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van Velkinburgh JC, Herbst MD, Casper SM. Diffusion tensor imaging in the courtroom: Distinction between scientific specificity and legally admissible evidence. World J Clin Cases 2023; 11:4477-4497. [PMID: 37469746 PMCID: PMC10353495 DOI: 10.12998/wjcc.v11.i19.4477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/26/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023] Open
Abstract
Interest and uptake of science and medicine peer-reviewed literature by readers outside of a paper’s topical subject, field or even discipline is ever-expanding. While the application of knowledge from one field or discipline to others can stimulate innovative solutions to problems facing modern society, it is also fraught with danger for misuse. In the practice of law in the United States, academic papers are submitted to the courts as evidence in personal injury litigation from both the plaintiff (complainant) and defendant. Such transcendence of an academic publication over disciplinary boundaries is immediately met with the challenge of application by a group that inherently lacks in-depth knowledge on the scientific method, the practice of evidence-based medicine, or the publication process as a structured and internationally synthesized process involving peer review and guided by ethical standards and norms. A modern-day example of this is the ongoing conflict between the sensitivity of diffusion tensor imaging (DTI) and the legal standards for admissibility of evidence in litigation cases of mild traumatic brain injury (mTBI). In this review, we amalgamate the peer-reviewed research on DTI in mTBI with the court’s rationale underlying decisions to admit or exclude evidence of DTI abnormalities to support claims of brain injury. We found that the papers which are critical of the use of DTI in the courtroom reflect a primary misunderstanding about how diagnostic biomarkers differ legally from relevant and admissible evidence. The clinical use of DTI to identify white matter abnormalities in the brain at the chronic stage is a valid methodology both clinically as well as forensically, contributes data that may or may not corroborate the existence of white matter damage, and should be admitted into evidence in personal injury trials if supported by a clinician. We also delve into an aspect of science publication and peer review that can be manipulated by scientists and clinicians to publish an opinion piece and misrepresent it as an unbiased, evidence-based, systematic research article in court cases, the decisions of which establish precedence for future cases and have implications on future legislation that will impact the lives of every citizen and erode the integrity of science and medicine practitioners.
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Affiliation(s)
| | - Mark D Herbst
- Diagnostic Radiology, Independent Diagnostic Radiology Inc, St Petersburg, FL 33711, United States
| | - Stewart M Casper
- Personal Injury Law, Casper & DeToledo LLC, Stamford, CT 06905, United States
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White SF, Estrada Gonzalez SM, Moriarty EM. Raging Hormones: Why Age-Based Etiological Conceptualizations of the Development of Antisocial Behavior Are Insufficient. Front Behav Neurosci 2022; 16:853697. [PMID: 35493950 PMCID: PMC9041342 DOI: 10.3389/fnbeh.2022.853697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/17/2022] [Indexed: 12/15/2022] Open
Abstract
Developmental science, particularly developmental neuroscience, has substantially influenced the modern legal system. However, this science has typically failed to consider the role of puberty and pubertal hormones on development when considering antisocial behavior. This review describes major theoretical positions on the developmental neuroscience of antisocial behavior and highlights where basic developmental neuroscience suggests that the role of puberty and pubertal hormones should be considered. The implications of the current state of the science with respect to developmental neuroscience is considered, particularly what is known in light of development beyond puberty. This review shows that development continues to an older age for many youth than the legal system typically acknowledges. The plasticity of the brain that this continued development implies has implications for the outcome of interventions in the legal system in ways that have not been explored. Future directions for both developmental scientists and legal professions are recommended.
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Affiliation(s)
- Stuart F. White
- Boys Town National Research Hospital, Omaha, NE, United States
- *Correspondence: Stuart F. White,
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Shenton ME, Price BH, Levin L, Edersheim JG. Mild traumatic brain injury: Is DTI ready for the courtroom? INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 61:50-63. [PMID: 30391039 DOI: 10.1016/j.ijlp.2018.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 09/11/2018] [Accepted: 09/11/2018] [Indexed: 06/08/2023]
Abstract
Important advances in neuroscience and neuroimaging have revolutionized our understanding of the human brain. Many of these advances provide new evidence regarding compensable injuries that have been used to support changes in legal policy. For example, we now know that regions of the brain involved in decision making continue to develop into the mid-20s, and this information weighs heavily in determining that execution or automatic sentence of life without the possibility of parole for someone younger than 18 years old, at the time of the crime, violates the 8th Amendment prohibition against "cruel and unusual punishment." The probative value of other testimony regarding neuroimaging, however, is less clear, particularly for mild traumatic brain injury (mTBI), also known as concussion. There is nonetheless some evidence that new imaging technologies, most notably diffusion tensor imaging (DTI), may be useful in detecting mTBI. More specifically, DTI is sensitive to detecting diffuse axonal brain injuries in white matter, the most common brain injury in mTBI. DTI is, in fact, the most promising technique available today for such injuries and it is beginning to be used clinically, although it remains largely within the purview of research. Its probative value is also not clear as it may be both prejudicial and misleading given that standardization is not yet established for use in either the clinic or the courtroom, and thus it may be premature for use in either. There are also concerns with the methods and analyses that have been used to provide quantitative evidence in legal cases. It is within this context that we provide a commentary on the use of neuroimaging in the courtroom, most particularly DTI, and the admissibility of evidence, as well as the definition and role of expert testimony. While there is a great deal of evidence demonstrating cognitive impairments in attention, processing speed, memory, and concentration from neuropsychological testing following mTBI, we focus here on the more recent introduction of DTI imaging in the courtroom. We also review definitions of mTBI followed by admissibility standards for scientific evidence in the courtroom, including Daubert criteria and two subsequent cases that comprise the so-called Daubert trilogy rulings on the admissibility of expert testimony. This is followed by a brief review of neuroimaging techniques available today, the latter with an emphasis on DTI and its application to mTBI. We then review some of the court rulings on the use of DTI. We end by highlighting the importance of neuroimaging in providing a new window on the brain, while cautioning against the premature use of new advances in imaging in the courtroom before standards are established in the clinical arena, which are informed by research. We also discuss further what is needed to reach a tipping point where such advances will provide important and meaningful data with respect to their probative value.
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Affiliation(s)
- Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Harvard Medical School, Boston, MA, United States; VA Boston Healthcare System, Brockton Division, Brockton, MA, United States.
| | - Bruce H Price
- Department of Neurology at McLean Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Center for Law, Brain and Behavior, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Laura Levin
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, United States
| | - Judith G Edersheim
- Center for Law, Brain and Behavior, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Rudolph MD, Miranda-Domínguez O, Cohen AO, Breiner K, Steinberg L, Bonnie RJ, Scott ES, Taylor-Thompson K, Chein J, Fettich KC, Richeson JA, Dellarco DV, Galván A, Casey BJ, Fair DA. At risk of being risky: The relationship between "brain age" under emotional states and risk preference. Dev Cogn Neurosci 2017; 24:93-106. [PMID: 28279917 PMCID: PMC5849238 DOI: 10.1016/j.dcn.2017.01.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 11/28/2022] Open
Abstract
Multivariate-analyses significantly predict age in randomized train & test groups using pseudo-resting state data. Emotional states affect underlying functional connectivity and lead to changes in an individual’s predicted “brain age”. Under emotional states adolescents on average demonstrated a reduction in “brain age” from their true age (i.e., a younger brain phenotype). On average, a phenotype of a younger “brain age” during emotional states, relative to a neutral state is related to risk preference and perception.
Developmental differences regarding decision making are often reported in the absence of emotional stimuli and without context, failing to explain why some individuals are more likely to have a greater inclination toward risk. The current study (N = 212; 10–25y) examined the influence of emotional context on underlying functional brain connectivity over development and its impact on risk preference. Using functional imaging data in a neutral brain-state we first identify the “brain age” of a given individual then validate it with an independent measure of cortical thickness. We then show, on average, that “brain age” across the group during the teen years has the propensity to look younger in emotional contexts. Further, we show this phenotype (i.e. a younger brain age in emotional contexts) relates to a group mean difference in risk perception − a pattern exemplified greatest in young-adults (ages 18–21). The results are suggestive of a specified functional brain phenotype that relates to being at “risk to be risky.”
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Affiliation(s)
- Marc D Rudolph
- Department of Behavioral Neuroscience, Department of Psychiatry, Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States
| | - Oscar Miranda-Domínguez
- Department of Behavioral Neuroscience, Department of Psychiatry, Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States
| | - Alexandra O Cohen
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States
| | - Kaitlyn Breiner
- Department of Psychology, University of California, Los Angeles, CA, United States
| | - Laurence Steinberg
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Richard J Bonnie
- University of Virginia School of Law, Charlottesville, VA, United States
| | | | | | - Jason Chein
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Karla C Fettich
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Jennifer A Richeson
- Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, IL, United States; Department of Psychology, Yale University, New Haven CT, United States
| | - Danielle V Dellarco
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States
| | - Adriana Galván
- Department of Psychology, University of California, Los Angeles, CA, United States
| | - B J Casey
- Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States; Department of Psychology, Yale University, New Haven CT, United States
| | - Damien A Fair
- Department of Behavioral Neuroscience, Department of Psychiatry, Advanced Imaging Research Center, Oregon Health & Science University, Portland, OR, United States.
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