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Quality over quantity: powering neuroimaging samples in psychiatry

Neuropsychopharmacology (2024)Cite this article

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Abstract

Neuroimaging has been widely adopted in psychiatric research, with hopes that these non-invasive methods will provide important clues to the underpinnings and prediction of various mental health symptoms and outcomes. However, the translational impact of neuroimaging has not yet reached its promise, despite the plethora of computational methods, tools, and datasets at our disposal. Some have lamented that too many psychiatric neuroimaging studies have been underpowered with respect to sample size. In this review, we encourage this discourse to shift from a focus on sheer increases in sample size to more thoughtful choices surrounding experimental study designs. We propose considerations at multiple decision points throughout the study design, data modeling and analysis process that may help researchers working in psychiatric neuroimaging boost power for their research questions of interest without necessarily increasing sample size. We also provide suggestions for leveraging multiple datasets to inform each other and strengthen our confidence in the generalization of findings to both population-level and clinical samples. Through a greater emphasis on improving the quality of brain-based and clinical measures rather than merely quantity, meaningful and potentially translational clinical associations with neuroimaging measures can be achieved with more modest sample sizes in psychiatry.

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Fig. 1: Considerations discussed throughout the review to improve power in detecting brain-behavior associations, beyond increasing sample size.

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Acknowledgements

The authors would like to thank Timothy Brown, Terry Jernigan, and Robert Loughnan for insightful conversations that helped shape some of the perspectives shared in this manuscript.

Funding

This work was supported by the National Institutes of Mental Health (award number K99MH132886; CM). The funding agency did not influence the perspectives outlined in the manuscript, nor the decision to publish.

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Authors and Affiliations

  1. Department of Radiology, University of California San Diego, San Diego, CA, USA

    Carolina Makowski

  2. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

    Thomas E. Nichols

  3. Departments of Radiology and Neurosciences, University of California San Diego, San Diego, CA, USA

    Anders M. Dale

Authors
  1. Carolina Makowski
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  2. Thomas E. Nichols
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  3. Anders M. Dale
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Contributions

CM and AMD conceived the ideas presented in this manuscript. CM wrote the first draft. TN provided statistical expertise on presented concepts. All authors contributed to editing the final manuscript.

Corresponding author

Correspondence to Carolina Makowski.

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Competing interests

AMD reports that he was a Founder of and holds equity in CorTechs Labs, Inc., and serves on its Scientific Advisory Board. He is a member of the Scientific Advisory Board of Human Longevity, Inc. He receives funding through research grants from GE Healthcare to UCSD. The terms of these arrangements have been reviewed by and approved by UCSD in accordance with its conflict of interest policies. AMD also reports that he has memberships with the following research consortia: Alzheimer’s Disease Genetics Consortium (ADGC); Enhancing Neuro Imaging Genetics Through Meta Analysis (ENIGMA); Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL); Psychiatric Genomics Consortium (PGC). All other authors have no conflicts of interest.

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Makowski, C., Nichols, T.E. & Dale, A.M. Quality over quantity: powering neuroimaging samples in psychiatry. Neuropsychopharmacol. (2024). https://doi.org/10.1038/s41386-024-01893-4

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  • DOI: https://doi.org/10.1038/s41386-024-01893-4

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