Big steps forward in human functional brain imaging, but collaborations key to patient benefit

Posted by Biomechanism

Twenty years after the publication of the first human study using functional magnetic resonance imaging (fMRI)* – a technique to measure activity in the brain through the flow of blood – the Wellcome Trust has published a report providing reflections on the field of human functional brain imaging.

The Wellcome Trust report assesses the key developments in human functional brain imaging and examines the role it has played as a funder. Supporting neuroscience research has been a cornerstone of the Trust’s funding strategy: the first grant it ever awarded was in neuroscience in 1938, to Nobel laureate Dr Otto Loewi. Understanding the brain remains a key part of the Trust’s strategy today.

Sir Mark Walport, Director of the Wellcome Trust, says: “The introduction of fMRI 20 years ago has revolutionised our understanding of how the brain operates. However, whilst it is true that the field has seen immense progress over these two decades, there is still a vast amount to discover and develop if we are to use our new knowledge to deliver benefits to patients.”

Between 1990 and 2009, the Wellcome Trust invested £114 million on human functional brain imaging research (2 per cent of the Trust’s funding commitment over this time). Of this, approximately £50m was allocated to the Wellcome Trust Centre for Neuroimaging at UCL (formerly the Functional Imaging Laboratory).

Following the introduction of fMRI in humans, the review identifies a range of key breakthroughs in functional brain imaging that have been critical in enhancing our understanding of the brain, including the development of statistical and computational modelling that are helping to revolutionise our understanding of brain function.

The review found that the Wellcome Trust’s specific contributions to the field have been in providing long-term and sustained funding for multidisciplinary research hubs, where individuals from a range of disciplinary backgrounds and sectors are brought together, and in providing a sustained stream of funding specifically for equipment, tools and technologies.

In supporting researchers to build independent research careers through its training programmes and fellowships, the Wellcome Trust is thought to have helped ensure the emergence of a number of world leaders in brain imaging research. Today, of the 20 most highly cited authors in brain imaging research worldwide, the top four – Karl Friston, Ray Dolan, Richard Frackowiak and Christopher Frith – are all currently, or have recently been, associated with the Wellcome Trust Centre for Neuroimaging.

While this portfolio review demonstrated the significant progress that has been achieved in the field of human functional brain imaging in the last two decades, it also concludes that there is much to be done before this is translated into patient benefit.

The review identified a number of current challenges and opportunities for the functional brain imaging research community. These include:

• the need to identify a number of specific goals and targets for human functional brain imaging research
• a continued need for support for multidisciplinary and multi-sector research hubs
• a requirement to increase sample sizes in functional brain imaging studies to enhance our understanding of the normal brain and the prevalence of specific conditions
• the importance of encouraging and facilitating the involvement of clinicians in the development of clinical applications – to help bring functional brain imaging to the clinic
• the potential for greater working with industry to bring about developments in molecular imaging and to drive innovation in drug development
• a need to continue to develop human functional brain imaging techniques and do basic, exploratory research
• the importance of ensuring we understand the social and ethical implications of brain-imaging research.

Dr John Williams, Head of Neuroscience and Mental Health at the Wellcome Trust, adds: “Strategic collaborations across disciplines, and with clinicians and partners in industry, will be the key to delivering on the promise offered by advances in brain imaging. If we work together to address the major research and training challenges presented within the field, then the technology can be as transformative in the next 20 years as it has been during the past 20.”

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*Belliveau JW et al. Functional mapping of the human visual cortex by magnetic resonance imaging. Science 1991;254(5032):716-9.