Some useful approaches for future research
- There is a need for studies to integrate information across imaging modalities for improved understanding of biology at the level of the individual.
- Multimodal imaging and studies that combine imaging with randomized clinical trials can help overcome biased sampling, constrain interpretations of pathophysiology derived from fMRI, and elucidate mechanisms of treatment response. Preceding this, small studies of the best cohort possible are needed to see if one can detect therapeutic changes on imaging.
- Studies are needed to identify biomarkers and to determine which modalities will be most helpful for specific diseases or purposes.
- Coupling fMRI with perfusion and MRS to look at medication effects would provide better quantification, stronger links to chemical changes, and more generalizable information than BOLD fMRI alone, as well as enhance our understanding of BOLD effects.
- Studies of children at risk for disorders designed to identify predictors of psychopathology would be useful. Other "predictive" strategies would be prognostic.
- Resting perfusion studies may provide more stable, quantitative markers than conventional BOLD-fMRI cognitive paradigms. Perfusion studies may minimize variability across scanners and sites. Although temporal resolution is poorer, such studies may reflect low frequency activity and indicate connectivity.
- Studies directed toward better understanding of the baseline state or "default mode" and corresponding effects on the size or variance of the activation are needed.
- Pilot ASL (perfusion) projects should use simple fMRI tasks with resting or simple baselines across 3-4 sites in children, adolescents and young adults to determine if these produce biologically meaningful information.
- Simple, basic sensorimotor or psychophysiological tasks may help to anchor, track and index processes with potential cascading influences on higher-level processes.
- Independent components analysis (ICA) may be of value even with simple tasks, resting states or simple baselines such as visual fixation.
