Functional Brain Imaging in Neuropsychology Over the Past 25 Years

Objective: Outline effects of functional neuroimaging on neuropsychology over the past 25 years. Method: Functional neuroimaging methods and studies will be described that provide a historical context, offer examples of the utility of neuroimaging in specific domains, and discuss the limitations and future directions of neuroimaging in neuropsychology. Results: Tracking the history of publications on functional neuroimaging related to neuropsychology indicates early involvement of neuropsychologists in the development of these methodologies. Initial progress in neuropsychological application of functional neuroimaging has been hampered by costs and the exposure to ionizing radiation. With rapid evolution of functional methods-in particular functional MRI (fMRI)-neuroimaging has profoundly transformed our knowledge of the brain. Its current applications span the spectrum of normative development to clinical applications. The field is moving toward applying sophisticated statistical approaches that will help elucidate distinct neural activation networks associated with specific behavioral domains. The impact of functional neuroimaging on clinical neuropsychology is more circumscribed, but the prospects remain enticing. Conclusions: The theoretical insights and empirical findings of functional neuroimaging have been led by many neuropsychologists and have transformed the field of behavioral neuroscience. Thus far they have had limited effects on the clinical practices of neuropsychologists. Perhaps it is time to add training in functional neuroimaging to the clinical neuropsychologist's toolkit and from there to the clinic or bedside. General Scientific Summary Functional neuroimaging (fMRI) has transformed the field of behavioral neuroscience, with resounding clinical implications. Yet, to date fMRI has had minimal effects on the clinical practices of neuropsychologists. Future endeavors should focus on bringing the products of fMRI research to the clinical neuropsychologist's toolkit and from there to the clinic or bedside.