It's all about image?

In this issue of Acta Neuropsychiatrica we have several articles that have used brain imaging to examine neuropsychiatric disorders. In addition, playing with a similar theme, we have an entertaining Pictures and Prose piece by Dinesh Bhugra that examines images in a particular form of entertainment, namely Hindi cinema. The impact of images in terms of the emotions they invoke and the commercial value attached to them is not to be underestimated, as is evident from the remarkable revenues associated with advertising in television, print and film. Indeed, even in scientific publishing, the inclusion of pictures attracts a significant premium in most journals. This is not surprising, after all seeing is believing’, although many would argue that in some instances in order to see one has to first believe’. In research, generally, the first step is usually the development of a testable hypothesis. Inherent in this process is some degree of investigator bias that the design of the experiment attempts to nullify or at least diminish. This is a critical issue in modern neuroimaging research where pictures’ of the brain, especially its various structures or functional networks, are actually generated’ through extensive mathematical modelling and computational processing (1,2). By altering key parameters or changing the statistical threshold applied to data, the images created for presentation can be modified considerably. The majority of these manipulations’ constitute mandatory steps in processing data that are needed to decipher signal from noise. However, the complexities of modern day analysis and image presentation often make clinical interpretation difficult especially for those unfamiliar with the nuances of neuroimaging techniques. Clearly, neuroimaging researchers need to be mindful of these limitations and try to ensure that not only their message but also their method is better understood. Images, per se are important as they can convey simple and strong messages both quickly and effectively (3). Therefore, in order to meet researchers half way, perhaps clinicians too should be encouraged to become increasingly conversant with the means by which neuroimaging pictures are created, so as to better appraise the many novel insights that modern day neuroimaging affords (4).