Neuroimaging clinics of North America
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This review summarizes current knowledge obtained from psychoradiological studies of posttraumatic stress disorder (PTSD). We first focus on 3 key anatomic structures (hippocampus, amygdala, and medial prefrontal cortex) and the functional circuits to which they contribute. In addition, we discuss the triple-network model, a widely accepted neurobiological model of PTSD that explains the vast majority of neuroimaging findings, as well as their interactions and relationships to functional disruptions in PTSD.
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Neuroimaging Clin. N. Am. · Feb 2020
ReviewPsychoradiological Biomarkers for Psychopharmaceutical Effects.
The application of personalized medicine to psychiatry is challenging. Psychoradiology could provide biomarkers based on objective tests in support of the diagnostic classifications and treatment planning. ⋯ Although none of the biomarkers reviewed are yet of sufficient clinical utility to inform the selection of a specific pharmacologic compound for an individual patient, there is strong consensus that advanced multimodal approaches will contribute to discovery of novel treatment predictors in psychiatric disorders. Progress has been sufficient to warrant enthusiasm, in which application of neuroimaging-based biomarkers would represent a paradigm shift and modernization of psychiatric practice.
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Neuroimaging Clin. N. Am. · Feb 2020
ReviewWidespread Morphometric Abnormalities in Major Depression: Neuroplasticity and Potential for Biomarker Development.
Major depression is common and debilitating. Identifying neurobiological subtypes that comprise the disorder and predict clinical outcome are key challenges. Genetic and environmental factors leading to major depression are expressed in neural structure and function. ⋯ MR imaging observable abnormalities reflect cytoarchitectonic alterations within a local neuroendocrine milieu with systemic effects. Multivariate pattern analysis offers the potential to identify the neurobiological subtypes and predictors of clinical outcome. It is essential to characterize disease heterogeneity by incorporating data-driven inductive and symptom-based deductive approaches in an iterative process.
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In neuroimaging research, averaging data at the level of the group results in blurring of potentially meaningful individual differences. A more widespread use of an individual-specific approach is advocated for, which involves a more thorough investigation of each individual in a group, and characterization of idiosyncrasies at the level of behavior, cognition, and symptoms, as well as at the level of brain organization. It is hoped that such an approach, focused on individuals, will provide convergent findings that will help identify the underlying pathologic condition in various psychiatric disorders and help in the development of treatments individualized for each patient.
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Despite considerable research evidence demonstrating significant neurobiological alterations in psychiatric disorders, incorporating neuroimaging approaches into clinical practice remains challenging. There is an urgent need for biologically validated psychiatric disease constructs that can inform diagnostic algorithms and targeted treatment development. In this article, we present a conceptual review of the most robust and impactful findings from studies that use neuroimaging methods in efforts to define distinct disease subtypes, while emphasizing cross-diagnostic and dimensional approaches. In addition, we discuss current challenges in psychoradiology and outline potential future strategies for clinically applicable translation.