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Mazzolenis ME, Bulat E, Schatman ME, Gumb C, Gilligan CJ, Yong RJ. The Ethical Stewardship of Artificial Intelligence in Chronic Pain and Headache: A Narrative Review. Curr Pain Headache Rep 2024; 28:785-792. [PMID: 38809404 DOI: 10.1007/s11916-024-01272-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF REVIEW As artificial intelligence (AI) and machine learning (ML) are becoming more pervasive in medicine, understanding their ethical considerations for chronic pain and headache management is crucial for optimizing their safety. RECENT FINDINGS We reviewed thirty-eight editorial and original research articles published between 2018 and 2023, focusing on the application of AI and ML to chronic pain or headache. The core medical principles of beneficence, non-maleficence, autonomy, and justice constituted the evaluation framework. The AI applications addressed topics such as pain intensity prediction, diagnostic aides, risk assessment for medication misuse, empowering patients to self-manage their conditions, and optimizing access to care. Virtually all AI applications aligned both positively and negatively with specific medical ethics principles. This review highlights the potential of AI to enhance patient outcomes and physicians' experiences in managing chronic pain and headache. We emphasize the importance of carefully considering the advantages, disadvantages, and unintended consequences of utilizing AI tools in chronic pain and headache, and propose the four core principles of medical ethics as an evaluation framework.
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Affiliation(s)
- Maria Emilia Mazzolenis
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Evgeny Bulat
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, 02115, MA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, Department of Population Health - Division of Medical Ethics, New York University Grossman School of Medicine, New York, NY, USA
| | - Chris Gumb
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Christopher J Gilligan
- Department of Anesthesiology, Robert Wood Johnson University Hospital, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Robert J Yong
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, 02115, MA, USA.
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Zhang Q, Liu X, Gao S, Yan S, Li A, Wei Z, Han S, Hou Y, Li X, Cao D, Yue J. Multimodal magnetic resonance imaging on brain structure and function changes in vascular cognitive impairment without dementia. Front Aging Neurosci 2023; 15:1278390. [PMID: 38035274 PMCID: PMC10687453 DOI: 10.3389/fnagi.2023.1278390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Vascular cognitive impairment not dementia (VCIND) is one of the three subtypes of vascular cognitive impairment (VCI), with cognitive dysfunction and symptoms ranging between normal cognitive function and vascular dementia. The specific mechanisms underlying VCIND are still not fully understood, and there is a lack of specific diagnostic markers in clinical practice. With the rapid development of magnetic resonance imaging (MRI) technology, structural MRI (sMRI) and functional MRI (fMRI) have become effective methods for exploring the neurobiological mechanisms of VCIND and have made continuous progress. This article provides a comprehensive overview of the research progress in VCIND using multimodal MRI, including sMRI, diffusion tensor imaging, resting-state fMRI, and magnetic resonance spectroscopy. By integrating findings from these multiple modalities, this study presents a novel perspective on the neuropathological mechanisms underlying VCIND. It not only highlights the importance of multimodal MRI in unraveling the complex nature of VCIND but also lays the foundation for future research examining the relationship between brain structure, function, and cognitive impairment in VCIND. These new perspectives and strategies ultimately hold the potential to contribute to the development of more effective diagnostic tools and therapeutic interventions for VCIND.
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Affiliation(s)
- Qinhong Zhang
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
- Department of Acupuncture and Moxibustion, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiao Liu
- Department of Pediatrics, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shenglan Gao
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shiyan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ang Li
- Servier (Beijing) Pharmaceutical Research and Development Co., Ltd., Beijing, China
| | - Zeyi Wei
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shengwang Han
- Third Ward of Rehabilitation Department, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yu Hou
- Department of Gynecology, Harbin Traditional Chinese Medicine Hospital, Harbin, China
| | - Xiaoling Li
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Danna Cao
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinhuan Yue
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
- Department of Acupuncture and Moxibustion, Vitality University, Hayward, CA, United States
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Gao SL, Yue J, Li XL, Li A, Cao DN, Han SW, Wei ZY, Yang G, Zhang Q. Multimodal magnetic resonance imaging on brain network in amnestic mild cognitive impairment: A mini-review. Medicine (Baltimore) 2023; 102:e34994. [PMID: 37653770 PMCID: PMC10470781 DOI: 10.1097/md.0000000000034994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/02/2023] Open
Abstract
Amnestic mild cognitive impairment (aMCI) is a stage between normal aging and Alzheimer disease (AD) where individuals experience a noticeable decline in memory that is greater than what is expected with normal aging, but dose not meet the clinical criteria for AD. This stage is considered a transitional phase that puts individuals at a high risk for developing AD. It is crucial to intervene during this stage to reduce the changes of AD development. Recently, advanced multimodal magnetic resonance imaging techniques have been used to study the brain structure and functional networks in individuals with aMCI. Through the use of structural magnetic resonance imaging, diffusion tensor imaging, and functional magnetic resonance imaging, abnormalities in certain brain regions have been observed in individuals with aMCI. Specifically, the default mode network, salience network, and executive control network have been found to show abnormalities in both structure and function. This review aims to provide a comprehensive understanding of the brain structure and functional networks associated with aMCI. By analyzing the existing literature on multimodal magnetic resonance imaging and aMCI, this study seeks to uncover potential biomarkers and gain insight into the underlying pathogenesis of aMCI. This knowledge can then guide the development of future treatments and interventions to delay or prevent the progression of aMCI to AD.
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Affiliation(s)
- Sheng-Lan Gao
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jinhuan Yue
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
| | - Xiao-Ling Li
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ang Li
- Sanofi-Aventis China Investment Co., Ltd, Beijing, China
| | - Dan-Na Cao
- Division of CT and MRI, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Sheng-Wang Han
- Third Ward of Rehabilitation Department, Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ze-Yi Wei
- Graduate School of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guanhu Yang
- Department of Specialty Medicine, Ohio University, Athens, OH
| | - Qinhong Zhang
- Shenzhen Frontiers in Chinese Medicine Research Co., Ltd., Shenzhen, China
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