Desmond, J. E., & Annabel Chen, S. H. (2002). Ethical issues in the clinical application of fMRI: Factors affecting the validity and interpretation of activations. Brain & Cognition, 50(3), 482.

The ability of functional magnetic resonance imaging (fMRI) to localize activations in a single patient, along with the safety and widespread availability of this methodology, has lead to an increasing use of fMRI for clinical purposes such as pre-surgical planning. As methodology continues to improve and more experience with fMRI in the clinical setting is acquired, clinical functional neuroimaging will likely have an increasing influence over patient care. Therefore, ethical use of fMRI, as with other medical techniques, requires understanding the factors impacting the interpretation of the methodology. Issues affecting the validity and interpretation of clinical functional neuroimaging, including effects of altered hemodynamic response function, head motion, and structural changes in the brain, are reviewed. The distinction between correlated and necessary activation in a clinical context is discussed. Different types of statistical errors in fMRI analysis are described, along with their consequences to the patient. Finally, for the future of clinical fMRI development, the need for normative patient data, as well as standardized tasks, scan protocols, and data analyses, is discussed. Copyright 2002 Elsevier Copyright of Brain & Cognition is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

Ford, P. J., & Kubu, C. S. (2006). Stimulating debate: Ethics in a multidisciplinary functional neurosurgery committee. Journal of Medical Ethics, 32(2), 106-109.

Multidisciplinary healthcare committees meet regularly to discuss patients candidacy for emerging functional neurosurgical procedures, such as Deep Brain Stimulation (DBS). Through debate and discussion around the surgical candidacy of particular patients, functional neurosurgery programs begin to mold practice and policy supported both by scientific evidence and clear value choices. These neurosurgical decisions have special considerations not found in non-neurologic committees. The professional time used to resolve these conflicts provides opportunities for the emergence of careful, ethical practices simultaneous with the expansion of therapy applications ABSTRACT FROM AUTHOR Copyright of Journal of Medical Ethics is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts); 

Illes, J., Rosen, A., Greicius, M., & Racine, E. (2007). Prospects for prediction. Annals of the New York Academy of Sciences, 1097(1), 278-295.

This article focuses on the prospects and ethics of using neuroimaging to predict Alzheimer's disease (AD). It is motivated by consideration of the historical roles of science in medicine and society, and considerations specifically contemporary of capabilities in imaging and aging, and the benefits and hope they bring. A general consensus is that combinations of imaging methods will ultimately be most fruitful in predicting disease. Their roll-out into translational practice will not be free of complexity, however, as culture and values differ in terms of what defines benefit and risk, who will benefit and who is at risk, what methods must be in place to assure the maximum safety, comfort, and protection of subjects and patients, and educational and policy needs. Proactive planning for the ethical and societal implications of predicting diseases of the aging brain is critical and will benefit all stakeholders—researchers, patients and families, health care providers, and policy makers. ABSTRACT FROM AUTHOR Copyright of Annals of the New York Academy of Sciences is the property of Blackwell Publishing Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

Illes, J., Kann, D., Karetsky, K., Letourneau, P., Raffin, T. A., Schraedley-Desmond, P., et al. (2004). Advertising, patient decision making, and self-referral for computed tomographic and magnetic resonance imaging. Archives of Internal Medicine, 164(22), 2415-2419.

Background Self-referred imaging is one of the latest health care services to be marketed directly to consumers. Most aspects of these services are unregulated, and little is known about the messages in advertising used to attract potential consumers. We conducted a detailed analysis of print advertisements and informational brochures for self-referred imaging with respect to themes, content, accuracy, and emotional valence. Methods Forty print advertisements from US newspapers around the country and 20 informational brochures were analyzed by 2 independent raters according to 7 major themes: health care technology; emotion, empowerment, and assurance; incentives; limited supporting evidence; popular appeal; statistics; and images. The Fisher exact test was used to identify significant differences in information content. Results Both the advertisements and the brochures emphasized health care and technology information and provided assurances of good health and incentives to self-refer. These materials also encouraged consumers to seek further information from company resources; virtually none referred to noncomplying sources of information or to the risks of having a scan. Images of people commonly portrayed European Americans. We found statistical differences between newspaper advertisements and mailed brochures for references to “prevalence of disease” (P<.001), “death” (P<.003), and “radiation” (P<.001). Statements lacking clear scientific evidence were identified in 38% of the advertisements (n = 15) and 25% of the brochures (n = 5). Conclusions Direct-to-consumer marketing of self-referred imaging services, in both print advertisements and informational brochures, fails to provide prospective consumers with comprehensive balanced information vital to informed autonomous decision making. Professional guidelines and oversight for advertising and promotion of these services are needed. ABSTRACT FROM AUTHOR Copyright of Archives of Internal Medicine is the property of American Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

Konarski, J. Z., McIntyre, R. S., Soczynska, J. K., Bottas, A., & Kennedy, S. H. (2006). Clinical translation of neuroimaging research in mood disorders. Psychiatry, 3(2), 46-57.

Background: Practitioners are increasingly presented with data procured from studies employing advanced neuroimaging techniques. The central role that neuroimaging occupies in contemporary psychiatric research highlights the need for practitioner familiarity with the neuroimaging technology and its clinical translation. Methods: We conducted a PubMed search of till English-language articles published between January 1964-October 2005. The search words were major depressive disorder, bipolar disorder, functional magnetic resonance imaging (fMRI), single-photon-emission computed tomography (SPECT), positron emission tomography (PET), voxel-based morphometry (VBM), region of interest (ROI), blood-oxygen-level-dependent (BOLD), glucose metabolism, blood Sow, statistical parametric mapping (SPM), magnetic resonance spectroscopy (MRS), and diffusion-tensor imaging (DTI). The search was supplemented with a manual review of relevant references. The authors organize the review by addressing frequently asked questions on the topic of neuroimaging by mental healthcare providers. Results: The localization of regional brain volumetric abnormalities with CT is enhanced with MRI techniques that allow for a. separate assay of white and gray matter pathology (segmentation), cellular metabolism (MRS), and neurocircuitry (DTI). Positron emission tomography permits the quantification of brain glucose metabolism, regional blood flow, and receptor/transporter localization and function. Rapid changes in regional oxygen consumption may also be quantified with fMRI. Conclusions: Neuroimaging technology has helped refine pathophysiological models of disease activity in mood disorders and illuminate mechanisms of drug activity. A priority research vista in mood disorders is the integration of neuroimaging investigations with other research methods (e.g., genetics, endocrinology, etc.). (PsycINFO Database Record (c) 2007 APA, all rights reserved)