Martha J. Farah’s research while affiliated with University of Pennsylvania and other places

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Publications (252)


Conducting Research with Highly Portable MRI in Community Settings: A Practical Guide to Navigating Ethical Issues and ELSI Checklist
  • Article
  • Full-text available

January 2025

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9 Reads

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4 Citations

The Journal of Law Medicine & Ethics

Francis X. Shen

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Susan M. Wolf

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Frances Lawrenz

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Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

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Socioeconomic Factors in Brain Research: Increasing Sample Representativeness with Portable MRI

January 2025

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17 Reads

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1 Citation

The Journal of Law Medicine & Ethics

People of low socioeconomic status (SES) are often underrepresented in biomedical research. The importance of demographically diverse research samples is widely recognized, especially given socioeconomic disparities in health, but have been challenging to achieve. One barrier to research participation by low SES individuals is their distance from research centers and the difficulty of traveling. This article examines the promise of portable magnetic resonance imaging (pMRI) for enrolling participants of diverse SES in structural neuroimaging studies, and anticipates some of the challenges, practical and ethical, that may arise in the course of such research.


Ethical, legal, and policy challenges in field-based neuroimaging research using emerging portable MRI technologies: guidance for investigators and for oversight

June 2024

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56 Reads

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17 Citations

Journal of Law and the Biosciences

Researchers are rapidly developing and deploying highly portable MRI technology to conduct field-based research. The new technology will widen access to include new investigators in remote and unconventional settings and will facilitate greater inclusion of rural, economically disadvantaged, and historically underrepresented populations. To address the ethical, legal, and societal issues raised by highly accessible and portable MRI, an interdisciplinary Working Group (WG) engaged in a multi-year structured process of analysis and consensus building, informed by empirical research on the perspectives of experts and the general public. This article presents the WG’s consensus recommendations. These recommendations address technology quality control, design and oversight of research, including safety of research participants and others in the scanning environment, engagement of diverse participants, therapeutic misconception, use of artificial intelligence algorithms to acquire and analyze MRI data, data privacy and security, return of results and managing incidental findings, and research participant data access and control.


Fig. 1. Path diagram of amygdala volume and perceived stress in the association of SES and current depression symptom load, controlled for gender, age, and race. Indirect path of amygdala volume: b = 0.01, S.E. = 0.01, 95% CI = 0.003 to 0.024. Indirect path of perceived stress: b = −0.10, S.E. = 0.02, 95% CI = −0.132 to −0.060. Contrast of the indirect paths, b = −0.11, S.E. = 0.02, 95% CI = −0.146 to −0.071. Standard coefficients on paths and SE in parentheses. Notation: ***P < 0.001, **P < 0.01, *P < 0.05, †P < 0.1
Heterogeneity of depression across the socioeconomic spectrum

April 2023

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42 Reads

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6 Citations

Proceedings of the National Academy of Sciences

Why is lower socioeconomic status associated with higher rates of depression? And, is the surplus of depression at lower SES just more of the same type as depression found at higher levels, or is it distinctive? We addressed these questions by examining the relations among SES, amygdala volume, and symptoms of depression in healthy young adults. Amygdala volume, a risk factor for depression, does not synergize with SES in a diathesis-stress relation, nor does it mediate the relation of SES to depression. Rather, SES and amygdala volume are independent, additive risk factors. They are also associated with different depression symptoms and, whereas perceived stress fully mediates the relation of SES to depression, it has no relation to amygdala volume. These findings suggest heterogeneity of depression across the socioeconomic spectrum, with implications for treatment selection as well as for future genetic and brain studies.


Distributions of pessimistic attributional style, persistent pervasive adversity, psychological and behavioral problems and the depression symptom from the Child Behavior Questionnaire.
Path diagram showing mediation of the income to needs ratio and pessimistic attributional style relation by persistent pervasive adversity for children at age 9, controlling for gender. Standard coefficients on paths and standard errors in parentheses. As shown in Table 2, the indirect (mediated) path is statistically significant. ***p < 0.001; **p < 0.01; * p < 0.05.
Path diagram showing mediation of the relation of income to needs ratio and psychological and behavioral problems by pessimistic attributional style for children at age 9, controlled for gender. Standard coefficients on paths and standard errors in parentheses. As shown in Table 3A, the indirect (mediated) path is statistically significant. ***p < 0.001; **p < 0.01; *p < 0.05.
Path diagram showing mediation of the relation of income to needs ratio and psychological and behavioral problems by persistent pervasive adversity and pessimistic attributional style for children at age 9, controlled for gender. As shown in Table 4 the indirect (mediated) path is statistically significant. Standard coefficients on paths and standard errors in parentheses. ***p < 0.001; **p < 0.01; *p < 0.05.
Distributions of each SES measure.
Pessimistic cognitive biases mediate socioeconomic status and children’s mental health problems

March 2023

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108 Reads

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5 Citations

Low socioeconomic status (SES) is associated with higher rates of emotional disorders in childhood and beyond. Here we assessed one possible contributor to this disparity, a cognitive bias in the interpretation of negative events, in a group of 341 9-year-olds (49% female, 94% White) ranging widely in SES. This cognitive bias, known as pessimism in the attributional style literature, is the tendency to interpret negative events as persistent (Stable) and pervasive (Global). It was found to be more common among lower SES children (effect sizes = 0.18–0.24 depending on SES measures: income to needs ratio, proportion of poverty from birth to age 9, and parental educational attainment). Moreover, persistent, pervasive adversity in children’s lives predicted this bias and mediated the SES—pessimism link. Pessimistic attributional style, in turn, was related to childhood emotional problems and mediated the relation between SES and these problems. Finally, evidence for serial mediation of the SES-mental health problems relationship was found via persistent, pervasive adversity and pessimism, respectively.


Introduction to the Special Focus: The Affective Neuroscience of Poverty

September 2022

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75 Reads

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4 Citations

Growing up in poverty is associated with a heightened risk for mental and physical health problems across the life span, and there is a growing recognition of the role that social determinants of health play in driving these outcomes and inequities. How do the social conditions of poverty get under the skin to influence biology, and through what mechanisms do the stressors of poverty generate risk for a broad range of health problems? The growing field examining the neuroscience of socioeconomic status (SES) proposes that the brain is an entry point or pathway through which poverty and adversity become embedded in biology to generate these disparities. To date, however, the majority of research on the neuroscience of SES has focused on cognitive or executive control processes. However, the relationship between SES and brain systems involved in affective or emotional processes may be especially important for understanding social determinants of health. Accordingly, this Special Focus on The Affective Neuroscience of Poverty invited contributions from authors examining the relationship between SES and brain systems involved in generating and regulating emotions. In this editorial introduction, we (a) provide an overview of the neuroscience of SES; (b) introduce each of the articles in this Special Focus; and (c) discuss the scientific, treatment, and policy implications of studying the affective neuroscience of poverty.


Anger, Fear, and Sadness: Relations to Socioeconomic Status and the Amygdala

September 2022

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49 Reads

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10 Citations

Here, we test three often proposed hypotheses about socioeconomic status (SES), affect, and the brain, for which evidence is mixed or lacking. The first hypothesis, that negative affect is more common at lower levels of SES, has ample evidence from studies of psychiatric symptoms but is tested for the first time here across multiple measures of negative emotions in healthy young adults. The second hypothesis is actually a set of hypotheses, that SES is associated with three structural and functional properties of the amygdala. Third, and most important for the affective neuroscience of SES, is the hypothesis that SES differences in the amygdala are responsible for the affective differences. Despite the intuitive appeal of this hypothesis, it has rarely been tested and has never been confirmed. Here, we review the literature for evidence on each of these hypotheses and find in a number of cases that the evidence is weak or nonexistant. We then subject each hypothesis to a new empirical test with a large sample of healthy young adults. We confirm that negative affect is more common at lower levels of SES and we find a positive relation between SES and amygdala volume. However, evidence is weak on the relation of SES to functional properties of amygdala. Finally, the tendency toward negative affect in lower SES individuals cannot be accounted for by the structural or functional characteristics of the amygdala measured here.


Pattern learning reveals brain asymmetry to be linked to socioeconomic status

May 2022

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225 Reads

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1 Citation

Cerebral Cortex Communications

Socioeconomic status (SES) anchors individuals in their social network layers. Our embedding in the societal fabric resonates with habitus, world view, opportunity, and health disparity. It remains obscure how distinct facets of SES are reflected in the architecture of the central nervous system. Here, we capitalized on multivariate multi-output learning algorithms to explore possible imprints of SES in gray and white matter structure in the wider population (n ≈ 10,000 UK Biobank participants). Individuals with higher SES, compared to those with lower SES, showed a pattern of increased region volumes in the left brain and decreased region volumes in the right brain. The analogous lateralization pattern emerged for the fiber structure of anatomical white matter tracts. Our multimodal findings suggest hemispheric asymmetry as an SES-related brain signature, which was consistent across six different indicators of SES: degree, education, income, job, neighborhood, and vehicle count. Hence, hemispheric specialization may have evolved in human primates in a way that reveals crucial links to socioeconomic status.


Pattern learning reveals brain asymmetry to be linked to socioeconomic status

May 2022

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64 Reads

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6 Citations

Cerebral Cortex Communications

Socioeconomic status (SES) anchors individuals in their social network layers. Our embedding in the societal fabric resonates with habitus, world view, opportunity, and health disparity. It remains obscure how distinct facets of SES are reflected in the architecture of the central nervous system. Here, we capitalized on multivariate multi-output learning algorithms to explore possible imprints of SES in gray and white matter structure in the wider population (n ≈ 10,000 UK Biobank participants). Individuals with higher SES, compared to those with lower SES, showed a pattern of increased region volumes in the left brain and decreased region volumes in the right brain. The analogous lateralization pattern emerged for the fiber structure of anatomical white matter tracts. Our multimodal findings suggest hemispheric asymmetry as an SES-related brain signature, which was consistent across six different indicators of SES: degree, education, income, job, neighborhood, and vehicle count. Hence, hemispheric specialization may have evolved in human primates in a way that reveals crucial links to socioeconomic status.


Fig. 1. Measures of SES and PCA. (A) On the left, a distance correlation matrix is plotted for seven indices of SES. On the right, the squared loadings for each PC are indicated. (B) Scatter plots of the first PC (PC1 SES ) against the second component (PC2 SES ). The points in different colors represent four SES groups defined by National Statistics Socio-economic Classification, which are approximately clustered by the two PCs. On the right, the same scatter plots are presented for each SES group. The mean values of each PC are indicated for each group. The regression lines are plotted to describe that SES is more complex for the lower SES groups.
Fig. 2. Manhattan plots: VBM of GMV and SES. (A) Univariate VBM results on the two PCs for SES. These regressions did not control for TIV. P values on a log 10 scale (top) and partial R 2 (bottom) are plotted for each voxel. The sign of the association is that of the first PC. The voxels were anatomically labeled according to the Neuromorphometrics atlas and grouped by the labeled regions. Within each region, the voxels were ordered by their distance to the medoid of their region. (B) Univariate VBM results with TIV controlled for.
Fig. 3. VBM of SES and its genetic and environmental components. (A) Univariate VBM results, with GMV as the dependent variable. Voxels significant at FWE rate of 5% level are plotted for (a) the two PCs measuring SES, (b) PGI SES , and (c) SES while controlling for PGI SES . (B) Percent reduction in the association between GMV and the two PCs for SES due to controlling for PGI SES . (C) Percent reduction due to controlling for BMI in the residual association between GMV and the two PCs for SES after controlling for PGI SES . The figures plot only voxels that had significant SES-GMV association before PGI SES and BMI were controlled for. Montreal Neurological Institute (MNI) coordinates are indicated for (A) and (B). Measurement error in PGI SES was adjusted for with genetic instrument variable regression for (B) and (C). The sample was restricted to individuals of European ancestry.
Fig. 5. Functional annotation of brain regions associated with SES. A total of 492 cognitive concepts, belonging to 10 categories, were taken from Cognitive Atlas, and their predicted fMRI meta-analysis results were generated by NeuroQuery. For each concept, we computed the difference in mean chi-square between voxels statistically significant at nominal 1% level and the rest of the voxels. Then, a pseudo-T score for the difference was computed and its P value was obtained by 10,000 spatial permutations. This procedure was carried out for the VBM results for (A) two PCs of SES, (B) PGI SES , and (C) SES controlling for PGI SES . The P values of the top five concepts from each category were plotted on a log 10 scale, where each category was ordered by the average of the top five concepts. The asterisk indicates the significance at the false discovery rate (FDR) of 5% level. See table S17 and fig. S15 for the full results.
Human brain anatomy reflects separable genetic and environmental components of socioeconomic status

May 2022

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200 Reads

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27 Citations

Science Advances

Socioeconomic status (SES) correlates with brain structure, a relation of interest given the long-observed relations of SES to cognitive abilities and health. Yet, major questions remain open, in particular, the pattern of causality that underlies this relation. In an unprecedently large study, here, we assess genetic and environmental contributions to SES differences in neuroanatomy. We first establish robust SES-gray matter relations across a number of brain regions, cortical and subcortical. These regional correlates are parsed into predominantly genetic factors and those potentially due to the environment. We show that genetic effects are stronger in some areas (prefrontal cortex, insula) than others. In areas showing less genetic effect (cerebellum, lateral temporal), environmental factors are likely to be influential. Our results imply a complex interplay of genetic and environmental factors that influence the SES-brain relation and may eventually provide insights relevant to policy.


Citations (82)


... One tool we have developed to help catalyze attention to these issues and operationalize solutions is a Portable MRI Research ELSI Checklist. 40 Information on the safety profile and clinical utility of pMRI is crucial for experts, researchers, participants, and the public, including how pMRI safety and utility may differ from fixed scanners with 1.5T or more powerful magnets. As discussed at length in consensus guidance produced by the Working Group associated with this project, new safety guidance is required for pMRI. ...

Reference:

Expert Stakeholder Perspectives on Emerging Technology for Neuroimaging Research with Highly Portable MRI: The Need for Guidance on Ethical, Legal, and Societal Issues
Conducting Research with Highly Portable MRI in Community Settings: A Practical Guide to Navigating Ethical Issues and ELSI Checklist

The Journal of Law Medicine & Ethics

... In "Socioeconomic Factors in Brain Research: Increasing Sample Representativeness with Portable MRI," Professor Martha Farah explores the potential for pMRI research to redress historical underrepresentation of participants with lower socioeconomics status (SES) in neuroimaging research. 15 Farah discusses the value that pMRI research with lower SES communities could provide, and the barriers to carrying out such studies. Farah cautions against the danger of biological essentialism and stresses the importance of ethical guidance on when and how to conduct and report comparative analyses of brain structure based on SES. ...

Socioeconomic Factors in Brain Research: Increasing Sample Representativeness with Portable MRI

The Journal of Law Medicine & Ethics

... Importantly, the faecal transfer-associated behavioural observations have been linked to neurophysiological changes (Kelly et al. 2016;Shen et al. 2020;Wolstenholme et al. 2022;Xiao et al. 2021;Lee et al. 2024) and modifications to transcriptomic profiles in the brain . For example, the transplantation of faecal material from animals in a substance abuse model (chronic alcohol exposure) to healthy recipients results in behavioural signs of anxiety and depression; this occurs in concert with increased intestinal and brain inflammation, a compromised blood-brain barrier, neurotrophic defects and alterations in the brain GABA system (Shen, Zhang, et al. 2024;Shen, Wolf, et al. 2024). ...

Ethical, legal, and policy challenges in field-based neuroimaging research using emerging portable MRI technologies: guidance for investigators and for oversight

Journal of Law and the Biosciences

... The high level of socioeconomic status in students' homes and communities leads to high socioeconomic status in the schools they attend and vice versa. Lower SES settings stress people significantly, impairing selective focus and affecting students' performance (Farah & Hackman, 2012). It is worth noting that many disadvantaged students succeed at school, and the socioeconomic status of students is a significant factor in the differences in countries' performances in all subjects, including mathematics. ...

SES, Childhood Experience, and the Neural Bases of Cognition
  • Citing Chapter
  • September 2012

... In the realm of mental illness, depression risk is correlated with SES, and SES-related depression may be distinctive in terms of anatomical correlates and the role of stress. 22 The effectiveness of particular treatments for depression may also depend on SES. 23 Why would brain imaging be relevant to SES gradients in such a wide range of diseases affecting organ systems other than the brain? ...

Heterogeneity of depression across the socioeconomic spectrum

Proceedings of the National Academy of Sciences

... These negative contact experiences contribute to negative expectations regarding intergroup contact among individuals from a lower class (Gómez et al., 2011;Schäfer et al., 2022). In addition, characteristics inherent to lower social classes make these individuals more prone to exhibiting negative expectations about themselves and others (Hao et al., 2023;Mahadevan et al., 2021;Varnum, 2015). The characteristics of individuals from a high-class background, that is, high competence and low warmth (Connor et al., 2021;Fiske et al., 2002), make individuals from a lowclass background more likely to exhibit negative contact expectations, thereby reducing their cross-class contact willingness (Finchilescu et al., 2007;Stephan et al., 2008). ...

Pessimistic cognitive biases mediate socioeconomic status and children’s mental health problems

... Risk factors for adolescent anger are found at each level of the socioecological model (Bronfenbrenner, 1977). At the structural level, lower socioeconomic status (SES) and higher inequality are associated with greater levels of anger, violence, and negative affect (Gallo and Matthews, 2003;Hao et al., 2022). It is unknown, however, how these concepts relate to anger among rural adolescents or how subjective measures may affect findings. ...

Anger, Fear, and Sadness: Relations to Socioeconomic Status and the Amygdala

... One example of research in phase #1 is research from the ABCD study that examined associations between income, brain structure, and mental health, while considering how state-level policies such as anti-poverty programs may impact these associations (Weissman et al., 2023). There is a growing body of work examining the neuroscience of socioeconomic status and proposing that the brain is an entry point or pathway through which poverty and adversity become embedded in biology to generate these disparities Nusslock & Farah, 2022). To address this question, over 10,000 9-to 11-year-old youth from 17 states participated in a neuroimaging assessment, and associations with family income and youth psychopathology were examined (Weissman et al., 2023). ...

Introduction to the Special Focus: The Affective Neuroscience of Poverty

... It is hypothesized that brain functional segregation, which refers to the lateralization of some functions in one hemisphere and some other functions in the opposite hemisphere, confers a selective advantage (Poeppl et al., 2022;Rogers, 2021). This could be by avoiding redundancy, preventing duplication of control systems which enhance the use of both hemispheres, increasing the brain's ability to perform multiple tasks simultaneously, maximizing available space, and allowing higher processing speed (Esteves, Lopes et al., 2020;Gerrits et al., 2020b;Güntürkün et al., 2020). ...

Pattern learning reveals brain asymmetry to be linked to socioeconomic status

Cerebral Cortex Communications

... As it is known that age [26], body mass index [27], and sex [28,29] are associated with clinical pain in biologically and clinically important ways, we decided not to deconfound these variables from brain imaging-derived target measures with the logic that deconfounding would remove precisely the variability we were hoping to exploit to define clinically relevant population-level modes of co-variation. We further note that, consistent with our previous work, we have not regressed out sociodemographic variables with the goal of preserving rich insights into brain and behavior, by interlocking effects with other variables of interest [30][31][32][33]. ...

Pattern learning reveals brain asymmetry to be linked to socioeconomic status

Cerebral Cortex Communications