Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder.

Improved diagnosis and treatment of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are needed for our military and veterans, their families, and society at large. Advances in brain imaging offer important biomarkers of structural, functional, and metabolic information concerning the brain. This article reviews the application of various imaging techniques to the clinical problems of TBI and PTSD. For TBI, we focus on findings and advances in neuroimaging that hold promise for better detection, characterization, and monitoring of objective brain changes in symptomatic patients with combat-related, closed-head brain injuries not readily apparent by standard computed tomography or conventional magnetic resonance imaging techniques.

The neural basis for simulated drawing and the semantic implications.

This functional magnetic resonance imaging (fMRI) study of the mental simulation of drawing (1) investigated the neural substrates of drawing and (2) delineated the semantic aspects of drawing. The goal was to advance our understanding of how drawing a familiar object is linked to lexical semantics and therefore a viable method to use to rehabilitate aphasia. We hypothesized that the semantic aspects of drawing familiar objects compared to drawing non-objects would yield greater activation in the inferior temporal cortex and the inferior frontal cortex of the left hemisphere. To test this hypothesis, eight right-handed subjects performed an fMRI experiment that directly contrasted drawing familiar objects to non-objects using mental imagery. Simulated drawing recruited a large, distributed network of frontal, parietal, and temporal structures. In the contrast comparing drawing familiar objects to non-objects there was stronger activation in the left hemisphere within the inferior temporal, anterior inferior frontal, inferior parietal and superior frontal cortices. The activation within the inferior temporal cortex was associated with visual semantic processing and semantic mediated naming. We suggest that the anterior inferior frontal activation is linked to the inferior temporal cortex and is involved in the selection of specific semantic features of the object as well as retrieval of information regarding the perceptual aspects of the object.

Sex differences in language processing: functional MRI methodological considerations.

PURPOSE: To evaluate the influence of both analysis methods and tasks used in the determination of language related sex differences. Previous neuroimaging studies evaluating sex differences in language processing have been inconsistent. MATERIALS AND METHODS: The current study compared FMRI activation between men and women on a variety of language tasks using different types of individual (laterality and activation volume) and group analyses to evaluate the effects of task and methodology. Forty subjects completed five language tasks, 19 men and 21 women. RESULTS: Group analyses revealed greater activation for men compared with women in the left pars orbitalis while women showed greater activation within the right insula. With individual analyses, there were no significant sex differences in laterality using two large regions of interest (ROIs) covering the inferior frontal and temporoparietal regions; however, there were significant sex effects within small, specific ROIs (insula, middle temporal and pars opercularis, triangularis, and orbitalis). When holding the task constant, some methods (for example different ROIs within individual analyses) revealed sex differences while others methods did not, indicating a dependence on methodology. CONCLUSION: The results partly explain why FMRI studies evaluating language related sex effects have been inconsistent.

Comparison of the neural basis for imagined writing and drawing.

Drawing and writing are complex processes that require the synchronization of cognition, language, and perceptual-motor skills. Drawing and writing have both been utilized in the treatment of aphasia to improve communication. Recent research suggests that the act of drawing an object facilitated naming, whereas writing the word diminished accurate naming in individuals with aphasia. However, the relationship between object drawing and subsequent phonological output is unclear. Although the right hemisphere is characteristically mute, there is evidence from split-brain research that the right hemisphere can integrate pictures and words, likely via a semantic network. We hypothesized that drawing activates right hemispheric and left perilesional regions that are spared in aphasic individuals and may contribute to semantic activation that supports naming. Eleven right-handed subjects participated in a functional MRI (fMRI) experiment involving imagined drawing and writing and 6 of the 11 subjects participated in a second fMRI experiment involving actual writing and drawing. Drawing and writing produced very similar group activation maps including activation bilaterally in the premotor, inferior frontal, posterior inferior temporal, and parietal areas. The comparison of drawing vs. writing revealed significant differences between the conditions in areas of the brain known for language processing. The direct comparison between drawing and writing revealed greater right hemisphere activation for drawing in language areas such as Brodmann area (BA) 46 and BA 37.

The intersubject and intrasubject reproducibility of FMRI activation during three encoding tasks: implications for clinical applications.

The goal of the present study was to evaluate the inter- and intrasubject reproducibility of FMRI activation for three memory encoding tasks previously used in the context of presurgical functional mapping. The primary region of interest (ROI) was the medial temporal lobe (MTL). Comparative ROIs included the inferior frontal and fusiform gyri which are less affected by susceptibility-induced signal losses than the MTL regions. Eighteen subjects were scanned using three memory encoding paradigms: word-pair, pattern, and scene encoding. Nine subjects underwent repeat scanning. Intersubject reproducibility of FMRI activation was evaluated by examining the percent of subjects who showed activation within a given ROI and the range to which individual laterality indices (LIs) varied from the mean. Intrasubject test-retest reproducibility was evaluated by examining the LI test-retest correlation, the average difference between LIs from two separate imaging sessions, and concordance ratios of activation volumes (R(volume) and R(overlap)). For scene encoding the reproducibility of activation volume and LIs within the MTL were as good as or better than the reproducibility within the fusiform and inferior frontal ROIs. For pattern encoding and word-pair encoding, the reproducibility of activation volume and LIs within the MTL tended to be worse compared to the fusiform and inferior frontal ROIs. The differences in FMRI reproducibility appeared more dependent on the task than the susceptibility effects. The results of this study suggest that FMRI-based assessment of the neural substrates of memory using a scene encoding task may be a useful clinical tool.