Volume 21, Issue 4, Pages xv-xxiii (December 1998) COLOR PLATES    Psychiatric Clinics  Volume 21, Issue 4, Pages xv-xxiii (December 1998) DOI: 10.1016/S0193-953X(05)70037-X Copyright © 1998 Terms and Conditions

Figure 1 Functional magnetic resonance imaging (fMRI) studies depicting sex differences in language function. The male image (left) depicts the expected activation in the left frontal region (right). In contrast, the female image (right) had bilateral activation. (From Shaywitz BA, Shaywitz, S. E., Pugh, K. R., et al: Sex differences in the functional organization of the brain for language. Nature 373:608, 1995; with permission.) Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 2 MRI study (left) compared to single photon emission computed tomography (SPECT) (right). A represents axial views for both MRI and SPECT, while B represents sagittal views. Notice the large defect on SPECT imaging showing no perfusion in the medial frontal region. This scan also depicts the white matter shear injury in several places between the border of white and gray matter as well as old hemorrhage in left frontal region. Also there are several white matter signal irregularities, often observed with aging and small vessel disease. For example, the patient shows a “rimming” with signal irregularity around the anterior aspect of the anterior horn of the lateral ventricle. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 2 MRI study (left) compared to single photon emission computed tomography (SPECT) (right). A represents axial views for both MRI and SPECT, while B represents sagittal views. Notice the large defect on SPECT imaging showing no perfusion in the medial frontal region. This scan also depicts the white matter shear injury in several places between the border of white and gray matter as well as old hemorrhage in left frontal region. Also there are several white matter signal irregularities, often observed with aging and small vessel disease. For example, the patient shows a “rimming” with signal irregularity around the anterior aspect of the anterior horn of the lateral ventricle. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 3 Bar graph (top) represents the quantitative changes that have occurred in this patient's brain in comparison to normal sample for his age. Normal MRI scan (middle row) for comparison to the patient's scan presented at the bottom. This patient (bottom row) sustained a severe head injury in a cliff fall and is evident that there is extensive wasting, particularly of the right frontal lobe (right). By applying quantitative image analysis techniques, any brain nucleus, region, or structure can be quantified. As can be seen the patient's various ventricular volume measures have all increased (black bar) in size while brain volume has decreased. These quantitative finding accurately delineate the changes in brain structure in response to trauma. The ventricle-to-brain (BVR) ratio score, a measure of global brain atrophy, is significantly elevated. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 4 (A & B), Lateral 3-D MR generated view of the head (sans hair) (upper left). Burr holes and craniotomy scar are clearly evident. Axial MRI depicting extensive cystic formation in the right frontal region, as a residual to severe trauma and resultant hemorrhagic contusion (upper right). Sagittal (lower left) and coronal (lower right) are presented. The cursor lines depict alignment of the images in the three planes. B, same patient as in A, but 3-D image of brain and cystic formation (blue). Cursor lines have been removed. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 4 (A & B), Lateral 3-D MR generated view of the head (sans hair) (upper left). Burr holes and craniotomy scar are clearly evident. Axial MRI depicting extensive cystic formation in the right frontal region, as a residual to severe trauma and resultant hemorrhagic contusion (upper right). Sagittal (lower left) and coronal (lower right) are presented. The cursor lines depict alignment of the images in the three planes. B, same patient as in A, but 3-D image of brain and cystic formation (blue). Cursor lines have been removed. Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 5 FDG-PET-based coronal sections from anterior to posterior (left to right) through the brains of AMN (top row), SO, a patient with a condition 6 months after a heart attack (middle row), and a control subject (bottom row). Note the reduction in cerebral metabolism in widespread cortical and subcortical areas in patient AMN, and the less severe metabolic reduction in SO, compared to a control subject's brain at corresponding levels. (From Markowitsch HJ, Kessler J, Van der Ven C, et al: Psychic trauma causing grossly reduced brain metabolism and cognitive deterioration. Neuropsychologia 36:77–82, 1998; with permission.) Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 6 Thalami from 15 normal patients and 20 never-medicated patients with schizophrenia as outlined by MRI. Images are on the relative scale for each full slice. Note that 13 of the 15 patients had at least one red pixel in the thalamus center, but only nine of the 20 patients showed the same level of activity (P = 0.01, Fisher's exact test). Individual differences were prominent with some patients resembling normal volunteers with high activity in the region surrounding the medial dorsal nucleus; others had little activity in this region. (From Buchsbaum MD, Someya T, Tang CY, et al: PET and MRI of the thalamus in never-medicated patients with schizophrenia. Am J Psychiatry 153:196, 1996; with permission.) Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions

Figure 7 A, Control and activation conditions in slice 4 from a healthy volunteer. During the control condition, occipital, and right parietal regions are activated, while additional areas of activation occur in the frontal cortex, in the motor cortex, and in Broca's area when the subject performs the Tower of London task. B, Control and activation conditions in a drug-naive schizophrenic patient. The patient shows a similar activation during the control condition, but fails to show prefrontal activation while performing the Tower of London task, although increased flow is seen in both Broca's area and in the motor strip, as well as in the right parietal and occipital regions. (From Andreason NC, et al: Hyprofrontality in neuroleptic-native patients and in patients with chronic schizophrenia: Assessment with xenon 133 single-photon emission computed tomography and the Tower of London. Arch Gen Psychiatry 49:951, 1992; with permission.) Psychiatric Clinics 1998 21, xv-xxiiiDOI: (10.1016/S0193-953X(05)70037-X) Copyright © 1998 Terms and Conditions