Defining Individual-Specific Functional Neuroanatomy for Precision Psychiatry

Studies comparing diverse groups have shown that many psychiatric diseases involve disruptions across distributed large-scale networks of the brain. There is hope that functional magnetic resonance imaging (fMRI) functional connectivity techniques will shed light on these disruptions, providing prognostic and diagnostic biomarkers as well as targets for therapeutic interventions. However, to date, progress on clinical translation of fMRI methods has been limited. Here, we argue that this limited translation is driven by a combination of intersubject heterogeneity and the relatively low reliability of standard fMRI techniques at the individual level. We review a potential solution to these limitations: the use of new "precision" fMRI approaches that shift the focus of analysis from groups to single individuals through the use of extended data acquisition strategies. We begin by discussing the potential advantages of fMRI functional connectivity methods for improving our understanding of functional neuroanatomy and disruptions in psychiatric disorders. We then discuss the budding field of precision fMRI and findings garnered from this work. We demonstrate that precision fMRI can improve the reliability of functional connectivity measures, while showing high stability and sensitivity to individual differences. We close by discussing the application of these approaches to clinical settings.