The Co-evolution of Neuroimaging and Psychiatric Neurosurgery

Area of Science:

• Neurosurgery
• Neuroimaging
• Psychiatry

Background:

• Psychiatric neurosurgery historically lacked advanced imaging, relying on early theories of frontal lobe dysfunction.
• The advent of structural and functional magnetic resonance imaging (fMRI) in the late 20th century revolutionized the field.

Purpose of the Study:

• To review the coevolution of psychiatric neurosurgery and neuroimaging.
• To describe how neuroimaging elucidates therapeutic mechanisms in neuromodulatory procedures.
• To highlight neuroimaging's role in candidate selection, surgical planning, and post-operative analysis.

Main Methods:

• Review of historical development and current applications of neuroimaging in psychiatric neurosurgery.
• Focus on ablative procedures for enhanced post-operative re-imaging opportunities.
• Inclusion of contributions from deep brain stimulation (DBS) literature.

Main Results:

• Neuroimaging is now central to psychiatric neurosurgery, influencing patient selection and surgical precision.
• fMRI and other modalities allow for mechanistic theories explaining treatment efficacy.
• Neuroimaging identifies network-level brain changes post-surgery, aiding in understanding treatment effects.

Conclusions:

• Neuroimaging has significantly advanced psychiatric neurosurgery, moving it towards mechanistic understanding and personalized interventions.
• The integration of neuroimaging is crucial for refining surgical targeting and evaluating treatment outcomes.
• Future psychiatric neurosurgery will be defined by precision medicine, driven by advanced neuroimaging techniques.