1. 권 준 수 서울의대 정신과학교실 뇌인지과학과 -WCU 프로그람 정신질환에서 뇌영상술의 이용

2. Psychiatry is the mainstream of Neuroscience !

3. normal schizophrenia Mental diseases as a brain disorder

4. Morphometry Voxel-based Morphometry ROI schizophrenia < normal

6. Shape modeling of subcortical gray matter (cont’d)  Spherical harmonics  Irregular samples from individual subjects: Resampling based on spherical harmonic basis function  Associated Legendre polynomial-based basis Hwang and Oh et al., Am J Psychiatry 2006; 163:276-85. (IF = 10.5)

7. Brain activity Neuronal activity is reflected in –local electrical/magnetic –local metabolic change –local blood flow change –local chemical change ? –local ??? PET SPECT fMRI PET ERP/MEG MRS ???

8. Functional Neuroimaging ModalityCharacteristicsSpatial Resolution Temporal Resolution Cost PET Metabolic effect ( 18 F-FDG) Hemodynamic effect (H 2 15 O) Receptor imaging 5-10 mm (medium) 20 min (poor) 1 min (medium) high fMRI Hemodynamic effect : BOLD (blood oxygenation level dependent) contrast 1-2 mm (high) 1 sec (rather high) rather high EEG/ ERP Electrical activity of brain10-20 mm (poor) 1 msec (very high) low MEG Magnetic activity of brain2-3 mm (high) 1 msec (very high) high

9. Positron Emission Tomography (PET) Positron Electron ++ e - Nucleus Positronium Annihilation 511 keV  -ray Coincidence determination F-18 110.0 18F-FDG 당대사 C-11 20.4 11C-methionine 아미노산대사 11C-spiperidol 도파민 수용체 N-13 10.0 13NH3 혈류 O-15 2.1 H2O, CO2 혈류 O2 산소대사 핵종 반감기 방사성의약품 이 용

10. Decreased glucose metabolism after 4-month treatment Kang DH et al, Acta Psychiatr Scand (2003) Increased glucose metabolism after 4-month treatment [ 18 F]FDG-PET study

11. Functional study by [ 15 O] H 2 O-PET Symptom Provocation paradigm Bilateral orbitofrontal and right prefrontal activation Shin YW et al (Acta Psych Scan, 2006 )

12. N-back test Kim et al., Am J Psychiatry (2003) [ 15 O]H 2 O-PET study in schizophrenia

13. Belliveau et al., 1991:the first report of localized changes in cerebral blood oxygenation in the occipital cortex following visual stimulation in humans Functional MRI

15. BOLD, rCBF Increase the usage of fMRI in psychiatric fields Group brain activation during random sampling of hallucinations Shergill et al., Arch Gen Psychiatry 2000

16. Structural Connectivity

17. Diffusion Tensor Images (DTI) Introduced by Basser et al. (1994) Measurement of a diffusion tensor of water White matter tractography

19. Functional Connectivity

20. Basic Structures of Brain Gray Matter –Functional activations –Structural imaging (sMRI) –Functional/molecular imaging (fMRI/MEG/PET) White Matter (Tracts) –Connecting distinctive functional regions –Diffusion Tensor Imaging for defining white matter pathway (anatomical connectivity) Subcortical Gray Matter Modeling (Hwang and Oh et al., 2006) White Matter Modeling (Oh et al., 2007,2009) Brodmann Areas Cortical Gray Matter Modeling Freesurfer (Fischl et al., 1999)

21. Changes in Effective Connectivity according to Working Memory Load: an fMRI Study of Face and Location Working Memory Tasks

22. Use of probabilistic anatomy priors (Approximately equivalent to the use of functional priors) Oh et al., submitted Adapted from Oh et al., Human Brain Mapping 2009; 30: 3812-25 (IF = 5.4)

23. Use of probabilistic anatomy priors (Approximately equivalent to the use of functional priors) Oh et al., submitted

24. Stochastic Tractography: A Tool for Integrating DTI (white matter tracts) and (gray matter) Functional Imaging Mapping Midline Corpus Callosum (mCC) and Cortical Surface using Stochastic Tractography Mapping Midline Corpus Callosum (mCC) and Cortical Surface using Stochastic Tractography  High concordance Oh, PhD Thesis, 2005, Seoul National University 16 2 3 5 1 2 3 5 4 4 6

26. Facial Emotion Processing (Ruben C. Gur, 2002, AJP)

28. Imaging Frontostriatal Function in Ultra-High-Risk, Early, and Chronic Schizophrenia During Executive Processing (Rajendra A. Arch Gen Psychiatry. 2005)

29. We all have blindsight? Backward Masking an example

30. We all have blindsight? Backward Masking an example slower view

31. We all have blindsight? Backward Masking 33msec

32. an fMRI study of backward masking Maked fearful faces versus maked happy face BOLD signal in the amygdala was higher during viewing masked fearful face than masked happy face Whalen 1998

33. Electrophysiology (EEG/ERP) 145msec 155msec 165msec 175msec

34. LORETA

35. Mismatch Negativity (MMN)

36. Dipole source localization of MMN Heschl’s gyrus

37. Serial LORETA images

38. ISSUES in studying psychopathology with functional brain imaging 연구하고자 하는 정신질환이 적절하게 정의되었는가 ? Has the psychiatric disorder under study been appropriately specified? 선택된 자극이 보고자 하는 심리과정을 잘 다루고 있는가 ? Has the chosen task enabled a clear manipulation of psychological process? 환자에서의 뇌 활성화 변화를 어떻게 해석할 것인가 ? Relating physiology to disorder

39. MEG (magnetoencephalography) TMS (repetitive transcranial magnetic stimulation) NIRS (near infrared spectroscopy) NIR imaging with laser diode arrays MEG system TMS

40. Multimodal imaging EEG + fMRI –high temporal resolution (EEG) high accuracy of source locations (fMRI) EEG + TMS –Selective exciting of cortical neurons by TMS and multichannel recording of EEG –non-invasive mapping of connectivity and reactivity of the human brain EEG + PET –Relationship between electrical activities and metabolic activities

41. TMS+EEG

42. The Future of Brain Imaging Rapid development in brain imaging methododogy Simultaneous acquisition of multimodal data –Helps avoid problems of registering multimodal data post hoc –Combines the time-space resolution windows of each modality New imaging devices –More precise anatomical/physiological brain model can be attained through higher spatio-temporal resolution –Promise new source of information which otherwise was not available Advances in Cognitive psychology