brain imaging

by neuromedia corner – www.neuromedia.eu

In research and clinical practice brain imaging (BI) technologies are playing a role more and more important for understanding the relationships between specific areas of the brain and their function, helping to locate the areas of the brain that are affected by neurological disorders, to identify neurological lesions and tumors and building new strategies for diagnosis and treatment.

What is brain imaging?

We can indentify two big categories

1. structural imaging

investigates the structure of the brain and can be used for the diagnosis of large scale intracranial disease, such as tumor, and injury.

We can indentify two big categories

1. structural imaging

2. functional imaging

reveals the activity in certain brain regions by detecting changes in metabolism, blood flow, regional chemical composition, and absorption. It can be used to diagnose metabolic diseases and lesions on a finer scale, for neurological and cognitive psychology research and brain-computer interfaces.

Examples of brain imaging techiniques:

•Computed Tomography(CT)•Magnetic Resonance Imaging (MRI)•Functional Magnetic Resonance Imaging (fMRI)•Positron Emission Tomography (PET)•Single-Photon Emission Computed Tomography(SPECT) •Magnetoencephalography (MEG) 

Thousands of papers using neuroimaging methods are published every year. Those studies are vital to help us to understand how the brain works and open new doors towards brain disease diagnosis and treatment.

BUT

While some of those studies find a great echo in the media, the public and even scientists are still uncertain about the potential applications of those techniques. Ethical, social and legal issues related to those applications are emerging, together with questions about the real meaning of results obtained.

In this presentation we will ask the most important questions arising from the public and scientific debate on brain imaging to a group of experts, the same who participated to the first bid’s workshop, organized in Cambridge in March 2009 by bid - brains in dialogue project.

Focusing our attention on one of the most promising and discussed uses of brain imaging techniques, the one in psychiatric conditions, we will explore some uses of BI as well as the emerging ethical, social and legal implications.

Usually, expecially by media, results of the brain imaging studies are presented to public in form of brain images coloured with “blobs”. But many scientists are critic. In their opinion media communication frequently doesn’t take in the right account the enormous complexity of data acquisition and image processing. While in brain research and in clinical practice, brain imaging techniques are becoming a tool more and more important, the need to pinpoint the major benefits and limits of these tecnhiques is emerging. Summarizing, the questions are:

What does the blobs mean? What are the most important benefits and limits of these techniques? Are mass media responsible for a sort of misunderstandig around BI Techniques and their potentialities?

Jonathan Roiser, from University College London, UK, answers to these questions

What does the blobs mean?

In the next interview Stephan Schleim from University Clinics Bonn, Germany, will answer to these questions

What neuroimaging still cannot do

Brain Imaging techniques and their applications are quite recent, although from a theoretical point a view the origins can be identified at the end of 18° century and beginnin of 19°, when people thought to localize the brain functions thanks to phrenology. Phrenology stated that the personality traits of a person can be derived from the shape of the skull. With BI researchers seeks INSIDE the skull, but the approach, looking at media communication, seems to be the same. Moreover, negleting the BI limitations, well-known among experts, some new applications are promoted. The most fascinating is related to lie detection. Looking at the brain functions will we be able to detects lies and discover a liar? Summarizing, the questions are:

What is the historical origin of brain imaging? What are its actual limitations? Can we detect lies with BI? How do the media communicate bi techniques and applications?

Exploring the BI use we must remember its important applications in clinical practice. Bi is commonly used clinical practice for diagnosis of lesions and tumors. While technology advances promise to improve accuracy and their field of application a great carfullness must be applied in their clinical use. We interviewed Daniela Seixas, neuroradiologist at São João hospital, Porto, Portugal to further explore benefits and limitations of BI in clinical practice as well as the expectations and perspectives related to their use.

BI in clinical practice

What are the advantages/disadvantages of using brain imaging in clinical practice? What's your experience with patients and families approaching the technology?How do we cope with expectations and frustrations related to the use of brain imaging? What are the future perspectives for brain imaging in the clinical practice?

BI can be used in the early diagnosis of neurodegenerative diseases as Alzheimer. In the next interview Roberto Cappa, from Università Vita-Salute, Milan, Italy, introduce us to the use of those techniques in this field, enlarging the discussion to the ethical, social and legal implications of BI use.

BI and Alzheimer disease diagnosis

What are the major issues of using brain imaging?Is it worth to have an early diagnosis of Alzheimer's Disease?Can you tell us more on the common drawbacks of not having a diagnosis of Alzheimer disease?Do we need to use brain imaging on healthy people?

The use of brain imaging in courts as evidence is more than a future possibility. The ethic debate on these applications is open since functional activities in individual brains linked to antisocial behaviour should become identificable and concepts as liability or responsability broadly subverted. But does BI allow us to associate the human behaviour to a physical brain operation? Will BI change the legal notion of liability or responsability? In the near future, will BI be really used in courts as evidence?

Neuroscience between psychiatry and the law

Italian judge Amedeo Santosuosso answers to those questions:

Does neuroscience change the game between psychiatry and the law? What is the game, then?Do you think that brain imaging devices will be used in courts as evidence in the near future?Do you think that BI techniques will be able to change the legal notion of liability or responsibility?Do you think that neuroscience and brain imaging will offer any chance of treatment for guilty people?

The future: regulating brain imaging?

“Regolatory questions are emerging from the quick development of BI technologies. One set of questions concerns the right kind of regulatory environment that need to be put in place to control the clinical o commercial use of these technologies; and the other set concerns the implications of these tecnologies being used by the State as part of its regluatory apparatus” wrote Roger Brownsword from the King’s College London, UK.

But is regulating brain imaging a different thing with respect to othertechnologies? Should we regulate the communication of this technology?Could we depict a worst case scenario for the use of

brain imaging?

Roger Brownsword answers to these questions.

The patient point of view

Can you tell us your personal experience with brain imaging?Have you ever seen your brain images? Do you see possible psychological effects of using brain imaging on patients with mental health problems? Would you agree that everybody should have a scan?

In the debate on BI applications it is fundamental to take in consideration the perspective of patients and research subjects. In this interview we present Janey Antoniou’s experience, freelance, adviser and researcher in the mental health area, London.