DEPARTMENTS: Reviews of Rehabilitation Technology Web Sites
The Whole Brain Atlas is an online resource for central nervous system imaging developed by Keith Johnson, MD, and Alex Becker, PhD. It is jointly supported by the Brigham and Women's Hospital Departments of Radiology and Neurology, Harvard Medical School, the Countway Library of Medicine, and the American Academy of Neurology. The site has six main sections: (1) a neuroimaging primer for those with limited knowledge of the imaging vocabulary; (2) a normal anatomy atlas; (3) cerebrovascular disease; (4) neoplastic disease; (5) degenerative disease; and (6) inflammatory disease.
The Normal Anatomy atlas contains a navigable brain volume presented in all three planes. T1- and T2-weighted magnetic resonance imaging for visualizing structure is available, and positron emission tomographic images can be overlaid to enrich the image. Brain structure labels can be toggled for studying or quizzing. A similar feature is available for major cerebrovascular structures, although some links were broken at the time of this review. Brain volumes of normal aging and movies of cerebrovascular structure are also available. The normal anatomy atlas has excellent potential for application to the classroom, especially neuroscience, pathology, or motor control courses.
The remaining four sections present common disease-related brain change. For the most part, axial sections can be navigated across the whole brain, rather than presenting only one slice as traditionally seen in textbooks. Again, multiple imaging modalities are available for comparison between structure and metabolic activity, for example, and over time. The interpretive value of the different modalities could be expanded somewhat in the explanations.
Clinical cases of particular interest to rehabilitation professionals may be multiple sclerosis and stroke, with magnetic resonance images captured at 4 hours and 4 days after the event. Numerous other cases are presented, including meningioma, Alzheimer disease, acquired immunodeficiency syndrome dementia, and encephalopathy. All clinical cases are presented with a brief history and explanation. In some cases, “guided tours” are provided to highlight clinically relevant findings. In other cases, these notes are not extensive and at times seem tailored for radiological trainees. Instructors may find it helpful to guide students through these clinical cases, rather than asking them to navigate these modules independently.
The interface is intuitive and worked across browser platforms when it was last accessed (February 23, 2012). A particular strength of the site is that the multiple modalities are captured on the same individual. Continuity across imaging modalities makes for a more rich and intuitive exploration of the brain. Although the site may be of some help to clinicians or researchers as a reference, it seems most well suited for didactic use. Overall, the Whole Brain Atlas provides a valuable and easy-to-use online learning resource for rehabilitation instructors, students, and professionals.
Eric D. Vidoni, PT, PhD
University of Kansas Alzheimer's Disease Center, Kansas