Brain Anatomy and Function © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved. 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 Temporal • Thought • Memory • Voluntary movement • Auditory function • Speech motor • Covers 1/3rd of area of the brain © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved. Parietal and Occipital Lobes Parietal • Sensation • Touch • Pressure • Pain Occipital • Vision • Visual processes • Reading • Temperature • Texture • 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. The Nerve Cell Synaptic junction © 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 Glutamate/GABA Normal functions  Emotions  Judgment  Sleep Normal functions Imbalances Imbalances • Involved in most facets of brain function  Depression  Memory disturbances  Suicidal behavior  Sleep disturbances  Anxiety  Anxiety  Impulsive behavior  Eating disorders © Copyright 2004 Cardinal Health, Inc. or one of its subsidiaries. All rights reserved. Dopamine Normal functions Endorphins Normal functions  Mood • Relieve pain  Movement • Induce euphoria  Memory 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 Normal Brain Metabolism © 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  Huntington’s Disease  Parkinson’s 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.