Functional neuroimaging in psychiatry and the case for failing better

Nour, Matthew M.; Liu, Yunzhe; Dolan, Raymond J.

doi:10.1016/j.neuron.2022.07.005

Cited by 55 publications

(59 citation statements)

References 307 publications

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“…Psychiatrists may wait for this type of precision psychiatry. Nothing has really come up in the past decades, as exemplified by the fields of psychiatric genetics [55] and functional neuroimaging [56], but we may be really close. In the meanwhile, diagnostic criteria may be integrated with clinimetrics to capture the personal attributes and the environment of each individual, as well as the evolutions of disturbances over time, yielding a different model of personalized psychiatry.…”

Section: Discussionmentioning

confidence: 99%

Clinimetric Integration of Diagnostic Criteria for a Personalized Psychiatry

Fava¹

2022

Psychother Psychosom

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Section: Discussionmentioning

confidence: 99%

Clinimetric Integration of Diagnostic Criteria for a Personalized Psychiatry

Fava¹

2022

Psychother Psychosom

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“…Associations between biology and psychopathology are often small 8,9 , fail to replicate 10,11 , and lack specificity 12 , with commonalities frequently observed across putatively distinct disorders [13][14][15][16][17][18][19][20] . Thus, despite decades of research, thousands of studies, and hundreds of millions of expended dollars, the promise of modern neuroimaging and genetic methodologies to uncover clinically actionable insights into the biology of mental illness has been largely unrealized 21 .…”

Section: Introductionmentioning

confidence: 99%

Precision behavioral phenotyping as a strategy for uncovering the biological correlates of psychopathology

Tiego¹,

Martin²,

DeYoung³

et al. 2022

Preprint

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Our capacity to measure diverse aspects of human biology in vivo has developed rapidly in the past decades, but the rate at which these techniques have generated translatable insights into the biology of psychopathological conditions has lagged far behind. This slow progress is partly due to the poor sensitivity, specificity, and replicability of many findings in the literature, which have in turn been attributed to small effect sizes, small sample sizes, and low statistical power. A commonly proposed solution is to rely on large, consortia-sized samples to facilitate discovery of replicable findings. Here, we argue that increasing sample sizes will have limited impact unless a more fundamental issue is addressed: the precision with which target behavioral phenotypes are measured. We discuss key problems and outline several ways forward, largely centered on the use of appropriate statistical models with deep, transdiagnostic assessment of hierarchically organized and homogeneous psychopathology dimensions across the full range of the severity spectrum. We provide worked examples to demonstrate key problems and potential solutions. Arguably, a precision phenotyping approach can enhance the discovery and replicability of associations between biology and behavior, thereby facilitating insights into the pathophysiological mechanisms underlying psychiatric disorders.

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“…Apart from nuclear imaging, reduced N-acetyl aspartate (NAA) within the hippocampi has been reported in psychosis in epilepsy ( 12 ). On the other hand, the lack of functional MRI studies may be notable, given the abundant applications to psychiatric disorders ( 51 ). While FDG-PET and perfusion SPECT are widely used in clinical practice for epilepsy ( 52 ), the clinical use of functional MRI is still limited, which might be a cause of the discrepancy.…”

Section: Functional Neuroimaging Of Psychosis In Epilepsymentioning

confidence: 99%

Neurobiological mechanisms of psychosis in epilepsy: Findings from neuroimaging studies

Sone

2022

Front. Psychiatry

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Despite the high prevalence and clinical importance of comorbid psychosis in epilepsy, its neurobiological mechanisms remain understudied. This narrative mini-review aims to provide an overview of recent updates in in vivo neuroimaging studies on psychosis in epilepsy, including structural and diffusion magnetic resonance imaging (MRI) and functional and molecular imaging, and to discuss future directions in this field. While the conventional morphological analysis of structural MRI has provided relatively inconsistent results, advanced methods, including brain network analysis, hippocampal subregion volumetry, and machine learning models, have recently provided novel findings. Diffusion MRI, for example, has revealed a reduction in white matter integrity mainly in the frontal and temporal lobes, as well as a disruption of brain white matter networks. Functional neuroimaging, such as perfusion single-photon emission computed tomography (SPECT) or fluorodeoxyglucose positron emission tomography (FDG-PET), often identifies hyperactivity in various brain regions. The current limitations of these more recent studies may include small and sometimes heterogeneous samples, insufficient control groups, the effects of psychoactive drugs, and the lack of longitudinal analysis. Further investigations are required to establish novel treatments and identify clinical diagnostic or disease-monitoring biomarkers in psychosis in epilepsy.

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Functional neuroimaging in psychiatry and the case for failing better

Cited by 55 publications

References 307 publications

Clinimetric Integration of Diagnostic Criteria for a Personalized Psychiatry

Clinimetric Integration of Diagnostic Criteria for a Personalized Psychiatry

Precision behavioral phenotyping as a strategy for uncovering the biological correlates of psychopathology

Neurobiological mechanisms of psychosis in epilepsy: Findings from neuroimaging studies

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