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Winter NR, Leenings R, Ernsting J, Sarink K, Fisch L, Emden D, Blanke J, Goltermann J, Opel N, Barkhau C, Meinert S, Dohm K, Repple J, Mauritz M, Gruber M, Leehr EJ, Grotegerd D, Redlich R, Jansen A, Nenadic I, Nöthen MM, Forstner A, Rietschel M, Groß J, Bauer J, Heindel W, Andlauer T, Eickhoff SB, Kircher T, Dannlowski U, Hahn T. Quantifying Deviations of Brain Structure and Function in Major Depressive Disorder Across Neuroimaging Modalities. JAMA Psychiatry 2022; 79:879-888. [PMID: 35895072 PMCID: PMC9330277 DOI: 10.1001/jamapsychiatry.2022.1780] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Identifying neurobiological differences between patients with major depressive disorder (MDD) and healthy individuals has been a mainstay of clinical neuroscience for decades. However, recent meta-analyses have raised concerns regarding the replicability and clinical relevance of brain alterations in depression. OBJECTIVE To quantify the upper bounds of univariate effect sizes, estimated predictive utility, and distributional dissimilarity of healthy individuals and those with depression across structural magnetic resonance imaging (MRI), diffusion-tensor imaging, and functional task-based as well as resting-state MRI, and to compare results with an MDD polygenic risk score (PRS) and environmental variables. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional, case-control clinical neuroimaging study. Data were part of the Marburg-Münster Affective Disorders Cohort Study. Patients with depression and healthy controls were recruited from primary care and the general population in Münster and Marburg, Germany. Study recruitment was performed from September 11, 2014, to September 26, 2018. The sample comprised patients with acute and chronic MDD as well as healthy controls in the age range of 18 to 65 years. Data were analyzed from October 29, 2020, to April 7, 2022. MAIN OUTCOMES AND MEASURES Primary analyses included univariate partial effect size (η2), classification accuracy, and distributional overlapping coefficient for healthy individuals and those with depression across neuroimaging modalities, controlling for age, sex, and additional modality-specific confounding variables. Secondary analyses included patient subgroups for acute or chronic depressive status. RESULTS A total of 1809 individuals (861 patients [47.6%] and 948 controls [52.4%]) were included in the analysis (mean [SD] age, 35.6 [13.2] years; 1165 female patients [64.4%]). The upper bound of the effect sizes of the single univariate measures displaying the largest group difference ranged from partial η2 of 0.004 to 0.017, and distributions overlapped between 87% and 95%, with classification accuracies ranging between 54% and 56% across neuroimaging modalities. This pattern remained virtually unchanged when considering either only patients with acute or chronic depression. Differences were comparable with those found for PRS but substantially smaller than for environmental variables. CONCLUSIONS AND RELEVANCE Results of this case-control study suggest that even for maximum univariate biological differences, deviations between patients with MDD and healthy controls were remarkably small, single-participant prediction was not possible, and similarity between study groups dominated. Biological psychiatry should facilitate meaningful outcome measures or predictive approaches to increase the potential for a personalization of the clinical practice.
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Affiliation(s)
- Nils R. Winter
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Ramona Leenings
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Department of Mathematics and Computer Science, Münster, Germany
| | - Jan Ernsting
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Department of Mathematics and Computer Science, Münster, Germany
| | - Kelvin Sarink
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Lukas Fisch
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Daniel Emden
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Julian Blanke
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Janik Goltermann
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Nils Opel
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Carlotta Barkhau
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Susanne Meinert
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,University of Münster, Institute for Translational Neuroscience, Münster, Germany
| | - Katharina Dohm
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Jonathan Repple
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marco Mauritz
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Marius Gruber
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Elisabeth J. Leehr
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Dominik Grotegerd
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Ronny Redlich
- University of Münster, Institute for Translational Psychiatry, Münster, Germany,Institute of Psychology, University of Halle, Halle, Germany
| | - Andreas Jansen
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Igor Nenadic
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Andreas Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany,Centre for Human Genetics, University of Marburg, Marburg, Germany,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Joachim Groß
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany
| | - Jochen Bauer
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Walter Heindel
- Department of Clinical Radiology, University of Münster, Münster, Germany
| | - Till Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Simon B. Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany,Institute of Neuroscience and Medicine (INM-7), Research Centre Jülich, Jülich, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Udo Dannlowski
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
| | - Tim Hahn
- University of Münster, Institute for Translational Psychiatry, Münster, Germany
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Shi W, Fan L, Wang H, Liu B, Li W, Li J, Cheng L, Chu C, Song M, Sui J, Luo N, Cui Y, Dong Z, Lu Y, Ma Y, Ma L, Li K, Chen J, Chen Y, Guo H, Li P, Lu L, Lv L, Wan P, Wang H, Wang H, Yan H, Yan J, Yang Y, Zhang H, Zhang D, Jiang T. Two subtypes of schizophrenia identified by an individual-level atypical pattern of tensor-based morphometric measurement. Cereb Cortex 2022; 33:3683-3700. [PMID: 36005854 DOI: 10.1093/cercor/bhac301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/12/2022] Open
Abstract
Difficulties in parsing the multiaspect heterogeneity of schizophrenia (SCZ) based on current nosology highlight the need to subtype SCZ using objective biomarkers. Here, utilizing a large-scale multisite SCZ dataset, we identified and validated 2 neuroanatomical subtypes with individual-level abnormal patterns of the tensor-based morphometric measurement. Remarkably, compared with subtype 1, which showed moderate deficits of some subcortical nuclei and an enlarged striatum and cerebellum, subtype 2, which showed cerebellar atrophy and more severe subcortical nuclei atrophy, had a higher subscale score of negative symptoms, which is considered to be a core aspect of SCZ and is associated with functional outcome. Moreover, with the neuroimaging-clinic association analysis, we explored the detailed relationship between the heterogeneity of clinical symptoms and the heterogeneous abnormal neuroanatomical patterns with respect to the 2 subtypes. And the neuroimaging-transcription association analysis highlighted several potential heterogeneous biological factors that may underlie the subtypes. Our work provided an effective framework for investigating the heterogeneity of SCZ from multilevel aspects and may provide new insights for precision psychiatry.
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Affiliation(s)
- Weiyang Shi
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lingzhong Fan
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China.,Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Haiyan Wang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Bing Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,Chinese Institute for Brain Research, Beijing 102206, China
| | - Wen Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jin Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Luqi Cheng
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China
| | - Congying Chu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Ming Song
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jing Sui
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Na Luo
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Yue Cui
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhenwei Dong
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuheng Lu
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yawei Ma
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Liang Ma
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kaixin Li
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Jun Chen
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yunchun Chen
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Hua Guo
- Zhumadian Psychiatric Hospital, Zhumadian 463000, China
| | - Peng Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Ping Wan
- Zhumadian Psychiatric Hospital, Zhumadian 463000, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - Huiling Wang
- Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Hao Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Jun Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.,Henan Key Lab of Biological Psychiatry of Xinxiang Medical University, International Joint Research Laboratory for Psychiatry and Neuroscience of Henan, Xinxiang 453002, China.,Department of Psychology, Xinxiang Medical University, Xinxiang 453002, China
| | - Dai Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China.,Key Laboratory of Mental Health, Ministry of Health, National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China.,Center for Life Sciences/PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing 100049, China.,Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China.,Research Center for Augmented Intelligence, Zhejiang Lab, Hangzhou 311100, China.,Innovation Academy for Artificial Intelligence, Chinese Academy of Sciences, Beijing 100190, China
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