Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities

Busatto Filho, Geraldo; Rosa, Pedro G.; Serpa, Mauricio H.; Squarzoni, Paula; Duran, Fabio L.

doi:10.1590/1516-4446-2019-0757

person Geraldo Busatto Filho

schoolLaboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

0000-0003-4749-4602

person Pedro G. Rosa

schoolLaboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

person Mauricio H. Serpa

schoolLaboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

person Paula Squarzoni

schoolLaboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

person Fabio L. Duran

schoolLaboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

Correspondence: Geraldo Busatto Filho, Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, CEP 05403-903, São Paulo, SP, Brazil.E-mail:
geraldo.busatto@hc.fm.usp.br

How to cite this article: Busatto Filho G, Rosa PG, Serpa MH, Squarzoni P, Duran FL. Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities. Braz J Psychiatry. 2020;00:000-000. http://dx.doi.org/10.1590/1516-4446-2019-0757

Figures (4)
Tables (2)

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Figure 1 Geographic distribution of research groups conducting psychiatric neuroimaging studies in public and private institutions in several Brazilian states. The fields of interest of each group are listed in .

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Figure 2 A) Total number of PubMed neuroimaging papers related to psychiatry published from the year 2000 onwards with participation of researchers based in all centers in Brazil (dotted line) and specifically Laboratory of Psychiatric Neuroimaging (LIM 21) at HCFMUSP (solid line), which contributed to 29.5% of the overall articles published to date. Details for the types of publications are provided in . The methods used to select publications (up until September 2019) are outlined in the online-only supplementary material. Neuroimaging papers published when researchers were working as members of research groups based in other countries were excluded, as were nonneuroimaging papers. B) Yearly number of papers published in the fields of psychiatry or neuroscience in journals with the highest impact factors (IF) (greater than 6, as calculated by Clarivate Analytics) by Brazilian groups (dotted line) and specifically by LIM 21 at the HCFMUSP (solid line). Journals were as follows: American Journal of Psychiatry (n=10); Biological Psychiatry (n=7); British Journal of Psychiatry (n=3); Cerebral Cortex (n=4); JAMA Psychiatry (formerly known as Archives of General Psychiatry) (n=6); Journal of Neurology, Neurosurgery and Psychiatry (n=1); Journal of Neuroscience (n=2); Lancet Psychiatry (n=1); Molecular Psychiatry (n=4); Neuropsychopharmacology (n=10); Neuroscience and Biobehavioural Reviews (n=6); and Schizophrenia Bulletin (n=3).

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Figure 3 Positron emission tomography (PET) images acquired after intravenous injection of Pittsburgh compound B labeled with carbon-11 (¹¹C-PiB) to map the anomalous deposition of extracellular amyloid plaques formed by amyloid β-peptide (Aβ) in the cerebral cortex. Top panel: transaxial slices from a usual ¹¹C-PiB PET dataset obtained from a healthy elderly volunteer, with very low tracer uptake in the cortex relative to white matter uptake. Bottom panel: ¹¹C-PiB PET data from a patient suffering from dementia compatible with Alzheimer’s disease (AD), with increased tracer uptake in the frontal, temporal, parietal, and cingulate cortices. Both datasets underwent automated processing typically employed in quantitative neuroimaging research studies, including spatial normalization to a standardized anatomical template (using the Statistical Parametric Mapping program) and correction for partial volume effects based on information from volumetric magnetic resonance imaging (MRI) datasets obtained from the same individuals. The original, preprocessed PET images were obtained in collaboration with scientists from the Centro de Medicina Nuclear, Instituto de Radiologia, Hospital de Clínicas, Faculdade de Medicina, Universidade de São Paulo, under the leadership of Dr. Daniele de Paula Faria and Prof. Carlos A. Buchpiguel.

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Figure 4 A) Illustrative depiction of neurite density and orientation dispersion (arborization) of dendritic trees within the cerebral cortex. Brain cortical variations in such microstructural gray matter indices, which may be present in patients with psychiatric disorders, can now be assessed using neurite orientation dispersion and density imaging (NODDI).¹⁶⁷ NODDI requires multishell/high angular resolution diffusion imaging (HARDI) acquisitions using magnetic resonance imaging (MRI). Please note that the figure is only meant for illustration and does not represent the actual spatial resolution achieved by NODDI (adapted from Genç et al.,¹⁶⁹ licensed under Creative Commons Attribution 4.0 International License). B) 3D schematic representation of a multishell encoding scheme generated using a gradient tool available at the Multiple Acquisitions for Standardization of Structural Imaging Validation and Evaluation (MASSIVE) website (http://www.massive-data.org/). The gradients (colored dots) are magnetic field pulses that sensitize diffusion in a particular direction; by doing this, MRI scans can obtain information related to the dispersion of water molecules for each voxel. The colored dots show each randomly defined gradient direction. For each shell, there is an operator-selected parameter called the b-factor that defines gradient strength and duration. In this example, each gray circumference represents one of the shells: the inner one has a b-value of 1,000 s/mm² (gradients represented in pink); the outermost one has a b-value of 3,000 s/mm² (dark blue gradients); and, in between, a shell with a b-value of 2,000 s/mm² (green gradients). The grey dots represent the diametrically opposite end of each gradient, i.e., the line (not shown) linking a colored dot to a grey dot is the gradient axis. This representation exemplifies how MRI acquisition protocols can be designed to measure the dispersion and orientation of water molecules to generate quantitative indices of gray matter microstructure at the level of neurites with NODDI.¹⁶⁷

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Table 1 Distribution of psychiatric neuroimaging publications by Brazilian research groups using different modalities from the year 2000 onwards

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Table 2 Characteristics of psychiatric neuroimaging publications from Brazilian research groups from the year 2000 onwards

Field of interest	Morphometric MRI	DTI	White matter hyperintensity/other brain lesions	Task-related fMRI	Resting-state fMRI	18F-FDG PET	rCBF SPECT	MRS	Molecular imaging – PET*	Molecular imaging – SPECT†	Pattern classification
ADHD in youth	••	•		•	•		•	•		••
ADHD in adults and old age	•••	•		••	••••••						••••
Anxiety disorders	••••••			••	••			•••			•
Autism	•••				••						•••
Drug abuse and dependence	•••				•
Gender identity	•
Impulse control and gambling disorders	•
Mood disorders – youth		•			•••
Mood disorders – adults	••••••••	••	•	•	••		•	••••••		••	••••
Mood disorders – old age	••	•••	•••
Obsessive-compulsive disorder	•••••	••		•••	•••••		•	••			•••
Personality disorders	•••••										••••
Post-traumatic stress disorder	•••			•						•
Psychotic disorders	••••••••••••	••	•	•				••			•••
Psychiatric symptoms in neurological disorders	•••••••			••	•		•	•		•••
Pharmacological studies (cannabinoids, antidepressants, BDZ)				•••			•	••
Psychedelics	••			••	••		••	••
Brain development in youth	••••	••••		•	••••						••••
Brain aging and dementia	•••••••••	•••	•••	••	••	••	••	••	•		•••
Emotional processing and social behavior in healthy subjects	•••			•••••••••	•••
Yoga and meditation	••			••	••

Characteristic	n (%)
Total number of papers	478 (100.0%)
Review papers vs. original publications and meta-analyses	69/409 (14.4%/85.6%)
Publications in international vs. Brazilian periodicals	428/50 (89.5%/10.5%)
International co-authorship: yes/no	248/230 (51.9%/48.1%)
Leadership by Brazilian scientists* vs. international leaders	346/132 (72.4%/27.6%)

[TFN01t01] ¹⁸
F-FDG = ¹⁸F-fluorodeoxyglucose; ADHD = attention-deficit/hyperactivity disorder; BDZ = benzodiazepines; DTI = diffusion-tensor imaging; fMRI = functional magnetic resonance imaging; MRI = magnetic resonance imaging; MRS = magnetic resonance spectroscopy; PET = positron emission tomography; rCBF = regional cerebral blood flow; SPECT = single-photon emission computed tomography.

[TFN02t01] ^*
Studies using carbon-11 labeled Pittsburgh compound B (¹¹C-PiB) for the visualization of cortical amyloid plaques.

[TFN03t01] ^†
Studies using technetium-99m labeled TRODAT (^99mTc-TRODAT) for the visualization of striatal dopaminergic terminals.

[TFN04t01] • Laboratório de Neuroimagem em Psiquiatria (LIM 21), Instituto de Psiquiatria (IPq), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP). • Other research groups based at HCFMUSP, São Paulo (IPq and others). • Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP). • Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, USP (FMRP-USP). • Núcleo de Cognição e Sistemas Complexos (NCSC), Universidade Federal do ABC, São Paulo (UFABC).• Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS) / Instituto de Cérebro (InsCer), Pontifícia Universidade Católica, Rio Grande do Sul (PUCRS). • Instituto D’Or de Ensino e Pesquisa, Rio de Janeiro (IDOR).• Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ) / Universidade Federal Fluminense, Rio de Janeiro (UFF). • Instituto Nacional de Ciência e Tecnologia de Medicina Molecular (INCT-MM), Universidade Federal de Minas Gerais (UFMG). • Departamento de Neurociências e Saúde Mental, Universidade Federal da Bahia (UFBA). • Departamento de Clínica Médica, Universidade Federal do Ceará (UFCE). • Instituto do Cérebro, Universidade Federal do Rio Grande do Norte (UFRN). • Departamento de Neuropsiquiatria, Universidade Federal de Pernambuco (UFPE). • Instituto Brasileiro de Neurociência e Neurotecnologia, Universidade Estadual de Campinas (UNICAMP), São Paulo. • Hospital Israelita Albert Einstein, São Paulo.

Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities

Abstract