Brain Scans May Help Predict Future Problems, And Solutions

Jan 7, 2015
Originally published on January 8, 2015 5:55 pm

Brain scans may soon be able to help predict a person's future — some aspects of it, anyway.

Information from these scans increasingly is able to suggest whether a child will have trouble with math, say, or whether someone with mental illness is going to respond to a particular treatment, according to a review of dozens of studies published Wednesday in the journal Neuron.

The review found "growing evidence that brain measures can predict future outcomes or behaviors," says John Gabrieli, a brain scientist at MIT and the review's lead author. And the results are often "better than currently available tests or clinical measures," he says.

The finding suggests that educators and mental health professionals could soon have new tools to help them decide how to assist a struggling student or patient, Gabrieli says. At the moment, he says, "we're in many ways flipping coins and stumbling in the darkness."

For example, some patients with depression or social anxiety disorder respond well to cognitive behavioral therapy, while others are better off taking drugs. But doctors often have to find that out through trial and error.

Studies from the past few years, though, suggest that a better strategy is to measure activity in several areas of the brain before choosing a treatment. These activity levels "predicted much better than clinical measures which patients would benefit the most and which patients would benefit the least" from cognitive behavioral therapy, Gabrieli says.

Other studies reviewed by Gabrieli found that brain scans also did a good job predicting which children would go on to have difficulties with reading or math. And still others showed which young people are likely to engage in future binge drinking or drug use.

The new approach has been a big help to Caryn Lerman, a professor of psychiatry at the University of Pennsylvania who does research on smoking cessation. She and her colleagues used to rely on interviews and questionnaires to predict which patients would actually quit.

"We were interested to see whether incorporating information from brain scans improved our ability to make those predictions," she says. And it did. The team found that measuring activity in an area of the prefrontal cortex helped them predict who would succeed or fail more than 80 percent of the time.

Brain data may be more reliable than questionnaires because people often have trouble accurately reporting their thoughts and feelings even when they are trying to be honest, Lerman says. The brain scans provide "a window" on what's actually happening, she says.

Brain scans also have the potential to do much more than simply identify who will quit smoking, Lerman says. "The next step is to use this information to develop better treatments to help people succeed." Those treatments could include brain exercises that increase activity in the area associated with successful quitting.

Despite the promising results in these research studies, predictive brain scans are not ready for use in the general public, says Gabrieli. "We're not within a year of using any of these," he says. "But we might be within something like five years."

And when that day comes, he says, it will be important to make sure the scanning approach is used appropriately. "We have to make sure that we don't somehow use it simply to avoid helping people because they're going to have difficulties," he says.

The goal, he says should be to start helping a child who is likely to struggle with reading or math long before the problem appears.

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MELISSA BLOCK, HOST:

There's growing evidence that brain scans can help predict a person's future, or some aspects of it anyway. NPR's Jon Hamilton reports that information from these scans can suggest whether a child will have trouble with math or whether someone with mental illness will respond to a particular treatment.

JON HAMILTON, BYLINE: For years, educators and mental health professionals have relied on old-fashioned tools, like questionnaires, when deciding how to help a struggling patient or student. John Gabrieli, a brain scientist at MIT, says those tools haven't been very effective.

JOHN GABRIELI: Currently, there's so little evidence about which treatment would really work for one individual compared to another, which educational approach would really work for one child compared to another. So we're currently, in many ways, flipping coins and stumbling in the darkness.

HAMILTON: Which is why Gabrieli decided to look at dozens of recent studies that made predictions using functional MRI and other brain scanning technologies. He and his colleagues report in the journal Neuron that the results are encouraging. The studies show that subtle differences in brain structure, activity and connections could predict future behavior. Take people with depression or social anxiety disorder - some respond well to cognitive behavioral therapy while others are better off taking drugs. But doctors often had to find out through trial and error. Gabrieli says studies from the past few years suggest a better strategy is to measure activity in several areas of the brain.

GABRIELI: One study examined brain function prior to patients receiving cognitive behavioral therapy and it predicted much better than clinical measures which patients would benefit the most and which patients would benefit the least.

HAMILTON: Gabrieli says other studies found that brain scans also did a good job predicting which children would go on to have difficulties with reading or math. And still others showed which young people are likely to engage in future binge drinking or drug use. Caryn Lerman, a professor of psychiatry at the University of Pennsylvania, has been using the new approach in her research on smoking cessation. She says she and her colleagues used to rely on interviews and questionnaires to predict which patients would actually quit.

CARYN LERMAN: We were interested to see whether incorporating information from brain scans improved our ability to make those predictions.

HAMILTON: And did it?

LERMAN: It did.

HAMILTON: Lerman's team found that measuring activity in an area of the prefrontal cortex helped them predict who would succeed more than 80 percent of the time. She has some ideas about why brain scans work better than questionnaires.

LERMAN: Individuals, even when they're as honest as possible, are often not as good at reporting their thoughts and feelings and the brain data provides a window.

HAMILTON: Lerman says brain scans have the potential to do much more than simply identify who will quit smoking.

LERMAN: The next step is to use this information to develop better treatments to help people succeed.

HAMILTON: Lerman says those treatments could include brain exercises that increase activity in the area associated with successful quitting. John Gabrieli, of MIT, says despite the promising results in all these research studies, predictive brain scans are not ready for widespread use.

GABRIELI: We're not within a year of use of any of these, but we might be within something like five years.

HAMILTON: And when that day comes, he says, it will be important to make sure the scans are used appropriately.

GABRIELI: The better we get at predicting near-term outcomes the more we have to be careful that we communicate that in constructive ways and the more we have to make sure that we don't somehow use it simply to avoid helping people because they're going to have difficulties and only support people who look like they're not going to have difficulties.

HAMILTON: The goal, he says, should be to start helping a child who is likely to struggle with reading or math long before the problem appears. Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.