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Commentary |

Neuroimaging of Pediatric Neuropsychiatric Disorders:  Is a Picture Really Worth a Thousand Words?

Jay N. Giedd, MD
Arch Gen Psychiatry. 2001;58(5):443-444. doi:10.1001/archpsyc.58.5.443.
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THE ARTICLE by Peterson et al1 illustrates many pediatric neuroimaging advances of the last decade and highlights many of the neuroimaging challenges yet to be faced. Strong features of the study include a large sample size; careful attention to subject and control characterization, scan acquisition, and image analysis; and recognition of the importance of age and gender effects on brain morphometry.

A central tenet of structural imaging studies is that size matters. Critics of the principle contend that the unimportance of size within a broad range of extremes is demonstrated by healthy children with similar IQs having as much as a 50% difference in brain volume,2 robust differences in brain sizes between males and females with similar functional capacity, and the paucity of established correlations between the size of any given brain structure and cognitive abilities. However, from a computational science perspective it seems likely that the number of neuronal connections in a structure reflects its information processing capacity,3 and from an evolutionary perspective, interspecies differences in cerebral morphometry are predictive of behavioral complexity. There is modest positive correlation between IQ and total cerebral volume4 and a possible relationship between hippocampal size and memory recall.5 To conclude straightforward relationships between the volume of a single structure and performance on a particular cognitive task, however, is incautious, considering the intricacy of various neurochemical systems and the diversity of afferent and efferent connections to the many distinct nuclei of most brain structures. This supports the concept of distributed neural systems, whereby functional attributes are not thought to lie so much within a single structure as within a network of structures.

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