That's the focus of a Jan. 6-7 meeting in Bethesda, Md., sponsored by the National Institutes of Health in collaboration with the Stanford University School of Medicine, designed to help research institutions set standards for their brain imaging studies.
Judy Illes, PhD, senior research scholar at the Stanford Center for Biomedical Ethics, who is chairing the meeting, said she realized the scale of this issue in 2002. At that time, she, radiology professor Scott Atlas, MD, and others at Stanford published a study showing that 18 percent of normal volunteers had unusual features in their brains. About 6 percent of the people required follow-up by a doctor. These features could be harmless, such as a benign cyst, but could also be life-threatening malignant tumors or abnormalities in the blood vessels.
Such results pose thorny problems that researchers must now consider. If, for instance, the benign tumor is added to the volunteer's medical record, it could alter health insurance rates - a fact research subjects may not realize.
In other types of studies - including some on the horizon - the subjects may find out things they didn't want to learn about how their brain responds to certain images. Who, if anyone, should tell a person that his or her brain showed an unusual response to sexual or aggressive images?
Illes also pointed out that undergraduate students sometimes operate the machines that acquire the images for this sort of research. "When a subject goes into the study, does he or she know it might not be a medical professional who looks at the brain images?" she said. While one possibility is to make sure that all brain studies have medical professionals on the research team, the cost of having a doctor read ever
Contact: Amy Adams
Stanford University Medical Center