Anyone who stays up to date on the latest medical research knows that functional MR exams, or fMRI, has been utilized in some of the most fascinating academic studies — many of which we have reported on in HCB News.

But as cool as it is to use medical imaging to predict the outcomes of anti-smoking campaigns, for example, the scans can also serve a much more direct medical purpose — such as illustrating how methylene blue can improve short-term memory.

Riverwoods Imaging Center in Provo, Utah, has started to offer these exams and HCB News spoke to the facility's Dr. Wendell Gibby to find out what it means for their patients.



HCB News: Why did Riverwoods Imaging Center decide to delve into functional MRI?

Dr. Wendell Gibby: We started about fourteen years ago looking at functional MRI as a potential tool to look for a more sensitive yard stick to evaluate brain function.

Initially our experience with fMRI was using it for preoperative evaluation identifying motor cortex or other coronaries of the brain, and we realized that there would be an opportunity to perhaps quantitatively evaluate different areas of brain function. So, we worked in conjunction with the neuroscience department at Brigham Young University and adapted a number of different standard neuropsychological tests to use in the MRI environment.

We took tests such as executive functioning or problem solving. There were even progressive matrix or trail-making tests. We looked at various memory testing: short-term and long-term memory; or generation object analysis, visual processing, etc. to look at different areas of brain function. And the primary impedance for this is that there are many neurologic conditions where the brain structurally looks normal but functionally it is very abnormal.

There are some examples, the most recent of which would be concussions. A big problem in the NFL and the recent movie about that. Just at the collegiate level there are 300,000 of these a year. There are lots of issues about return to play, whether someone… how soon you go back to athletic activity, etc. And we just don’t have good answers for those. And we felt that by looking at the brain functionally we could get additional objective information about whether the brain was functioning normally or not.

The problem with many of these conditions, concussions are a good example, is a patient will have significant symptoms. They will have memory loss, they will have nausea, they will have headaches, they will have fatigue, and other even non-descript symptoms. But their imaging is almost invariably normal with conventional techniques.

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