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Understanding Brain Imaging

Daniel Lende and Greg Downey run the though-provoking Neu­roan­thro­pol­ogy blog. Daniel also teaches a class at Uni­ver­sity of Notre Dame, and he asked his stu­dents to sub­mit group-based blog posts in lieu of the tra­di­tional final essays. He explains more on Why A Final Essay When We Can Do This?.

Below you have a spec­tac­u­lar post writ­ten by 4 of his stu­dents. They show how brain imag­ing is start­ing to pro­vide a win­dow into the plas­tic­ity (glos­sary here) of our brains, and how our very own actions impact them. For good and for bad.

Under­stand­ing Brain Imaging

— By Chris Dud­ley, Matt Gasperetti, Mikey Nar­vaez, and Sarah Walorski

Do you remem­ber the anti-drug pub­lic ser­vice announce­ment from the 1980s that showed an egg fry­ing in a hot pan which rep­re­sented your brain on drugs?

Dur­ing the 1990s, brain imag­ing moved beyond fried eggs as com­puter tech­nol­ogy allowed researchers to process large amounts of data required for func­tional imag­ing approaches. As a result, the PSA men­tioned above no longer pro­vides the most accu­rate anal­ogy illus­trat­ing what hap­pens to the brain when exposed to drugs.

Today, brain imag­ing research has helped cre­ate a sophis­ti­cated “dis­ease model of chem­i­cal depen­dence related to changes in the func­tion of neu­ro­trans­mit­ters and recep­tors in the brain. These cir­cuits are respon­si­ble for reward pro­cess­ing, mem­ory and learn­ing, moti­va­tion and drive, in addi­tion to con­trol (Nora Volkow describes these cir­cuits in a 2004 lit­er­a­ture review).

This par­tic­u­lar post focuses on the tech­niques used most com­monly to study the brain’s role in addic­tion and other men­tal health prob­lems. We will cover the prin­ci­ple behind each method, advan­tages and lim­i­ta­tions of each, and pro­vide an exam­ple of the results that can be obtained.

Beyond the Fry­ing Pan: EEG and CT

Elec­troen­cephalog­ra­phy (EEG) and Com­puted tomog­ra­phy (CT) were two of the first meth­ods used to study the brain. EEG uti­lizes elec­trodes placed on the scalp that mea­sure elec­tri­cal impulses, whereas CT cre­ates a three-dimensional image of the brain with two-dimensional x-rays.

EEG is a non-invasive pro­ce­dure with high tem­po­ral res­o­lu­tion; it is often used to record the brain’s response to a stim­u­lus (e.g. an indi­vid­ual ingests a drug and the change in brain activ­ity is recorded).

EEG is lim­ited because it can only record data from the sur­face of the brain. In addi­tion, EEG does not pro­duce images of the brain it only mea­sures elec­tri­cal impulses.

CT is used to cre­ate three-dimensional images. Unfor­tu­nately, CT can­not pro­duce high-resolution images of soft tis­sue (i.e. the brain) and requires high lev­els of radi­a­tion. While CT is still used, pre­dom­i­nately to cre­ate images of the body, it has to be used infre­quently to avoid exces­sive radi­a­tion expo­sure. Although EEG and CT did not teach us much about addic­tion, these meth­ods were the tech­no­log­i­cal pre­cur­sors to more egg-cellent brain imag­ing methods.

Unscram­bling the Mys­ter­ies of the Brain with MRI and fMRI

Ever won­der what it’s like to have radio waves sent through your brain? Well, Mag­netic Res­o­nance Imag­ing (MRI) may be for you! MRI pro­duces high qual­ity images of the brain by using a large, cylin­dri­cal mag­net to cre­ate a mag­netic field around the head. Radio waves are sent through this field and alter hydro­gen nuclei in the brain. These detectable changes are sub­se­quently trans­mit­ted to a com­puter and used to gen­er­ate a series of images.

Using these images, sci­en­tists are able to deter­mine minute changes in the brain that occur over time by com­par­ing dif­fer­ent MRI scans.

MRI is use­ful because it can pro­duce higher res­o­lu­tion images than CT scans and does not expose patients to exces­sive radi­a­tion. On the con­trary, MRI is lim­ited because there is no way to pro­duce high-resolution images mea­sur­ing tem­po­ral change.

This leads to the recent devel­op­ment of Func­tional Mag­netic Res­o­nance Imag­ing (fMRI). This tech­nique, devel­oped only recently, has allowed sci­en­tist to use MRI tech­nol­ogy to cap­ture images of var­i­ous brain func­tions.

Func­tional MRI focuses on the flow of oxy­genated blood within the brain. To sim­plify things, when an area of the brain is stim­u­lated, oxy­genated blood rushes to that area. Func­tional MRI is able to cap­ture this flow of blood because of the slight dif­fer­ence in mag­net­ism between oxy­genated and deoxy­genated blood.

This method is advan­ta­geous because it allows researchers to cap­ture a series of images every sec­ond. These images can be used to cre­ate “movies” mon­i­tor­ing changes in brain activity.

By pro­duc­ing sequen­tial images, fMRI records the areas of the brain that are acti­vated. In addi­tion to detect­ing sub­stance use, fMRI is also a good lie-detecting device, as it senses activ­ity in cer­tain regions of the brain asso­ci­ated with spe­cific behaviors.

Like all good things, includ­ing eggs, which con­tain a great deal of cho­les­terol, there is a down­side to fMRI: blood flow is only an indi­rect mea­sure of neu­ronal activ­ity and fMRI only shows where activ­ity takes place not exactly what is going on.

PET: Great Acronym, Great Images

Positron Emis­sion Tomog­ra­phy (PET) is another com­monly used brain imag­ing tech­nique. PET, which is derived from CT, was the first func­tional imag­ing technique.

This method uti­lizes small amounts of radio­trac­ers (i.e. mol­e­cules with a short-lived radioac­tive con­stituent atom such as carbon-11 or oxygen-15), which are local­ized by sen­sors that cre­ate computer-compiled images. These images depict the rel­a­tive amount of radio­tracer present by using a color gra­di­ent red being the high­est con­cen­tra­tion and blue the lowest.

Like fMRI, PET can be used to study regional cere­bral blood flow (rCBF) via radio-labeled water in the blood­stream. Addi­tion­ally, PET can look at glu­cose metab­o­lism that shows regional neu­ronal activation.

Unfor­tu­nately, PET can­not achieve the tem­po­ral or spa­tial res­o­lu­tion pos­si­ble with fMRI, and uses trace amounts of radi­a­tion: only one PET scan is allowed per year due to con­cerns regard­ing radi­a­tion exposure.

PET is most use­ful when study­ing neu­ro­trans­mit­ter func­tion and holds an advan­tage in tem­po­ral and spa­tial res­o­lu­tion over SPECT (dis­cussed below).

By using a radio-labeled neu­ro­trans­mit­ter, it is pos­si­ble to study the loca­tion a neurotransmitter’s action, the amount of neu­ro­trans­mit­ter release, and abun­dance of recep­tor lev­els. This has rel­e­vance in addic­tion stud­ies, which have shown that dopamine recep­tor lev­els decrease with long-term cocaine use, lead­ing to tol­er­ance to low drug doses.

The only down­side is that it takes time to develop appro­pri­ate radio­trac­ers. Cur­rently, the dopamine, GABA, and cannabi­noid cir­cuits can be exam­ined, but suit­able radio­trac­ers for other neu­ro­trans­mit­ters are still lack­ing. It is likely that future research will solve this problem.

Egg SPECT to Be Amazed

The name Sin­gle Pho­ton Emis­sion Com­put­er­ized Tomog­ra­phy (SPECT) sounds impres­sive because it is. This method uti­lizes trac­ers that are directly injected into the body’s blood flow to high­light the level of neu­ronal activ­ity in the brain.

After trac­ers are injected, a “gamma” cam­era rotates around the head to record data, and a com­puter uses the data to con­struct 2D or 3D images of active brain regions inac­tive areas of the brain show up as dark voids.

SPECT con­firms areas of the brain that cor­re­spond with a person’s neural activ­ity, and can be used to iden­tify symp­toms asso­ci­ated with drug use or men­tal ill­ness. It can track the effects of coun­sel­ing and med­ica­tions: as an indi­vid­ual gets bet­ter, brain areas will change in activ­ity level.

Although SPECT can’t cre­ate images as detailed as a PET scan, images can be viewed in both 2D and 3D. This method is not very expen­sive, and the pro­ce­dure doesn’t need as many tech­ni­cal and med­ical staff to com­plete. The fol­low­ing SPECT images illus­trate the effect of drug use on brain function.

SPECT not only shows dam­age, but also shows improve­ment when sub­stance use is discontinued.

To see more exam­ples of how the brain is affected by drug and alco­hol use using SPECT, click here: http://www.amenclinics.com/bp/atlas/ch15.php

Beyond Brain Imaging

We have come a long way since the fry­ing pan days. Clearly, the results of brain imag­ing stud­ies are very use­ful in that they help researchers bet­ter under­stand what hap­pens to a brain that has been fried by drugs.

Addi­tion­ally, poten­tial drug ther­apy treat­ments have been sug­gested based on the “cir­cuits” model. The gen­eral aim of this approach includes decreas­ing a drug’s reward value, dis­so­ci­at­ing drug use from plea­sur­able mem­o­ries, and restor­ing nor­mal brain activity.

While brain imag­ing is a very use­ful tool, it does not pro­vide a com­plete under­stand­ing of addic­tion. Each tech­nique has lim­i­ta­tions, as described above, but future devel­op­ments are sure to strengthen these tech­nolo­gies. In addi­tion, treat­ing addic­tion purely as a brain dis­ease has its own lim­i­ta­tions, in that it ignores the pow­er­ful socio-cultural fac­tors that con­tribute to drug use.

And just like any­thing else within the sci­en­tific realm, it is cru­cial that all hypothe­ses be rig­or­ously tested: qual­ity of research meth­ods, and restraint when inter­pret­ing results, must not be sac­ri­ficed in order to draw excit­ing conclusions.

Finally, it is impor­tant to note that brain imag­ing is only able to show cor­re­la­tions in data, not cau­sa­tions: as a wise pro­fes­sor once said, “lines drawn on a map can­not show you why coun­tries wage war.”  How­ever, in the future, increased sci­en­tific under­stand­ing of brain addic­tion, as well as the results of future imag­ing stud­ies, may be able to show how bor­ders change as a result of war.

—-

Remem­ber, this blog post was writ­ten as part of a Neu­roan­thro­pol­ogy class. You can find the other seven blog posts by click­ing on Why A Final Essay When We Can Do This?. Enjoy!

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5 Responses

  1. Kerri says:

    I have suf­fered with a mood dis­or­der (Major Depres­sion) for over 10 years. I know SPECT imag­ing is used now in treat­ment sit­u­a­tions, do you have any infor­ma­tion regard­ing this research or how it can be used by the con­sumer? –Thanks, Kerri

  2. Jacob says:

    I met Dr. Amen at a lec­ture he gave and then par­tic­i­pated in his brain study of injured and unin­jured brains. I learned a lot about the dam­age that can occur even from nor­mal children’s bangs to the head — the kind that hap­pen to most kids who engage in sports.

    If you are inter­ested in the brain and how it works, I highly rec­om­mend read­ing ““My Stroke of Insight”” by Dr. Jill Bolte Tay­lor. It’s on the NY Times Best­seller list and it’s a won­der­ful book. Dr. Taylor’s talk at TED dot com is also AMAZING! Oprah inter­viewed Dr. Tay­lor and you can check that out on Oprah.com. And Time Mag­a­zine named Dr. T one of the 100 Most Influ­en­tial peo­ple in the world. Hav­ing read her book, I can see why all the attention.

    Dr. Amen’s book is brain sci­ence and it’s great at that. Dr. Tay­lor is a Har­vard Brain Sci­en­tist, but what she writes about is the sci­ence and much more. She really cracks the code to under­stand how our brains (right and left hemi­spheres) work and she explains how we can get into our right brain and be hap­pier and more joy­ful. Aside from any of the sci­ence, My Stroke of Insight is also just a great story.

  3. Alvaro says:

    Dear Kerri, brain imag­ing such as SPECT may be use­ful for pro­fes­sion­als, but is not the main tool for either diag­no­sis or treat­ment. So it can be mis­lead­ing for con­sumers to expect too much from it. I encour­age you to con­sult with your doc­tor: he or she is the most qual­i­fied per­son to help you.

    Jacob: many thanks for your note. I heve in fact already ordered My Stroke of Insight for sum­mer reading!

  4. Nancy says:

    I met Dr. Amen too — in San Diego at a meet­ing by one of the Secret authors. He con­vinced me to try to get my son who plays soc­cer to wear the head­gear.
    I also heard Dr. Jill Bolte Taylor’s TED Talk video– http://www.ted.com/talks/jilltaylorwhen it was sent to me, and I read her book MY STROKE OF INSIGHT, which was one of the most pow­er­fully mov­ing and inspir­ing books I’ve read in ages. The PhD brain scientist’s inside view of her own stroke was fas­ci­nat­ing. The spir­i­tual lessons and right/left brain lessons were pro­found.
    THank you for shar­ing that Jacob!

  5. Jayman says:

    Very good arti­cle. Good dis­ec­tion of the dif­fer­ent options avail­able for patients seek­ing fur­ther diag­no­sis and insight.

    I actu­ally use the PET and SPECT images shown here dur­ing lec­tures at my addic­tions clinic.

    I wel­come sug­ges­tions on where to find new research on addic­tion and brain disease.

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