Test-retest reliability of resting-state fMRI functional connectivity: impact of scan length and number of participants

Resting-state functional MRI has been widely used to study brain connectivity, yet the test-retest reliability of commonly used metrics remains a concern. To improve reliability, extended scan lengths and larger subject cohorts are often recommended. However, these solutions can be impractical and pose challenges, particularly in studies of clinical populations. Here, we systematically assess the reliability of two main types of functional connectivity measures: node-based connectome metrics (edge-level intraclass correlation coefficient [ICC], connectome-level ICC, functional connectivity fingerprinting, and discriminability); and voxel-based resting-state networks (RSNs) (spatial similarity of independent component analysis [ICA]-derived RSN maps quantified using the Dice coefficient). Using data from the Human Connectome Project, we evaluated the effects of scan length (3.6, 7.2, 10.8, and 14.4 minutes) and number of participants (n = 10, 20, 50, and 100), on both within-session and between-session reliability. We found that multivariate connectome metrics demonstrated greater reliability than edge-level measures, and that scan length had stronger influence on test-retest reliability than the number of participants. For connectome metrics, 14 minutes of scanning and a cohort of approximately 20 participants were sufficient to achieve reliable estimates. In contrast, RSN measures benefited from larger cohort sizes. Our findings provide practical guidelines for designing resting-state fMRI studies in terms of scan length and number of participants, balancing reliability and feasibility. Ultimately, protocol choices should be guided by the specific study objectives and the functional connectivity metric of interest.