PET Imaging of Microglia Activation and Infection in Neuropsychiatric Disorders with Potential Infectious Origin

The central nervous system (CNS) is an immunoprivileged location for the possible sequestration of latent infections. The presence of pathogens may be involved in the etiology of neuropsychiatric diseases by inducing classical inflammatory responses, hypersensitivity, cellular toxicity, or direct alteration of cellular processes. Infection, persistence, and activation of microbes in the brain are not easy to assess in vivo, and the relation with clinical disease is very difficult to prove. An elegant way to determine an inflammatory response in the brain in vivo is by molecular imaging of microglia activation with [¹¹C]PK11195 and other radiopharmaceuticals that target the translocator protein (TSPO). In this chapter, we summarize the neuroimaging studies that target the TSPO in patients with neuropsychiatric diseases, and we propose positron emission tomography (PET) imaging with radiopharmaceuticals that target the metabolism of infectious agents directly.