Neuroimaging

Joshua P. Klein, MD, PhD, FANA, FASN, FAAN

The advent of cross-sectional imaging in the 1970s revolutionized the practice of neurology by enabling noninvasive visualization of nervous system structures in both health and disease. CT and MRI technologies have since led to incalculable improvements in patient care and advances in the field of neurology broadly. New and more sophisticated imaging modalities have continued to emerge, facilitating earlier diagnosis and affording clinicians a wealth of data to guide therapeutic interventions.

These latest developments in neuroimaging are complex and their application to specific neurologic diseases requires a deep understanding of anatomic, pathophysiologic, and clinical principles. Authoritative yet accessible reviews of the evolving state of the art are needed so that clinicians can take an active role in understanding the nature and significance of imaging abnormalities encountered in practice.

I am thrilled to have the opportunity to highlight in this Issue some of the most exciting recent progress in disease-based neuroimaging. The aim is to provide applicable and practical insights into the role of imaging in the diagnosis and treatment of a wide variety of neurological disorders. My hope is that the articles in this Issue will provide new knowledge and proficiency in neuroimaging for neurologists in all subspecialties and at all levels. I am fortunate to have recruited a superb team of authors who are not only clinical experts but also outstanding and highly respected educators. I am grateful to all authors for their enthusiasm and generosity in contributing to this Issue.

The Issue begins with two articles describing the correlation between structural brain abnormalities and functional connectivity. The first article, by Brian L. Edlow and colleagues, focuses on imaging of functional networks in disorders of consciousness using PET and fMRI modalities. Next is an exposition of the use of MR spectroscopy as a biomarker for chronic traumatic encephalopathy by Alexander Lin and colleagues. The third article is a detailed review of imaging of neurodegenerative conditions by Michael D. Geschwind and colleagues. Following are two articles that focus on exciting new methods of imaging in multiple sclerosis; first includes an examination of complementary imaging modalities by Antje Bischof and colleagues, and second is a presentation of the utilization of PET for visualizing microglial activation by Tarun Singhal and colleagues. An update on multimodal imaging in acute ischemic stroke is presented by Aaron P. Tansy and colleagues, followed by an in-depth review by Marc A. Bouffard and Sashank Prasad on the use of optical coherence tomography, MRI, and ultrasound techniques applied to neuroophthalmologic conditions. An expert review of the use of imaging for surgical planning in epilepsy is provided by Vamsidhar Chavakula and G. Rees Cosgrove. And lastly, Jörg Dietrich and I examine the effects of chemotherapy and radiotherapy on imaging of tumors, including discussion of the phenomena of pseudoprogression and pseudoresponse.

As evidenced by these articles, amazing breakthroughs and innovations in neuroimaging have occurred since I last had the honor of guest editing an issue of Seminars in Neurology in 2012. It has been an absolute privilege and pleasure to work alongside a most accomplished group of authors to highlight so many of these recent advancements. I would like to thank Ashley Stahle and her staff at the editorial office for their expertise and support. Lastly, this Issue was commissioned by a long-time role model, colleague, and friend, David M. Greer, whom I thank deeply for giving me the opportunity to serve as the guest editor.