We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
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.
Text Size: A A A
Published online


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.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

3 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Make the Diagnosis: Does This Patient With Headaches Have a Migraine or Need Neuroimaging?

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Original Article: Does This Patient With Headache Have a Migraine or Need Neuroimaging?