Towards automated detection of depression from brain structural magnetic resonance images

Classification of Major Depressive Disorder Based on Integrated Temporal and Spatial Functional MRI Variability Features of Dynamic Brain Network

BACKGROUND

Characterization of the dynamics of functional brain network has gained increased attention in the study of depression. However, most studies have focused on single temporal dimension, while ignoring spatial dimensional information, hampering the discovery of validated biomarkers for depression.

PURPOSE

To integrate temporal and spatial functional MRI variability features of dynamic brain network in machine-learning techniques to distinguish patients with major depressive disorder (MDD) from healthy controls (HCs).

STUDY TYPE

Prospective.

POPULATION

A discovery cohort including 119 patients and 106 HCs and an external validation cohort including 126 patients and 124 HCs from Rest-meta-MDD consortium.

FIELD STRENGTH/SEQUENCE

A 3.0 T/resting-state functional MRI using the gradient echo sequence.

ASSESSMENT

A random forest (RF) model integrating temporal and spatial variability features of dynamic brain networks with separate feature selection method (MSFS ) was implemented for MDD classification. Its performance was compared with three RF models that used: temporal variability features (MTVF ), spatial variability features (MSVF ), and integrated temporal and spatial variability features with hybrid feature selection method (MHFS ). A linear regression model based on MSFS was further established to assess MDD symptom severity, with prediction performance evaluated by the correlations between true and predicted scores.

STATISTICAL TESTS

Receiver operating characteristic analyses with the area under the curve (AUC) were used to evaluate models' performance. Pearson's correlation was used to assess relationship of predicted scores and true scores. P < 0.05 was considered statistically significant.

RESULTS

The model with MSFS achieved the best performance, with AUCs of 0.946 and 0.834 in the discovery and validation cohort, respectively. Additionally, altered temporal and spatial variability could significantly predict the severity of depression (r = 0.640) and anxiety (r = 0.616) in MDD.

DATA CONCLUSION

Integration of temporal and spatial variability features provides potential assistance for clinical diagnosis and symptom prediction of MDD.

EVIDENCE LEVEL

2.

TECHNICAL EFFICACY

Stage 2.

Automated recognition of major depressive disorder from cardiovascular and respiratory physiological signals

Major Depressive Disorder (MDD) is a neurohormonal disorder that causes persistent negative thoughts, mood and feelings, often accompanied with suicidal ideation (SI). Current clinical diagnostic approaches are solely based on psychiatric interview questionnaires. Thus, a computational intelligence tool for the automated detection of MDD with and without suicidal ideation is presented in this study. Since MDD is proven to affect cardiovascular and respiratory systems, the aim of the study is to automatically identify the disorder severity in MDD patients using corresponding multi-modal physiological signals, including electrocardiogram (ECG), finger photoplethysmography (PPG) and respiratory signals (RSP). Data from 88 subjects were used in this study, out of which 25 were MDD patients without SI (MDDSI-), 18 MDD patients with SI (MDDSI+), and 45 normal subjects. Multi-modal physiological signals were acquired from each subject, including ECG, RSP, and PPG signals, and then pre-processed. Discrete wavelet transform (DWT) was applied to the signals, which were decomposed up to six levels, and then eleven nonlinear features were extracted. The features were ranked according to the analysis of variance test and Marginal Fisher Analysis was employed to reduce the feature set, after which the reduced features were ranked again to select the most discriminatory features. Support vector machine with polynomial radial basis function (SVM-RBF) as well as k-nearest neighbor (KNN) classifiers were used to classify the significant features. The performance of the classifiers was evaluated in a 10-fold cross validation scheme. The best performance achieved for the classification of MDDSI+ patients was up to 85.2%, by using selected features from the obtained multi-modal signals with SVM-RBF, while it was up to 96.6% for the detection of MDD patients against healthy subjects. This work is a step toward the utilization of automated tools in diagnostics and monitoring of MDD patients in a personalized and wearable healthcare system.

Artificial intelligence assisted tools for the detection of anxiety and depression leading to suicidal ideation in adolescents: a review

Epidemiological studies report high levels of anxiety and depression amongst adolescents. These psychiatric conditions and complex interplays of biological, social and environmental factors are important risk factors for suicidal behaviours and suicide, which show a peak in late adolescence and early adulthood. Although deaths by suicide have fallen globally in recent years, suicide deaths are increasing in some countries, such as the US. Suicide prevention is a challenging global public health problem. Currently, there aren't any validated clinical biomarkers for suicidal diagnosis, and traditional methods exhibit limitations. Artificial intelligence (AI) is budding in many fields, including in the diagnosis of medical conditions. This review paper summarizes recent studies (past 8 years) that employed AI tools for the automated detection of depression and/or anxiety disorder and discusses the limitations and effects of some modalities. The studies assert that AI tools produce promising results and could overcome the limitations of traditional diagnostic methods. Although using AI tools for suicidal ideation exhibits limitations, these are outweighed by the advantages. Thus, this review article also proposes extracting a fusion of features such as facial images, speech signals, and visual and clinical history features from deep models for the automated detection of depression and/or anxiety disorder in individuals, for future work. This may pave the way for the identification of individuals with suicidal thoughts.

Support Vector Machines and Affective Science

Support vector machines (SVMs) are being used increasingly in affective science as a data-driven classification method and feature reduction technique. Whereas traditional statistical methods typically compare group averages on selected variables, SVMs use a predictive algorithm to learn multivariate patterns that optimally discriminate between groups. In this review, we provide a framework for understanding the methods of SVM-based analyses and summarize the findings of seminal studies that use SVMs for classification or data reduction in the behavioral and neural study of emotion and affective disorders. We conclude by discussing promising directions and potential applications of SVMs in future research in affective science.

Treatment-naïve first episode depression classification based on high-order brain functional network

BACKGROUND

Recent functional connectivity (FC) studies have proved the potential value of resting-state functional magnetic resonance imaging (rs-fMRI) in the study of major depressive disorder (MDD); yet, the rs-fMRI-based individualized diagnosis of MDD is still challenging.

METHODS

We enrolled 82 treatment-naïve first episode depression (FED) adults and 72 matched normal control (NC). A computer-aided diagnosis framework was utilized to classify the FEDs from the NCs based on the features extracted from not only traditional "low-order" FC networks (LON) based on temporal synchronization of original rs-fMRI signals, but also "high-order" FC networks (HON) that characterize more complex functional interactions via correlation of the dynamic (time-varying) FCs. We contrasted a classifier using HON feature (C_HON) and compared its performance with using LON only (C_LON). Finally, an integrated classification model with both features was proposed to further enhance FED classification.

RESULTS

The C_HON had significantly improved diagnostic accuracy compared to the C_LON (82.47% vs. 67.53%). Joint classification further improved the performance (83.77%). The brain regions with potential diagnostic values mainly encompass the high-order cognitive function-related networks. Importantly, we found previously less-reported potential imaging biomarkers that involve the vermis and the crus II in the cerebellum.

LIMITATIONS

We only used one imaging modality and did not examine data from different subtypes of depression.

CONCLUSIONS

Depression classification could be significantly improved by using HON features that better capture the higher-level brain functional interactions. The findings suggest the importance of higher-level cerebro-cerebellar interactions in the pathophysiology of MDD.

Application of clinical bioinformatics in lung cancer-specific biomarkers

The fact that lung cancer is a heterogeneous disease suggests that there is a high likelihood that effective lung cancer biomarkers will need to address patient-specific molecular defects, clinical characters, and aspects of the tumor microenvironment. In this transition, clinical bioinformatics tools and resources are the most appropriate means to improve the analysis, as major biological databases are now containing clinical data alongside genomics, proteomics, and other biological data. Clinical bioinformatics comprises a series of concepts and approaches that have been used successfully both to delineate novel biological mechanisms and to drive translational advances in individualized healthcare. In this article, we outline several of emerging clinical bioinformatics-based strategies as they apply specifically to lung cancer.

Toward Probabilistic Diagnosis and Understanding of Depression Based on Functional MRI Data Analysis with Logistic Group LASSO

Diagnosis of psychiatric disorders based on brain imaging data is highly desirable in clinical applications. However, a common problem in applying machine learning algorithms is that the number of imaging data dimensions often greatly exceeds the number of available training samples. Furthermore, interpretability of the learned classifier with respect to brain function and anatomy is an important, but non-trivial issue. We propose the use of logistic regression with a least absolute shrinkage and selection operator (LASSO) to capture the most critical input features. In particular, we consider application of group LASSO to select brain areas relevant to diagnosis. An additional advantage of LASSO is its probabilistic output, which allows evaluation of diagnosis certainty. To verify our approach, we obtained semantic and phonological verbal fluency fMRI data from 31 depression patients and 31 control subjects, and compared the performances of group LASSO (gLASSO), and sparse group LASSO (sgLASSO) to those of standard LASSO (sLASSO), Support Vector Machine (SVM), and Random Forest. Over 90% classification accuracy was achieved with gLASSO, sgLASSO, as well as SVM; however, in contrast to SVM, LASSO approaches allow for identification of the most discriminative weights and estimation of prediction reliability. Semantic task data revealed contributions to the classification from left precuneus, left precentral gyrus, left inferior frontal cortex (pars triangularis), and left cerebellum (c rus1). Weights for the phonological task indicated contributions from left inferior frontal operculum, left post central gyrus, left insula, left middle frontal cortex, bilateral middle temporal cortices, bilateral precuneus, left inferior frontal cortex (pars triangularis), and left precentral gyrus. The distribution of normalized odds ratios further showed, that predictions with absolute odds ratios higher than 0.2 could be regarded as certain.

Sparse network-based models for patient classification using fMRI

Pattern recognition applied to whole-brain neuroimaging data, such as functional Magnetic Resonance Imaging (fMRI), has proved successful at discriminating psychiatric patients from healthy participants. However, predictive patterns obtained from whole-brain voxel-based features are difficult to interpret in terms of the underlying neurobiology. Many psychiatric disorders, such as depression and schizophrenia, are thought to be brain connectivity disorders. Therefore, pattern recognition based on network models might provide deeper insights and potentially more powerful predictions than whole-brain voxel-based approaches. Here, we build a novel sparse network-based discriminative modeling framework, based on Gaussian graphical models and L1-norm regularized linear Support Vector Machines (SVM). In addition, the proposed framework is optimized in terms of both predictive power and reproducibility/stability of the patterns. Our approach aims to provide better pattern interpretation than voxel-based whole-brain approaches by yielding stable brain connectivity patterns that underlie discriminative changes in brain function between the groups. We illustrate our technique by classifying patients with major depressive disorder (MDD) and healthy participants, in two (event- and block-related) fMRI datasets acquired while participants performed a gender discrimination and emotional task, respectively, during the visualization of emotional valent faces.

An algorithm for determination of rank and degree of contribution of sMRI volumetric features in depression detection

Brain volume changes at structural level appear to have utmost importance in depression biomarkers studies. However, these brain volumetric findings have very minimal utilization in depression detection studies at individual level. Thus, this paper presents an evaluation of volumetric features to identify the relevant/optimal features for the detection of depression. An algorithm is presented for determination of rank and degree of contribution (DoC) of structural magnetic resonance imaging (sMRI) volumetric features. The algorithm is based on the frequencies of each feature contribution toward the desired accuracy limit. Forty-four volumetric features from various brain regions were adopted for evaluation. From DoC analysis, the DoC of each volumetric feature for depression detection is calculated and the features that dominate the contribution are determined.