Searching 10,000 Brains for Signs of Mental Illness

Ravin Haywood is one of the first 100 kids to get her brain scanned
 for a study on mental illness. By Cindy Rodriguez /WNYC

A group of scientists from the New York City-based Child Mind Institute, a non-profit that provides treatment and does research, plans to scan the brains of 10,000 New York City children to find the physical markers of a range of psychiatric disorders when they first take root. It's one of the largest and broadest studies of its kind.  

Scientists say that about half of all adult psychiatric disorders begin around the age of 14, and so understanding what brain development looks like when it first gets disrupted will help prevent more serious illness down the line.  

The study is expected to cost $30 million and take five to 10 years to complete. The organization says it's raised about half that so far, through private donations from individuals and foundations. Scientists have lofty goals — to be able to diagnose mental illness more accurately, and potentially redefine how disorders get classified. Project Director Michael Milham said the study could help explain a broader spectrum of illnesses.

"You need large scale data sets so we can look to the data for answers as to how to better individuate one presentation from another, and how to understand this broader range of variation that we see in psychiatric illness and to help refine the boundaries that are used currently to classify psychiatric illness, to diagnose individuals, and to make predictions."

Ultimately, the scientists said they want to get to a point where doctors can determine whether a treatment is effective by looking to see if a physical marker has disappeared. The markers could be revealed by an MRI, by an EEG—a test that detects electrical activity in the brain— or by blood samples that reveal chemical makeups and how genes get expressed.      

Most studies pay people to participate, but this one offers families free mental health evaluations by licensed clinicians that include screenings for learning disabilities. That’s valuable in areas where there's a dearth of mental health services, such as Staten Island, the starting point for the study. Angela Mceachern has experienced this shortage in services first-hand. She said she had to take her daughter, Ravin, to the emergency room at Bellevue Hospital in Manhattan to get an appointment at the overburdened clinics on Staten Island.

"I mean it’s sad but...they said, 'Angela, that’s the only way you’re going to be able to get her moved up because the list is so long' ", Mceachern said. "They don't have enough resources out here in Staten Island for people who got ADHD and other things that children have."

Ravin is 13-years-old and is among the first group of 94 children to get brain scans for this study. She was diagnosed with Attention Deficit Hyperactivity Disorder several years ago. The teenager said she gets bullied at school and struggles academically.

"I've been going through a little trouble lately at school and dealing with home life," Ravin said. "It's kind of hard and I've been very depressed."

She would prefer not to take medication and her mother said years of trial and error have made her suspicious of clinicians who write prescriptions based on conversations about Ravin’s behavior. Mceachern wants mental illness to be treated similarly to physical ailments and she brings up her own recent trip to the doctor for a pain in her arm that turned out to be arthritis.

"Before I could take these pain pills, I had to get an MRI to see to tell me exactly what’s wrong because I thought I had a stroke," she said. 

Ravin had her brain scanned for the study on a Friday evening this fall. The test took an hour and she got nervous beforehand. The type of MRI she received shows her brain function, meaning the patterns of activity and how different networks fluctuate and work together. 

Milham pointed to images of her brain on one screen and her heart rate and breathing patterns on another.

 "If we really want to know we're looking at neural activity, not respiration or cardiac signals, then we collect that information and take that into account during the analysis," Milham said.  The scientists will also have to account for the medication Ravin and other kids are on because those will likely impact brain activity too. 

Milham said advanced algorithms would be required to deal with the variables and make the data useful.  He plans to share the team's data with scientists from all over the world and hopefully attract a broad range of researchers outside psychiatry.

"That’s where you really need the computer scientists, the mathematicians, the engineers.  With the open data sharing model you enable that," Milham said. 

The test took place inside a trailer in the parking lot. Scientists need the MRI machine to be mobile because they plan to take it to all five boroughs in their quest for 10,000 research participants between the ages of five and 21. 

Julia Zehr, Program Officer in the Division of Translational Research at the National Institute of Mental Health, said that to her knowledge, if the project is completed, it would constitute the largest set of neuro-imaging data to date. She said the project reflects the latest thinking on how mental illness is a brain disorder.

"I think there is an increasing awareness that early experience can have long lasting impact on developmental outcome," she said. 

Studies such as this one hope to identify risk factors and predictors of more serious mental illness down the line. But Doctor Dolores Malaspina, professor of child and adolescent psychiatry at NYU School of Medicine, said mental health professionals must exercise caution when trying to predict risk in a child, because the information can cause families great anxiety. 

"That can lead someone to be demoralized, hopeless, it can change the families expectation for that person or the type of life they lead," Malaspina said. 

Back inside the MRI trailer, Mceachern waited for her daughter to be done and explained how frustrated she gets trying to find a treatment that works. She said her daughter’s therapy has its limits and she remains skeptical about medication.  

"How are you going to give somebody medication without getting them diagnosed, see the brain waves and all that good stuff to get some type of clear satisfaction before you give them medication?" she asked. 

Milham explained that to get to that point would take time.  

"It's just that we literally need to get the data and have some time for scientists to work on the challenge," he said. 

Ravin made it through the test without a problem.  There are no guarantees her contribution to science will pay off and even if it does, it will likely be too late for her to benefit. The teenager said she was OK with that.

"I think it's a good thing for the next generation, so like for people who have ADHD, they'll be more informed about it," the 13-year-old said.  "And they'll be able to explain it more thoroughly and so their parents can get a better understanding about how ADHD works."