Ethics. Incidental findings in brain imaging research

Research imaging studies have provided a steady stream of fundamental knowledge about the relation between brain and behavior in health and disease. Recent reports of clinical findings detected incidentally in this research (-), however, have created interest in the implications and ethics of how these findings are handled. We define incidental findings as observations of potential clinical significance unexpectedly discovered in healthy subjects or in patients recruited to brain imaging research studies and unrelated to the purpose or variables of the study. We believe that all investigators engaged in brain imaging research should anticipate incidental findings in their experimental protocols and establish a pathway for handling them. The central issues for consideration are how to protect subject welfare and research integrity while appropriately addressing investigator responsibility, subject expectations, informed consent, professional training of the research team, and the financial cost of following up on incidental findings. Protecting human subjects is of paramount importance.