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Chen Y, Xu J, Wu J, Chen H, Kang Y, Yang Y, Gong Z, Huang Y, Wang H, Wang B, Zhan S, Tan W. Aberrant concordance among dynamics of spontaneous brain activity in patients with migraine without aura: A multivariate pattern analysis study. Heliyon 2024; 10:e30008. [PMID: 38737279 PMCID: PMC11088259 DOI: 10.1016/j.heliyon.2024.e30008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/08/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Background Alterations in the static and dynamic characteristics of spontaneous brain activity have been extensively studied to investigate functional brain changes in migraine without aura (MwoA). However, alterations in concordance among the dynamics of spontaneous brain activity in MwoA remain largely unknown. This study aimed to determine the possibilities of diagnosis based on the concordance indices. Methods Resting-state functional MRI scans were performed on 32 patients with MwoA and 33 matched healthy controls (HCs) in the first cohort, as well as 36 patients with MwoA and 32 HCs in the validation cohort. The dynamic indices including fractional amplitude of low-frequency fluctuation, regional homogeneity, voxel-mirrored homotopic connectivity, degree centrality and global signal connectivity were analyzed. We calculated the concordance of grey matter volume-wise (across voxels) and voxel-wise (across time windows) to quantify the degree of integration among different functional levels represented by these dynamic indices. Subsequently, the voxel-wise concordance alterations were analyzed as features for multi-voxel pattern analysis (MVPA) utilizing the support vector machine. Results Compared with that of HCs, patients with MwoA had lower whole-grey matter volume-wise concordance, and the mean value of volume-wise concordance was negatively correlated with the frequency of migraine attacks. The MVPA results revealed that the most discriminative brain regions were the right thalamus, right cerebellar Crus II, left insula, left precentral gyrus, right cuneus, and left inferior occipital gyrus. Conclusions Concordance alterations in the dynamics of spontaneous brain activity in brain regions could be an important feature in the identification of patients with MwoA.
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Affiliation(s)
- Yilei Chen
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Xu
- Pharmacy Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiazhen Wu
- Department of Radiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Chen
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yingjie Kang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuchan Yang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhigang Gong
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanwen Huang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Wang
- Department of Acupuncture and Moxibustion, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Songhua Zhan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenli Tan
- Department of Radiology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Jia Y, Yang B, Yang Y, Zheng W, Wang L, Huang C, Lu J, Chen N. Application of machine learning techniques in the diagnostic approach of PTSD using MRI neuroimaging data: A systematic review. Heliyon 2024; 10:e28559. [PMID: 38571633 PMCID: PMC10988057 DOI: 10.1016/j.heliyon.2024.e28559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
Background At present, the diagnosis of post-traumatic stress disorder(PTSD) mainly relies on clinical symptoms and psychological scales, and finding objective indicators that are helpful for diagnosis has always been a challenge in clinical practice and academic research. Neuroimaging is a useful and powerful tool for discovering the biomarkers of PTSD,especially functional MRI (fMRI), structural MRI (sMRI) and Diffusion Weighted Imaging(DTI)are the most commonly used technologies, which can provide multiple perspectives on brain function, structure and its connectivity. Machine learning (ML) is an emerging and potentially powerful method, which has aroused people's interest because it is used together with neuroimaging data to define brain structural and functional abnormalities related to diseases, and identify phenotypes, such as helping physicians make early diagnosis. Objectives According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) declaration, a systematic review was conducted to assess its accuracy in distinguishing between PTSD patients, TEHC(Trauma-Exposed Healthy Controls), and HC(healthy controls). Methods We searched PubMed, Embase, and Web of Science using common words for ML methods and PTSD until June 2023, with no language or time limits. This review includes 13 studies, with sensitivity, specificity, and accuracy taken from each publication or acquired directly from the authors. Results All ML techniques have an diagnostic accuracy rate above 70%,and support vector machine(SVM) are the most commonly used techniques. This series of studies has revealed significant neurobiological differences in key brain regions among individuals with PTSD, TEHC, and HC. The connectivity patterns of regions such as the Insula and Amygdala hold particular significance in distinguishing these groups. TEHC exhibits more normal connectivity patterns compared to PTSD, providing valuable insights for the application of machine learning in PTSD diagnosis. Conclusion In contrast to any currently available assessment and clinical diagnosis, ML techniques can be used as an effective and non-invasive support for early identification and detection of patients as well as for early screening of high-risk populations.
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Affiliation(s)
- Y.L. Jia
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - B.N. Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - Y.H. Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - W.M. Zheng
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - L. Wang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - C.Y. Huang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - J. Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
| | - N. Chen
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, 100053, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, 100053, China
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Chen Z, Ou Y, Liu F, Li H, Li P, Xie G, Cui X, Guo W. Increased brain nucleus accumbens functional connectivity in melancholic depression. Neuropharmacology 2024; 243:109798. [PMID: 37995807 DOI: 10.1016/j.neuropharm.2023.109798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Melancholic depression, marked by typical symptoms of anhedonia, is regarded as a homogeneous subtype of major depressive disorder (MDD). However, little attention was paid to underlying mechanisms of melancholic depression. This study aims to examine functional connectivity of the reward circuit associated with anhedonia symptoms in melancholic depression. METHODS Fifty-nine patients with first-episode drug- naive MDD, including 31 melancholic patients and 28 non-melancholic patients, were recruited and underwent resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-two healthy volunteers were recruited as controls. Bilateral nucleus accumbens (NAc) were selected as seed points to form functional NAc network. Then support vector machine (SVM) was used to distinguish melancholic patients from non-melancholic patients. RESULTS Relative to non-melancholic patients, melancholic patients displayed increased functional connectivity (FC) between bilateral NAc and right middle frontal gyrus (MFG) and between right NAc and left cerebellum lobule VIII. Compared to healthy controls, melancholic patients showed increased FC between right NAc and right lingual gyrus and between left NAc and left postcentral gyrus; non-melancholic patients had increased FC between bilateral NAc and right lingual gyrus. No significant correlations were observed between altered FC and clinical variables in melancholic patients. SVM results showed that FC between left NAc and right MFG could accurately distinguish melancholic patients from non-melancholic patients. CONCLUSION Melancholic depression exhibited different patterns of functional connectivity of the reward circuit relative to non-melancholic patients. This study highlights the significance of the reward circuit in the neuropathology of melancholic depression.
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Affiliation(s)
- Zhaobin Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yangpan Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Guangrong Xie
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xilong Cui
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Zhu X, Kim Y, Ravid O, He X, Suarez-Jimenez B, Zilcha-Mano S, Lazarov A, Lee S, Abdallah CG, Angstadt M, Averill CL, Baird CL, Baugh LA, Blackford JU, Bomyea J, Bruce SE, Bryant RA, Cao Z, Choi K, Cisler J, Cotton AS, Daniels JK, Davenport ND, Davidson RJ, DeBellis MD, Dennis EL, Densmore M, deRoon-Cassini T, Disner SG, Hage WE, Etkin A, Fani N, Fercho KA, Fitzgerald J, Forster GL, Frijling JL, Geuze E, Gonenc A, Gordon EM, Gruber S, Grupe DW, Guenette JP, Haswell CC, Herringa RJ, Herzog J, Hofmann DB, Hosseini B, Hudson AR, Huggins AA, Ipser JC, Jahanshad N, Jia-Richards M, Jovanovic T, Kaufman ML, Kennis M, King A, Kinzel P, Koch SBJ, Koerte IK, Koopowitz SM, Korgaonkar MS, Krystal JH, Lanius R, Larson CL, Lebois LAM, Li G, Liberzon I, Lu GM, Luo Y, Magnotta VA, Manthey A, Maron-Katz A, May G, McLaughlin K, Mueller SC, Nawijn L, Nelson SM, Neufeld RWJ, Nitschke JB, O'Leary EM, Olatunji BO, Olff M, Peverill M, Phan KL, Qi R, Quidé Y, Rektor I, Ressler K, Riha P, Ross M, Rosso IM, Salminen LE, Sambrook K, Schmahl C, Shenton ME, Sheridan M, Shih C, Sicorello M, Sierk A, Simmons AN, Simons RM, Simons JS, Sponheim SR, Stein MB, Stein DJ, Stevens JS, Straube T, Sun D, Théberge J, Thompson PM, Thomopoulos SI, van der Wee NJA, van der Werff SJA, van Erp TGM, van Rooij SJH, van Zuiden M, Varkevisser T, Veltman DJ, Vermeiren RRJM, Walter H, Wang L, Wang X, Weis C, Winternitz S, Xie H, Zhu Y, Wall M, Neria Y, Morey RA. Neuroimaging-based classification of PTSD using data-driven computational approaches: A multisite big data study from the ENIGMA-PGC PTSD consortium. Neuroimage 2023; 283:120412. [PMID: 37858907 PMCID: PMC10842116 DOI: 10.1016/j.neuroimage.2023.120412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/10/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. However, current machine learning studies limited to small homogeneous samples, different methodologies, and different imaging collection protocols, limit the ability to directly compare and generalize their results. Here we aimed to classify individuals with PTSD versus controls and assess the generalizability using a large heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group. METHODS We analyzed brain MRI data from 3,477 structural-MRI; 2,495 resting state-fMRI; and 1,952 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls using traditional machine learning methods. Second, we assessed the utility of the denoising variational autoencoder (DVAE) and evaluated its classification performance. Third, we assessed the generalizability and reproducibility of both models using leave-one-site-out cross-validation procedure for each modality. RESULTS We found lower performance in classifying PTSD vs. controls with data from over 20 sites (60 % test AUC for s-MRI, 59 % for rs-fMRI and 56 % for d-MRI), as compared to other studies run on single-site data. The performance increased when classifying PTSD from HC without trauma history in each modality (75 % AUC). The classification performance remained intact when applying the DVAE framework, which reduced the number of features. Finally, we found that the DVAE framework achieved better generalization to unseen datasets compared with the traditional machine learning frameworks, albeit performance was slightly above chance. CONCLUSION These results have the potential to provide a baseline classification performance for PTSD when using large scale neuroimaging datasets. Our findings show that the control group used can heavily affect classification performance. The DVAE framework provided better generalizability for the multi-site data. This may be more significant in clinical practice since the neuroimaging-based diagnostic DVAE classification models are much less site-specific, rendering them more generalizable.
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Affiliation(s)
- Xi Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Yoojean Kim
- New York State Psychiatric Institute, New York, NY, USA
| | - Orren Ravid
- New York State Psychiatric Institute, New York, NY, USA
| | - Xiaofu He
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | | | | | | | - Seonjoo Lee
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Chadi G Abdallah
- Baylor College of Medicine, Houston, TX, USA; Yale University School of Medicine, New Haven, CT, USA
| | | | - Christopher L Averill
- Baylor College of Medicine, Houston, TX, USA; Yale University School of Medicine, New Haven, CT, USA
| | | | - Lee A Baugh
- Sanford School of Medicine, University of South Dakota, Vermillion, SD, USA
| | | | | | - Steven E Bruce
- Center for Trauma Recovery, Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Zhihong Cao
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China
| | - Kyle Choi
- University of California San Diego, La Jolla, CA, USA
| | - Josh Cisler
- Department of Psychiatry, University of Texas at Austin, Austin, TX, USA
| | | | | | | | | | | | - Emily L Dennis
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Maria Densmore
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | | | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Wissam El Hage
- UMR 1253, CIC 1415, University of Tours, CHRU de Tours, INSERM, France
| | | | - Negar Fani
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Kelene A Fercho
- Civil Aerospace Medical Institute, US Federal Aviation Administration, Oklahoma City, OK, USA
| | | | - Gina L Forster
- Brain Health Research Centre, Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Atilla Gonenc
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
| | - Evan M Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Staci Gruber
- Cognitive and Clinical Neuroimaging Core, McLean Hospital, Belmont, MA, USA
| | | | - Jeffrey P Guenette
- Division of Neuroradiology, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Ryan J Herringa
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | | | | | | | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | - Milissa L Kaufman
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Mitzy Kennis
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | | | - Philipp Kinzel
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - Saskia B J Koch
- Donders Institute for Brain, Cognition and Behavior, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Inga K Koerte
- Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Ruth Lanius
- Department of Neuroscience, Western University, London, ON, Canada
| | | | - Lauren A M Lebois
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Gen Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Israel Liberzon
- Psychiatry and Behavioral Science, Texas A&M University Health Science Center, College Station, TX, USA
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yifeng Luo
- Department of Radiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China
| | | | - Antje Manthey
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | | | - Geoffery May
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA
| | | | | | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, VU University, Amsterdam, The Netherlands
| | - Steven M Nelson
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Richard W J Neufeld
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | | | | | - Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - K Luan Phan
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | - Rongfeng Qi
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Yann Quidé
- School of Psychology, University of New South Wales, Sydney, NSW, Australia; Neuroscience Research Australia, Randwick, NSW, Australia
| | | | - Kerry Ressler
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Marisa Ross
- Northwestern Neighborhood and Networks Initiative, Northwestern University Institute for Policy Research, Evanston, IL, USA
| | - Isabelle M Rosso
- McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Lauren E Salminen
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | - Anika Sierk
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Alan N Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | | | | | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN, USA; University of Minnesota, Minneapolis, MN, USA
| | | | - Dan J Stein
- University of Cape Town, Cape Town, South Africa
| | - Jennifer S Stevens
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | | | | | - Jean Théberge
- Departments of Psychology and Psychiatry, Neuroscience Program, Western University, London, ON, Canada; Department of Psychology, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, CA, USA
| | | | | | | | - Sanne J H van Rooij
- Emory University Department of Psychiatry and Behavioral Sciences, Atlanta, GA, USA
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tim Varkevisser
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, VU University Medical Center, VU University, Amsterdam, The Netherlands
| | | | - Henrik Walter
- Charité Universitätsmedizin Berlin Campus Charite Mitte: Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Li Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Wang
- University of Toledo, Toledo, OH, USA
| | - Carissa Weis
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sherry Winternitz
- Division of Women's Mental Health, McLean Hospital, Belmont, MA, USA
| | - Hong Xie
- University of Toledo, Toledo, OH, USA
| | - Ye Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Melanie Wall
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Yuval Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
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Wu Y, Mao K, Dennett L, Zhang Y, Chen J. Systematic review of machine learning in PTSD studies for automated diagnosis evaluation. NPJ MENTAL HEALTH RESEARCH 2023; 2:16. [PMID: 38609504 PMCID: PMC10955977 DOI: 10.1038/s44184-023-00035-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/18/2023] [Indexed: 04/14/2024]
Abstract
Post-traumatic stress disorder (PTSD) is frequently underdiagnosed due to its clinical and biological heterogeneity. Worldwide, many people face barriers to accessing accurate and timely diagnoses. Machine learning (ML) techniques have been utilized for early assessments and outcome prediction to address these challenges. This paper aims to conduct a systematic review to investigate if ML is a promising approach for PTSD diagnosis. In this review, statistical methods were employed to synthesize the outcomes of the included research and provide guidance on critical considerations for ML task implementation. These included (a) selection of the most appropriate ML model for the available dataset, (b) identification of optimal ML features based on the chosen diagnostic method, (c) determination of appropriate sample size based on the distribution of the data, and (d) implementation of suitable validation tools to assess the performance of the selected ML models. We screened 3186 studies and included 41 articles based on eligibility criteria in the final synthesis. Here we report that the analysis of the included studies highlights the potential of artificial intelligence (AI) in PTSD diagnosis. However, implementing AI-based diagnostic systems in real clinical settings requires addressing several limitations, including appropriate regulation, ethical considerations, and protection of patient privacy.
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Affiliation(s)
- Yuqi Wu
- Electrical & Computer Engineering Department, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Kaining Mao
- Electrical & Computer Engineering Department, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Liz Dennett
- Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
| | - Jie Chen
- Electrical & Computer Engineering Department, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada.
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Lee H, Oh S, Ha E, Joo Y, Suh C, Kim Y, Jeong H, Lyoo IK, Yoon S, Hong H. Cerebral cortical thinning in brain regions involved in emotional regulation relates to persistent symptoms in subjects with posttraumatic stress disorder. Psychiatry Res 2023; 327:115345. [PMID: 37516039 DOI: 10.1016/j.psychres.2023.115345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 07/31/2023]
Abstract
A considerable proportion of individuals exposed to trauma experience chronic and persistent posttraumatic stress disorder (PTSD). However, the specific brain and clinical features that render trauma-exposed individuals more susceptible to enduring symptoms remain elusive. This study investigated 112 trauma-exposed participants who had been diagnosed with PTSD and 112 demographically-matched healthy controls. Trauma-exposed participants were classified into those with current PTSD (persistent PTSD, n = 78) and those without (remitted PTSD, n = 34). Cortical thickness analysis was performed to discern group-specific brain structural characteristics. Coping strategies and resilience levels, assessed as clinical attributes, were compared across the groups. The persistent PTSD group displayed cortical thinning in the superior frontal cortex (SFC), insula, superior temporal cortex, dorsolateral prefrontal cortex, superior parietal cortex, and precuneus, relative to the remitted PTSD and control groups. Cortical thinning in the SFC was associated with increased utilization of maladaptive coping strategies, while diminished thickness in the insula correlated with lower resilience levels among trauma-exposed individuals. These findings imply that cortical thinning in brain regions related to coping strategy and resilience plays a vital role in the persistence of PTSD symptoms.
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Affiliation(s)
- Hyangwon Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sohyun Oh
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Yoonji Joo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Chaewon Suh
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yejin Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Hyeonseok Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea; Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
| | - Haejin Hong
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea.
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7
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Chang B, Xiong C, Ni C, Chen P, Jiang M, Mei J, Niu C. Prediction of STN-DBS for Parkinson's disease by uric acid-related brain function connectivity: A machine learning study based on resting state function MRI. Front Aging Neurosci 2023; 15:1105107. [PMID: 36824266 PMCID: PMC9941535 DOI: 10.3389/fnagi.2023.1105107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Parkinson's disease (PD) is a neurodegenerative disorder characterized by dyskinesia and is closely related to oxidative stress. Uric acid (UA) is a natural antioxidant found in the body. Previous studies have shown that UA has played an important role in the development and development of PD and is an important biomarker. Subthalamic nucleus deep brain stimulation (STN-DBS) is a common treatment for PD. Methods Based on resting state function MRI (rs-fMRI), the relationship between UA-related brain function connectivity (FC) and STN-DBS outcomes in PD patients was studied. We use UA and DC values from different brain regions to build the FC characteristics and then use the SVR model to predict the outcome of the operation. Results The results show that PD patients with UA-related FCs are closely related to STN-DBS efficacy and can be used to predict prognosis. A machine learning model based on UA-related FC was successfully developed for PD patients. Discussion The two biomarkers, UA and rs-fMRI, were combined to predict the prognosis of STN-DBS in treating PD. Neurosurgeons are provided with effective tools to screen the best candidate and predict the prognosis of the patient.
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Affiliation(s)
- Bowen Chang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Chi Xiong
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Chen Ni
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Peng Chen
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Manli Jiang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Jiaming Mei
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China
| | - Chaoshi Niu
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, Anhui, China,*Correspondence: Chaoshi Niu,
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8
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Li Q, Coulson Theodorsen M, Konvalinka I, Eskelund K, Karstoft KI, Bo Andersen S, Andersen TS. Resting-state EEG functional connectivity predicts post-traumatic stress disorder subtypes in veterans. J Neural Eng 2022; 19. [PMID: 36250685 DOI: 10.1088/1741-2552/ac9aaf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/13/2022] [Indexed: 01/11/2023]
Abstract
Objective. Post-traumatic stress disorder (PTSD) is highly heterogeneous, and identification of quantifiable biomarkers that could pave the way for targeted treatment remains a challenge. Most previous electroencephalography (EEG) studies on PTSD have been limited to specific handpicked features, and their findings have been highly variable and inconsistent. Therefore, to disentangle the role of promising EEG biomarkers, we developed a machine learning framework to investigate a wide range of commonly used EEG biomarkers in order to identify which features or combinations of features are capable of characterizing PTSD and potential subtypes.Approach. We recorded 5 min of eyes-closed and 5 min of eyes-open resting-state EEG from 202 combat-exposed veterans (53% with probable PTSD and 47% combat-exposed controls). Multiple spectral, temporal, and connectivity features were computed and logistic regression, random forest, and support vector machines with feature selection methods were employed to classify PTSD. To obtain robust results, we performed repeated two-layer cross-validation to test on an entirely unseen test set.Main results. Our classifiers obtained a balanced test accuracy of up to 62.9% for predicting PTSD patients. In addition, we identified two subtypes within PTSD: one where EEG patterns were similar to those of the combat-exposed controls, and another that were characterized by increased global functional connectivity. Our classifier obtained a balanced test accuracy of 79.4% when classifying this PTSD subtype from controls, a clear improvement compared to predicting the whole PTSD group. Interestingly, alpha connectivity in the dorsal and ventral attention network was particularly important for the prediction, and these connections were positively correlated with arousal symptom scores, a central symptom cluster of PTSD.Significance. Taken together, the novel framework presented here demonstrates how unsupervised subtyping can delineate heterogeneity and improve machine learning prediction of PTSD, and may pave the way for better identification of quantifiable biomarkers.
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Affiliation(s)
- Qianliang Li
- Section for Cognitive Systems, DTU Compute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Maya Coulson Theodorsen
- Section for Cognitive Systems, DTU Compute, Technical University of Denmark, Kongens Lyngby, Denmark.,Department of Military Psychology, Danish Veteran Centre, Danish Defence, Copenhagen, Denmark.,Research and Knowledge Centre, Danish Veteran Centre, Danish Defence, Ringsted, Denmark
| | - Ivana Konvalinka
- Section for Cognitive Systems, DTU Compute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Kasper Eskelund
- Department of Military Psychology, Danish Veteran Centre, Danish Defence, Copenhagen, Denmark.,Research and Knowledge Centre, Danish Veteran Centre, Danish Defence, Ringsted, Denmark
| | - Karen-Inge Karstoft
- Research and Knowledge Centre, Danish Veteran Centre, Danish Defence, Ringsted, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Søren Bo Andersen
- Research and Knowledge Centre, Danish Veteran Centre, Danish Defence, Ringsted, Denmark
| | - Tobias S Andersen
- Section for Cognitive Systems, DTU Compute, Technical University of Denmark, Kongens Lyngby, Denmark
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9
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Fitzgerald JM, Webb EK, Weis CN, Huggins AA, Bennett KP, Miskovich TA, Krukowski JL, deRoon-Cassini TA, Larson CL. Hippocampal Resting-State Functional Connectivity Forecasts Individual Posttraumatic Stress Disorder Symptoms: A Data-Driven Approach. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:139-149. [PMID: 34478884 PMCID: PMC8825698 DOI: 10.1016/j.bpsc.2021.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/18/2021] [Accepted: 08/22/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a debilitating disorder, and there is no current accurate prediction of who develops it after trauma. Neurobiologically, individuals with chronic PTSD exhibit aberrant resting-state functional connectivity (rsFC) between the hippocampus and other brain regions (e.g., amygdala, prefrontal cortex, posterior cingulate), and these aberrations correlate with severity of illness. Previous small-scale research (n < 25) has also shown that hippocampal rsFC measured acutely after trauma is predictive of future severity using a region-of-interest-based approach. While this is a promising biomarker, to date, no study has used a data-driven approach to test whole-brain hippocampal FC patterns in forecasting the development of PTSD symptoms. METHODS A total of 98 adults at risk of PTSD were recruited from the emergency department after traumatic injury and completed resting-state functional magnetic resonance imaging (8 min) within 1 month; 6 months later, they completed the Clinician-Administered PTSD Scale for DSM-5 for assessment of PTSD symptom severity. Whole-brain rsFC values with bilateral hippocampi were extracted (using CONN) and used in a machine learning kernel ridge regression analysis (PRoNTo); a k-folds (k = 10) and 70/30 testing versus training split approach were used for cross-validation (1000 iterations to bootstrap confidence intervals for significance values). RESULTS Acute hippocampal rsFC significantly predicted Clinician-Administered PTSD Scale for DSM-5 scores at 6 months (r = 0.30, p = .006; mean squared error = 120.58, p = .006; R2 = 0.09, p = .025). In post hoc analyses, hippocampal rsFC remained significant after controlling for demographics, PTSD symptoms at baseline, and depression, anxiety, and stress severity at 6 months (B = 0.59, SE = 0.20, p = .003). CONCLUSIONS Findings suggest that functional connectivity of the hippocampus across the brain acutely after traumatic injury is associated with prospective PTSD symptom severity.
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Affiliation(s)
| | - Elisabeth Kate Webb
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Carissa N. Weis
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Ashley A. Huggins
- Medical University of South Carolina, Department of Psychiatry, Charleston, SC, USA
| | | | | | | | - Terri A. deRoon-Cassini
- Medical College of Wisconsin, Department of Surgery, Division of Trauma & Acute Care Surgery, Milwaukee, WI, USA
| | - Christine L. Larson
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
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10
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Trousset V, Lefèvre T. Artificial Intelligence in Medicine and PTSD. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Bertl M, Metsallik J, Ross P. A systematic literature review of AI-based digital decision support systems for post-traumatic stress disorder. Front Psychiatry 2022; 13:923613. [PMID: 36016975 PMCID: PMC9396247 DOI: 10.3389/fpsyt.2022.923613] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Over the last decade, an increase in research on medical decision support systems has been observed. However, compared to other disciplines, decision support systems in mental health are still in the minority, especially for rare diseases like post-traumatic stress disorder (PTSD). We aim to provide a comprehensive analysis of state-of-the-art digital decision support systems (DDSSs) for PTSD. METHODS Based on our systematic literature review of DDSSs for PTSD, we created an analytical framework using thematic analysis for feature extraction and quantitative analysis for the literature. Based on this framework, we extracted information around the medical domain of DDSSs, the data used, the technology used for data collection, user interaction, decision-making, user groups, validation, decision type and maturity level. Extracting data for all of these framework dimensions ensures consistency in our analysis and gives a holistic overview of DDSSs. RESULTS Research on DDSSs for PTSD is rare and primarily deals with the algorithmic part of DDSSs (n = 17). Only one DDSS was found to be a usable product. From a data perspective, mostly checklists or questionnaires were used (n = 9). While the median sample size of 151 was rather low, the average accuracy was 82%. Validation, excluding algorithmic accuracy (like user acceptance), was mostly neglected, as was an analysis concerning possible user groups. CONCLUSION Based on a systematic literature review, we developed a framework covering all parts (medical domain, data used, technology used for data collection, user interaction, decision-making, user groups, validation, decision type and maturity level) of DDSSs. Our framework was then used to analyze DDSSs for post-traumatic stress disorder. We found that DDSSs are not ready-to-use products but are mostly algorithms based on secondary datasets. This shows that there is still a gap between technical possibilities and real-world clinical work.
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Affiliation(s)
- Markus Bertl
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Janek Metsallik
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
| | - Peeter Ross
- Department of Health Technologies, School of Information Technologies, Tallinn University of Technology, Tallinn, Estonia
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12
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Roeckner AR, Oliver KI, Lebois LAM, van Rooij SJH, Stevens JS. Neural contributors to trauma resilience: a review of longitudinal neuroimaging studies. Transl Psychiatry 2021; 11:508. [PMID: 34611129 PMCID: PMC8492865 DOI: 10.1038/s41398-021-01633-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
Resilience in the face of major life stressors is changeable over time and with experience. Accordingly, differing sets of neurobiological factors may contribute to an adaptive stress response before, during, and after the stressor. Longitudinal studies are therefore particularly effective in answering questions about the determinants of resilience. Here we provide an overview of the rapidly-growing body of longitudinal neuroimaging research on stress resilience. Despite lingering gaps and limitations, these studies are beginning to reveal individual differences in neural circuit structure and function that appear protective against the emergence of future psychopathology following a major life stressor. Here we outline a neural circuit model of resilience to trauma. Specifically, pre-trauma biomarkers of resilience show that an ability to modulate activity within threat and salience networks predicts fewer stress-related symptoms. In contrast, early post-trauma biomarkers of subsequent resilience or recovery show a more complex pattern, spanning a number of major circuits including attention and cognitive control networks as well as primary sensory cortices. This novel synthesis suggests stress resilience may be scaffolded by stable individual differences in the processing of threat cues, and further buttressed by post-trauma adaptations to the stressor that encompass multiple mechanisms and circuits. More attention and resources supporting this work will inform the targets and timing of mechanistic resilience-boosting interventions.
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Affiliation(s)
- Alyssa R. Roeckner
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Katelyn I. Oliver
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Lauren A. M. Lebois
- grid.240206.20000 0000 8795 072XDivision of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA
| | - Sanne J. H. van Rooij
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
| | - Jennifer S. Stevens
- grid.189967.80000 0001 0941 6502Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA USA
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13
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Zhu Z, Lei D, Qin K, Suo X, Li W, Li L, DelBello MP, Sweeney JA, Gong Q. Combining Deep Learning and Graph-Theoretic Brain Features to Detect Posttraumatic Stress Disorder at the Individual Level. Diagnostics (Basel) 2021; 11:1416. [PMID: 34441350 PMCID: PMC8391111 DOI: 10.3390/diagnostics11081416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/18/2021] [Accepted: 07/28/2021] [Indexed: 02/05/2023] Open
Abstract
Previous studies using resting-state functional MRI (rs-fMRI) have revealed alterations in graphical metrics in groups of individuals with posttraumatic stress disorder (PTSD). To explore the ability of graph measures to diagnose PTSD and capture its essential features in individual patients, we used a deep learning (DL) model based on a graph-theoretic approach to discriminate PTSD from trauma-exposed non-PTSD at the individual level and to identify its most discriminant features. Our study was performed on rs-fMRI data from 91 individuals with PTSD and 126 trauma-exposed non-PTSD patients. To evaluate our DL method, we used the traditional support vector machine (SVM) classifier as a reference. Our results showed that the proposed DL model allowed single-subject discrimination of PTSD and trauma-exposed non-PTSD individuals with higher accuracy (average: 80%) than the traditional SVM (average: 57.7%). The top 10 DL features were identified within the default mode, central executive, and salience networks; the first two of these networks were also identified in the SVM classification. We also found that nodal efficiency in the left fusiform gyrus was negatively correlated with the Clinician Administered PTSD Scale score. These findings demonstrate that DL based on graphical features is a promising method for assisting in the diagnosis of PTSD.
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Affiliation(s)
- Ziyu Zhu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45219, USA; (D.L.); (M.P.D.)
| | - Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
| | - Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha 410008, China;
| | - Melissa P. DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45219, USA; (D.L.); (M.P.D.)
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH 45219, USA; (D.L.); (M.P.D.)
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; (Z.Z.); (K.Q.); (X.S.); (W.L.); (J.A.S.)
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610000, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Chengdu 610000, China
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14
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Jia C, Ou Y, Chen Y, Ma J, Zhan C, Lv D, Yang R, Shang T, Sun L, Wang Y, Zhang G, Sun Z, Wang W, Wang X, Guo W, Li P. Disrupted Asymmetry of Inter- and Intra-Hemispheric Functional Connectivity at Rest in Medication-Free Obsessive-Compulsive Disorder. Front Neurosci 2021; 15:634557. [PMID: 34177445 PMCID: PMC8220135 DOI: 10.3389/fnins.2021.634557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Disrupted functional asymmetry of cerebral hemispheres may be altered in patients with obsessive-compulsive disorder (OCD). However, little is known about whether anomalous brain asymmetries originate from inter- and/or intra-hemispheric functional connectivity (FC) at rest in OCD. In this study, resting-state functional magnetic resonance imaging was applied to 40 medication-free patients with OCD and 38 gender-, age-, and education-matched healthy controls (HCs). Data were analyzed using the parameter of asymmetry (PAS) and support vector machine methods. Patients with OCD showed significantly increased PAS in the left posterior cingulate cortex, left precentral gyrus/postcentral gyrus, and right inferior occipital gyrus and decreased PAS in the left dorsolateral prefrontal cortex (DLPFC), bilateral middle cingulate cortex (MCC), left inferior parietal lobule, and left cerebellum Crus I. A negative correlation was found between decreased PAS in the left DLPFC and Yale-Brown Obsessive-compulsive Scale compulsive behavior scores in the patients. Furthermore, decreased PAS in the bilateral MCC could be used to distinguish OCD from HCs with a sensitivity of 87.50%, an accuracy of 88.46%, and a specificity of 89.47%. These results highlighted the contribution of disrupted asymmetry of intra-hemispheric FC within and outside the cortico-striato-thalamocortical circuits at rest in the pathophysiology of OCD, and reduced intra-hemispheric FC in the bilateral MCC may serve as a potential biomarker to classify individuals with OCD from HCs.
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Affiliation(s)
- Cuicui Jia
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Yangpan Ou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yunhui Chen
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Jidong Ma
- Department of Psychiatry, Baiyupao Psychiatric Hospital of Harbin, Harbin, China
| | - Chuang Zhan
- Department of Psychiatry, Baiyupao Psychiatric Hospital of Harbin, Harbin, China
| | - Dan Lv
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tinghuizi Shang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Lei Sun
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Yuhua Wang
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Guangfeng Zhang
- Department of Radiology, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China
| | - Zhenghai Sun
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
| | - Wei Wang
- Department of Library, Qiqihar Medical University, Qiqihar, China
| | - Xiaoping Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, China
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15
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Decreased Nucleus Accumbens Connectivity at Rest in Medication-Free Patients with Obsessive-Compulsive Disorder. Neural Plast 2021; 2021:9966378. [PMID: 34158811 PMCID: PMC8187042 DOI: 10.1155/2021/9966378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/08/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022] Open
Abstract
Background Patients with obsessive-compulsive disorder (OCD) experience deficiencies in reward processing. The investigation of the reward circuit and its essential connectivity may further clarify the pathogenesis of OCD. Methods The current research was designed to analyze the nucleus accumbens (NAc) functional connectivity at rest in medicine-free patients with OCD. Forty medication-free patients and 38 gender-, education-, and age-matched healthy controls (HCs) were recruited for resting-state functional magnetic resonance imaging. Seed-based functional connectivity (FC) was used to analyze the data. LIBSVM (library for support vector machines) was designed to identify whether altered FC could be applied to differentiate OCD. Results Patients with OCD showed remarkably decreased FC values between the left NAc and the bilateral orbitofrontal cortex (OFC) and bilateral medial prefrontal cortex (MPFC) and between the right NAc and the left OFC at rest in the reward circuit. Moreover, decreased left NAc-bilateral MPFC connectivity can be deemed as a potential biomarker to differentiate OCD from HCs with a sensitivity of 80.00% and a specificity of 76.32%. Conclusion The current results emphasize the importance of the reward circuit in the pathogenesis of OCD.
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16
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McCunn P, Richardson JD, Jetly R, Dunkley B. Diffusion Tensor Imaging Reveals White Matter Differences in Military Personnel Exposed to Trauma with and without Post-traumatic Stress Disorder. Psychiatry Res 2021; 298:113797. [PMID: 33582526 DOI: 10.1016/j.psychres.2021.113797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a debilitating mental health condition that develops in response to exposure to a traumatic event. The purpose of this study was to investigate white matter differences using diffusion tensor imaging (DTI) in trauma exposed military personnel with and without PTSD. METHODS Data were acquired in compliance with the Hospital for Sick Children and Canadian Armed Forces Research Ethics Boards for the following groups: military personnel with PTSD (PTSD, n = 23), trauma exposed military personnel with no PTSD diagnosis (TE, n = 25) and civilian controls (CC, n =13) . All participants were male. DTI was acquired on a Siemens Trio 3T MRI. Maps of Fractional Anisotropy (FA), Mean Diffusivity (MD), Axial Diffusivity (AD), and Radial Diffusivity (RD) were analyzed using Tract-Based Spatial Statistics (TBSS). RESULTS In the PTSD and TE groups, FA was significantly greater within the hippocampus, corpus callosum, cingulum, and several associated white matter tracts. Elevated FA was shown to be largely due to reduced RD suggesting a possible structural substrate that underscores neurophysiological connectivity. CONCLUSIONS This study reinforces previous findings showing differences in DTI metrics within the limbic system in military personnel exposed to trauma with and without PTSD.
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Affiliation(s)
- Patrick McCunn
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario.
| | - J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario; Department of Psychiatry, Western University, London, Ontario; Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario; Operational Stress Injury Clinic, St. Joseph's Health Care, London, Ontario, Canada
| | - Rakesh Jetly
- Canadian Forces Health Services Group HQ, Department of National Defence, Ottawa, Ontario
| | - Benjamin Dunkley
- Neurosciences & Mental Health, The Hospital for Sick Children (SickKids) Research Institute, Toronto, Ontario; Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), Toronto, Ontario; Department of Medical Imaging, University of Toronto, Toronto, Ontario
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17
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Li L, Pan N, Zhang L, Lui S, Huang X, Xu X, Wang S, Lei D, Li L, Kemp GJ, Gong Q. Hippocampal subfield alterations in pediatric patients with post-traumatic stress disorder. Soc Cogn Affect Neurosci 2021; 16:334-344. [PMID: 33315100 PMCID: PMC7943370 DOI: 10.1093/scan/nsaa162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 02/05/2023] Open
Abstract
The hippocampus, a key structure with distinct subfield functions, is strongly implicated in the pathophysiology of post-traumatic stress disorder (PTSD); however, few studies of hippocampus subfields in PTSD have focused on pediatric patients. We therefore investigated the hippocampal subfield volume using an automated segmentation method and explored the subfield-centered functional connectivity aberrations related to the anatomical changes, in a homogenous population of traumatized children with and without PTSD. To investigate the potential diagnostic value in individual patients, we used a machine learning approach to identify features with significant discriminative power for diagnosis of PTSD using random forest classifiers. Compared to controls, we found significant mean volume reductions of 8.4% and 9.7% in the right presubiculum and hippocampal tail in patients, respectively. These two subfields' volumes were the most significant contributors to group discrimination, with a mean classification accuracy of 69% and a specificity of 81%. These anatomical alterations, along with the altered functional connectivity between (pre)subiculum and inferior frontal gyrus, may underlie deficits in fear circuitry leading to dysfunction of fear extinction and episodic memory, causally important in post-traumatic symptoms such as hypervigilance and re-experience. For the first time, we suggest that hippocampal subfield volumes might be useful in discriminating traumatized children with and without PTSD.
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Affiliation(s)
- Lei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lianqing Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xin Xu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha 410008, China
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L693BX, UK
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
- Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
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18
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Trousset V, Lefèvre T. Artificial Intelligence in Medicine and PTSD. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Suo X, Lei D, Li W, Yang J, Li L, Sweeney JA, Gong Q. Individualized Prediction of PTSD Symptom Severity in Trauma Survivors From Whole-Brain Resting-State Functional Connectivity. Front Behav Neurosci 2020; 14:563152. [PMID: 33408617 PMCID: PMC7779396 DOI: 10.3389/fnbeh.2020.563152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 11/23/2020] [Indexed: 02/05/2023] Open
Abstract
Previous studies have demonstrated relations between spontaneous neural activity evaluated by resting-state functional magnetic resonance imaging (fMRI) and symptom severity in post-traumatic stress disorder. However, few studies have used brain-based measures to identify imaging associations with illness severity at the level of individual patients. This study applied connectome-based predictive modeling (CPM), a recently developed data-driven and subject-level method, to identify brain function features that are related to symptom severity of trauma survivors. Resting-state fMRI scans and clinical ratings were obtained 10-15 months after the earthquake from 122 earthquake survivors. Symptom severity of post-traumatic stress disorder features for each survivor was evaluated using the Clinician Administered Post-traumatic Stress Disorder Scale (CAPS-IV). A functionally pre-defined atlas was applied to divide the human brain into 268 regions. Each individual's functional connectivity 268 × 268 matrix was created to reflect correlations of functional time series data across each pair of nodes. The relationship between CAPS-IV scores and brain functional connectivity was explored in a CPM linear model. Using a leave-one-out cross-validation (LOOCV) procedure, findings showed that the positive network model predicted the left-out individual's CAPS-IV scores from resting-state functional connectivity. CPM predicted CAPS-IV scores, as indicated by a significant correspondence between predicted and actual values (r = 0.30, P = 0.001) utilizing primarily functional connectivity between visual cortex, subcortical-cerebellum, limbic, and motor systems. The current study provides data-driven evidence regarding the functional brain features that predict symptom severity based on the organization of intrinsic brain networks and highlights its potential application in making clinical evaluation of symptom severity at the individual level.
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Affiliation(s)
- Xueling Suo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Du Lei
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Wenbin Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Jing Yang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China
| | - Lingjiang Li
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.,Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu, China.,Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu, China.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States
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20
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Rashid B, Calhoun V. Towards a brain-based predictome of mental illness. Hum Brain Mapp 2020; 41:3468-3535. [PMID: 32374075 PMCID: PMC7375108 DOI: 10.1002/hbm.25013] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 01/10/2023] Open
Abstract
Neuroimaging-based approaches have been extensively applied to study mental illness in recent years and have deepened our understanding of both cognitively healthy and disordered brain structure and function. Recent advancements in machine learning techniques have shown promising outcomes for individualized prediction and characterization of patients with psychiatric disorders. Studies have utilized features from a variety of neuroimaging modalities, including structural, functional, and diffusion magnetic resonance imaging data, as well as jointly estimated features from multiple modalities, to assess patients with heterogeneous mental disorders, such as schizophrenia and autism. We use the term "predictome" to describe the use of multivariate brain network features from one or more neuroimaging modalities to predict mental illness. In the predictome, multiple brain network-based features (either from the same modality or multiple modalities) are incorporated into a predictive model to jointly estimate features that are unique to a disorder and predict subjects accordingly. To date, more than 650 studies have been published on subject-level prediction focusing on psychiatric disorders. We have surveyed about 250 studies including schizophrenia, major depression, bipolar disorder, autism spectrum disorder, attention-deficit hyperactivity disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, and substance dependence. In this review, we present a comprehensive review of recent neuroimaging-based predictomic approaches, current trends, and common shortcomings and share our vision for future directions.
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Affiliation(s)
- Barnaly Rashid
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Vince Calhoun
- Tri‐Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS)Georgia State University, Georgia Institute of Technology, and Emory UniversityAtlantaGeorgiaUSA
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21
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Cwik JC, Vahle N, Woud ML, Potthoff D, Kessler H, Sartory G, Seitz RJ. Reduced gray matter volume in the left prefrontal, occipital, and temporal regions as predictors for posttraumatic stress disorder: a voxel-based morphometric study. Eur Arch Psychiatry Clin Neurosci 2020; 270:577-588. [PMID: 30937515 DOI: 10.1007/s00406-019-01011-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
Abstract
The concept of acute stress disorder (ASD) was introduced as a diagnostic entity to improve the identification of traumatized people who are likely to develop posttraumatic stress disorder (PTSD). Neuroanatomical models suggest that changes in the prefrontal cortex, amygdala, and hippocampus play a role in the development of PTSD. Using voxel-based morphometry, this study aimed to investigate the predictive power of gray matter volume (GMV) alterations for developing PTSD. The GMVs of ASD patients (n = 21) were compared to those of PTSD patients (n = 17) and healthy controls (n = 18) in whole-brain and region-of-interest analyses. The GMV alterations seen in ASD patients shortly after the traumatic event (T1) were also correlated with PTSD symptom severity and symptom clusters 4 weeks later (T2). Compared with healthy controls, the ASD patients had significantly reduced GMV in the left visual cortex shortly after the traumatic event (T1) and in the left occipital and prefrontal regions 4 weeks later (T2); no significant differences in GMV were seen between the ASD and PTSD patients. Furthermore, a significant negative association was found between the GMV reduction in the left lateral temporal regions seen after the traumatic event (T1) and PTSD hyperarousal symptoms 4 weeks later (T2). Neither amygdala nor hippocampus alterations were predictive for the development of PTSD. These data suggest that gray matter deficiencies in the left hemispheric occipital and temporal regions in ASD patients may predict a liability for developing PTSD.
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Affiliation(s)
- Jan Christopher Cwik
- Department of Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Universität zu Köln, Pohligstr. 1, 50969, Cologne, Germany. .,Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany.
| | - Nils Vahle
- Department of Psychology and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Marcella Lydia Woud
- Faculty of Psychology, Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Denise Potthoff
- Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
| | - Henrik Kessler
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-Universität Bochum, Bochum, Germany
| | - Gudrun Sartory
- Department of Clinical Psychology and Psychotherapy, School of Human and Social Sciences, Bergische Universität Wuppertal, Wuppertal, Germany
| | - Rüdiger J Seitz
- Department of Neurology, Center for Neurology and Neuropsychiatry, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
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22
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Fitzgerald JM, Belleau EL, Miskovich TA, Pedersen WS, Larson CL. Multi-voxel pattern analysis of amygdala functional connectivity at rest predicts variability in posttraumatic stress severity. Brain Behav 2020; 10:e01707. [PMID: 32525273 PMCID: PMC7428479 DOI: 10.1002/brb3.1707] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/16/2020] [Accepted: 05/15/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Resting state functional magnetic resonance imaging (rsfMRI) studies demonstrate that individuals with posttraumatic stress disorder (PTSD) exhibit atypical functional connectivity (FC) between the amygdala, involved in the generation of emotion, and regions responsible for emotional appraisal (e.g., insula, orbitofrontal cortex [OFC]) and regulation (prefrontal cortex [PFC], anterior cingulate cortex). Consequently, atypical amygdala FC within an emotional processing and regulation network may be a defining feature of PTSD, although altered FC does not seem constrained to one brain region. Instead, altered amygdala FC involves a large, distributed brain network in those with PTSD. The present study used a machine-learning data-driven approach, multi-voxel pattern analysis (MVPA), to predict PTSD severity based on whole-brain patterns of amygdala FC. METHODS Trauma-exposed adults (N = 90) completed the PTSD Checklist-Civilian Version to assess symptoms and a 5-min rsfMRI. Whole-brain FC values to bilateral amygdala were extracted and used in a relevance vector regression analysis with a leave-one-out approach for cross-validation with permutation testing (1,000) to obtain significance values. RESULTS Results demonstrated that amygdala FC predicted PCL-C scores with statistically significant accuracy (r = .46, p = .001; mean sum of squares = 130.46, p = .001; R2 = 0.21, p = .001). Prediction was based on whole-brain amygdala FC, although regions that informed prediction (top 10%) included the OFC, amygdala, and dorsolateral PFC. CONCLUSION Findings demonstrate the utility of MVPA based on amygdala FC to predict individual severity of PTSD symptoms and that amygdala FC within a fear acquisition and regulation network contributed to accurate prediction.
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Affiliation(s)
| | - Emily L Belleau
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | | - Walker S Pedersen
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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23
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Luo J, Yang R, Yang W, Duan C, Deng Y, Zhang J, Chen J, Liu J. Increased Amplitude of Low-Frequency Fluctuation in Right Angular Gyrus and Left Superior Occipital Gyrus Negatively Correlated With Heroin Use. Front Psychiatry 2020; 11:492. [PMID: 32719620 PMCID: PMC7350776 DOI: 10.3389/fpsyt.2020.00492] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/14/2020] [Indexed: 12/01/2022] Open
Abstract
Abnormal amplitude of low-frequency fluctuation has been implicated in heroin addiction. However, previous studies lacked consistency and didn't consider the impact of confounding factors such as methadone and alcohol. Fifty-one heroin-dependent (HD) individuals and 40 healthy controls underwent resting-state functional magnetic resonance imaging. The 'amplitude of low-frequency fluctuation' (ALFF) value was calculated and support vector machine (SVM) classification analysis was applied to analyze the data. Compared with healthy controls, heroin addicts exhibited increased ALFF in the right angular gyrus (AG) and left superior occipital gyrus (SOG). A negative correlation was observed between increased ALFF in the right angular gyrus and left superior occipital gyrus and the duration of heroin use (p 1=0.004, r 1=-0.426; p 2=0.009, r 2=-0.361). Moreover, the ALFF in the right AG and left SOG could discriminate the HD subjects from the controls with acceptable accuracy (Acc1=64.85%, p 1=0.004; Acc2=63.80%, p 2=0.005). HD patients showed abnormal ALFF in the brain areas involved in semantic memory and visual networks. The longer HD individuals abused heroin, the less the ALFF of associated brain regions increased. These observed patterns suggested that the accumulative effect of heroin's neurotoxicity overpowered self-recovery of the brain and may be applied as a potential biomarker to identify HD individuals from the controls.
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Affiliation(s)
- Jing Luo
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenhan Yang
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | | | - Yuan Deng
- Yunnan Institute for Drug Abuse, Kunming, China
| | - Jun Zhang
- Hunan Judicial Police Academy, Changsha, China
| | - Jiyuan Chen
- Hunan Drug Rehabilitation Administration, Changsha, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
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24
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Zilcha-Mano S, Zhu X, Suarez-Jimenez B, Pickover A, Tal S, Such S, Marohasy C, Chrisanthopoulos M, Salzman C, Lazarov A, Neria Y, Rutherford BR. Diagnostic and Predictive Neuroimaging Biomarkers for Posttraumatic Stress Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:688-696. [PMID: 32507508 PMCID: PMC7354213 DOI: 10.1016/j.bpsc.2020.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/29/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Comorbidity between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) has been commonly overlooked by studies examining resting-state functional connectivity patterns in PTSD. The current study used a data-driven approach to identify resting-state functional connectivity biomarkers to 1) differentiate individuals with PTSD (with or without MDD) from trauma-exposed healthy control subjects (TEHCs), 2) compare individuals with PTSD alone with those with comorbid PTSD+MDD, and 3) explore the clinical utility of the identified biomarkers by testing their associations with clinical symptoms and treatment response. METHODS Resting-state magnetic resonance images were obtained from 51 individuals with PTSD alone, 52 individuals with PTSD+MDD, and 76 TEHCs. Of the 103 individuals with PTSD, 55 were enrolled in prolonged exposure treatment. A support vector machine model was used to identify resting-state functional connectivity biomarkers differentiating individuals with PTSD (with or without MDD) from TEHCs and differentiating individuals with PTSD alone from those with PTSD+MDD. The associations between the identified features and symptomatology were tested with Pearson correlations. RESULTS The support vector machine model achieved 70.6% accuracy in discriminating between individuals with PTSD and TEHCs and achieved 76.7% accuracy in discriminating between individuals with PTSD alone and those with PTSD+MDD for out-of-sample prediction. Within-network connectivity in the executive control network, prefrontal network, and salience network discriminated individuals with PTSD from TEHCs. The basal ganglia network played an important role in differentiating individuals with PTSD alone from those with PTSD+MDD. PTSD scores were inversely correlated with within-executive control network connectivity (p < .001), and executive control network connectivity was positively correlated with treatment response (p < .001). CONCLUSIONS Results suggest that unique brain-based abnormalities differentiate individuals with PTSD from TEHCs, differentiate individuals with PTSD from those with PTSD+MDD, and demonstrate clinical utility in predicting levels of symptomatology and treatment response.
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Affiliation(s)
- Sigal Zilcha-Mano
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel.
| | - Xi Zhu
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Benjamin Suarez-Jimenez
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Alison Pickover
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Shachaf Tal
- Department of Psychology, University of Haifa, Mount Carmel, Haifa, Israel
| | - Sara Such
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Caroline Marohasy
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Marika Chrisanthopoulos
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York; Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Chloe Salzman
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York; Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Amit Lazarov
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel; Department of Psychiatry, Columbia University, New York, New York
| | - Yuval Neria
- Department of Psychiatry, Columbia University, New York, New York; New York State Psychiatric Institute, Columbia University Medical Center, New York, New York
| | - Bret R Rutherford
- New York State Psychiatric Institute, Columbia University Medical Center, New York, New York; Columbia University Vagelos College of Physicians and Surgeons, New York, New York
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25
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Li Y, Zhu H, Ren Z, Lui S, Yuan M, Gong Q, Yuan C, Gao M, Qiu C, Zhang W. Exploring memory function in earthquake trauma survivors with resting-state fMRI and machine learning. BMC Psychiatry 2020; 20:43. [PMID: 32013935 PMCID: PMC6998246 DOI: 10.1186/s12888-020-2452-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 01/21/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Traumatized earthquake survivors may develop poor memory function. Resting-state functional magnetic resonance imaging (rs-fMRI) and machine learning techniques may one day aid the clinical assessment of individual psychiatric patients. This study aims to use machine learning with Rs-fMRI from the perspectives of neurophysiology and neuroimaging to explore the association between it and the individual memory function of trauma survivors. METHODS Rs-fMRI data was acquired for eighty-nine survivors (male (33%), average age (SD):45.18(6.31) years) of Wenchuan earthquakes in 2008 each of whom was screened by experienced psychiatrists based on the clinician-administered post-traumatic stress disorder (PTSD) scale (CAPS), and their memory function scores were determined by the Wechsler Memory Scale-IV (WMS-IV). We explored which memory function scores were significantly associated with CAPS scores. Using simple multiple kernel learning (MKL), Rs-fMRI was used to predict the memory function scores that were associated with CAPS scores. A support vector machine (SVM) was also used to make classifications in trauma survivors with or without PTSD. RESULTS Spatial addition (SA), which is defined by spatial working memory function, was negatively correlated with the total CAPS score (r = - 0.22, P = 0.04). The use of simple MKL allowed quantitative association of SA scores with statistically significant accuracy (correlation = 0.28, P = 0.03; mean squared error = 8.36; P = 0.04). The left middle frontal gyrus and the left precuneus contributed the largest proportion to the simple MKL association frame. The SVM could not make a quantitative classification of diagnosis with statistically significant accuracy. LIMITATIONS The use of the cross-sectional study design after exposure to an earthquake and the leave-one-out cross-validation (LOOCV) increases the risk of overfitting. CONCLUSION Spontaneous brain activity of the left middle frontal gyrus and the left precuneus acquired by rs-fMRI may be a brain mechanism of visual working memory that is related to PTSD symptoms. Machine learning may be a useful tool in the identification of brain mechanisms of memory impairment in trauma survivors.
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Affiliation(s)
- Yuchen Li
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hongru Zhu
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China ,0000 0004 1770 1022grid.412901.fMental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China ,0000 0004 1770 1022grid.412901.fHuaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China ,0000 0004 1760 6682grid.410570.7Department of Clinical Psychology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Su Lui
- 0000 0004 1770 1022grid.412901.fHuaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Minlan Yuan
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- 0000 0004 1770 1022grid.412901.fHuaxi MR Research Center (HMRRC), Department of Radiology, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Cui Yuan
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Meng Gao
- 0000 0004 1770 1022grid.412901.fMental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
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26
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Ramos-Lima LF, Waikamp V, Antonelli-Salgado T, Passos IC, Freitas LHM. The use of machine learning techniques in trauma-related disorders: a systematic review. J Psychiatr Res 2020; 121:159-172. [PMID: 31830722 DOI: 10.1016/j.jpsychires.2019.12.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/22/2019] [Accepted: 12/05/2019] [Indexed: 12/27/2022]
Abstract
Establishing the diagnosis of trauma-related disorders such as Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) have always been a challenge in clinical practice and in academic research, due to clinical and biological heterogeneity. Machine learning (ML) techniques can be applied to improve classification of disorders, to predict outcomes or to determine person-specific treatment selection. We aim to review the existing literature on the use of machine learning techniques in the assessment of subjects with ASD or PTSD. We systematically searched PubMed, Embase and Web of Science for articles published in any language up to May 2019. We found 806 abstracts and included 49 studies in our review. Most of the included studies used multiple levels of biological data to predict risk factors or to identify early symptoms related to PTSD. Other studies used ML classification techniques to distinguish individuals with ASD or PTSD from other psychiatric disorder or from trauma-exposed and healthy controls. We also found studies that attempted to define outcome profiles using clustering techniques and studies that assessed the relationship among symptoms using network analysis. Finally, we proposed a quality assessment in this review, evaluating methodological and technical features on machine learning studies. We concluded that etiologic and clinical heterogeneity of ASD/PTSD patients is suitable to machine learning techniques and a major challenge for the future is to use it in clinical practice for the benefit of patients in an individual level.
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Affiliation(s)
- Luis Francisco Ramos-Lima
- Post-graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil; Psychological Trauma Research and Treatment Program (NET-Trauma), Clinical Hospital of Porto Alegre, Porto Alegre, Brazil.
| | - Vitoria Waikamp
- Post-graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil; Psychological Trauma Research and Treatment Program (NET-Trauma), Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Thyago Antonelli-Salgado
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Post-graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
| | - Lucia Helena Machado Freitas
- Post-graduate Program in Psychiatry and Behavioral Sciences, Federal University at Rio Grande do Sul, Porto Alegre, Brazil; Psychological Trauma Research and Treatment Program (NET-Trauma), Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
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Hilbert K, Lueken U. Prädiktive Analytik aus der Perspektive der Klinischen Psychologie und Psychotherapie. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000505302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Reduced connectivity in anterior cingulate cortex as an early predictor for treatment response in drug-naive, first-episode schizophrenia: A global-brain functional connectivity analysis. Schizophr Res 2020; 215:337-343. [PMID: 31522869 DOI: 10.1016/j.schres.2019.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/27/2019] [Accepted: 09/02/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Antipsychotic medications may have acute effect on brain functional connectivity (FC) after only a few days of treatment. It is unclear if early changes in FC can predict treatment response in patients with schizophrenia. METHODS The study included 32 patients with drug-naive, first-episode schizophrenia and 32 healthy controls. Resting-state functional magnetic resonance imaging was obtained from the patients at two time-points (pre-treatment baseline and 1 week after treatment) and healthy controls at baseline. Patients were treated with olanzapine for 8 weeks, and clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) at three time points (baseline, 1 week and 8 weeks after treatment). Imaging data were analyzed using global-brain FC (GFC) and support vector regression (SVR). RESULTS At baseline, an increased GFC was observed in bilateral anterior cingulate cortex (ACC) in patients compared with healthy controls. After 1 week of olanzapine treatment, patients showed decreased GFC in bilateral ACC compared to the baseline values. SVR analysis suggested a positive relationship between GFC changes in bilateral ACC at week 1 and improvement in negative symptoms at week 8 (r = 0.957, p < 0.001). CONCLUSION An early decrease in GFC in bilateral ACC may serve as a predictor for treatment response in patients with schizophrenia. If further confirmed, our finding may be able to help clinicians decide, during the early treatment course, whether the patient should stay on the chosen antipsychotic medication or switch to a different one.
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Individual prediction of psychotherapy outcome in posttraumatic stress disorder using neuroimaging data. Transl Psychiatry 2019; 9:326. [PMID: 31792202 PMCID: PMC6889413 DOI: 10.1038/s41398-019-0663-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/30/2019] [Accepted: 11/01/2019] [Indexed: 01/10/2023] Open
Abstract
Trauma-focused psychotherapy is the first-line treatment for posttraumatic stress disorder (PTSD) but 30-50% of patients do not benefit sufficiently. We investigated whether structural and resting-state functional magnetic resonance imaging (MRI/rs-fMRI) data could distinguish between treatment responders and non-responders on the group and individual level. Forty-four male veterans with PTSD underwent baseline scanning followed by trauma-focused psychotherapy. Voxel-wise gray matter volumes were extracted from the structural MRI data and resting-state networks (RSNs) were calculated from rs-fMRI data using independent component analysis. Data were used to detect differences between responders and non-responders on the group level using permutation testing, and the single-subject level using Gaussian process classification with cross-validation. A RSN centered on the bilateral superior frontal gyrus differed between responders and non-responder groups (PFWE < 0.05) while a RSN centered on the pre-supplementary motor area distinguished between responders and non-responders on an individual-level with 81.4% accuracy (P < 0.001, 84.8% sensitivity, 78% specificity and AUC of 0.93). No significant single-subject classification or group differences were observed for gray matter volume. This proof-of-concept study demonstrates the feasibility of using rs-fMRI to develop neuroimaging biomarkers for treatment response, which could enable personalized treatment of patients with PTSD.
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30
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Reinders AATS, Marquand AF, Schlumpf YR, Chalavi S, Vissia EM, Nijenhuis ERS, Dazzan P, Jäncke L, Veltman DJ. Aiding the diagnosis of dissociative identity disorder: pattern recognition study of brain biomarkers. Br J Psychiatry 2019; 215:536-544. [PMID: 30523772 DOI: 10.1192/bjp.2018.255] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND A diagnosis of dissociative identity disorder (DID) is controversial and prone to under- and misdiagnosis. From the moment of seeking treatment for symptoms to the time of an accurate diagnosis of DID individuals received an average of four prior other diagnoses and spent 7 years, with reports of up to 12 years, in mental health services. AIM To investigate whether data-driven pattern recognition methodologies applied to structural brain images can provide biomarkers to aid DID diagnosis. METHOD Structural brain images of 75 participants were included: 32 female individuals with DID and 43 matched healthy controls. Individuals with DID were recruited from psychiatry and psychotherapy out-patient clinics. Probabilistic pattern classifiers were trained to discriminate cohorts based on measures of brain morphology. RESULTS The pattern classifiers were able to accurately discriminate between individuals with DID and healthy controls with high sensitivity (72%) and specificity (74%) on the basis of brain structure. These findings provide evidence for a biological basis for distinguishing between DID-affected and healthy individuals. CONCLUSIONS We propose a pattern of neuroimaging biomarkers that could be used to inform the identification of individuals with DID from healthy controls at the individual level. This is important and clinically relevant because the DID diagnosis is controversial and individuals with DID are often misdiagnosed. Ultimately, the application of pattern recognition methodologies could prevent unnecessary suffering of individuals with DID because of an earlier accurate diagnosis, which will facilitate faster and targeted interventions. DECLARATION OF INTEREST The authors declare no competing financial interests.
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Affiliation(s)
- Antje A T S Reinders
- Senior Research Associate with Lecturer status, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Andre F Marquand
- Assistant Professor, Donders Institute for Brain Cognition and Behaviour, Radboud University, The Netherlands and Honorary Lecturer, Department of Clinical Neuroscience, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Yolanda R Schlumpf
- Postdoctoral Assistant, Division of Neuropsychology, Department of Psychology, University of Zurich and Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland
| | - Sima Chalavi
- Postdoctoral Researcher, Department of Neuroscience, University Medical Center Groningen, University of Groningen, The Netherlands and Research Center for Movement Control and Neuroplasticity, Department of Movement Sciences, Katholieke Universiteit Leuven, Belgium
| | - Eline M Vissia
- Mental Healthcare Psychologist, Department of Neuroscience, University Medical Center Groningen, University of Groningen and Top Referent Trauma Centrum, GGz Centraal, The Netherlands
| | - Ellert R S Nijenhuis
- Psychologist/Psychotherapist, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy, Switzerland
| | - Paola Dazzan
- Professor of Neurobiology of Psychosis, Vice Dean International, Honorary Consultant Psychiatrist, Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - Lutz Jäncke
- Professor of Neuropsychology, Scientific Director, Clienia Littenheid AG, Private Clinic for Psychiatry and Psychotherapy and Research Unit for Plasticity and Learning of the Healthy Aging Brain, University of Zurich, Switzerland
| | - Dick J Veltman
- Professor of Neuroimaging in Psychiatry, Department of Psychiatry, VU University Medical Center, The Netherlands
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Zhu F, Liu Y, Liu F, Yang R, Li H, Chen J, Kennedy DN, Zhao J, Guo W. Functional asymmetry of thalamocortical networks in subjects at ultra-high risk for psychosis and first-episode schizophrenia. Eur Neuropsychopharmacol 2019; 29:519-528. [PMID: 30770234 DOI: 10.1016/j.euroneuro.2019.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 01/18/2023]
Abstract
Disrupted functional asymmetry has been implicated in schizophrenia. However, it remains unknown whether disrupted functional asymmetry originates from intra-hemispheric and/or inter-hemispheric functional connectivity (FC) in the patients, and whether it starts at very early stage of psychosis. Seventy-six patients with first-episode, drug-naive schizophrenia, 74 subjects at ultra-high risk for psychosis (UHR), and 71 healthy controls underwent resting-state functional magnetic resonance imaging. The 'Parameter of asymmetry' (PAS) metric was calculated and support vector machine (SVM) classification analysis was applied to analyze the data. Compared with healthy controls, patients exhibited decreased PAS in the left thalamus/pallidum, right hippocampus/parahippocampus, right inferior frontal gyrus/insula, right thalamus, and left inferior parietal lobule, and increased PAS in the left calcarine, right superior occipital gyrus/middle occipital gyrus, and right precentral gyrus/postcentral gyrus. By contrast, UHR subjects showed decreased PAS in the left thalamus relative to healthy controls. A negative correlation was observed between decreased PAS in the right hippocampus/parahippocampus and Brief Visuospatial Memory Test-Revised (BVMT-R) scores in the patients (r = -0.364, p = 0.002). Moreover, the PAS values in the left thalamus could discriminate the patients/UHR subjects from the controls with acceptable sensitivities (68.42%/81.08%). First-episode patients and UHR subjects shared decreased PAS in the left thalamus. This observed pattern of functional asymmetry highlights the involvement of the thalamus in the pathophysiology of psychosis and may also be applied as a very early marker for psychosis.
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Affiliation(s)
- Furong Zhu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yi Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Ru Yang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - David N Kennedy
- Department of Psychiatry, Division of Neuroinformatics, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester, MA 01605, United States
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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A transdiagnostic neuroanatomical signature of psychiatric illness. Neuropsychopharmacology 2019; 44:869-875. [PMID: 30127342 PMCID: PMC6461829 DOI: 10.1038/s41386-018-0175-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/15/2018] [Accepted: 07/19/2018] [Indexed: 02/05/2023]
Abstract
Despite an increasing focus on transdiagnostic approaches to mental health, it remains unclear whether different diagnostic categories share a common neuronatomical basis. The current investigation sought to investigate whether a transdiagnostic set of structural alterations characterized schizophrenia, depression, post-traumatic stress disorder, and obsessive-compulsive disorder, and determine whether any such alterations reflected markers of psychiatric illness or pre-existing familial vulnerability. A total of 404 patients with a psychiatric diagnosis were recruited (psychosis, n = 129; unipolar depression, n = 92; post-traumatic stress disorder, n = 91; obsessive-compulsive disorder, n = 92) alongside n = 201 healthy controls and n = 20 unaffected first-degree relatives. We collected structural magnetic resonance imaging scans from each participant, and tested for transdiagnostic alterations using Voxel-based morphometry. Inferences were made at p < 0.05 after family-wise error correction for multiple comparisons. The four psychiatric groups relative to healthy controls were all characterized by significantly greater gray matter volume in the putamen (right: z-score: 5.97, p-value < 0.001; left: z-score: 4.97, p-value = 0.001); the volume of this region was positively correlated with severity of symptoms across groups (r = 0.313; p < 0.001). Putamen enlargement was also evident in unaffected relatives compared to healthy controls (right: z-score: 8.13, p-value < 0.001; left: z-score: 9.38, p-value < 0.001). Taken collectively, these findings indicate that increased putamen volume may reflect a transdiagnostic marker of familial vulnerability to psychopathology. This is consistent with emerging conceptualizations of psychiatric illness, in which each disorder is understood as a combination of diagnosis-specific features and a transdiagnostic factor reflecting general psychopathology.
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Corne R, Leconte C, Ouradou M, Fassina V, Zhu Y, Déou E, Besson V, Plotkine M, Marchand-Leroux C, Mongeau R. Spontaneous resurgence of conditioned fear weeks after successful extinction in brain injured mice. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:276-286. [PMID: 30096331 DOI: 10.1016/j.pnpbp.2018.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/28/2018] [Accepted: 07/29/2018] [Indexed: 12/25/2022]
Abstract
Mild traumatic brain injury (TBI) is a major risk factor for post-traumatic stress disorder (PTSD), and both disorders share common symptoms and neurobiological defects. Relapse after successful treatment, known as long-term fear resurgence, is common in PTSD patients and a major therapeutic hurdle. We induced a mild focal TBI by controlled cortical impact (CCI) in male C57BL/6 J mice and used fear conditioning to assess PTSD-like behaviors and concomitant alterations in the fear circuitry. We found for the first time that mild TBI, and to a lesser extent sham (craniotomy), mice displayed a spontaneous resurgence of conditioned fear when tested for fear extinction memory recall, despite having effectively acquired and extinguished conditioned fear 6 weeks earlier in the same context. Other characteristic symptoms of PTSD are risk-taking behaviors and cognitive deficits. CCI mice displayed risk-taking behaviors, behavioral inflexibility and reductions in processing speed compared to naïve mice. In conjunction with these changes there were alterations in amygdala morphology 3 months post-trauma, and decreased myelin basic protein density at the primary lesion site and in distant secondary sites such as the hippocampus, thalamus, and amygdala, compared to sham mice. Furthermore, activity-dependent brain-derived neurotrophic factor (BDNF) transcripts were decreased in the prefrontal cortex, a key region for fear extinction consolidation, following fear extinction training in both TBI and, to a lesser extent, sham mice. This study shows for the first time that a mild brain injury can generate a spontaneous resurgence of conditioned fear associated with defective BDNF signalling in the prefrontal cortex, PTSD-like behaviors, and have enduring effects on the brain.
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Affiliation(s)
- R Corne
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - C Leconte
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - M Ouradou
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - V Fassina
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - Y Zhu
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - E Déou
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - V Besson
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - M Plotkine
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - C Marchand-Leroux
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
| | - R Mongeau
- EA4475 - Pharmacologie de la Circulation Cérébrale, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France.
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Wu R, Ou Y, Liu F, Chen J, Li H, Zhao J, Guo W, Fan X. Reduced Brain Activity in the Right Putamen as an Early Predictor for Treatment Response in Drug-Naive, First-Episode Schizophrenia. Front Psychiatry 2019; 10:741. [PMID: 31649567 PMCID: PMC6791918 DOI: 10.3389/fpsyt.2019.00741] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022] Open
Abstract
Antipsychotic medications can have a significant effect on brain function after only several days of treatment. It is unclear whether such an acute effect can serve as an early predictor for treatment response in schizophrenia. Thirty-two patients with drug-naive, first-episode schizophrenia and 32 healthy controls underwent resting-state functional magnetic resonance imaging. Patients were treated with olanzapine and were scanned at baseline and 1 week of treatment. Healthy controls were scanned once at baseline. Symptom severity was assessed within the patient group using the Positive and Negative Syndrome Scale (PANSS) at three time points (baseline, 1 week of treatment, and 8 weeks of treatment). The fractional amplitude of low frequency fluctuation (fALFF) and support vector regression (SVR) methods were used to analyze the data. Compared with the control group, the patient group showed increased levels of fALFF in the bilateral putamen at baseline. After 1week of olanzapine treatment, the patient group showed decreased levels of fALFF in the right putamen relative to those at baseline. The SVR analysis found a significantly positive relationship between the reduction in fALFF after 1 week of treatment and the improvement in positive symptoms after 8 weeks of treatment (r = 0.431, p = 0.014). The present study provides evidence that early reduction and normalization of fALFF in the right putamen may serve as a predictor for treatment response in patients with schizophrenia.
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Affiliation(s)
- Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Yangpan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, Changsha, China
| | - Xiaoduo Fan
- University of Massachusetts Medical School, UMass Memorial Medical Center, One Biotech, Worcester, MA, United States
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Ou Y, Su Q, Liu F, Ding Y, Chen J, Zhang Z, Zhao J, Guo W. Increased Nucleus Accumbens Connectivity in Resting-State Patients With Drug-Naive, First-Episode Somatization Disorder. Front Psychiatry 2019; 10:585. [PMID: 31474890 PMCID: PMC6706814 DOI: 10.3389/fpsyt.2019.00585] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/25/2019] [Indexed: 11/13/2022] Open
Abstract
The nucleus accumbens (NAc) plays an important role in the reward circuit, and abnormal regional activities of the reward circuit have been reported in various psychiatric disorders including somatization disorder (SD). However, few researches are designed to analyze the NAc connectivity in SD. This study was designed to explore the NAc connectivity in first-episode, drug-naive patients with SD using the bilateral NAc as seeds. Twenty-five first-episode, drug-naive patients with SD and 28 healthy controls were recruited. Functional connectivity (FC) was designed to analyze the images. LIBSVM (a library for support vector machines) was used to identify whether abnormal FC could be utilized to discriminate the patients from the controls. The patients showed significantly increased FC between the left NAc and the right gyrus rectus and left medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC), and between the right NAc and the left gyrus rectus and left MPFC/ACC compared with the controls. The patients could be separated from the controls through increased FC between the left NAc and the right gyrus rectus with a sensitivity of 88.00% and a specificity of 82.14%. The findings reveal that patients with SD have increased NAc connectivity with the frontal regions of the reward circuit. Increased left NAc-right gyrus rectus connectivity can be used as a potential marker to discriminate patients with SD from healthy controls. The study thus highlights the importance of the reward circuit in the neuropathology of SD.
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Affiliation(s)
- Yangpan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Qinji Su
- Mental Health Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yudan Ding
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Zhikun Zhang
- Mental Health Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center on Mental Disorders, Changsha, China
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36
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Zhu F, Liu F, Guo W, Chen J, Su Q, Zhang Z, Li H, Fan X, Zhao J. Disrupted asymmetry of inter- and intra-hemispheric functional connectivity in patients with drug-naive, first-episode schizophrenia and their unaffected siblings. EBioMedicine 2018; 36:429-435. [PMID: 30241918 PMCID: PMC6197719 DOI: 10.1016/j.ebiom.2018.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 11/25/2022] Open
Abstract
Background Lack of normal asymmetry in the brain has been reported in patients with schizophrenia. However, it remains unclear whether disrupted asymmetry originates from inter-hemispheric functional connectivity (FC) and/or intra-hemispheric FC in this patient population. Methods Forty-four patients with drug-naive, first-episode schizophrenia, 42 unaffected siblings, and 44 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) scan. The parameter of asymmetry (PAS) and support vector machine (SVM) were used to analyze the data. Patients were treated with olanzapine for 8 weeks. Findings Compared with healthy controls, patients showed lower PAS scores in the left middle temporal gyrus (MTG)/inferior temporal gyrus (ITG), left posterior cingulate cortex (PCC)/precuneus and left angular gyrus, and higher PAS scores in the left precentral gyrus/postcentral gyrus. Unaffected siblings also showed lower PAS scores in the left MTG/ITG and left PCC/precuneus relative to healthy controls. Further, SVM analysis showed that a combination of the PAS scores in these two clusters in patients at baseline was able to predict clinical response after 8 weeks of olanzapine treatment with 77.27% sensitivity, 72.73% specificity, and 75.00% accuracy. Interpretation The present study suggests disrupted asymmetry of inter- and intra-hemispheric FC in drug-naive, first-episode schizophrenia; in addition, a reduced asymmetry of inter-hemispheric FC in the left MTG/ITG and left PCC/precuneus may serve as an endophenotype for schizophrenia, and may have clinical utility to predict response to olanzapine treatment. Fund The National Key R&D Program of China and the National Natural Science Foundation of China.
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Affiliation(s)
- Furong Zhu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Qinji Su
- Mental Health Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Zhikun Zhang
- Mental Health Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Xiaoduo Fan
- University of Massachusetts Medical School, UMass Memorial Medical Center, One Biotech, Suite 100, 365 Plantation Street, Worcester, MA 01605, United States.
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
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37
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Ou Y, Liu F, Chen J, Pan P, Wu R, Su Q, Zhang Z, Zhao J, Guo W. Increased coherence-based regional homogeneity in resting-state patients with first-episode, drug-naive somatization disorder. J Affect Disord 2018; 235:150-154. [PMID: 29656259 DOI: 10.1016/j.jad.2018.04.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/08/2018] [Accepted: 04/04/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Abnormal neural activity has been observed in patients with somatization disorder (SD), especially in brain regions of the default-mode network (DMN). In this study, a coherence-based regional homogeneity (Cohe-ReHo) approach was used to detect abnormal regional synchronization in patients with SD, which might be used to differentiate the patients from the controls. METHODS We recruited 25 patients with SD and 28 healthy controls. The imaging data of the participants were analyzed using the Cohe-ReHo approach. LIBSVM (a library for support vector machines) was utilized to verify whether abnormal Cohe-ReHo values could be applied to separate patients with SD from healthy controls. RESULTS Compared with healthy controls, patients with SD showed an increased Cohe-ReHo in the left medial prefrontal cortex/anterior cingulate cortex (MPFC/ACC) (t = 5.5017, p < 0.001). No correlations were detected between the increased Cohe-ReHo values and clinical variables of the patients. The Cohe-ReHo values in the left MPFC/ACC could be applied to distinguish patients from controls with a sensitivity and a specificity of 84.00% and 85.71%, respectively. CONCLUSIONS An increased Cohe-ReHo was observed in the anterior DMN of the patients and could be applied as a marker to distinguish patients from healthy controls. These results highlighted the importance of the DMN in the pathophysiology of SD.
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Affiliation(s)
- Yangpan Ou
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300000, China
| | - Jindong Chen
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Pan Pan
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Renrong Wu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Qinji Su
- Mental Health Center of the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Zhikun Zhang
- Mental Health Center of the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi 530007, China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Wenbin Guo
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
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Wojtalik JA, Eack SM, Smith MJ, Keshavan MS. Using Cognitive Neuroscience to Improve Mental Health Treatment: A Comprehensive Review. JOURNAL OF THE SOCIETY FOR SOCIAL WORK AND RESEARCH 2018; 9:223-260. [PMID: 30505392 PMCID: PMC6258037 DOI: 10.1086/697566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Mental health interventions do not yet offer complete, client-defined functional recovery, and novel directions in treatment research are needed to improve the efficacy of available interventions. One promising direction is the integration of social work and cognitive neuroscience methods, which provides new opportunities for clinical intervention research that will guide development of more effective mental health treatments that holistically attend to the biological, social, and environmental contributors to disability and recovery. This article reviews emerging trends in cognitive neuroscience and provides examples of how these advances can be used by social workers and allied professions to improve mental health treatment. We discuss neuroplasticity, which is the dynamic and malleable nature of the brain. We also review the use of risk and resiliency biomarkers and novel treatment targets based on neuroimaging findings to prevent disability, personalize treatment, and make interventions more targeted and effective. The potential of treatment research to contribute to neuroscience discoveries regarding brain change is considered from the experimental-medicine approach adopted by the National Institute of Mental Health. Finally, we provide resources and recommendations to facilitate the integration of cognitive neuroscience into mental health research in social work.
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Affiliation(s)
- Jessica A Wojtalik
- Doctoral candidate at the University of Pittsburgh School of Social Work
| | - Shaun M Eack
- Professor at the University of Pittsburgh School of Social Work and Department of Psychiatry
| | - Matthew J Smith
- Associate professor at the University of Michigan School of Social Work
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Guo W, Liu F, Chen J, Wu R, Li L, Zhang Z, Chen H, Zhao J. Using short-range and long-range functional connectivity to identify schizophrenia with a family-based case-control design. Psychiatry Res Neuroimaging 2017; 264:60-67. [PMID: 28463748 DOI: 10.1016/j.pscychresns.2017.04.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/06/2017] [Accepted: 04/22/2017] [Indexed: 01/10/2023]
Abstract
Abnormal short-range and long-range functional connectivities (FCs) have been implicated in the neurophysiology of schizophrenia. This study was conducted to examine the potential of short-range and long-range FCs for differentiating the patients from the controls with a family-based case-control design. Twenty-eight first-episode, drug-naive patients with schizophrenia, 28 unaffected siblings of the patients (family-based controls, FBCs), and 40 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (fMRI) scans. The data were analyzed by short-range and long-range FC analyses, receiver operating characteristic curve (ROC) and support vector machine (SVM). Compared with the FBCs/HCs, the patients exhibit increased short-range positive FC strength (spFCS) and/or long-range positive FC strength (lpFCS) in the default-mode network (DMN) and decreased spFCS and lpFCS in the sensorimotor circuits. Furthermore, a combination of the spFCS values in the right superior parietal lobule and the lpFCS values in the left fusiform gyrus/cerebellum VI can differentiate the patients from the FBCs with high sensitivity and specificity. The findings highlight the importance of the DMN and sensorimotor circuits in the pathogenesis of schizophrenia. Combining with family-based case-control design may be a viable option to limit the confounding effects of environmental risk factors in neuroimaging studies of schizophrenia.
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Affiliation(s)
- Wenbin Guo
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
| | - Feng Liu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jindong Chen
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Renrong Wu
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Lehua Li
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Zhikun Zhang
- Mental Health Center of the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Huafu Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Jingping Zhao
- Department of Psychiatry of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center on Mental Disorders, Changsha, Hunan, China; National Technology Institute on Mental Disorders, Changsha, Hunan, China; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
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Lui S, Zhou XJ, Sweeney JA, Gong Q. Psychoradiology: The Frontier of Neuroimaging in Psychiatry. Radiology 2017; 281:357-372. [PMID: 27755933 DOI: 10.1148/radiol.2016152149] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Unlike neurologic conditions, such as brain tumors, dementia, and stroke, the neural mechanisms for all psychiatric disorders remain unclear. A large body of research obtained with structural and functional magnetic resonance imaging, positron emission tomography/single photon emission computed tomography, and optical imaging has demonstrated regional and illness-specific brain changes at the onset of psychiatric disorders and in individuals at risk for such disorders. Many studies have shown that psychiatric medications induce specific measurable changes in brain anatomy and function that are related to clinical outcomes. As a result, a new field of radiology, termed psychoradiology, seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with psychiatric disorders. This article will present the state of the art in this area, as well as perspectives regarding preparations in the field of radiology for its evolution. Furthermore, this article will (a) give an overview of the imaging and analysis methods for psychoradiology; (b) review the most robust and important radiologic findings and their potential clinical value from studies of major psychiatric disorders, such as depression and schizophrenia; and (c) describe the main challenges and future directions in this field. An ongoing and iterative process of developing biologically based nomenclatures with which to delineate psychiatric disorders and translational research to predict and track response to different therapeutic drugs is laying the foundation for a shift in diagnostic practice in psychiatry from a psychologic symptom-based approach to an imaging-based approach over the next generation. This shift will require considerable innovations for the acquisition, analysis, and interpretation of brain images, all of which will undoubtedly require the active involvement of radiologists. © RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Su Lui
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Xiaohong Joe Zhou
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - John A Sweeney
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
| | - Qiyong Gong
- From the Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China (S.L., J.A.S., Q.G.); and Center for MR Research and Departments of Radiology, Neurosurgery and Bioengineering, University of Illinois at Chicago, Chicago, Ill (X.J.Z.)
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Family-based case-control study of homotopic connectivity in first-episode, drug-naive schizophrenia at rest. Sci Rep 2017; 7:43312. [PMID: 28256527 PMCID: PMC5335664 DOI: 10.1038/srep43312] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 01/23/2017] [Indexed: 11/09/2022] Open
Abstract
Family-based case-control design is rarely used but powerful to reduce the confounding effects of environmental factors on schizophrenia. Twenty-eight first-episode, drug-naive patients with schizophrenia, 28 family-based controls (FBC), and 40 healthy controls (HC) underwent resting-state functional MRI. Voxel-mirrored homotopic connectivity (VMHC), receiver operating characteristic curve (ROC), and support vector machine (SVM) were used to process the data. Compared with the FBC, the patients showed lower VMHC in the precuneus, fusiform gyrus/cerebellum lobule VI, and lingual gyrus/cerebellum lobule VI. The patients exhibited lower VMHC in the precuneus relative to the HC. ROC analysis exhibited that the VMHC values in these brain regions might not be ideal biomarkers to distinguish the patients from the FBC/HC. However, SVM analysis indicated that a combination of VMHC values in the precuneus and lingual gyrus/cerebellum lobule VI might be used as a potential biomarker to distinguish the patients from the FBC with a sensitivity of 96.43%, a specificity of 89.29%, and an accuracy of 92.86%. Results suggested that patients with schizophrenia have decreased homotopic connectivity in the motor and low level sensory processing regions. Neuroimaging studies can adopt family-based case-control design as a viable option to reduce the confounding effects of environmental factors on schizophrenia.
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Zhang Q, Wu Q, Zhu H, He L, Huang H, Zhang J, Zhang W. Multimodal MRI-Based Classification of Trauma Survivors with and without Post-Traumatic Stress Disorder. Front Neurosci 2016; 10:292. [PMID: 27445664 PMCID: PMC4919361 DOI: 10.3389/fnins.2016.00292] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/10/2016] [Indexed: 02/05/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder. It can be difficult to discern the symptoms of PTSD and obtain an accurate diagnosis. Different magnetic resonance imaging (MRI) modalities focus on different aspects, which may provide complementary information for PTSD discrimination. However, none of the published studies assessed the diagnostic potential of multimodal MRI in identifying individuals with and without PTSD. In the current study, we investigated whether the complementary information conveyed by multimodal MRI scans could be combined to improve PTSD classification performance. Structural and resting-state functional MRI (rs-fMRI) scans were conducted on 17 PTSD patients, 20 trauma-exposed controls without PTSD (TEC) and 20 non-traumatized healthy controls (HC). Gray matter volume (GMV), amplitude of low-frequency fluctuations (ALFF), and regional homogeneity were extracted as classification features, and in order to integrate the information of structural and functional MRI data, the extracted features were combined by a multi-kernel combination strategy. Then a support vector machine (SVM) classifier was trained to distinguish the subjects at individual level. The performance of the classifier was evaluated using the leave-one-out cross-validation (LOOCV) method. In the pairwise comparison of PTSD, TEC, and HC groups, classification accuracies obtained by the proposed approach were 2.70, 2.50, and 2.71% higher than the best single feature way, with the accuracies of 89.19, 90.00, and 67.57% for PTSD vs. HC, TEC vs. HC, and PTSD vs. TEC respectively. The proposed approach could improve PTSD identification at individual level. Additionally, it provides preliminary support to develop the multimodal MRI method as a clinical diagnostic aid.
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Affiliation(s)
- Qiongmin Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Qizhu Wu
- Monash Medical Imaging, Monash University Clayton, VIC, Australia
| | - Hongru Zhu
- Mental Health Center, West China Hospital of Sichuan University Chengdu, China
| | - Ling He
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Hua Huang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Junran Zhang
- Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University Chengdu, China
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University Chengdu, China
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Differences among first-episode schizophrenia patients, healthy siblings, and controls at the individual level. Int J Psychophysiol 2016; 104:24-32. [DOI: 10.1016/j.ijpsycho.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/17/2016] [Accepted: 04/15/2016] [Indexed: 01/02/2023]
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Mueller SG, Ng P, Neylan T, Mackin S, Wolkowitz O, Mellon S, Yan X, Flory J, Yehuda R, Marmar CR, Weiner MW. Evidence for disrupted gray matter structural connectivity in posttraumatic stress disorder. Psychiatry Res 2015; 234:194-201. [PMID: 26419357 DOI: 10.1016/j.pscychresns.2015.09.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 08/30/2015] [Accepted: 09/02/2015] [Indexed: 12/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is characterized by atrophy within the prefrontal-limbic network. Graph analysis was used to investigate to what degree atrophy in PTSD is associated with impaired structural connectivity within prefrontal limbic network (restricted) and how this affects the integration of the prefrontal limbic network with the rest of the brain (whole-brain). 85 male veterans (45 PTSD neg, 40 PTSD pos) underwent volumetric MRI on a 3T MR. Subfield volumes were obtained using a manual labeling scheme and cortical thickness measurements and subcortical volumes from FreeSurfer. Regression analysis was used to identify regions with volume loss. Graph analytical Toolbox (GAT) was used for graph-analysis. PTSD pos had a thinner rostral anterior cingulate and insular cortex but no hippocampal volume loss. PTSD was characterized by decreased nodal degree (orbitofrontal, anterior cingulate) and clustering coefficients (thalamus) but increased nodal betweenness (insula, orbitofrontal) and a reduced small world index in the whole brain analysis and by orbitofrontal and insular nodes with increased nodal degree, clustering coefficient and nodal betweenness in the restricted analysis. PTSD associated atrophy in the prefrontal-limbic network results in an increased structural connectivity within that network that negatively affected its integration with the rest of the brain.
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Affiliation(s)
- Susanne G Mueller
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA.
| | - Peter Ng
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
| | - Thomas Neylan
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Scott Mackin
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Owen Wolkowitz
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Synthia Mellon
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Xiaodan Yan
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles R Marmar
- Department of Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases, VAMC San Francisco, Clement Street 4150, San Francisco, CA 94121, USA
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Crossley NA, Scott J, Ellison-Wright I, Mechelli A. Neuroimaging distinction between neurological and psychiatric disorders. Br J Psychiatry 2015; 207:429-34. [PMID: 26045351 PMCID: PMC4629073 DOI: 10.1192/bjp.bp.114.154393] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 10/19/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is unclear to what extent the traditional distinction between neurological and psychiatric disorders reflects biological differences. AIMS To examine neuroimaging evidence for the distinction between neurological and psychiatric disorders. METHOD We performed an activation likelihood estimation meta-analysis on voxel-based morphometry studies reporting decreased grey matter in 14 neurological and 10 psychiatric disorders, and compared the regional and network-level alterations for these two classes of disease. In addition, we estimated neuroanatomical heterogeneity within and between the two classes. RESULTS Basal ganglia, insula, sensorimotor and temporal cortex showed greater impairment in neurological disorders; whereas cingulate, medial frontal, superior frontal and occipital cortex showed greater impairment in psychiatric disorders. The two classes of disorders affected distinct functional networks. Similarity within classes was higher than between classes; furthermore, similarity within class was higher for neurological than psychiatric disorders. CONCLUSIONS From a neuroimaging perspective, neurological and psychiatric disorders represent two distinct classes of disorders.
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Affiliation(s)
| | | | | | - Andrea Mechelli
- Nicolas A. Crossley, MRCPsych, PhD, Jessica Scott, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London; Ian Ellison-Wright, MRCPsych, Avon and Wiltshire Mental Health Partnership NHS Trust, Salisbury; Andrea Mechelli, PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, UK
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Wolfers T, Buitelaar JK, Beckmann CF, Franke B, Marquand AF. From estimating activation locality to predicting disorder: A review of pattern recognition for neuroimaging-based psychiatric diagnostics. Neurosci Biobehav Rev 2015; 57:328-49. [PMID: 26254595 DOI: 10.1016/j.neubiorev.2015.08.001] [Citation(s) in RCA: 183] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/29/2015] [Accepted: 08/02/2015] [Indexed: 12/19/2022]
Abstract
Psychiatric disorders are increasingly being recognised as having a biological basis, but their diagnosis is made exclusively behaviourally. A promising approach for 'biomarker' discovery has been based on pattern recognition methods applied to neuroimaging data, which could yield clinical utility in future. In this review we survey the literature on pattern recognition for making diagnostic predictions in psychiatric disorders, and evaluate progress made in translating such findings towards clinical application. We evaluate studies on many criteria, including data modalities used, the types of features extracted and algorithm applied. We identify problems common to many studies, such as a relatively small sample size and a primary focus on estimating generalisability within a single study. Furthermore, we highlight challenges that are not widely acknowledged in the field including the importance of accommodating disease prevalence, the necessity of more extensive validation using large carefully acquired samples, the need for methodological innovations to improve accuracy and to discriminate between multiple disorders simultaneously. Finally, we identify specific clinical contexts in which pattern recognition can add value in the short to medium term.
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Affiliation(s)
- Thomas Wolfers
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Christian F Beckmann
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Centre for Functional MRI of the Brain (FMRIB), University of Oxford, Oxford, United Kingdom
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andre F Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB Nijmegen, The Netherlands; Department of Neuroimaging, Institute of Psychiatry, King's College London, LondonUnited Kingdom
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Galatzer-Levy IR, Karstoft KI, Statnikov A, Shalev AY. Quantitative forecasting of PTSD from early trauma responses: a Machine Learning application. J Psychiatr Res 2014; 59:68-76. [PMID: 25260752 PMCID: PMC4252741 DOI: 10.1016/j.jpsychires.2014.08.017] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 07/28/2014] [Accepted: 08/28/2014] [Indexed: 11/26/2022]
Abstract
There is broad interest in predicting the clinical course of mental disorders from early, multimodal clinical and biological information. Current computational models, however, constitute a significant barrier to realizing this goal. The early identification of trauma survivors at risk of post-traumatic stress disorder (PTSD) is plausible given the disorder's salient onset and the abundance of putative biological and clinical risk indicators. This work evaluates the ability of Machine Learning (ML) forecasting approaches to identify and integrate a panel of unique predictive characteristics and determine their accuracy in forecasting non-remitting PTSD from information collected within 10 days of a traumatic event. Data on event characteristics, emergency department observations, and early symptoms were collected in 957 trauma survivors, followed for fifteen months. An ML feature selection algorithm identified a set of predictors that rendered all others redundant. Support Vector Machines (SVMs) as well as other ML classification algorithms were used to evaluate the forecasting accuracy of i) ML selected features, ii) all available features without selection, and iii) Acute Stress Disorder (ASD) symptoms alone. SVM also compared the prediction of a) PTSD diagnostic status at 15 months to b) posterior probability of membership in an empirically derived non-remitting PTSD symptom trajectory. Results are expressed as mean Area Under Receiver Operating Characteristics Curve (AUC). The feature selection algorithm identified 16 predictors, present in ≥ 95% cross-validation trials. The accuracy of predicting non-remitting PTSD from that set (AUC = .77) did not differ from predicting from all available information (AUC = .78). Predicting from ASD symptoms was not better then chance (AUC = .60). The prediction of PTSD status was less accurate than that of membership in a non-remitting trajectory (AUC = .71). ML methods may fill a critical gap in forecasting PTSD. The ability to identify and integrate unique risk indicators makes this a promising approach for developing algorithms that infer probabilistic risk of chronic posttraumatic stress psychopathology based on complex sources of biological, psychological, and social information.
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Affiliation(s)
| | - Karen-Inge Karstoft
- Department of Psychiatry, NYU School of Medicine, New York, NY,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Alexander Statnikov
- Center for Health Informatics and Bioinformatics, NYU School of Medicine, New York, NY,Department of Medicine, NYU School of Medicine, New York, NY
| | - Arieh Y. Shalev
- Center for Traumatic Stress Studies, Hadassah University Hospital, Jerusalem, Israel,Department of Psychiatry, NYU School of Medicine, New York, NY
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Qiu L, Huang X, Zhang J, Wang Y, Kuang W, Li J, Wang X, Wang L, Yang X, Lui S, Mechelli A, Gong Q. Characterization of major depressive disorder using a multiparametric classification approach based on high resolution structural images. J Psychiatry Neurosci 2014; 39:78-86. [PMID: 24083459 PMCID: PMC3937284 DOI: 10.1503/jpn.130034] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the most disabling mental illnesses. Previous neuroanatomical studies of MDD have revealed regional alterations in grey matter volume and density. However, owing to the heterogeneous symptomatology and complex etiology, MDD is likely to be associated with multiple morphometric alterations in brain structure. We sought to distinguish first-episode, medication-naive, adult patients with MDD from healthy controls and characterize neuroanatomical differences between the groups using a multiparameter classification approach. METHODS We recruited medication-naive patients with first-episode depression and healthy controls matched for age, sex, handedness and years of education. High-resolution T1-weighted images were used to extract 7 morphometric parameters, including both volumetric and geometric features, based on the surface data of the entire cerebral cortex. These parameters were used to compare patients and controls using multivariate support vector machine, and the regions that informed the discrimination between the 2 groups were identified based on maximal classification weights. RESULTS Thirty-two patients and 32 controls participated in the study. Both volumetric and geometric parameters could discriminate patients with MDD from healthy controls, with cortical thickness in the right hemisphere providing the greatest accuracy (78%, p ≤ 0.001). This discrimination was informed by a bilateral network comprising mainly frontal, temporal and parietal regions. LIMITATIONS The sample size was relatively small and our results were based on first-episode, medication-naive patients. CONCLUSION Our investigation demonstrates that multiple cortical features are affected in medication-naive patients with first-episode MDD. These findings extend the current understanding of the neuropathological underpinnings of MDD and provide preliminary support for the use of neuroanatomical scans in the early detection of MDD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Qiyong Gong
- Correspondence to: Q. Gong, Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China;
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50
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Quantitative prediction of individual psychopathology in trauma survivors using resting-state FMRI. Neuropsychopharmacology 2014; 39:681-7. [PMID: 24064470 PMCID: PMC3895245 DOI: 10.1038/npp.2013.251] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/12/2013] [Accepted: 08/29/2013] [Indexed: 02/05/2023]
Abstract
Neuroimaging techniques hold the promise that they may one day aid the clinical assessment of individual psychiatric patients. However, the vast majority of studies published so far have been based on average differences between groups. This study employed a multivariate approach to examine the potential of resting-state functional magnetic resonance imaging (MRI) data for making accurate predictions about psychopathology in survivors of the 2008 Sichuan earthquake at an individual level. Resting-state functional MRI data was acquired for 121 survivors of the 2008 Sichuan earthquake each of whom was assessed for symptoms of post-traumatic stress disorder (PTSD) using the 17-item PTSD Checklist (PCL). Using a multivariate analytical method known as relevance vector regression (RVR), we examined the relationship between resting-state functional MRI data and symptom scores. We found that the use of RVR allowed quantitative prediction of clinical scores with statistically significant accuracy (correlation=0.32, P=0.006; mean squared error=176.88, P=0.001). Accurate prediction was based on functional activation in a number of prefrontal, parietal, and occipital regions. This is the first evidence that neuroimaging techniques may inform the clinical assessment of trauma-exposed individuals by providing an accurate and objective quantitative estimation of psychopathology. Furthermore, the significant contribution of parietal and occipital regions to such estimation challenges the traditional view of PTSD as a disorder specific to the fronto-limbic network.
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