Structured phone interview for screening Panel volunteers and other volunteers for fMRI

Name of volunteer:

Date:

Introduction and brief explanation

1. Introduce yourself, and describe why you are phoning.

2. Do you think you may be interested, in principle? Would you like to hear more?

3. Check handedness, age and language (if appropriate):

Handedness¹ R/L

Age¹:

Native language¹:

4. As you may know, MRI is an acronym for Magnetic Resonance Imaging. MRI can be used to examine both brain structure and the 'brain at work'. It is safe and painless, and allows us to examine how different parts of the brain may be involved in language, hearing, vision, movement, memory, thought and emotion. (Or something similar…)

Claustrophobia

5. Volunteers lie on a bed that slides into a tunnel in the large magnet so that their head is inside. People who don't like small spaces might find this uncomfortable - would this be a problem for you²? YES/NO

Hearing

6. Do you have normal hearing? YES/NO (details, if appropriate)

7. The scanner makes a banging noise when it is working, and this can be loud. You will be given earplugs, which will block some of the noise, and headphones. By the way, if, eventually you are scanned, we'll ask you to bring a music CD because quite a lot of the time that you'll be lying on the bed in the scanner we'll be setting up and you just have to lie back and relax - and you can listen to music in this time.

Vision

8. Do you wear glasses? YES/NO

Will you need glasses to look at a computer screen in the scanner? If so, do you have contact lenses, as glasses may not be suitable.

Lying still

9. Volunteers are typically in the scanner for two hours or so, during which time they have to lie fairly still on the scanner bed. Would this be a problem for you?³ YES/NO

Metal

10. Because MRI requires volunteers to be in a strong magnetic field, we have to be very careful to ask about metal in the body, since any bits of metal could move or heat up, causing discomfort or damage. Do you have any metal implants?⁴ YES/NO

Pacemaker?⁴ YES/NO

Ever break a bone that required a pin or plate or something similar to be put in?⁴ YES/NO

How about piercings?⁴ YES/NO

If yes, are they removable?

Any extensive experience of metalworking, or any accidents involving metal (splinters in the eye, for example?)⁴ YES/NO

General health

11. I need to ask you some questions about your general health. Have you ever had a serious accident; have you ever broken an arm or leg which required pinning?

YES/NO

Have you ever been in hospital or had an operation?^5,4,6,7,8 YES/NO

If so, why? (Particular attention to: convulsions, head injury, ischaemia/stroke, cardiac/respiratory problems, operations in which there is ANY chance of a metal clip/pin/plate/ having been inserted).

Have you ever had an MR scan?^8,5,4 YES/NO

Are you on any medication currently?⁹ YES/NO

If yes, what? (And what is it for?)

[Of course, health exclusion criteria are a judgement call (except when metal implants are an issue), but careful consideration should be given before scanning anyone with a history of convulsions/epilepsy (except febrile convulsions, which are quite common in infancy), loss of consciousness of more than a couple of hours, or psychoactive medication. Migraine is only a factor if very frequent, i.e. more than one per week, or accompanied by visual loss or hemiparesis, which is very rare.]

12. There are some other things you should know:

(if female): we do not scan women if they are pregnant.¹

(again, if female) If you have a contraceptive coil, you cannot be scanned for at least 6 weeks after insertion.⁴

We do not scan people under the influence of alcohol.¹⁰

We do not recommend that you are scanned with a hangover. ¹⁰

We pay £10.00 an hour, and we'll also give you a picture of your brain.

[END OF QUESTIONNAIRE]

Explanatory Notes:

1. These questions are designed to make sure subjects fit into the ethics protocol.

f.M.R.I. subjects (of either sex) need to be over 18. If female, then subjects must not be pregnant or trying to become pregnant.

Bear in mind that the age ranges differ from ethics protocol to ethics protocol, so find out exactly what age limits exist for the ethics protocol you will be using before speaking to potential subjects.

2) Lying in the MRI scanner involves one’s whole body being enclosed in a relatively narrow tube. Claustrophobia would make it difficult for the subject to remain comfortable during this. Significant claustrophobia would be grounds for dismissing the subject from suitability for fMRI.

3) Given that subjects might have to lie on their backs without moving their heads constantly in the fMRI scanner for over two hours, any bladder, neck or back problems might make it very uncomfortable for the subject. They might also exacerbate existing neck problems. Half length scans on two occasions are possible, but overall would take up considerably more time for both subject and experimenter.

4) Any ferromagnetic metal in the subject’s body could potentially kill that subject if s/he goes into the MRI scanner, so it is important to make sure there is absolutely nothing in the subject’s body of this sort (except for fillings, dental braces, mitral valves - although if there are many fillings, this might cause an artefact in a non-brain area of the scan, but won’t be dangerous for the volunteer). Any implants may contain metal, even if the subject believes they are made from another material. Check with radiographer if not clear. If the subject has ever worked with metal, such as welding, or any job where metal shards might have flown into the subject’s skin or eyes, then this could be a problem. If the subject has worn eye and other protection, this may still mean there are some shards under finger-nails, etc. If in doubt, then it is possible to have an x-ray of the danger area of the body before MRI scanning, to make sure things are safe. Ask at the WBIC for the feasibility of this. Obviously for an fMRI scan, exclusion on metal grounds means exclusion from the study.

N.B. many questions in this questionnaire are designed to get at whether there could be anything in the subject’s body that might be metallic, given the importance of this consideration.

5) There is no evidence that loss of consciousness for a few minutes necessarily causes detectable brain damage. If they have lost consciousness for several hours at any point and have been admitted to hospital for more than overnight observation (which used to be quite common with concussion), then it is worth considering excluding them. Any more serious brain injury than concussion must mean the subject is excluded from any study involving normals. Remember that subjects might not think of combat sports, such as boxing, kick-boxing, martial arts, etc. as causing brain injury, but in any sport where there are repeated blows to the head are probably grounds for exclusion, for similar reasons.

6) A subject who is not healthy may make scanning a problem (e.g. severe asthmatic). Any problems with health may underlie other considerations (see 6 and 7).

7) May reveal head injury or implant considerations, as well as revealing other problems. E.g. any physical disability will cause difficulties in getting in the scanner.

8) Having had a scan before might reveal evidence of head injury again.

9) If subject is on long term psychiatric medication (or within the last few years has been on any such medication), such as anti-depressants, neuroleptics, tranquillisers, or anything else, then this is grounds for excluding the subject until a considerable time after taking such drugs.

10) Make sure the subject doesn’t have a hangover at the time of the scan, which would make things unpleasant for him/her and probably, interfere with the task. Also ensure that the subject is not an alcoholic or has a history of any substance abuse, which would be a clear reason for exclusion.