Does fMRI Have A Role in Personalized Health Care for Psychiatric Patients?

Functional magnetic resonance imaging (fMRI) has rapidly emerged as an important tool for understanding the neural correlates of myriad cognitive and emotional processes. By offering a direct window into brain activity, fMRI promised to usher in a new era of psychiatry, in which clinical decisions would be based on objective neurobiological measures rather than often-contentious symptom classifications. However, research conducted over the past two decades has failed to realise this goal, and fMRI remains an unutilized tool in the psychiatric clinic. In this chapter, we consider reasons why fMRI has failed to fulfill its promise as a clinically useful tool for psychiatrists and consider recent progress towards this goal in three key clinical domains: diagnosis, prediction and treatment monitoring. In particular, we focus on moving away from using traditional casecontrol comparisons of mean differences in brain activation to more sophisticated statistical techniques using brain activity patterns to classify individual participants to key clinical outcome variables, such as diagnosis or treatment response.