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Chapter 4. Laboratory Testing and Imaging Studies in Psychiatry

Elisabeth Wilde, Ph.D.; H. Kim, M.D.; Paul Schulz, M.D.; Stuart Yudofsky, M.D.
DOI: 10.1176/appi.books.9781585625031.076870

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Laboratory and diagnostic testing traditionally have not held a central role in the diagnosis and treatment of patients with psychiatric disorders, although other specialties of modern medicine have come to rely heavily on laboratory and imaging modalities to provide the necessary information to diagnose and treat patients with disorders such as cancer, heart disease, and pulmonary problems. Psychiatric diagnoses continue to be made primarily on clinical grounds, with laboratory and diagnostic testing being relegated to informing clinicians about medical causes of psychiatric symptoms that might be excluded from the differential diagnosis or used to monitor psychotropic drug levels during treatment. However, clinical laboratory and diagnostic imaging is on the threshold of a new era.

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Computed tomography (CT) tissue attenuation values and appearance.Source. Adapted from J Levine lecture “Structural Neuroimaging in Psychiatry,” given as part of the Neuroimaging in Psychiatry lecture series, Department of Psychiatry, Baylor College of Medicine, March 2006.

Comparison of computed tomography (CT) and various magnetic resonance imaging (MRI) modalities.The images are derived at the same level within the same individual and demonstrate the characteristic appearance of white matter, gray matter, and cerebrospinal fluid (CSF) on CT and various conventional sequences in common use in clinical practice. FLAIR = fluid attenuated inversion recovery; GRE = gradient echo; PD = proton density.Source. Images courtesy of Elisabeth A. Wilde, Ph.D., Departments of Physical Medicine and Rehabilitation, Neurology and Radiology, Baylor College of Medicine, Houston, Texas, and Erin D. Bigler, Ph.D., Departments of Psychology and Neuroscience, Brigham Young University, Provo, Utah.

Side-by-side comparison of structural imaging modalities: computed tomography (CT) and magnetic resonance imaging (MRI).The sensitivity of head CT versus MRI of the brain in the same patient is demonstrated here in a patient who presented with memory loss. Head CT scan at left shows a large area of decreased density consistent with edema. It is difficult to ascertain whether there is an underlying mass or what its shape might be. The image on the right is from a brain MRI (T2 image) and also demonstrates an area of increased intensity of about the same shape as the CT abnormality. The patient was found to be HIV positive, and a subsequent brain biopsy demonstrated that the mass was a B-cell lymphoma.Source. Images courtesy of Paul E. Schulz, MD, Department of Neurology, Baylor College of Medicine, Houston, Texas.

Diffusion tensor imaging (DTI).A, Fractional anisotropy color map derived from DTI in the sagittal plane. Red indicates white matter fibers coursing in a right-left direction, blue indicates fibers running in a superior-inferior direction, and green reflects fibers oriented in an anterior-posterior direction. B, Fiber tracking using DTI of the total corpus callosum overlaid on a T1-weighted inversion recovery image from the same brain.To view this figure in color, see Plate 1 in Color Gallery in middle of book.Source. Images courtesy of Elisabeth A. Wilde, Ph.D., Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas.

Side-by-side comparison of structural and functional neuroimaging: magnetic resonance imaging (MRI) and positron emission tomography (PET).

Side-by-side comparison of single-photon emission computed tomography (SPECT) versus positron emission tomography (PET).SPECT (top row) and PET images from two patients with clinically similar degrees of mild cognitive impairment. The PET scan demonstrates parietal changes, suggesting that this patient is at greater risk of developing Alzheimer’s disease. The PET scan also demonstrates much better resolution than the SPECT scan.Source. Images courtesy of Paul E. Schulz, M.D., Department of Neurology, Baylor College of Medicine, Houston, Texas.

Structural magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging of a healthy control subject and a patient with traumatic brain injury.Coronal slices (MRI) and three-dimensional reconstruction of the cortical surface (pink) and hippocampi (yellow) of a typically developing adolescent male (left) and an adolescent male with traumatic brain injury (right). Note the significant cortical and hippocampal atrophy in the patient as compared with the age-matched control. The top right image portrays PET findings overlaid on the MRI. PET reveals significant bilateral metabolic defects in the patient’s mesial temporal areas as indicated by the absence of “warm” colors. Red represents areas of the greatest metabolic activity, followed by orange, yellow, green, blue, and violet.Source. Images courtesy of Erin Bigler, Ph.D., University of Utah, Salt Lake City, Utah.

Single photon emission computed tomography (SPECT), structural magnetic resonance imaging (MRI), and magnetoencephalography (MEG) imaging of a patient with traumatic brain injury.Findings from multiple neuroimaging modalities in a patient with traumatic brain injury reveal structural and functional deficits in the inferior frontal and temporal regions, common sites of focal injury in head trauma. Functional imaging reveals even more extensive defects in perfusion (SPECT, left) and dipole abnormality (MEG, right) than the areas of focal injury evident on structural MRI (center). The fused image (bottom) displays the results of the SPECT and MEG overlaid on the MRI.Source. Images courtesy of Erin Bigler, Ph.D., University of Utah, Salt Lake City, Utah.
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Selected medical conditions with psychiatric manifestations
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Recommended diagnostic workup for a patient with new-onset psychosis
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Recommended diagnostic workup for a patient with new-onset depressive or manic symptoms
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Recommended diagnostic workup for a patient with new-onset anxiety symptoms
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Recommended diagnostic workup for a patient with altered mental status
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Recommended diagnostic workup for a patient with cognitive decline
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Substances of abuse
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Medication monitoring
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Psychiatric drug metabolism by specific P450 enzymes
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Drug metabolizer phenotype classification
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Comparison of tissue signal on T1-weighted, T2-weighted, and proton density (PD)–weighted magnetic resonance imaging (MRI)
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Comparison of computed tomography (CT) and magnetic resonance imaging (MRI)
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Indications for computed tomography (CT) prior to or instead of magnetic resonance imaging (MRI)
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Comparison of SPECT, PET, and fMRI
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Summary of neuroimaging findings in selected psychiatric disorders

References

Agzarian MJ, Chryssidis S, Davies RP, et al: Use of routine computed tomography brain scanning of psychiatry patients. Australas Radiol 50:27–28, 2006
[PubMed]
 
Albon E, Tsourapas A, Frew E, et al: Structural neuroimaging in psychosis: a systematic review and economic evaluation. Health Technol Assess 12:iii–iv, ix–163, 2008
[PubMed]
 
Amen DG, Highum D, Licata R, et al: Specific ways brain SPECT imaging enhances clinical psychiatric practice. J Psychoactive Drugs 44:96–106, 2012
[PubMed]
 
American Academy of Neurology: American Academy of Neurology practice guidelines for dementia. Continuum 13: Appendix A, 2007
 
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Arlington, VA, American Psychiatric Association, 2013
 
American Psychiatric Association Task Force on the Use of Laboratory Tests in Psychiatry: Tricyclic antidepressants: blood level measurements and clinical outcome. An APA Task Force report. Am J Psychiatry 142:155–162, 1985
[PubMed]
 
Amin M, Wang J: Routine laboratory testing to evaluate for medical illness in psychiatric patients in the emergency department is largely unrevealing. West J Emerg Med 10:97–100, 2009
[PubMed]
 
Anfinson TJ, Kathol RG: Screening laboratory evaluation in psychiatric patients: a review. Gen Hosp Psychiatry 14:248–257, 1992
[PubMed]
 
Anfinson TJ, Stoudemire A: Laboratory and neuroendocrine assessment in medical-psychiatric patients, in Psychiatric Care of the Medical Patient, 2nd Edition. Edited by Stoudemire AS, Fogel BS, Greenberg D. New York, Oxford University Press, 2000, pp 119–145
 
Arnone D, Cavanagh J, Gerber D, et al: Magnetic resonance imaging studies in bipolar disorder and schizophrenia: meta-analysis. Br J Psychiatry 195:194–201, 2009
[PubMed]
 
Aylward EH, Harris GL, Hoehn-Saric R, et al: Normal caudate nucleus in obsessive-compulsive disorder assessed by quantitative neuroimaging. Arch Gen Psychiatry 53:577–584, 1996
[PubMed]
 
Bansal R, Staib LH, Laine AF, et al: Anatomical brain images alone can accurately diagnose chronic neuropsychiatric illnesses. PloS One 7:e50698, 2012
[PubMed]
 
Baxter LR Jr, Schwartz JM, Bergman KS, et al: Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Arch Gen Psychiatry 49:681–689, 1992
[PubMed]
 
Berkemeier KL, Nipper ML, Williams JM: Is the chest x-ray an appropriate screening exam for ER patients with AMS?Emerg Radiol 15:421–425, 2008
[PubMed]
 
Bernardo M, Palao DJ, Arauxo A, et al: Monitoring plasma level of haloperidol in schizophrenia. Hosp Community Psychiatry 44:115–118, 1993
[PubMed]
 
Bertolino A, Callicott JH, Elman I, et al: Regionally specific neuronal pathology in untreated patients with schizophrenia: a proton magnetic resonance spectroscopic imaging study. Biol Psychiatry 43:641–648, 1998
[PubMed]
 
Bertolino A, Callicott JH, Mattay VS, et al: The effect of treatment with antipsychotic drugs on brain N-acetylaspartate measures in patients with schizophrenia. Biol Psychiatry 49:39–46, 2001
[PubMed]
 
Bonne O, Gilboa A, Louzoun Y, et al: Cerebral blood flow in chronic symptomatic mild traumatic brain injury. Psychiatry Res 124:141–152, 2003
[PubMed]
 
Bora E, Harrison BJ, Davey CG, et al: Meta-analysis of volumetric abnormalities in cortico-striatal-pallidal-thalamic circuits in major depressive disorders. Psychol Med 42:671–681, 2012
[PubMed]
 
Boutros N, Struve F: Electrophysiological testing, in Neuropsychiatric Assessment. Edited by Yudofsky SC, Kim HF (Review of Psychiatry Series; Oldham JM and Riba MB, series eds). Washington, DC, American Psychiatric Publishing, 2004, pp 69–104
 
Brody AL, Barsom MW, Bota RG, et al: Prefrontal-subcortical and limbic circuit mediation of major depressive disorder. Semin Clin Neuropsychiatry 6:102–112, 2001
[PubMed]
 
Buchsbaum MS, Ingvar DH, Kessler RC, et al: Cerebral glucography with positron tomography: use in normal subjects and in patients with schizophrenia. Arch Gen Psychiatry 39:251–259, 1982
[PubMed]
 
Carroll BJ: Problems with diagnostic criteria for depression. J Clin Psychiatry 45:14–18, 1984
[PubMed]
 
Curry S: The strategy and value of neuroleptic drug monitoring. J Clin Psychopharmacol 5:263–271, 1985
[PubMed]
 
de Leon J: Psychopharmacological treatment based on individual drug metabolism: CYP2D6 poor metabolizers. CNS Spectr 11:8–12, 2006
[PubMed]
 
de Leon J, Armstrong S, Cozza KL: Clinical guidelines for psychiatrists for the use of pharmacogenetic testing for CYP450 2D6 and CYP450 2C19. Psychosomatics 47:75–85, 2006
[PubMed]
 
Elkis H, Friedman L, Wise A, et al: Meta-analyses of studies of ventricular enlargement and cortical sulcal prominence in mood disorders: comparisons with controls or patients with schizophrenia. Arch Gen Psychiatry 52:735–746, 1995
[PubMed]
 
Ellison-Wright I, Bullmore E: Meta-analysis of diffusion tensor imaging studies in schizophrenia. Schizophr Res 108:3–10, 2009
[PubMed]
 
Engel J Jr: The epilepsies, in Cecil Textbook of Medicine, 19th Edition, Vol 2. Edited by Wyngaarden JB, Smith LH, Bennett JC. Philadelphia, PA, WB Saunders, 1992, pp 2202–2213
 
Erhart SM, Young AS, Marder SR, et al: Clinical utility of magnetic resonance imaging radiographs for suspected organic syndromes in adult psychiatry. J Clin Psychiatry 66:968–973, 2005
[PubMed]
 
Fowler JS, Logan J, Volkow ND, et al. Translational neuroimaging: positron emission tomography studies of monoamine oxidase. Mol Imaging Biol 7:377–387, 2005
[PubMed]
 
Fouche JP, van Der Wee NJ, Roelofs K, et al: Recent advances in the brain imaging of social anxiety disorder. Hum Psychopharmacol 28:102–105, 2013
[PubMed]
 
Gu H, Salmeron BJ, Ross TJ, et al: Mesocorticolimbic circuits are impaired in chronic cocaine users as demonstrated by resting-state functional connectivity. Neuroimage 53:593–601, 2010
[PubMed]
 
Guller Y, Tononi G, Postle BR: Conserved functional connectivity but impaired effective connectivity of thalamocortical circuitry in schizophrenia. Brain Connect 2:311–319, 2012
[PubMed]
 
Henry TR, van Heertum RL: Positron emission tomography and single photon emission computed tomography in epilepsy care. Semin Nucl Med 33:88–104, 2003
[PubMed]
 
Herringa R, Phillips M, Almeida J, et al: Post-traumatic stress symptoms correlate with smaller subgenual cingulate, caudate, and insula volumes in unmedicated combat veterans. Psychiatry Res 203:139–145, 2012
[PubMed]
 
Hollister LE: Electrocardiographic screening in psychiatric patients. J Clin Psychiatry 56:26–29, 1995
[PubMed]
 
Hollister LE, Shah NN: Structural brain scanning in psychiatric patients: a further look. J Clin Psychiatry 57:241–244, 1996
[PubMed]
 
Holzschneider K, Mulert C: Neuroimaging in anxiety disorders. Dialogues Clin Neurosci 13:453–461, 2011
[PubMed]
 
Honig A, Tan ES, Weenink A, et al: Utility of a symptom checklist for detecting physical disease in chronic psychiatric patients. Hosp Community Psychiatry 42:531–533, 1991
[PubMed]
 
Hughes JR, John ER: Conventional and quantitative electroencephalography in psychiatry. J Neuropsychiatry Clin Neurosci 11:190–208, 1999
[PubMed]
 
Hund M, Rezai AR, Kronberg E, et al: Magnetoencephalographic mapping: basic of a new functional risk profile in the selection of patients with cortical brain lesions. Neurosurgery 40:936–942, discussion 942–943, 1997
[PubMed]
 
Hyman SE, Arana GW: Handbook of Psychiatric Drug Therapy, 2nd Edition. Boston, MA, Little, Brown, 1991
 
Ingelman-Sundberg M, Oscarson M, McLellan RA: Polymorphic human cytochrome P450 enzymes: an opportunity for individualized drug treatment. Trends Pharmacol Sci 20:342–349, 1999
[PubMed]
 
Keedwell PA, Linden DE: Integrative neuroimaging in mood disorders. Curr Opin Psychiatry 26:27–32, 2013
[PubMed]
 
Kempton MJ, Geddes JR, Ettinger U, et al: Meta-analysis database, and meta-regres-sion of 98 structural imaging studies in bipolar disorder. Arch Gen Psychiatry 65:1017–1032, 2008
[PubMed]
 
Ketter TA, George MS, Kimbrell TA, et al: Functional brain imaging, limbic function, and affective disorders. The Neuroscientist 2:55–65, 1996
[PubMed]
 
Kirchheiner J, Brosen K, Dahl ML, et al: CYP2D6 and CYP2C19 genotype-based dose recommendations for antidepressants: a first step towards subpopulation-specific dosages. Acta Psychiatr Scand 104:173–192, 2001
[PubMed]
 
Kubicki M, McCarly R, Westin CF: A review of diffusion tensor imaging studies in schizophrenia. J Psychiatr Res 41:15–30, 2007
[PubMed]
 
Lim KO, Tew W, Kushner M, et al: Cortical gray matter volume deficit in patients with first-episode schizophrenia. Am J Psychiatry 153:1548–1553, 1996
[PubMed]
 
Liu CH, Ma X, Li F, et al: Regional homogeneity within the default mode network in bipolar depression: a resting-state functional magnetic resonance imaging study. PloS One 7:e48181, 2012
[PubMed]
 
Lukens TW, Wolf SJ, Edlow JA, et al: Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department. Ann Emerg Med 47:79–99, 2006
[PubMed]
 
Marangell LB, Martinez JM, Silver JM, et al: Concise Guide to Psychopharmacology. Washington, DC, American Psychiatric Publishing, 2002
 
McDonald C, Marshall N, Sham PC, et al: Regional brain morphometry in patients with schizophrenia or bipolar disorder and their affected relatives. Am J Psychiatry 163:478–487, 2006
[PubMed]
 
Minzenberg MJ, Laird AR, Thelen S, et al: Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia. Arch Gen Psychiatry 66:811–822, 2009
[PubMed]
 
Moles JK, Franchina JJ, Sforza PP: Increasing the clinical yield of computerized tomography for psychiatric patients. Gen Hosp Psychiatry 20:282–291, 1998
[PubMed]
 
Mookhoek EJ, Sterrenburg-vdNieuwegiessen IM: Screening for somatic disease in elderly psychiatric patients. Gen Hosp Psychiatry 20:102–107, 1998
[PubMed]
 
Mrazek DA: Incorporating pharmacogenetics into clinical practice: reality of a new tool in psychiatry. The context of genetic testing in clinical psychiatric practice. CNS Spectr 11(3, suppl 3):3–4, 2006
[PubMed]
 
Nordahl TE, Carter CS, Salo RE, et al: Anterior cingulate metabolism correlates with Stroop errors in paranoid schizophrenia patients. Neuropsychopharmacology 25:139–148, 2001
[PubMed]
 
Olshaker JS, Browne B, Jerrard DA, et al: Medical clearance and screening of psychiatric patients in the emergency department. Acad Emerg Med 4:124–128, 1997
[PubMed]
 
Parvas MA, Alia-Klein N, Woicik PA, et al: Neuroimaging for drug addiction and related behaviors. Rev Neurosci 22:609–624, 2011
[PubMed]
 
Pasternak O, Westin CF, Bouix S, et al: Excessive extracellular volume reveals a neurodegenerative pattern in schizophrenia onset. J Neurosci 28:17365–17372, 2012
[PubMed]
 
Petersen RC, Thomas RG, Grundman M, et al: Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 352:2379–2388, 2005
[PubMed]
 
Pitman RK, Rasmusson AM, Koenen KC, et al: Biological studies of post-traumatic stress disorder. Nat Rev Neurosci 13:769–787, 2012
[PubMed]
 
Rauch SL, Renshaw PF: Clinical neuroimaging in psychiatry. Harv Rev Psychiatry 2:297–312, 1995
[PubMed]
 
Reite M, Teale P, Rojas DC: Magnetoencephalography: applications in psychiatry. Biol Psychiatry 45:1553–1563, 1999
[PubMed]
 
Renshaw PF, Parow AM, Hirashima F, et al: Multinuclear magnetic resonance spectroscopy studies of brain purines in major depression. Am J Psychiatry 158:2048–2055, 2001
[PubMed]
 
Ringholz GR: Differential diagnosis. Lecture presented at Current Neurology conference, Houston, TX, November 2001
 
Rosazza C, Minati L: Resting-state brain networks: literature review and clinical applications. Neurol Sci 32:773–785, 2011
[PubMed]
 
Rossi R, Lanfredi M, Pievani M, et al: Volumetric and topographic differences in hippocampal subdivisions in borderline personality and bipolar disorders. Psychiatry Res 203:132–138, 2012
[PubMed]
 
Sachse C, Brockmoller J, Bauer S, et al: Cytochrome P450 2D6 variants in a Caucasian population: allele frequencies and phenotypic consequences. Am J Hum Genet 60:284–295, 1997
[PubMed]
 
Sadock BJ, Sadock VA: Laboratory tests in psychiatry, in Kaplan and Sadock’s Synopsis of Psychiatry, 10th Edition. Baltimore, MD, Lippincott Williams & Wilkins, 2007, pp 255–267
 
Sagar M, Seensalu R, Tybring G, et al: CYP 2C19 genotype and phenotype determined with omeprazole in patients with acid-related disorders with and without Helicobacter pylori infection. Scand J Gastroenterol 33:1034–1038, 1998
[PubMed]
 
Selvaraj S, Arnone D, Job D, et al: Grey matter differences in bipolar disorder: a meta-analysis of voxel-based morphometry studies. Bipolar Disord 14:135–145, 2012
[PubMed]
 
Sheline Y, Kehr C: Cost and utility of routine admission laboratory testing for psychiatric inpatients. Gen Hosp Psychiatry 12:329–334, 1990
[PubMed]
 
Shenton ME, Dickey CC, Frumin M, et al: A review of MRI findings in schizophrenia. Schizophr Res 49:1–52, 2001
[PubMed]
 
Shepherd AM, Laurens KR, Matheson SL, et al: Systematic meta-review and quality assessment of the structural brain alterations in schizophrenia. Neurosci Biobehav Rev 36:1342–1356, 2012
[PubMed]
 
Soares JC, Boada F, Spencer S, et al: NAA and choline measures in the anterior cingulate of bipolar disorder patients (abstract). Biol Psychiatry 45(suppl):119S, 1999
[PubMed]
 
Strasser HC, Lilyestrom J, Ashby ER, et al: Hippocampal and ventricular volumes in psychotic and nonpsychotic bipolar patients compared with schizophrenia patients and community control subjects: a pilot study. Biol Psychiatry 57:633–639, 2005
[PubMed]
 
Streetman DS: Metabolic basis of drug interactions in the intensive care unit. Crit Care Nurs Q 22:1–13, 2000
[PubMed]
 
Swedo SE, Schapiro MB, Grady CL, et al: Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder. Arch Gen Psychiatry 46:518–523, 1989
[PubMed]
 
Swedo SE, Pietrini P, Leonard HL, et al: Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder: revisualization during pharmacotherapy. Arch Gen Psychiatry 49:690–694, 1992
[PubMed]
 
Taber KH, Pierpaoli C, Rose SE, et al: The future for diffusion tensor imaging in neuropsychiatry. J Neuropsychiatry Clin Neurosci 14:1–5, 2002
[PubMed]
 
Tamminga CA, Thaker GK, Buchanan R, et al: Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluoro-deoxy-glu-cose and neocortical alterations with deficit syndrome. Arch Gen Psychiatry 49:522–530, 1992
[PubMed]
 
Tomasi D, Volkow ND: Functional connectivity density mapping. Proc Natl Acad Sci U S A 107:9885–9890, 2010
[PubMed]
 
Videbech P: MRI findings in patients with affective disorder: a meta-analysis. Acta Psychiatr Scand 96:157–168, 1997
[PubMed]
 
Volkow ND, Wang GJ, Fowler JS, et al: Imaging endogenous dopamine competition with [11C]raclopride in the human brain. Synapse 16:255–262, 1994
[PubMed]
 
Volkow ND, Rosen B, Farde L: Imaging the living human brain: magnetic resonance imaging and positron emission tomography. Proc Natl Acad Sci U S A 94:2787–2788, 1997a
[PubMed]
 
Volkow ND, Wang GJ, Fischman MW, et al: Relationship between subjective effects of cocaine and dopamine transporter occupancy. Nature 386:827–830, 1997b
[PubMed]
 
Vyas NS, Patel NH, Herscovitch P, et al: Recent developments in neurochemical imaging in schizophrenia: an update. Curr Med Chem 20(3):351–356, 2013
[PubMed]
 
Wallach J: Interpretation of Diagnostic Tests. Boston, MA, Little, Brown, 1992
 
Wallach J: Interpretation of Diagnostic Tests, 7th Edition. Philadelphia, PA, Lippincott Williams & Wilkins, 2000
 
Whalley HC, Papmeyer M, Sprooten E, et al: Review if functional magnetic resonance imaging studies comparing bipolar disorder and schizophrenia. Bipolar Disord 14:411–431, 2012
[PubMed]
 
Yurgelun-Todd DA, Renshaw PF, Gruber SA, et al: Proton magnetic resonance spectroscopy of the temporal lobes in schizophrenics and normal controls. Schizophr Res 19:55–59, 1996
[PubMed]
 
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