Disorder/Disease Biomarkers: Large pooled data sets that also contain structural data, genetic data, and a slew of behavioral data are just starting to be mined with advanced processing methods. Already specific networks related to behavior, lifestyle, and genetic disorders have been discovered. The long term goal here is the creation of multivariate biomarkers that can be applied to individuals either to screen, diagnose, or guide treatment with an acceptable degree of certainty. There are perhaps hard limits to fMRI sensitivity and reliability, but if the number of meaningful dimensions of information from fMRI are increased, then the hope is that this massively multivariate data may allow highly sensitive and specific individual subject and/or patient differentiation based on resting state or activation information.
Biofeedback: It has been demonstrated that when presented in real time with useful fMRI activation-based feedback in real time on a specific aspect of their dynamic brain activity, subjects were able to alter and tune their activity. In many studies, this led to a change in an aspect of their behavior – touching on depression, phobias, and pain perception. The fMRI signal is still slow and noisy, however, of higher fidelity than other real time neuronal measures. Recently, simultaneous use of EEG has been proposed to enhance the effectiveness of real time fMRI feedback. This is still in its early stages, however, clinical trials are underway.
Localization for Neuromodulation: An emerging area of clinical treatment is that of neuromodulation by the use of methods to stimulate or interfere with brain activity in a targeted manner either invasively or non-invasively. Deep brain stimulation, TMS, tDCS, focused ultrasound, and more are currently being developed for clinical applications – alleviating depression, Parkinson’s disease, and other disorders. The placement and targeting of these interventions is critical to their success. I see fMRI a playing a significant role in providing functional localizers so that the efficacy of these neuromodulation approaches may be fully realized.
Assessment of locked in patients:Recent studies have shown that fMRI is superior to EEG in assessing the brain health, activity, and function of locked in patients. In some instances fMRI activity was used as a means for communication. This approach has considerable potential to be used on a regular basis in a clinical setting as no other methods compare – even in its early stages of implementation.
Brain Metabolism/Neurovascular Coupling/Blood Oxygenation Assessment: While activation and connectivity studies dominate potential fMRI clinical applications, more fundamental physiologic information obtained using simultaneous fMRI measures with the appropriate pulse sequence, such as a combined arterial spin-labelling (ASL) for perfusion, blood oxygenation level dependent (BOLD), and/or Vascular Space Occupancy (VASO) contrast for blood volume, during a stress such as breath-hold or CO2 inhalation – or even during normal breathing variations at rest, can provide insights into baseline blood oxygenation, neurovascular coupling, and even resting and activation-induced changes in Cerebral Metabolic Rate (CMRO2). All these provide potentially unique and useful information related to vascular patency and metabolic health of brain tissue – with potentially immediate clinical applications that may fill a niche between CT angiography, ultrasound, and positron emission tomography (PET).
- Perfusion Deficit Detection using ASL: has been in existence as long as BOLD contrast and significant effort has been made to test it clinically. While the baseline perfusion information that it provides is comparable to that obtained with injected Gd contrast, its sensitivity is significantly lower, requiring a much longer acquisition time for averaging. This has slowed widespread clinical implementation.
- Perfusion Deficit Detection using resting state BOLD: This is perhaps the most promising of the possible clinical implementations of fMRI in the broadest interpretation of the name. Mapping the relative latencies of resting state BOLD fluctuations clearly reveals regions of flow deficit. This approach compares well to the clinically used approach of Gd contrast in terms of sensitivity and specificity. Creation of latency maps from BOLD fluctuations is also relatively straightforward and could be performed seamlessly and quickly in an automated manner. This approach is currently being implemented in a limited manner in hospitals in Germany and China.
- Localization of seizure foci: The flip side of mapping regions for surgeons NOT to remove for pre surgical mapping applications is the mapping of seizure generating tissue to provide surgeons with a target for removal. For certain types of seizure activity, the brain is constantly generating uniquely unusual activity, which translates into unique temporal signatures recorded with either EEG or resting state fMRI. Detection with EEG is much more easily and cheaply performed, but has less spatial precision fMRI.
Clinical Importance of Basic Neuroscience: Many would argue that the clinical importance of basic and cognitive neuroscience research, while not having a direct clinical application, has so many secondary and tertiary influences on the state of the art of clinical practice that this is in itself a sufficient justification for continued fMRI research funding by both basic science funding agencies as well as more clinically focused agencies.
The organizers of the upcoming conference Cognitive Computational Neuroscience (#CCNeuro) have done a very cool thing ahead of the meeting. They asked their keynote speakers the same set of 5 questions, and posted their responses on the conference blog.
The first of these questions is “How can we find out how the brain works?”. In addition to recommending reading the insightful responses of the speakers, I offer here my own unsolicited suggestion.
A common theme among the responses is the difficulty posed by the complexity of the brain and the extraordinary expanse of scales across which it is organized.
The most direct approach to this challenge may be to focus on the development of recording technologies to measure neural activity that more and more densely span the scales until ultimately the entire set of neural connections and synaptic weights is known. At that point the system would be known but not understood.
In the machine learning world, this condition (known but not understood) is just upon us with AlphaGo and other deep networks. While it has not been proven that AlphaGo works like a brain, it seems close enough that it would be silly not to use as a testbed for any theory that tries to penetrate the complexity of the brain a system that has human level performance in a complex task, is perfectly and noiselessly known, and was designed to learn specifically because we could not make it successful by programming it to execute known algorithms (contrast Watson).
Perhaps the most typical conceptual approach to understanding the brain is based on the idea (hope) that the brain is modular in some fashion, and that models of lower scale objects such as cortical columns may encapsulate their function with sufficiently few parameters that the models can be built up hierarchically and arrive at a global model whose complexity is in some way still humanly understandable, whatever that means.
I think that modularity, or something effectively like modularity is necessary in order to distill understanding from the complexity. However, the ‘modularity’ that must be exploited in understanding the brain will likely need to be at a higher level of abstraction than spatially contiguous structures such as columns, built up into larger structures. The idea of brain networks that can be overlapping is already such an abstraction, but considering the density of long range connections witnessed by the volume of our white matter, the distributed nature of representations, and the intricate coding that occurs at the individual neuron level, it is likely that the concept of overlapping networks will be necessary all the way down to the neuron, and that the brain is like an extremely fine sparse sieve of information flow, with structure at all levels, rather than a finite set of building blocks with countable interactions.
Most of our brain activity is not conscious – from processes that maintain our basic physiology to those that determine how we catch a baseball and play a piano well. Further, these unconscious processes include those that influence our basic perceptions of the world. Our opinions and deepest held beliefs – those that we prefer to feel that our conscious mind completely determines – are shaped largely by unconscious processes. The book, “Incognito: Secret Lives of the Brain” by David Eagleman, is an engaging account of those processes – packed with practical and interesting examples and insight. Eagleman is not only a neuroscientist, but an extremely clear and engaging writer. His writing, completely accessible to the non expert, is filled with solid neuroscience, packaged in a way that not only provides interesting information, but also builds perspective. It’s the first book that I’ve encountered that delves deeply into this particular subject. We mostly think of our brains as generating conscious thought, but, as he explains it’s just the small tip of the iceberg.
“Explaining the Brain” is a 2007 book by Carl Craver, who applies philosophical principles to comment on the current state of neuroscience. This is my first and only exposure to the philosophy of science, so my viewpoint is very naive, but here are some main points from the book that I found insightful.
The book starts by making a distinction between two broad goals in neuroscience: explanation, which is concerned with how the brain works; and control, which is concerned with practical things like diagnosis, repair, and augmentation of the brain. In my previous post on this blog, I tried to highlight that same distinction. This book focuses on explanation, which is essentially defined as the ability to fully describe the mechanisms by which a system operates.
A major emphasis is on the question of what it takes to establish a mechanism, and the notion of causality is integral to this question.
The future of healthcare both small and big. It’s big data, machine learning, and massive amounts of data coming from tiny robust devices or phone apps of individuals. It’s individualized medicine – not only for patients who need care but for healthy individuals. The data will come from devices that will become ever more ubiquitous – stickers on skin, tattoos, clothing, contact lenses, and more. This conference, organized by Applysci, and held on Feb 7 and 8, 2017 at Stanford University, involved a slate of some of the most creative, ambitious, and successful people in the digital health industry. I was both mesmerized and inspired.
I decided to venture outside my comfort zone of fMRI and brain imaging conferences to get a glimpse of the future of wearable technology and digital health by attending this conference. The speakers were mostly academics who have started companies related to their particular area of expertise. Others were solidly in industry or government. Some were quite famous and others were just getting started. All were great communicators – many having night jobs as writers. My goal for being here was to see how these innovations could complement fMRI – or vise versa. Were there new directions to go, strategies to consider, or experiments to try? What were the neural correlates of expanding one’s “umwelt?” – a fascinating concept elegantly described by one of the speakers, David Engleman.
On a personal level, I just love this stuff. I feel that use of the right data can truly provide insight into so many aspects of an individual’s health, fitness, and overall well-being, and can be used for prediction and classification. There’s so much untapped data that can be measured and understood on an individual level.
Many talks were focussed on flexible, pliable, wearable, and implantable devices that can measure, among other things, hemodynamics, neuronal activity, sweat content, sweat rate, body heat, solar radiation, body motion, heart rate, heart rate variability, skin conductance, blood pressure, electrocardiogram measures, then communicate this to the user and the cloud – all for analysis, feedback, and diagnosis. Other talks were on the next generation of brain analysis and imaging techniques. Others focussed on brain computer interfaces to allow for wired and wireless prosthetic interfacing. Frankly, the talks at this conference were almost all stunning. The prevailing theme that ran through each talk could be summarized as: In five or so years, not much will happen, but in ten to fifteen years, brace yourselves. The world will change! Technophiles see this future as a huge leap forward – as information will be more accessible and usable – reducing the cost of healthcare and, in some contexts – bypassing clinicians altogether and increasing the well-being of a very large fraction of the population. Others may see a dystopia wrought with the inevitable ethical issues of who can use and control the data.
Below are abbreviated notes, highlights, and personal thoughts from each of the talks that I attended. I don’t talk about the speakers themselves as they are easily googled – and most are more or less famous. I focus simply on what the highlights were for me.
In a very revealing paper: “Could a neuroscientist understand a microprocessor?”, Jonas and Kording tested a battery of neuroscientific methods to see if they were useful in helping to understand the workings of a basic microprocessor. This paper has already stirred quite a response, including from Numenta, the Spike, Arstechnica, the Atlantic, and lots of chatter on Twitter.
This is a fascinating paper. To a large degree, the answer to the title question as addressed by their methods (connectomics, lesion studies, tuning properties, LFPs, Granger causality, and dimensionality reduction), is simply ‘no’, but perhaps even more importantly, the paper brings focus to the question of what it means to ‘understand’ something that processes information, like a brain or a microprocessor. Continue reading “Understanding ‘Understanding’: Comments on “Could a neuroscientist understand a microprocessor?””
I recently had a meeting where the topic discussed was: “What would we like to see in the ideal cutting edge and future-focussed fMRI/DTI scanner?” While those who use fMRI are used to some progress being made in pulse sequences and scanner hardware, the technological capability exists to create something substantially better than we have now.
In this blog posting, I start out with a brief overview of what
we currently have now in terms of scanner technology. The second part of this blog is then focussed on what my ideal fMRI system would have. Lastly, the article ends with a summary outline of my wish list – so if you want to get the gist of this blog, scroll to the list at the bottom. Enjoy and enter your comments! Feedback, pushback, and more ideas are welcome!
A motivation for this blog is that since our graduate student days, Eric Wong and I have had hundreds of great conversations about MRI, fMRI, brain imaging, neuroscience, machine learning, and more. We finally decided to go ahead and start posting some of these, as well as thoughts of our own. It’s better – for us and hopefully others – to publicly share our thoughts, perspectives, and questions, than to keep them to ourselves. The posts are varied in topic and format. In certain areas, we know what we’re talking about, and in other others, we might be naïve or just wrong, so we welcome feedback! We also welcome guest blogs as we hope to grow the list of guest contributors and readers. Continue reading “Ten Unique Characteristics of fMRI”
Thanks to Peter Bandettini for the idea of starting a blog, and for offering to let me partner with him in this endeavor. We hope you find it interesting.
In this my first contribution to theBrainBlog, I would like to outline some of my initial thoughts about what a useful understanding of the human brain might look like. Continue reading “What does it mean to understand the brain?”