Imaging Techniques in Neurotoxicology Research and Development

The impact of neuroimaging techniques in the work up of intoxicated patients is nowadays increasing regarding both macroscopic anatomical damage (CT and MR) and ultrastructural damage (DWI), but also regarding metabolic (MR spectroscopy) and functional impairment (fMRI). Perfusional status of diseased areas may also be investigated by magnetic resonance imaging (MRI) using exogenous or even endogenous tracers, and the density of membrane receptors can be investigated using isotopic techniques (positron emission tomography (PET), single photon emission computed tomography (SPECT)). There is growing evidence for elective sensitivity of defined brain areas like basal ganglia towards toxic exposure and for relative specificity of topographical brain damage for some substances, but with significant overlapping between toxins. Uncertain relationships between severity of brain abnormalities on CT or MR images at an acute phase and functional clinical outcome renders mandatory the investigation of better early prognostic parameters which could mainly involve DWI and 1H-MRS data in clinical routine, and fMRI data, perfusion parameters, and receptors density in the investigational field. Keywords: neurotoxicity; morphological imaging; functional imaging; carbon monoxide; cyanide; alcohols; illicit drugs; nicotine; metals; solvents