Functional Neuroimaging in Psychiatry—Aiding in Diagnosis and Guiding Treatment. What the American Psychiatric Association Does Not Know

Henderson, Theodore A.; Lierop, Muriel J. van; McLean, Mary Kay; Uszler, J.M.; Thornton, John F.; Siow, Yin-Hui; Pavel, Dan G.; Cardaci, Joe; Cohen, Philip

doi:10.3389/fpsyt.2020.00276

Cited by 37 publications

(35 citation statements)

References 131 publications

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“…The primary diagnostic tools in contemporary psychiatry are the International Classification of Diseases[ 9 ] and the Diagnostic and Statistical Manual of Mental Disorders[ 10 ], yet their foundational criterial categorization lacks biological validity[ 11 , 12 ]. This phenomenon is illustrated by existing barriers, such as heterogeneity, comorbidity, and ambiguous distinctions between healthy and abnormal behavior, which impede the diagnostic process.…”

Section: Psychiatric Diagnostics In the 21 St Centurymentioning

confidence: 99%

Implications from translational cross-validation of clinical assessment tools for diagnosis and treatment in psychiatry

Aryutova

Paunova

Kandilarova

et al. 2021

WJP

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Traditional therapeutic methods in psychiatry, such as psychopharmacology and psychotherapy help many people suffering from mental disorders, but in the long-term prove to be effective in a relatively small proportion of those affected. Therapeutically, resistant forms of mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder lead to persistent distress and dysfunction in personal, social, and professional aspects. In an effort to address these problems, the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising results. For instance, neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity, integration, and segregation of neural networks, focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy (ECT), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS). These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective disorders. The current review is focused on the translational approach in the management of schizophrenia and mood disorders, as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT, TMS, tDCS and DBS.

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Section: Psychiatric Diagnostics In the 21 St Centurymentioning

confidence: 99%

Implications from translational cross-validation of clinical assessment tools for diagnosis and treatment in psychiatry

Aryutova

Paunova

Kandilarova

et al. 2021

WJP

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show abstract

“…With regard to neurofeedback, scholars have raised concerns about bias, given that those who publish research-as well as those actively involved in neurofeedback societies-often have financial interests, either via private practice or connections to vendors of neurofeedback equipment (Thibault, Lifshitz, and Raz 2017b;Thibault and Raz 2017). With regard to SPECT, many of the publications supporting its utility for psychiatric evaluation have been conducted by those who have a financial stake in the research outcome (see, e.g., Amen, Hanks, and Prunella 2008;Amen et al 2011;Amen and Carmichael 1997;Henderson et al 2020;Raji et al 2014). Although concerns regarding potential conflict of interest are not uncommon in biomedical sciences more broadly (Dunn et al 2016;Johnston 2008), the commercial interests and lack of independent research in these two domains are particularly notable.…”

Section: Conflicts Of Interestmentioning

confidence: 99%

Ethical and Legal Considerations of Alternative Neurotherapies

2021

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Neurotherapies for diagnostics and treatment-such as electroencephalography (EEG) neurofeedback, single-photon emission computerized tomography (SPECT) imaging for neuropsychiatric evaluation, and off-label/experimental uses of brain stimulation-are continuously being offered to the public outside mainstream healthcare settings. Because these neurotherapies share many key features of complementary and alternative medicine (CAM) techniques-and meet the definition of CAM as set out in Kaptchuk and Eisenberg-here we refer to them as "alternative neurotherapies." By explicitly linking these alternative neurotherapy practices under a common conceptual framework, this paper draws attention to, and critically considers, the cross-cutting ethical and legal issues related to the provision of these services. The first section of this paper provides an updated empirical overview of uses of SPECT neuropsychiatric evaluations, EEG neurofeedback, and experimental/off-label forms of brain stimulation. Next, drawing on CAM bioethics scholarship, we highlight the pertinent ethical issues in the alternative neurotherapy context, including the truthful representation of evidence base, marketing to vulnerable populations, potential harms, provider competency, and conflicts of interest. Finally, we consider the principal legal issues at stake for the provision of alternative neurotherapies in the U.S., namely those related to licensing and scope-of-practice considerations. We conclude with recommendations for future research in this domain.

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“…Etkin's point of a disconnect between neuroimaging and "real-world clinical care" is well taken ( 1), yet the ISAN and other groups are actively using neuroimaging to guide clinical treatment. The person with ADHD with normal frontal lobe function, but with decreased temporal lobe function, is treated differently than the person with ADHD and decreased frontal lobe function (9,10). The ISAN is also striving toward a unified data processing algorithm that will be openly available to all clinicians and that will foster a common language for evaluating scan results (9).…”

Section: A Reckoning To Keep Doing What We Are Already Doing With Pet and Spect Functional Neuroimagingmentioning

confidence: 99%

“…The ISAN encourages APA to explore the use of brain SPECT and FDG-PET functional neuroimaging in psychiatry with those who are experienced and knowledgeable about their practical applications (9,10).…”

Section: A Reckoning To Keep Doing What We Are Already Doing With Pet and Spect Functional Neuroimagingmentioning

confidence: 99%

A Reckoning to Keep Doing What We Are Already Doing With PET and SPECT Functional Neuroimaging

Henderson¹,

Cohen²,

Lierop³

et al. 2020

AJP

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Functional Neuroimaging in Psychiatry—Aiding in Diagnosis and Guiding Treatment. What the American Psychiatric Association Does Not Know

Cited by 37 publications

References 131 publications

Implications from translational cross-validation of clinical assessment tools for diagnosis and treatment in psychiatry

Implications from translational cross-validation of clinical assessment tools for diagnosis and treatment in psychiatry

Ethical and Legal Considerations of Alternative Neurotherapies

A Reckoning to Keep Doing What We Are Already Doing With PET and SPECT Functional Neuroimaging

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