Skating to where the puck will be: the importance of neuroimaging literacy in child psychiatry.
Skating to where the puck will be: the importance of neuroimaging literacy in child psychiatry.
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滑向冰球所在的位置：神经影像素养在儿童精神病学中的重要性。
DOI：
10.1097/chi.0b013e318185dab8
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发表时间：
2008
影响因子：
13.3
通讯作者：
Leibenluft,Ellen
中科院分区：
文献类型：
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作者：
Leibenluft,Ellen
当被要求解释他成功的秘诀时，杰出的曲棍球运动员韦恩·格雷茨基坚称，他滑到了冰球应该在的地方，而不是它在哪里。如果在这种情况下的“冰球”是关于儿科精神疾病的病理生理学知识，那么“滑向冰球将在哪里”直接将我们引向大脑。值得注意的是，这种对大脑的关注并不排除对环境的同样强烈的关注：数据表明，环境影响和精神病理学风险之间的关联反映了这种影响对大脑发育的影响。1因此，如果儿童精神病学家要用最先进的精神病理学知识来处理病人护理，重要的是他们对大脑结构和功能有一定的了解。为了做到这一点，他们必须是受过教育的新兴神经成像文学的消费者。为什么神经成像素养对执业精神病学家来说很重要？换句话说，神经成像技术是如何推动该领域向前发展的？正如几位作者在本期中指出的那样，这种技术使精神病学家的行为研究与大脑研究相联系成为可能。随着大脑行为联系的阐明，新的治疗方法可以被开发出来，因为药物和心理治疗干预都可能针对大脑行为链中的许多环节中的任何一个。此外，这些大脑行为“联系”中的每一个都是一个潜在的生物标记物，有时与遗传标记物相结合，可能有助于诊断，指示风险，和/或用于监测治疗反应。最后，在某些情况下，例如在焦虑症中，人类神经成像研究建立在动物模型的大量数据基础上，描绘了相关的神经回路，使精神病学实践有可能因最近的神经科学革命而得到推动。这些神经成像技术应用的例子都可以在本期杂志中找到。
Asked to explain the secret to his success, the pre-eminent hockey player Wayne Gretzky asserted that he skated to where the puck would be, rather than to where it was. If “the puck” in this instance is pathophysiologic knowledge about pediatric psychiatric illnesses, then “skating to where the puck will be” leads us directly to the brain. Of note, this focus on the brain does not obviate an equally strong focus on the environment: data suggest that associations between environmental influences and risk for psychopathology reflect the impact of such influences on brain development. 1 Thus, if child psychiatrists are to approach patient care with state-of-the-art knowledge about psychopathology, it is important that they be knowledgeable about brain structure and function. In order to do that, they must be educated consumers of the emerging neuroimaging literature.Why is neuroimaging literacy important for practicing psychiatrists? Put another way, how are neuroimaging techniques moving the field forward? As noted by several authors in this issue, such techniques make it possible to link the study of behavior, psychiatrists’ stock-in-trade, with studies of the brain. As brain-behavior connections are elucidated, new treatment approaches can be developed, since both pharmacologic and psychotherapeutic interventions can potentially target any one of a number of links in the brain-behavior chain. In addition, each one of these brain-behavior “links” is a potential biomarker that, sometimes in combination with genetic markers, might facilitate diagnosis, index risk, and/or be used to monitor treatment response. Finally, in some instances, as for example in anxiety disorders, human neuroimaging studies build on a wealth of data in animal models delineating relevant neural circuitry, making it possible for psychiatric practice to be advanced by the recent revolution in neuroscience. Examples of each of these applications of neuroimaging techniques can be found in this issue of the Journal.