Çocuk ve ergen psikiyatrisinde beyin görüntüleme

Amaç: Son yıllarda psikiyatrik hastalıklarda hem yapısal hem de işlevsel beyin görüntüleme çalışmaları giderek yaygınlaşmaktadır. Bu yazının amacı, çocuk ve ergenlerde görülen psikiyatrik hastalıklardan üzerinde daha yoğun olarak beyin görüntüleme çalışmaları yapılanlarda elde edilen verileri gözden geçirmektir. Yöntem: Dikkat eksikliği hiperaktivite bozukluğu (DEHB), otizm ve çocukluk başlangıçlı şizofreni ile yapılan beyin görüntüleme çalışmaları yazından taranmış ve sonuçları değerlendirilmiştir. Sonuçlar: Birçok çalışmada DEHB’de frontal- striatal-talamokortikal devrede ve serebellumda; otizmde temporal bölgede yapısal ve işlevsel anormallikler bildirilmiştir. Çocukluk başlangıçlı şizofrenide ise en tutarlı bulgu toplam beyin ve kortikal gri cevher hacminde azalma ve ventrikül hacminde artma olmasıdır. Tartışma: Çocuk ve ergenlerde görülen psikiyatrik hastalıklarda beyin görüntüleme çalışmaları ile henüz hastalıklara özgül ve tutarlı veriler elde edilmiş değildir. Beyin görüntüleme çalışmaları bu nedenle tanı aracı olarak kullanılmıyor olsalar da psikiyatrik hastalıkların oluş mekanizmalarının aydınlatılmasında önemli yere sahiptir.

Neuroimaging in child and adolescent psychiatry

Objective: Usage of both structural and functional neuroimaging in evaluation of psychiatric disorders has been increasing in recent years. The aim of this article is to review the neuroimaging data about the most intensely studied child and adolescent psychiatric disorders. Method: Neuroimaging studies on attention deficit hyperactivity disorder (ADHD), autism and chilhood-onset schizophrenia were searched from the literature and their findings were discussed. Results: In many studies structural and functional abnormalities were detected in fronto-striatal-thalamocortical loop and cerebellum in ADHD and temporal region in autism. Most consistent finding in chilhood-onset schizophrenia was decreased brain and cortical grey matter volumes and increased ventricular volumes. Discussion: There are no specific and consistent neuroimaging findings about child and adolescent psychiatric disorders yet. Although they are not used as diagnostic tools, neuroimaging studies play an important role in elucidating pathophysiologic mechanisms of psychiatric disorders.

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