Imaging: window on the brain.

Abstract

Given the rapid advances in neuroimaging and brain mapping, it is no surprise that a whole host of new and burgeoning techniques are on the horizon as we enter the 21st century. This brief review focuses on methods that are just entering the clinical experience or are now being explored in a research setting but have the imminent potential for clinical use. A number of brain mapping techniques now allow the clinician to monitor disease progression and therapeutic effects in either the routine clinical setting or experimental clinical trials. A battery of methods are now available for the preoperative and intraoperative evaluation of patients with lesions in or near critical cortical areas or for targeting purposes when deep nuclei of the brain are potential sites of therapeutic ablation or electrophysiologic stimulation. The development of probabilistic atlases will soon provide a means of understanding normal variants of human brain structure and function and studying brain disorders and their treatment in an objective and quantifiable fashion. Techniques that are now on the horizon for imaging gene expression, neuronal excitivity, and connectivity are presented in their current stage of development. It is clear that brain mapping and neuroimaging will continue to be ever more important parts of clinical neuroscience and may ultimately serve as the bridge between the molecular and clinical domains of this field. Arch Neurol. 2000;57:1413-1421