Functional neuroimaging of treatment effects in psychiatry: methodological challenges and recommendations (original) (raw)
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Advances in functional neuroimaging of psychopathology
2011
Kanaan and McGuire (2011) review a number of methodological and analytical obstacles associated with the use of functional magnetic resonance imaging (fMRI) to study psychiatric disorders. Although we agree that there are challenges and limitations to this end, it would be a shame for those without a background in neuroimaging to walk away from this article with the impression that such work is too daunting, and thus not worth pursuing.
Insights and treatment options for psychiatric disorders guided by functional MRI
Journal of Clinical Investigation, 2003
The author has declared that no conflict of interest exists. Nonstandard abbreviations used: functional MRI (fMRI); prefrontal cortex (PFC); dorsolateral prefrontal cortex (DLPFC); mental state attribution (MSA); blood oxygen level-dependent (BOLD); positron emission tomography (PET); prepulse inhibition (PPI); obsessive-compulsive disorder (OCD); procedural learning (PL).
Reproducibility of fMRI in the clinical setting: Implications for trial designs
Neuroimage, 2008
With expanding potential clinical applications of functional magnetic resonance imaging (fMRI) it is important to test how reliable different measures of fMRI activation are between subjects and sessions and between centres. This study compared variability across 17 patients with multiple sclerosis (MS) and 22 agematched healthy controls (HC) in 5 European centres performing an fMRI block design with hand tapping. We recruited subjects from sites using 1.5 T scanners from different manufacturers. 5 healthy volunteers also were studied at each of 4 of the centres. We found that reproducibility between runs and sessions for single individuals was consistently much greater than between individuals. There was greater run-to-run variability for MS patients than for HC. Measurements of maximum signal change (MSC) appeared to provide higher reproducibility within individuals and greater sensitivity to differences between individuals than region of interest (ROI) suprathreshold voxel counts. The variability in measurements between centres was not as great as that between individuals. Consistent with these observations, we estimated that power should not be reduced substantially with use of multi-, as opposed to single-, centre study designs with similar numbers of subjects. Multi-centre interventional studies in which fMRI is used as an outcome measure thus appear practical even when implemented in conventional clinical environments.
Frontiers in Neuroimaging
Functional magnetic resonance imaging (fMRI) is a non-invasive technique that can be used to examine neural responses with and without the use of a functional task. Indeed, fMRI has been used in clinical trials and pharmacological research studies. In mental health, it has been used to identify brain areas linked to specific symptoms but also has the potential to help identify possible treatment targets. Despite fMRI's many advantages, such findings are rarely the primary outcome measure in clinical trials or research studies. This article reviews fMRI studies in depression that sought to assess the efficacy and mechanism of action of compounds with antidepressant effects. Our search results focused on selective serotonin reuptake inhibitors (SSRIs), the most commonly prescribed treatments for depression and ketamine, a fast-acting antidepressant treatment. Normalization of amygdala hyperactivity in response to negative emotional stimuli was found to underlie successful treatmen...
Functional Magnetic Resonance Imaging (fMRI)
Elsevier eBooks, 2014
The sophisticated methods of neuroscience-including molecular genetics, structural and functional neuroimaging, animal models, and experimental tasks that approximate real-world behaviors in human research-have yielded important insights about typical functioning and neurobehavioral disorders. Translational neuroscience endeavors to use this knowledge to improve the human condition by developing and improving interventions for these disorders. This paper reviews the literature on the contribution of functional magnetic resonance imaging (fMRI) and two related techniques, resting-state fMRI (rs-fMRI) and real-time fMRI (rt-fMRI), to the diagnosis and treatment of behavioral problems and psychiatric disorders. It also explains how incorporating neuroscience principles and techniques into research on the prevention of substance misuse and antisocial behavior may spur advances and innovations in this important area. This article argues that fMRI's potential contribution to these prevention efforts has yet to be fully realized, explores new ways in which the technique could be adapted to that end, highlights some of the work by researchers in the vanguard of this effort, and notes limitations of fMRI and ethical concerns the technique raises. Contents Neuroimaging: A Major Driver of Neuroscience Research introduction a Brain With a View: Functional neuroimaging Neuroimaging: A New Driver of Translational Neuroscience fMRi as a tool in the Diagnosis and treatment of neurobehavioral problems importance of integrating fMRi With other approaches Translational Neuroscience and Prevention: Substance Misuse and Antisocial Behavior the complex etiology of substance Misuse and antisocial Behavior neurobehavioral characteristics associated With later substance Misuse and antisocial Behavior fMRi Research on substance Misuse and antisocial Behavior, and implications for prevention Integrating fMRI into Prevention Research Rti international's transdisciplinary science and translational prevention program fMRi limitations and neuroethics Future Applications and Conclusions References Acknowledgments inside back cover
Poor test-retest reliability of task-fMRI: New empirical evidence and a meta-analysis
2019
Identifying brain biomarkers of disease risk and treatment response is a growing priority in neuroscience. The ability to identify meaningful biomarkers is fundamentally limited by measurement reliability; measures that do not yield reliable values are unsuitable as biomarkers to predict clinical outcomes. Measuring brain activity using task-fMRI is a major focus of biomarker development; however, the reliability of task-fMRI has not been systematically evaluated. We present converging evidence demonstrating poor reliability of task-fMRI measures. First, a meta-analysis of 90 experiments with 1,088 participants reporting 1,146 ICCs for task-fMRI revealed poor overall reliability (mean ICC=.397). Second, the test-retest reliabilities of activity in a priori regions of interest across 11 commonly used fMRI tasks collected in the Human Connectome Proj ect and the Dunedin Longitudinal Study were poor (ICCs=.067-.485). Collectively, these findings demonstrate that commonly used task-fMRI measures are not currently suitable for brain biomarker discovery or individual differences research in cognitive neuroscience (i.e., brain-behavior mapping). We review how this state of affairs came to be and consider several avenues for improving the reliability of task-fMRI. 2 .
PLOS ONE, 2015
Longitudinal investigation of the neural correlates of reward processing in depression may represent an important step in defining effective biomarkers for antidepressant treatment outcome prediction, but the reliability of reward-related activation is not well understood. Thirty-seven healthy control participants were scanned using fMRI while performing a reward-related guessing task on two occasions, approximately one week apart. Two main contrasts were examined: right ventral striatum (VS) activation fMRI BOLD signal related to signed prediction errors (PE) and reward expectancy (RE). We also examined bilateral visual cortex activation coupled to outcome anticipation. Significant VS PE-related activity was observed at the first testing session, but at the second testing session, VS PE-related activation was significantly reduced. Conversely, significant VS RE-related activity was observed at time 2 but not time 1. Increases in VS RE-related activity from time 1 to time 2 were significantly associated with decreases in VS PE-related activity from time 1 to time 2 across participants. Intraclass correlations (ICCs) in VS were very low. By contrast, visual cortex activation had much larger ICCs, particularly in individuals with high quality data. Dynamic changes in brain activation are widely predicted, and failure to account for these changes could lead to inaccurate evaluations of the reliability of functional MRI signals. Conventional measures of reliability cannot distinguish between changes specified by algorithmic models of neural function and noisy signal. Here, we provide evidence for the former
Current Challenges in Translational and Clinical fMRI and Future Directions
Frontiers in Psychiatry, 2020
Translational neuroscience is an important field that brings together clinical praxis with neuroscience methods. In this review article, the focus will be on functional neuroimaging (fMRI) and its applicability in clinical fMRI studies. In the light of the "replication crisis," three aspects will be critically discussed: First, the fMRI signal itself, second, current fMRI praxis, and, third, the next generation of analysis strategies. Current attempts such as restingstate fMRI, meta-analyses, and machine learning will be discussed with their advantages and potential pitfalls and disadvantages. One major concern is that the fMRI signal shows substantial within-and between-subject variability, which affects the reliability of both taskrelated, but in particularly resting-state fMRI studies. Furthermore, the lack of standardized acquisition and analysis methods hinders the further development of clinical relevant approaches. However, meta-analyses and machine-learning approaches may help to overcome current shortcomings in the methods by identifying new, and yet hidden relationships, and may help to build new models on disorder mechanisms. Furthermore, better control of parameters that may have an influence on the fMRI signal and that can easily be controlled for, like blood pressure, heart rate, diet, time of day, might improve reliability substantially.