Functional magnetic resonance imaging in schizophrenia: current evidence, methodological advances, limitations and future directions.

Schizophrenia biomarkers clinical utility cognition functional magnetic resonance imaging functional outcomes negative symptoms precision medicine therapeutic mechanisms treatment response

Journal

World psychiatry : official journal of the World Psychiatric Association (WPA)
ISSN: 1723-8617
Titre abrégé: World Psychiatry
Pays: Italy
ID NLM: 101189643

Informations de publication

Date de publication:
Feb 2024
Historique:
medline: 12 1 2024
pubmed: 12 1 2024
entrez: 12 1 2024
Statut: ppublish

Résumé

Functional neuroimaging emerged with great promise and has provided fundamental insights into the neurobiology of schizophrenia. However, it has faced challenges and criticisms, most notably a lack of clinical translation. This paper provides a comprehensive review and critical summary of the literature on functional neuroimaging, in particular functional magnetic resonance imaging (fMRI), in schizophrenia. We begin by reviewing research on fMRI biomarkers in schizophrenia and the clinical high risk phase through a historical lens, moving from case-control regional brain activation to global connectivity and advanced analytical approaches, and more recent machine learning algorithms to identify predictive neuroimaging features. Findings from fMRI studies of negative symptoms as well as of neurocognitive and social cognitive deficits are then reviewed. Functional neural markers of these symptoms and deficits may represent promising treatment targets in schizophrenia. Next, we summarize fMRI research related to antipsychotic medication, psychotherapy and psychosocial interventions, and neurostimulation, including treatment response and resistance, therapeutic mechanisms, and treatment targeting. We also review the utility of fMRI and data-driven approaches to dissect the heterogeneity of schizophrenia, moving beyond case-control comparisons, as well as methodological considerations and advances, including consortia and precision fMRI. Lastly, limitations and future directions of research in the field are discussed. Our comprehensive review suggests that, in order for fMRI to be clinically useful in the care of patients with schizophrenia, research should address potentially actionable clinical decisions that are routine in schizophrenia treatment, such as which antipsychotic should be prescribed or whether a given patient is likely to have persistent functional impairment. The potential clinical utility of fMRI is influenced by and must be weighed against cost and accessibility factors. Future evaluations of the utility of fMRI in prognostic and treatment response studies may consider including a health economics analysis.

Identifiants

DOI: 10.1002/wps.21159 PMID: 38214624
pubmed: 38214624
doi: 10.1002/wps.21159
doi:

Types de publication

Journal Article

Langues

eng

Pagination

26-51

Informations de copyright

© 2024 World Psychiatric Association.

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Auteurs

Aristotle N Voineskos (AN)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Colin Hawco (C)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Nicholas H Neufeld (NH)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Jessica A Turner (JA)

Department of Psychiatry and Behavioral Health, Wexner Medical Center, Ohio State University, Columbus, OH, USA.

Stephanie H Ameis (SH)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Cundill Centre for Child and Youth Depression and McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Alan Anticevic (A)

Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA.
Department of Psychiatry, Yale University, New Haven, CT, USA.

Robert W Buchanan (RW)

Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.

Kristin Cadenhead (K)

Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.

Paola Dazzan (P)

Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Erin W Dickie (EW)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Julia Gallucci (J)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Institute of Medical Science, University of Toronto, Toronto, ON, Canada.

Adrienne C Lahti (AC)

Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.

Anil K Malhotra (AK)

Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA.

Dost Öngür (D)

McLean Hospital/Harvard Medical School, Belmont, MA, USA.

Todd Lencz (T)

Institute for Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
Department of Psychiatry, Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA.

Deepak K Sarpal (DK)

Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Lindsay D Oliver (LD)

Campbell Family Mental Health Research Institute and Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.

Classifications MeSH