Background
Functional magnetic resonance imaging (fMRI) is a tool that is used in the medical field for identifying possible changes or activities in the brain which can be caused by neurological dysfunction or deviance. This specific technique of magnetic resonance imaging (MRI) was introduced in the early part of the 1990s, and it attracted specialists’ attention because of its effectiveness in localizing the brain regions that are responsible for certain activities to observe changes and processes in them (Jenkinson & Chappell, 2018).
The technique is often based on determining the blood oxygenation level-dependent (BOLD) changes in the brain that are identified because of alterations in oxygen consumption (Ugurbil, 2016). Neurological deviance can be defined in this context as the presence of certain neuropathology that is associated with the development of physical and psychological conditions and diseases, including epilepsy, multiple sclerosis, brain damage, tremor, and others (Jenkinson & Chappell, 2018; Oathes, Patenaude, Schatzberg, & Etkin, 2015).
It is possible to state that fMRI is actively used today as a non-invasive approach to examining the brain functioning and correlating distinctive symptoms in patients with their anatomy and processes in the brain.
It is important to note that fMRI studies and experiments can be based on imaging various changes and processes in the brain when a patient performs any selected task or when he or she is resting. Typically, sensory (visual, auditory, and other) stimuli are used to make patients perform certain behavioral tasks to stimulate their brain activity in the context of a conducted experiment (Rockswold et al., 2018).
In this case, the BOLD contrast can be applied to make these processes visible through imaging to determine their location and duration, but the use of the BOLD-based fMRI approach is usually viewed as complex (Chen & Glover, 2015; Ugurbil, 2016). Currently, the use of fMRI is more typical of clinical settings than it was previously because of the use of modern equipment for the procedure of imaging (Jenkinson & Chappell, 2018). Furthermore, the adoption of suitable devices for presenting stimuli and scanning internal processes in the brain allows for applying the method effectively, with a focus on positive results for a patient.
While conducting an fMRI study, a series of images are usually made to demonstrate specific and unique processes in different regions of the brain as a result of a person’s reaction to a stimulus. According to researchers, the application of the BOLD contrast allows for determining the location and intensity of the brain activity that can be indicative of the presence of certain abnormalities (Jenkinson & Chappell, 2018; Rockswold et al., 2018).
Therefore, currently, fMRI is used for determining the localization of certain neurological processes and their intensity before planning surgery, as it is in the case of treating patients with epilepsy and brain damage (Benjamin et al., 2018; Ugurbil, 2016). This method is used in these cases because it guarantees the collection of specific information regarding the location of abnormalities in the brain to contribute to a successful surgical intervention.
Although the application of fMRI is generally supported by healthcare providers and researchers, it has both proponents and opponents. Studies support the idea that fMRI is a comparably cost-efficient procedure that can be widely applied in different clinical settings because of the quality of findings for further analysis and diagnosis (Oathes et al., 2015; Ugurbil, 2016). However, some researchers and experts state that, in many hospitals and other clinical settings, there are no resources to conduct the fMRI procedure (Chen & Glover, 2015).
Furthermore, there is a shortage related to specialists that can appropriately analyze and interpret the results of this imaging (Jenkinson & Chappell, 2018; Oathes et al., 2015). Thus, the existing research on the topic of using fMRI accentuates its benefits for practice in the field of medicine, but further research is still required to support the effectiveness of this method and discuss possible disadvantages.
Rationale
In the field of neuroscience, there are still debates regarding the effectiveness of using fMRI for examining and measuring the activity of the brain to diagnose, study, and treat its possible dysfunction. Criticism regarding the appropriateness of fMRI for determining the areas of neurological dysfunction in the brain and further diagnosing indicates the necessity of further research in this specific field (Chen & Glover, 2015; Rockswold et al., 2018; Ugurbil, 2016). The problem is that fMRI was introduced about two decades ago, but it is still not actively used in the medical area because of some limitations in the application of this tool.
A range of experiments on applying this method demonstrated a great promise in studying the activities and processes in the brain. The results of these studies were interesting and important to contribute to diagnosing and treating neurological deviance in patients (Chen & Glover, 2015; Ugurbil, 2016). From this perspective, the purpose of this research is to examine the role of fMRI in studying the processes in the brain that are typical of healthy people and patients with certain neurological problems (Chen & Glover, 2015). It is important to examine how the development of fMRI and its use in the medical field influenced the processes of measuring and diagnosing neurological conditions associated with brain activity.
Theoretical Framework
The theorists and developers of fMRI proposed a certain theoretical framework that can be applied to this study. According to this framework, some mental state associated with neurological deviance affects internal processes in the brain and a human’s reactions to stimuli (Chen & Glover, 2015; Granhag, Vrij, & Verschuere, 2015). In this context, internal processes can also be defined as neural processes, and they can be measured with the help of fMRI (Granhag et al., 2015; Jenkinson & Chappell, 2018). Thus, fMRI allows for examining specifics of different internal processes, and further analysis is important for making conclusions about the mental state and different reactions to stimuli.
Aim and Objectives of the Research
This research aims to examine and discuss the application of fMRI for determining and diagnosing neurological deviance in the clinical field concerning the adoption and development of this technique in medical practice. This aim allows for guiding the research in terms of determining a kind of relationship between applying fMRI and identifying the causes of neurological deviance in practice. The following objectives will be addressed with the help of this study:
- To define fMRI and determine the course and process of the adoption and development of this technique in the medical field.
- To determine whether fMRI can effectively identify neurological deviance or dysfunction in patients with epilepsy.
- To describe how fMRI is currently applied for diagnosing different types of neurological deviance in patients.
Research Questions
To address the aim and objectives that have been set for this study, it is necessary to formulate research questions appropriate for an experimental study with the elements of observation and a review. The research questions need to reflect the study objectives directly to guarantee their achievement. The following research questions will guide the planned research on fMRI and its application in clinical settings for diagnosing:
- What is the process of adopting, applying, and developing fMRI in the medical field?
- How can fMRI be used for identifying neurological deviance or dysfunction in patients with epilepsy and what are the effects?
- How is fMRI currently applied for diagnosing different types of neurological deviance in patients?
Methodology
Laboratory Experiment with the Elements of Observation
Qualitative methodology, quantitative methodology, and mixed methods can be selected for conducting different types of studies depending on their purpose. Qualitative methods are associated with collecting subjective and detailed data that cannot be generalized. Quantitative studies are related to collecting objective data and conducting statistical analysis to determine how these data address research questions (Swanwick, Forrest, & O’Brien, 2018).
It is important to note that both methods have a variety of limitations. Therefore, for this study, the mixed methods approach that is based on conducting an experiment supported by statistical analysis and a qualitative review of primary sources will be chosen as most appropriate.
For this research, the experimental design has been selected as the key methodology suitable for responding to the set research questions. Twenty persons will be invited to participate in this study: ten patients with epilepsy and ten persons without the symptoms of epilepsy to form the group of control subjects. A random sampling technique will be applied for this study while referring to the larger populations of individuals with and without epilepsy who have no other conditions that can influence the results of fMRI (Swanwick et al., 2018). Ten patients with epilepsy will be assigned to an experimental group, and ten persons without any neurological disease will be assigned to a control group.
Visual stimulation will be used while applying fMRI for both groups of participants. During the experiment, the researcher will make observational notes on the course of the procedure and participants’ reactions (Swanwick et al., 2018). One should note that the received images will be analyzed for determining the presence of any abnormalities in the brain function and response. The researcher who will check these images will not know whether the sequence of analyzed images is from a patient or a member of a control group to ensure the validity of this study and analysis (Swanwick et al., 2018). Along with the visual stimulation, the changes in blood oxygenation occurring in a certain region of the brain will be potentially observed.
It is important to state that these changes can indicate an increase in a specific neural activity that is responsible for neurological dysfunction or deviance. Differences in the frequency and number of abnormalities in the brain functioning associated with neurological deviance in patients and control subjects can be calculated with the help of such a statistical test as Fisher’s Exact Test (one-tailed) (Chen & Glover, 2015; Swanwick et al., 2018). This test can be viewed as appropriate for determining the significance of findings related to a small number of subjects.
To conduct a laboratory experiment involving human subjects, it will be necessary to receive the approval of the ethics committee. The application of the methodology typical for quantitative studies and experiments, as well as the completion of the review on the selected topic, allows for guaranteeing triangulation (Swanwick et al., 2018). Thus, the proposed methodology will contribute to minimizing possible limitations and increasing the validity and reliability of this study because these are important factors for a high-quality study.
Review of Primary Sources
To find the answers to the research questions about a specific process of adopting, applying, and developing fMRI in the medical field and the current application of fMRI for diagnosing different types of neurological deviance in patients, it will be necessary to review a range of primary sources on the topic. The researcher will review and analyze clinical reports and the results of clinical studies and experiments to conclude about possible changes in the application of fMRI for determining cases of neurological deviance in a medical setting (Chen & Glover, 2015; Swanwick et al., 2018). Also, the conclusions will be made concerning the published findings of other researchers and experts in the field, as well as the results of the experiment that will be conducted in the context of this investigation.
Outcomes and Value
The outcomes of this research will potentially accentuate a variety of positive trends in the application of fMRI for determining neurological deviance in situations when the use of other tools and imaging technologies is not effective. The reference to the standard and illustrative case of examining patients with epilepsy will contribute to discussing fMRI as one of the most appropriate techniques for finding the injured or affected brain regions (Benjamin et al., 2018; Chen & Glover, 2015).
It is possible to expect the identification of several advantages of using fMRI for diagnosis (Jenkinson & Chappell, 2018; Rockswold et al., 2018). Possible limitations of this technique identified during a laboratory experiment will also be determined, if any, to provide the recommendations on how to improve the application of fMRI to achieve better results.
The findings of this study will be used to support or not the effectiveness of fMRI for studying the human brain concerning the problem of neurological deviance. Even though each method of imaging and examining the brain processes has its advantages and disadvantages, it is possible to expect finding evidence to conclude about the easiness and appropriateness of using fMRI for diagnosing brain dysfunction with the help of the sample of patients with epilepsy.
It is expected that the use of fMRI will be supported by primary and secondary evidence to state that this technique is most effective for providing rich information on the brain of an examined patient.
References
Benjamin, C. F., Li, A. X., Blumenfeld, H., Constable, R. T., Alkawadri, R., Bickel, S.,… Peters, J. M. (2018). Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning. Human Brain Mapping, 39, 2777–2785.
Chen, J. E., & Glover, G. H. (2015). Functional magnetic resonance imaging methods. Neuropsychology Review, 25(3), 289-313.
Granhag, P. A., Vrij, A., & Verschuere, B. (Eds.). (2015). Detecting deception: Current challenges and cognitive approaches. New York, NY: John Wiley & Sons.
Jenkinson, M., & Chappell, M. (2018). Introduction to neuroimaging analysis. Oxford, UK: Oxford University Press.
Oathes, D. J., Patenaude, B., Schatzberg, A. F., & Etkin, A. (2015). Neurobiological signatures of anxiety and depression in resting-state functional magnetic resonance imaging. Biological Psychiatry, 77(4), 385-393.
Rockswold, S. B., Burton, P. C., Chang, A., McNally, N., Grant, A., Rockswold, G. L.,… Lenglet, C. (2018). Functional magnetic resonance imaging and oculomotor dysfunction in mild traumatic brain injury. Journal of Neurotrauma, 35, 1-7.
Swanwick, T., Forrest, K., & O’Brien, B. C. (Eds.). (2018). Understanding medical education: Evidence, theory, and practice (3rd ed.). New York, NY: John Wiley & Sons.
Ugurbil, K. (2016). What is feasible with imaging human brain function and connectivity using functional magnetic resonance imaging. Philosophical Transactions of the Royal Society B: Biological Sciences, 371, 1-14.