Magnetic Resonance (MR) imaging affords the opportunity to use safe, noninvasive techniques to identify and quantify regional brain abnormalities in living patients with psychiatric and neurological diseases. Methods We use MR structural imaging to quantify regional volumes of gray matter (comprising mostly neurons), white matter (comprising mostly neuronal tracts), and cerebral spinal fluid-filled spaces (sulci and ventricles); proton MR spectroscopy (MRS) to detect and quantify critical brain metabolites, such as N-acetylaspartate (NAA), which is a marker for living neurons; and phosphorous MR spectroscopy to measure brain cell membrane turnover. Results and Discussion We have found, for example, that: (1) Patients with Alzheimer' 5 disease have a significant cortical gray matter volume deficit that is greater in younger than older patients, relative to age norms derived from our healthy control subjects. Thus, the early onset form of this disease may be more virulent than the late onset form. (2) Patients with schizophrenia have a widespread cortical gray matter volume deficit that is most pronounced in the prefrontal and frontal-temporal regions. (3) Detoxified chronic alcoholics have cortical volume deficits that include both gray matter and white matter, and also have volume deficits of the anterior hippocampus. The alcohol-related brain volume loss appears to accelerate with age. We also found significant volume deficits in the anterior superior regions of the cerebellar vermis, which may underlie postural instability and falling even in detoxified alcoholics. (4) Recovering alcoholics show improvement in cortical gray matter, sulcal, and ventricular volumes early in the course of abstinence, and improvement in third ventricular volumes later with continued abstinence. Because of the brain dysmorphology in these patient groups is typically imperceptible to clinical review, we are excited about the advanced imaging capabilities available to quantify regional and structural brain volumes in terms of their constituent parts.
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