Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · Nov 2003
ReviewPositron emission tomography in central nervous system drug discovery and development.
Genetics, neuroscience, and imaging science have advanced greatly in the last few years. These advances can be brought together and applied in creative new ways to make available better drugs for treating neuropsychiatric disorders and for getting candidate drugs through the development process faster. One particular approach, built around [18F]fluordeoxyglucose positron emission tomography, is described.
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Neuroimaging Clin. N. Am. · Nov 2003
ReviewThe use of positron emission tomography in cerebrovascular disease.
Even with rapid development of other neuroimaging modalities such as MR imaging and CT, PET is the only technique that provides accurate, quantitative measurements of regional hemodynamics and metabolism in human subjects. Through the use of these combined measurements, we have greatly expanded our knowledge of the pathophysiology of cerebrovascular disease of different types. It has been possible to document the compensatory responses of the brain to reductions in perfusion pressure and to directly relate these responses to prognosis. ⋯ In the field of cerebrovascular disease, PET has served as a specialized research tool at a few centers to help elucidate the pathophysiology of stroke. Up until now, however, PET scans in individual patients have not been demonstrated to be necessary for making patient care decisions. Whether the role of PET expands to impact the management of individual patients will depend on the results of investigations like the Carotid Occlusion Surgery Study that directly assess the ability of PET to influence patient outcome.
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Neuroimaging Clin. N. Am. · Nov 2003
ReviewPositron emission tomography imaging in depression: a neural systems perspective.
PET measures of regional glucose metabolism, although chemically nonspecific, are sensitive indices of brain function in the untreated state and following disparate treatments. The continued development of imaging and multivariate statistical strategies is expected to provide an important perspective toward the full characterization of the depression phenotype at the neural systems level. An additional goal is the development of routine, brain-based clinical algorithms that optimize diagnosis and treatment of individual depressed patients.
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Neuroimaging Clin. N. Am. · Nov 2003
ReviewThe role of positron emission tomography imaging in movement disorders.
PET imaging provides the means to study neurochemical, hemodynamic, or metabolic processes that underlie movement disorders in vivo. Because the extent of presynaptic nigrostriatal dopaminergic denervation can be quantified in PD even at an early or preclinical stage of the disease, PET imaging may allow the selection of at-risk subjects for neuroprotective intervention trials. These techniques may also provide markers to follow progression of disease or evaluate the effects of neurorestorative interventions in patients who have more advanced disease. ⋯ Studies have shown striatal dopamine receptor loss in selected subtypes of dystonic patients. In conclusion, it is expected that PET will help us to better understand the pathophysiology of movement disorders, increase the diagnostic accuracy, allow preclinical diagnosis, monitor disease progression, and evaluate the efficacy of therapeutic agents. Pharmacologic radioligand displacement studies and the development of new nondopaminergic ligands may further aid in the unraveling of cerebral mechanisms that underlie movement disorders.
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Neuroimaging Clin. N. Am. · Nov 2003
ReviewNeuroimaging and mechanisms of drug abuse: interface of molecular imaging and molecular genetics.
Whereas ligand studies can inform the end-products of dysregulation of genetic expression, reporter gene imaging can provide the means to understand the genetic origin of these end-products. As with radioligand studies, in vivo direct measurement of gene expression will allow genetic processes to be monitored over time in the same subject, use of a subject as his/her own control in intervention studies (i.e., measurement before and after an intervention), and monitoring the spatial distribution of molecular events in the whole brain. Furthermore, reporter gene imaging, by advancing knowledge of the biologic mechanisms of disease states, has important clinical implications, particularly in the development and monitoring of treatments. We expect PET to play a prominent role in the elucidation of substance abuse mechanisms and contribute significantly to the development of innovative treatment strategies.