Human Brain Function: Assessment and Rehabilitation – serie

Until recent advents in neuroimaging, the brain had been inaccessible to in vivo visualization, short of neurosurgical procedures or some unfortunate traumatic exposure. It is a tribute to the early contributors to clinical neuroscience that through what, by today's standards, would be deemed extremely crude measure­ ments, advancements in understanding brain function were made. For example, the theories of higher cortical functions of the brain by Aleksandr Luria or Hans-Lukas Teuber in the 1950s were essentially based on military subjects who sustained traumatic head wounds during World War II. These researchers could inspect the patient and determine where penetrating entrance and exit wounds were on the head; sometimes they had skull films to identify entrance and exit fracture wounds, sometimes neurosurgical reports were available, and Luria even had the opportunity to acutely examine some patients with exposed wounds. Thus, one would take whatever information might be available and infer what regions of the brain were involved but could never actually visualize the brain. Of course, this changed dramatically with the introduction of brain imag­ ing in the 1970s, but it really was not until the 1990s that analysis and image display technologies finally caught up with the basic brain-imaging methods of computerized tomography (CT) and magnetic resonance imaging (MRI).

The focus of Volume I of the Handbook of Human Brain Function was on basic scientific principles of brain imaging as it relates to the study of human brain function. Once the scientific bases for a particular discipline are established, follow. Such is the status of brain imaging in the study of clinical applications human brain function. It is of interest to note that the 1952 Nobel Prize for Physics was awarded to Felix Bloch and Edward Purcell, who discovered that nuclei precessing in the radiofrequency range could emit a radiofrquency signal detected by a radio receiver. Their findings initiated a series of very basic re­ search studies on the characteristics of nuclear magnetic resonance. It would take over 25 years of basic research before findings began to point toward truly biomedical applications. However, once realized, clinical applications became standard fare for nuclear magnetic resonance. The example of Bloch and Pur­ cell's work in an area of very basic science expanding to clinical application has been repeated throughout the medical and neurological sciences. This type of progress is what drives science. As a benefit from these scientific advances, research, clinical, and diagnostic imaging from a variety of modalities, not just computerized tomography or magnetic resonance imaging, can be performed. This volume focuses on the clinical applications of various neuroimaging meth­ ods. Chapter 1 introduces the topic of clinical neuroimaging in the study of human brain function.

In this volume of the series Human Brain Function: Assessment and Rehabilitation we cover the area of how brain function is assessed with behavioral or neuropsycholog­ ical instruments. These assessments are typically conducted by clinical neuropsy­ chologists or behavioral neurologists, and so we made an effort to present the somewhat differing approaches to these two related disciplines. Clinical neuropsy­ chologists are psychologists who typically utilize standardized tests, while behav­ ioral neurologists are physicians who generally assess brain function as part of the clinical neurological evaluation. Both approaches have much to offer. The basic assumption of neuropsychological assessment is that the brain is the organ of behavior, and therefore, the condition of the brain may be evaluated with behavioral measures. Neuropsychological tests are those measures found by re­ search to be particularly sensitive to alterations in brain function. An adequate neuropsychological test is a procedure that can be related to some objective mea­ sure of alteration in brain function. Over the years, these objective measures have changed, but generally involve documentation through direct observation of brain tissue, or through histological, pathological, neuroimaging, or other laboratory procedures. The methods described in the first two volumes of this series describe the neuroimaging procedures that are often used in the validation of neuropsycho­ logical tests.

In this, the fourth and final volume in the series Human Brain Function, Goldstein and Beers outline how the different rehabilitation specialties assess brain function. Using straightforward explanations, the contributors not only cover the assessment approaches and methods used by each specialty, but uniquely expand this focus to describe evaluation and treatment planning for a variety of neurobehavioral disorders.Rehabilitation specialists and non-specialists alike will value the original scope and accessibility of this work.

In this, the fourth and final volume in the series Human Brain Function, Goldstein and Beers outline how the different rehabilitation specialties assess brain function. Using straightforward explanations, the contributors not only cover the assessment approaches and methods used by each specialty, but uniquely expand this focus to describe evaluation and treatment planning for a variety of neurobehavioral disorders.Rehabilitation specialists and non-specialists alike will value the original scope and accessibility of this work.

Until recent advents in neuroimaging, the brain had been inaccessible to in vivo visualization, short of neurosurgical procedures or some unfortunate traumatic exposure. It is a tribute to the early contributors to clinical neuroscience that through what, by today's standards, would be deemed extremely crude measure­ ments, advancements in understanding brain function were made. For example, the theories of higher cortical functions of the brain by Aleksandr Luria or Hans-Lukas Teuber in the 1950s were essentially based on military subjects who sustained traumatic head wounds during World War II. These researchers could inspect the patient and determine where penetrating entrance and exit wounds were on the head; sometimes they had skull films to identify entrance and exit fracture wounds, sometimes neurosurgical reports were available, and Luria even had the opportunity to acutely examine some patients with exposed wounds. Thus, one would take whatever information might be available and infer what regions of the brain were involved but could never actually visualize the brain. Of course, this changed dramatically with the introduction of brain imag­ ing in the 1970s, but it really was not until the 1990s that analysis and image display technologies finally caught up with the basic brain-imaging methods of computerized tomography (CT) and magnetic resonance imaging (MRI).

The focus of Volume I of the Handbook of Human Brain Function was on basic scientific principles of brain imaging as it relates to the study of human brain function. Once the scientific bases for a particular discipline are established, follow. Such is the status of brain imaging in the study of clinical applications human brain function. It is of interest to note that the 1952 Nobel Prize for Physics was awarded to Felix Bloch and Edward Purcell, who discovered that nuclei precessing in the radiofrequency range could emit a radiofrquency signal detected by a radio receiver. Their findings initiated a series of very basic re­ search studies on the characteristics of nuclear magnetic resonance. It would take over 25 years of basic research before findings began to point toward truly biomedical applications. However, once realized, clinical applications became standard fare for nuclear magnetic resonance. The example of Bloch and Pur­ cell's work in an area of very basic science expanding to clinical application has been repeated throughout the medical and neurological sciences. This type of progress is what drives science. As a benefit from these scientific advances, research, clinical, and diagnostic imaging from a variety of modalities, not just computerized tomography or magnetic resonance imaging, can be performed. This volume focuses on the clinical applications of various neuroimaging meth­ ods. Chapter 1 introduces the topic of clinical neuroimaging in the study of human brain function.