1. Brain Anatomy and Function

2. Anatomy of the Brain
Separated into right and left halves by the Interhemispheric Fissure
The Central Sulcus
runs down & forward
The Lateral Fissure runs backward & up

3. Frontal and Temporal Lobes
Thought
Voluntary movement
Speech motor
Covers 1/3rd of area of the brain
Memory
Auditory function
Complex movements

4. Parietal and Occipital Lobes
Sensation
Touch
Pressure
Pain
Temperature
Texture
Position/spatial orientation
Vision
Visual processes
Reading
Complex movements

5. Medulla Oblongata, Cerebellum, and Pons
Large Muscle Coordination
Balance
Walking, Writing
Respiration
Heart rate
Continuous with the spinal cord (2.5 cm)
Pons
Complex movements
Relay between the cerebral hemispheres and the cerebellum

6. Basal Ganglia and Thalamus
“The Brakes”
Modifies movement on a minute-to-minute basis
Inhibits Movement
Coordination
Cortical relay

7. Limbic System Attention Sensory gateway Memory processing Rage
Aggression
Sexuality
Appetite/Thirst

8. The Nerve Cell
Synaptic junction

9. Lichtman, J., et al Washington University 2002
Neurotransmitters
Serotonin – major – emotions, judgment, eating and sleep disorders (associated with frontotemporal disorder)
Glutamate/GABA - Widespread, anxiety, sleep, (Valium targets this)
Dopamine – memory, mood, movement, Parkinson's Disease, psychiatric problems
Endorphins – relief of pain, (Morphine targets this)
Lichtman, J., et al Washington University 2002

10. Serotonin Glutamate/GABA Normal functions Emotions Judgment Sleep
Involved in most facets of brain function
Imbalances
Depression
Suicidal behavior
Anxiety
Impulsive behavior
Eating disorders
Imbalances
Memory disturbances
Sleep disturbances
Anxiety

11. Dopamine Endorphins Normal functions Normal functions Imbalances
Relieve pain
Induce euphoria
Normal functions
Mood
Movement
Memory
Imbalances
Movement disorders
Schizophrenia
Addiction

12. Normal Aging Brain
Brain weight and volume decrease
Grooves widen
Surface smoothes
Neurofibrillary tangles increase
Understanding normal variation is key to interpretation

13. Brain Glucose Metabolism – Normal
Normal brain tissue actively metabolizes glucose and its analogue (F-18 FDG)
Glucose metabolism provides 95% of the energy required for brain function
FDG is irreversibly trapped within brain cells in proportion to its use because it cannot be broken down or stored unlike glucose

14. FDG-PET Normal Brain Metabolism

15. FDG-PET Abnormal Brain Imaging
Dementia
Memory loss
Cognitive Decline
Epilepsy
Localization of a seizure focus
Tumor Assessment
Radiation Necrosis vs Tumor
Grade
Objective Imaging Diagnosis of Movement Disorders
Huntington’s Disease
Parkinson’s Disease

16. Dementia Diagnosis: Current Methods
History and physical examination
Neurologist (Sens. = 50-80%)
Neuropsychologist / Neuropsychiatrist
Neuropsychological testing
MRI / CT
Blood testing
Functional Neuroimaging (SPECT/ PET/MR)
Sens.=80-90%

17. Summary Normal Brain Anatomy Normal Brain Function
Current PET Brain Applications:
Diagnosis of Dementia
Seizure Localization
Tumor Assessment
Objective Imaging Diagnosis of Movement Disorders (not CMS approved)

18. Contributors Rebecca Trunnell Hyman Coordinator of PET Services
Clinical PET of West County - Creve Coeur, MO
Kevin L. Berger, M.D.
Assistant Professor of Radiology
Director of PET Imaging
Michigan State University – East Lansing, MI