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Makowski C, Nichols TE, Dale AM. Quality over quantity: powering neuroimaging samples in psychiatry. Neuropsychopharmacology 2024:10.1038/s41386-024-01893-4. [PMID: 38902353 DOI: 10.1038/s41386-024-01893-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/06/2024] [Accepted: 05/24/2024] [Indexed: 06/22/2024]
Abstract
Neuroimaging has been widely adopted in psychiatric research, with hopes that these non-invasive methods will provide important clues to the underpinnings and prediction of various mental health symptoms and outcomes. However, the translational impact of neuroimaging has not yet reached its promise, despite the plethora of computational methods, tools, and datasets at our disposal. Some have lamented that too many psychiatric neuroimaging studies have been underpowered with respect to sample size. In this review, we encourage this discourse to shift from a focus on sheer increases in sample size to more thoughtful choices surrounding experimental study designs. We propose considerations at multiple decision points throughout the study design, data modeling and analysis process that may help researchers working in psychiatric neuroimaging boost power for their research questions of interest without necessarily increasing sample size. We also provide suggestions for leveraging multiple datasets to inform each other and strengthen our confidence in the generalization of findings to both population-level and clinical samples. Through a greater emphasis on improving the quality of brain-based and clinical measures rather than merely quantity, meaningful and potentially translational clinical associations with neuroimaging measures can be achieved with more modest sample sizes in psychiatry.
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Affiliation(s)
- Carolina Makowski
- Department of Radiology, University of California San Diego, San Diego, CA, USA.
| | - Thomas E Nichols
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Anders M Dale
- Departments of Radiology and Neurosciences, University of California San Diego, San Diego, CA, USA
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Adkinson BD, Rosenblatt M, Dadashkarimi J, Tejavibulya L, Jiang R, Noble S, Scheinost D. Brain-phenotype predictions can survive across diverse real-world data. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.23.576916. [PMID: 38328100 PMCID: PMC10849571 DOI: 10.1101/2024.01.23.576916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Recent work suggests that machine learning models predicting psychiatric treatment outcomes based on clinical data may fail when applied to unharmonized samples. Neuroimaging predictive models offer the opportunity to incorporate neurobiological information, which may be more robust to dataset shifts. Yet, among the minority of neuroimaging studies that undertake any form of external validation, there is a notable lack of attention to generalization across dataset-specific idiosyncrasies. Research settings, by design, remove the between-site variations that real-world and, eventually, clinical applications demand. Here, we rigorously test the ability of a range of predictive models to generalize across three diverse, unharmonized samples: the Philadelphia Neurodevelopmental Cohort (n=1291), the Healthy Brain Network (n=1110), and the Human Connectome Project in Development (n=428). These datasets have high inter-dataset heterogeneity, encompassing substantial variations in age distribution, sex, racial and ethnic minority representation, recruitment geography, clinical symptom burdens, fMRI tasks, sequences, and behavioral measures. We demonstrate that reproducible and generalizable brain-behavior associations can be realized across diverse dataset features with sample sizes in the hundreds. Results indicate the potential of functional connectivity-based predictive models to be robust despite substantial inter-dataset variability. Notably, for the HCPD and HBN datasets, the best predictions were not from training and testing in the same dataset (i.e., cross-validation) but across datasets. This result suggests that training on diverse data may improve prediction in specific cases. Overall, this work provides a critical foundation for future work evaluating the generalizability of neuroimaging predictive models in real-world scenarios and clinical settings.
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Affiliation(s)
- Brendan D Adkinson
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Matthew Rosenblatt
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
| | - Javid Dadashkarimi
- Department of Radiology, Athinoula. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA, 02129, USA
| | - Link Tejavibulya
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Rongtao Jiang
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Stephanie Noble
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Bioengineering, Northeastern University, Boston, MA, 02120, USA
- Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Dustin Scheinost
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Biomedical Engineering, Yale University, New Haven, CT, 06520, USA
- Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06510, USA
- Department of Statistics & Data Science, Yale University, New Haven, CT, 06520, USA
- Child Study Center, Yale School of Medicine, New Haven, CT, 06510, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
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