title: Clinical applications of the functional connectome.
abstract: Central to the development of clinical applications of functional connectomics for neurology and psychiatry is the discovery and validation of biomarkers. Resting state fMRI (R-fMRI) is emerging as a mainstream approach for imaging-based biomarker identification, detecting variations in the functional connectome that can be attributed to clinical variables (e.g., diagnostic status). Despite growing enthusiasm, many challenges remain. Here, we assess evidence of the readiness of R-fMRI based functional connectomics to lead to clinically meaningful biomarker identification through the lens of the criteria used to evaluate clinical tests (i.e., validity, reliability, sensitivity, specificity, and applicability). We focus on current R-fMRI-based prediction efforts, and survey R-fMRI used for neurosurgical planning. We identify gaps and needs for R-fMRI-based biomarker identification, highlighting the potential of emerging conceptual, analytical and cultural innovations (e.g., the Research Domain Criteria Project (RDoC), open science initiatives, and Big Data) to address them. Additionally, we note the need to expand future efforts beyond identification of biomarkers for disease status alone to include clinical variables related to risk, expected treatment response and prognosis.
authors: Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, New York University Child Study Center, New York, NY 10016, USA. Francisco.Castellanos@nyumc.org
authors: F Xavier
authors: FX
authors: Castellanos
authors: Adriana
authors: A
authors: Di Martino
authors: R Cameron
authors: RC
authors: Craddock
authors: Ashesh D
authors: AD
authors: Mehta
authors: Michael P
authors: MP
authors: Milham
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D063132:Connectome / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology*
keywords: Functional connectome; Predictive modeling; Reliability; Sensitivity; Specificity; Validity
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