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Brain Anatomy and Function

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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
Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Frontal and Temporal Lobes


Frontal
Thought Voluntary movement Speech motor Covers 1/3rd of area of the brain

Temporal
Memory Auditory function

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Parietal and Occipital Lobes


Parietal
Sensation
Touch Pressure Pain Temperature Texture

Occipital
Vision Visual processes
Reading

Position/spatial orientation

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Medulla Oblongata, Cerebellum, and Pons


Medulla Oblongata
Respiration Heart rate Continuous with the spinal cord (2.5 cm)

Cerebellum
Large Muscle Coordination Balance
Walking, Writing

Pons
Relay between the cerebral hemispheres and the cerebellum
Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Basal Ganglia and Thalamus


The Brakes
Modifies movement on a minute-tominute basis

Inhibits Movement
Coordination Cortical relay

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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
Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Serotonin
Normal functions Emotions Judgment Sleep Imbalances Depression Suicidal behavior Anxiety Impulsive behavior Eating disorders

Glutamate/GABA
Normal functions Involved in most facets of brain function Imbalances Memory disturbances Sleep disturbances Anxiety

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Dopamine
Normal functions
Mood Movement Memory

Endorphins
Normal functions
Relieve pain Induce euphoria

Imbalances
Movement disorders Schizophrenia Addiction

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

Normal Aging Brain


Brain weight and volume decrease Grooves widen Surface smoothes Neurofibrillary tangles increase

Understanding normal variation is key to interpretation


Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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


Huntingtons Disease Parkinsons Disease
Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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%

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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)

Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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
Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.

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