Pharmacological Applications of fMRI

Modern drug development presents new challenges by the unmet medical needs of chronic neurological and psychiatric disease. Imaging provides a potentially powerful tool for more efficiently translating pre-clinical and clinical studies and enhancing confidence in progression through early phase clinical development. Pharmacological MRI (phMRI) refers specifically to the applications of fMRI methods for direct or indirect measures of drug action. phMRI can be coupled to advanced structural methods to relate pharmacological effects and functional anatomy. Current and potential applications of phMRI to target stratification, patient validation, and pharmacodynamic studies are described. While great new opportunities could arise from extension of these methods as surrogate markers of clinical responses, this review highlights the substantial additional work that would need to be done to make this feasible. The review concludes that there is a strong rational for investment in phMRI for early phase clinical development, but that the short- to medium-term impact on late phase clinical development likely will be modest.