphasize the similarities and differences.
PET has been widely used as a research tool in the investigation
of human physiology and pathology for over a decade. By labeling
suitable components (i.e., glucose, amino acids, ammonia, DOPA,
or drugs) with positron emitting isotopes, which are then adminis-
VI Preface
tered in tracer amounts, blood flow, metabolism, and even cell
receptor or neurotransmitter distribution can be assessed in vivo.
The section "Functional Imaging Methods (Positron Emission
Tomography - PET)" endeavors to explain briefly the principles of
the PET technique and then outlines promising areas in which PET
has become clinically useful, such as neuroreceptor and dopamine
receptor imaging.
The birth of magnetoencephalography (MEG) in the 1970s and
its development in the 1980s came at a time when CT and MRI were
able to provide excellent structural images of the brain. The cur
rent generation of equipment with nearly 40 MEG channels has
already provided a unique view in the brain, and samples from these
studies are discussed in the section "Functional Imaging Methods
(Magnetencephalography - MEG)."
Mapping of spontaneous and activated EEG activity and evoked
potentials uses computer technology to quantify the electrophysio
logical data and plot out results in an understandable form. It also
employs statistical tests to give significance to the data analyzed.
Advantages over the other imaging methods are extremely short
analysis times, in the millisecond range, and noninvasiveness, with
the possibility of performing follow-up examinations as often as
needed. The section "Functional Imaging Methods (Computerized
Electroencephalographic Topography - CET)" describes the major
findings of EEG and EP mapping in psychiatry, also including
advanced methods such as dipole source estimation, neurometrics,
and microstates of the brain's electrical fields.
A section has been devoted to the multimodal application of
imaging measurements. Within this section imaging procedures such
as CET and PET have been applied simultaneously to explore
pathophysiologic and metabolic peculiarities in psychoses. The
so-called biochemical imaging (BCI) describes topographic maps of
biochemical data (biopsy, neurotransmitter, postmortem) and in
cludes immunocytochemistry, autoradiography and topography of
drug action. Imaging techniques can now even be used to assess
neuropsychological data; this is called behavioral imaging.
The impetus for this book was provided at an international
symposium entitled "Imaging of the Brain in Psychiatry and Related
Fields," which took place in 1990 in Wiirzburg, Germany. This
symposium was also the inaugural meeting of the International
Society for Neuroimaging in Psychiatry (ISNIP). Participants who
presented their data at the symposium were asked to prepare a
contribution to this volume, discussing their recent research ac
tivities and clinical results. Altogether 54 chapters written by a total
of 206 authors are presented here. These authors, who represent
research laboratories and clinics in many parts of Europe, Japan,
Preface VII
Australia, and the United States, include original pioneers as well as
current experts in the field of neuroimaging in psychiatry. Through
the high quality of their scientific and clinical data, they all have
made valuable contributions both to the symposium and to this
volume. I wish to express my sincere thanks to all of them.
I would also like to thank Dr. Grimmel and Dr. Bergmann from
Rhone-Poulenc Rorer Pharmaceuticals for their generous support
and for making it possible to hold this symposium. I am also grateful
to Ms. Grabner, Ms. Moslein, Dr. Dierks, Dr. Frolich, and Dr. Ihl
for their efforts in organizing the meeting and editing this volume.
I am also very grateful to Dr. T. Thiekotter and Ms. B. Wehner of
Springer-Verlag who made it possible to produce this book with an
abundance of lavish illustrations.
As editor, it is my hope and wish that this book will help to
promote research and application of neuroimaging in psychiatry and
also to promote the goals of the International Society for Neuro
imaging in Psychiatry (ISNIP) and its journal Psychiatry Research -
N euroimaging.
Konrad Maurer
Contents
Structural Imaging Methods
(Computerized Tomography /
Nuclear Magnetic Resonance Imaging)
Schizophrenia as an Anomaly of Cerebral Asymmetry
T.1. CROW (With 6 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Structural Brain Changes in Schizophrenia:
The Issue of Subgroups
L. MARSH and D.R. WEINBERGER. . . . . . . . . . . . . . . . . . . . . . . . . . 19
Volumetry of Limbic Structures in Schizophrenics and Controls
S. HECKERS, H. HEINSEN, and H. BECKMANN. . . . . . . . . . . . . . .. 27
Hippocampus and Basal Ganglia Pathology
in Chronic Schizophrenics.
A Replication Study from a New Brain Collection
B. BOGERTS, P. FALKAI, M. HAUPTS, B. GREVE,
U. TAPERNON-FRANZ, and U. HEINZMANN. . . .. . . . . . . . . . . . . .. 31
Normal Size of Temporal Areas in a Group
of Schizophrenic Patients:
A Magnetic Resonance Imaging Study
C. COLOMBO, G. CALABRESE, S. LIVIAN, G. SCOTTI,
and S. SCARONE ......................................... 37
Ventricle Size and P300 in Elderly Depressed Patients
S. SCHLEGEL and D. NIEBER (With 1 Figure) . . . . . . . . . . . . . . . .. 43
Fast Magnetic Resonance Imaging
and Three Dimensional Volumetric Calculations
in Degenerative Central Nervous System Diseases
G. BIRBAMER, S. FELBER, A. KAMPFL, F. AICHNER,
F. GERSTENBRAND, and H. BENESCH (With 3 "Figures) . . . . . . . .. 47
x Contents
Arachnoid Cysts in Psychiatric Patients:
A Retrospective Computerized Tomography
and Magnetic Resonance Imaging Study
T. BECKER, M. LANCZIK, E. HOFMANN, T. MULLER,
M. WARMUTH-METZ, 1. FRITZE, and B. SCHUKNECHT.......... 53
Cerebral Effects of Stereotactic Subcaudate Tractotomy
A.L. MALIZIA, M.G. GRAVES, 1.B. BINGHAM, 1.R. BARTLETf,
and P.K. BRIDGES (With 1 Figure) ......................... 57
Comparisons of Linear and Planimetric Indices as Estimators
of Intraventricular Cerebrospinal Fluid Spaces (CSF)
in Normal Autoptic Brains
K. NIEMANN, L. WOECKEL, and 1. WASEL
(With 2 Figures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 61
Automatic Transfer from Three-Dimensional Volume
Elements in the Brain to Knowledge-Based Artificial Diagrams
D. GRAF VON KEYSERLINGK, K. NIEMANN, and H. KNOTf
(With 4 Figures). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 65
Functional Imaging Methods (Cerebral Blood Flow/
Single Photon Emission
Computerized Tomography)
Regional Cerebral Blood Flow in Schizophrenia
S. WARKENTIN and 1. RISBERG (With 1 Figure) . . . . . . . .. . . . . .. 73
The Regional Cerebral Blood Flow Landscape
in Chronic Schizophrenia: An 18 Year Follow-up Study
E. CANTOR-GRAAE, S. WARKENTIN, G. FRANZEN, D.H. INGVAR,
and 1. RISBERG (With 2 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . .. 81
Cortical and Subcortical Brain Function in Schizophrenia
P. RUBIN, L. FRIBERG, S. HOLM, P. VIDEBECH, H.S. ANDERSEN,
B.B. BENDSEN, N. STR0MS0, 1.K. LARSEN, N.A. LASSEN,
and R. HEMMINGSEN (With 1 Figure) . . . . . . . . . . . . . . . . . . . . . .. 87
Technetium-99m Hexamethylpropilene-amino-oxime
Cerebral Single Photon Emission Computerized Tomography
in Drug-Free Schizophrenic Patients
A. VITA, G. INVERNIZZI, M. GARBARINI, G.M. GIOBBIO,
M. DIECI, C. MORGANTI, G. POGGI LONGOSTREVI,
E. SACCHETfI, and C.L. CAZZULLO . . . . . . . . . . . . . . . . . . . . . . . .. 93
Contents XI
A New Methodical Approach for the Imaging
of Cerebral Benzodiazepine Receptors in Schizophrenia:
Preliminary Results of a Single Photon Emission
Tomography Study with (1231) Iomazenil
J. SCHRODER, B. BUBECK, U. ROELCKE, M. JAUSS,
P.A. SCHUBIGER, and H. SAUER (With 3 Figures) . . . . . . . . . . . .. 97
Parietal Lobe Effects of Somatosensory Stimulation
in Single Photon Emission Computerized Tomography:
A Study on Mood Disorders and Schizophrenia
D. EBERT, H. FEISTEL, A. BAROCKA, T. MOKRUSCH,
and W. KASCHKA (With 1 Figure) . . . . . . . . . . . . . . . . . . . . . . . . .. 105
Changes in the Regional Activation Pattern
in the Normal Human Brain
During Dreaming and Rapid Eye Movement Sleep
as Measured with Single Photon Emission
Computerized Tomography
P.L. MADSEN, L. FRIBERG, S. HOLM, S. VORSTRUP,
N.A. LASSEN, and G. WILDSCHI0DTZ ....................... 109
Evaluation of Total Sleep Deprivation
by Single Photon Emission Computerized Tomography
S.H. KAENDLER, S. YOLK, F.D. MAuL, R. WEBER, K. GEORGI,
A. HERTEL, B. PFLUG, and G. HOR
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 115
Correlation of 99m Tc-Labeled HMPAO-SPECT
with Spectral EEG Activity in Dementia of Alzheimer Type
L. FRoucH, C. EILLES, R. IHL, T. DIERKS, and K. MAURER
(With 3 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 121
The Dynamic Investigation of Brain Function
with Split-Dose Tc 99m-Exametazime
Single Photon Emission Computerized Tomography
G.M. GOODWIN, K.J. SHEDLACK, R. HUNTER, and D. WYPER
(With 2 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 131
Regional Cerebral Blood Flow and Auditory Evoked
Potential Studies in Childhood Autism
N. BRUNEAU, M. ZILBOVICIUS, B. GARREAU, C. RAYNAUD,
B.M. MAZOYER, C. BARTHEU~,MY, A. SYROTA, and G. LELORD
(With 1 Figure) ,........................................ 137
XII Contents
Hexamethylpropilene-amino-oxime Perfusion Scintigraphy
in Brain Death
P. BERLlT, E. WETZEL, and P. VETTER (With 1 Figure) . . . . . . .. 141
Concussion: Regional Cerebral Blood Flow
and Associate Learning Ability
T. POGACNIK, B. PECNIK, and B. ZVAN (With 1 Figure). . . . . . .. 145
Functional Imaging Methods (Positron Emission Tomography)
Imaging Neuroreceptors with Positron Emission Tomography:
A New Strategy for Measuring Pharmacological Activity
in the Treatment of Schizophrenia
J.D. BRODIE, S.L. DEWEY, A.P. WOLF, and G.S. SMITH
(With 1 Figure) ......................................... 153
Bimodal Distribution of Brain Dopamine D2 Receptors
in Schizophrenic Patients Explained by In Vivo Binding Studies
J. KORF, S. ZULSTRA, J.A.A. SWART,
and J.W. LOUWERENS .................................... 163
Age-Dependent Changes of the Metabolic Pattern
in Patients with Alzheimer's Disease
R. MIELKE, M. GROND, K. HERHOLZ, J. KESSLER,
and W.D. HEISS (With 1 Figure). . . . . . . . . . . . . . . . . . . . . . . . . .. 171
Activity Changes in the Human Brain
Due to Vibratory Stimulation of the Hand Studied
with Positron Emission Tomography
R.J. SEITZ and P.E. ROLAND (With 2 Figures). . . . . . . . . . . . . .. 177
Functional Imaging Methods (Magnetoencephalography)
The Use of Magnetoencephalography in Psychiatry
P. FENWICK, A. IOANNIDES, and J. LUMSDEN
(With 4 Figures). . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . .. 185
Comparison of Single-Channel
and Multichannel Magnetoencephalogram Recordings
J. VIETH (With 3 Figures) ................................. 203