Brain and nervous system illnesses are exceptionally difficult to research and diagnose, partly because changes in the local environment of the brain are difficult to assess within the confines of the skull. Although diagnostic tests for diseases like cancer and diabetes are common and can use samples from blood, urine, or tissue, diagnostic tests for many brain-related illnesses are only beginning to emerge.

Neuroimaging is revolutionizing the diagnosis and treatment of brain-related illness. It is difficult to imagine treating patients with brain tumors, cerebrovascular disorders, or epilepsy without current imaging tools. Several decades of neuroimaging research have contributed enormously to our understanding of structural and functional differences in people with neurological and psychiatric disorders. For example, PET scans have been shown to be 93% accurate in detecting Alzheimer’s disease about 3 years before the conventional diagnosis of ‘‘probable Alzheimer’s”. Imaging now offers
insights into the mechanisms of action of drugs used to treat schizophrenia and the causal mechanisms that may be at the root of many disorders. Diagnosis of mental illness and differential treatment selection is one of the most difficult aspects of psychiatric treatment, yet this is where neuroimaging will add tremendous value in the years ahead.

On the neurofeedback front, Omneuron, a private company, in conjunction with Stanford University, is using real-time functional MRI (rtfMRI) to train patients in pain management techniques by monitoring the ongoing activity of their brains. Within a 13-minute session, patients can learn to control activity in different parts of their brain and alter their sensitivity to painful stimuli, allowing them to better control pain. Patients watched their brain’s level of activity as seen by rtfMRI and were trained to decrease pain intensity through mental exercises, such as focusing on a part of the body where they did not have pain. In years to come, rtfMRI has the potential to add an entirely new treatment option for a whole host of brain-related illnesses including depression, addiction, and dementia.