Neuroimaging in Psychiatric Disorders

Öz

Advanced neuroimaging methods have greatly expanded our understanding of psychiatric disorders by enabling detailed evaluation of brain structure, function, and connectivity. This review synthesizes findings from major psychiatric conditions, including schizophrenia, major depressive disorder, bipolar disorder, obsessive–compulsive disorder (OCD), anxiety disorders, autism spectrum disorder, and attention-deficit/hyperactivity disorder (ADHD). Across disorders, structural mahnetic resonance imaging (MRI) consistently reveals cortical and subcortical abnormalities, while diffusion tensor imaging highlights widespread white-matter dysconnectivity. Functional MRI studies demonstrate disorder-specific but overlapping alterations in network activity, particularly involving prefrontal, limbic, and default mode systems. Molecular and spectroscopic imaging add complementary insights into neurotransmitter and metabolic disturbances, including dopaminergic dysfunction in schizophrenia, glutamatergic abnormalities in mood disorders and OCD, GABAergic deficits in anxiety, and excitatory–inhibitory imbalance in autism and ADHD. Although no single imaging marker has sufficient specificity for clinical diagnosis, neuroimaging has substantially advanced mechanistic models of psychiatric illness. Longitudinal and multimodal approaches reveal developmental trajectories, illness progression, and treatment effects, such as lithium-related neurotrophic changes in bipolar disorder or normalization of hyperactive circuits following cognitive behavioral therapy (CBT) in OCD and anxiety disorders. Neuroimaging has transformed the conceptualization of psychiatric disorders from region-specific abnormalities to distributed network and molecular dysfunction. While still largely confined to research, ongoing advances in multimodal integration, large-scale collaborations, and precision imaging approaches hold promise for earlier detection, individualized intervention, and improved patient outcomes.

Anahtar Kelimeler

• psychiatric disorders
• neuroimaging
• MRI

Psikiyatrik Bozukluklarda Nörogörüntüleme

Öz

İleri nörogörüntüleme yöntemleri, beyin yapısı, işlevi ve bağlantısallığının ayrıntılı değerlendirilmesini sağlayarak psikiyatrik bozukluklar hakkındaki anlayışımızı büyük ölçüde genişletmiştir. Bu derleme, şizofreni, majör depresif bozukluk, bipolar bozukluk, obsesif-kompulsif bozukluk (OKB), anksiyete bozuklukları, otizm spektrum bozukluğu ve dikkat eksikliği/hiperaktivite bozukluğu (DEHB) gibi başlıca psikiyatrik durumlara ilişkin bulguları sentezlemektedir. Bozukluklar genelinde, yapısal manyetik rezonans görüntüleme (MRI) sürekli olarak kortikal ve subkortikal anormallikler ortaya koyarken, difüzyon tensör görüntüleme yaygın beyaz madde bağlantı bozukluklarını vurgular. Fonksiyonel MRI çalışmaları, özellikle prefrontal, limbik ve varsayılan mod sistemlerini içeren ağ aktivitelerinde bozukluğa özgü ancak örtüşen değişiklikler gösterir. Moleküler ve spektroskopik görüntüleme, nörotransmitter ve metabolik bozukluklar hakkında tamamlayıcı içgörüler sunar; bunlar arasında şizofrenide dopaminerjik işlev bozukluğu, duygu durum bozuklukları ve OKB'de glutamaterjik anormallikler, anksiyetede GABAerjik eksiklikler ve otizm ile DEHB'de uyarılma-inhibitör dengesizlik yer alır. Tek bir görüntüleme belirteci klinik tanı için yeterli özgüllüğe sahip olmasa da, nörogörüntüleme psikiyatrik hastalıkların mekanistik modellerini önemli ölçüde ilerletmiştir. Boylamsal ve çok modlu yaklaşımlar, gelişimsel yörüngeleri, hastalık ilerlemesini ve tedavi etkilerini ortaya koyar; örneğin, bipolar bozuklukta lityumla ilişkili nörotrofik değişiklikler veya OKB ve anksiyete bozukluklarında bilişsel davranışçı terapi (BDT) sonrası hiperaktif devrelerin normalleşmesi gibi. Nörogörüntüleme, psikiyatrik bozuklukların kavramsallaştırılmasını bölgeye özgü anormalliklerden daha geniş ağ ve moleküler işlev bozukluğuna dönüştürmüştür. Hâlen büyük ölçüde araştırmayla sınırlı olsa da, çok modlu entegrasyon, büyük ölçekli iş birlikleri ve hassas görüntüleme yaklaşımlarındaki devam eden ilerlemeler, daha erken teşhis, bireyselleştirilmiş müdahale ve hasta sonuçlarının iyileştirilmesi için umut vadetmektedir..

Anahtar Kelimeler

• psikiyatrik bozukluklar
• nörogörüntüleme
• MRI

Kaynakça

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