Should we expect "neural signatures" for DSM diagnoses?

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Current psychiatric nosology aims for empirical observation, following Robins and Guze's 1970 principles.
• For over two decades, neuroimaging has been explored for
• laboratory studies
• to validate psychiatric diagnoses by identifying
• neural signatures
• of disorders.

Purpose of the Study:

• To assess the feasibility of using neuroimaging to identify neural signatures for psychiatric diagnoses.
• To examine if the current Diagnostic and Statistical Manual of Mental Disorders (DSM) nosology supports the identification of neural signatures.

Main Methods:

• Analysis of current neuroimaging methodologies in psychiatric research.
• Examination of the structure and heterogeneity of DSM-defined psychiatric categories.
• Review of the application of neuroimaging in psychiatric diagnosis.

Main Results:

• Neuroimaging primarily detects group differences, making individual diagnosis unlikely.
• The heterogeneity within DSM categories indicates they do not represent neurologically distinct phenomena.
• Neural correlates of psychopathology are often not unique to specific diagnoses.

Conclusions:

• Neuroimaging is currently unrealistic for diagnosing psychiatric disorders as presently conceived.
• Despite limitations for diagnosis, neuroimaging is advancing other areas of psychiatric investigation.