Aberrant Functional Network Connectivity Transition Probability in Major Depressive Disorder

Uncovering Effects of Schizophrenia upon a Maximally Significant, Minimally Complex Subset of Default Mode Network Connectivity Features

A common analysis approach for resting state functional magnetic resonance imaging (rs-fMRI) dynamic functional network connectivity (dFNC) data involves clustering windowed correlation time-series and assigning time windows to clusters (i.e., states) that can be quantified to summarize aspects of the dFNC dynamics. However, those methods can be dominated by a select few features and obscure key dynamics related to less dominant features. This study presents an iterative feature learning approach to identify a maximally significant and minimally complex subset of dFNC features within the default mode network (DMN) in schizophrenia (SZ). Utilizing dFNC data from individuals with SZ and healthy controls (HC), our approach uncovers a subset of features that has a greater number of dFNC states with disorder-related dynamics than is found when all features are present in the clustering. We find that anterior cingulate cortex/posterior cingulate cortex (ACC/PCC) interactions are consistently related to SZ across the most significant iterations of the feature learning analysis and that individuals with SZ tend to spend more time in states with greater intra-ACC anticorrelation and almost no time in a state of high intra-ACC correlation that HCs periodically enter. Our findings highlight the need for nuanced analyses to reveal disorder-related dynamics and advance our understanding of neuropsychiatric disorders.

Explainable fuzzy clustering framework reveals divergent default mode network connectivity dynamics in schizophrenia

Introduction

Dynamic functional network connectivity (dFNC) analysis of resting state functional magnetic resonance imaging data has yielded insights into many neurological and neuropsychiatric disorders. A common dFNC analysis approach uses hard clustering methods like k-means clustering to assign samples to states that summarize network dynamics. However, hard clustering methods obscure network dynamics by assuming (1) that all samples within a cluster are equally like their assigned centroids and (2) that samples closer to one another in the data space than to their centroids are well-represented by their centroids. In addition, it can be hard to compare subjects, as in some cases an individual may not manifest a state strongly enough to enter a hard cluster. Approaches that allow a dimensional approach to connectivity patterns (e.g., fuzzy clustering) can mitigate these issues. In this study, we present an explainable fuzzy clustering framework by combining fuzzy c-means clustering with several explainability metrics and novel summary features.

Methods

We apply our framework for schizophrenia (SZ) default mode network analysis. Namely, we extract dFNC from individuals with SZ and controls, identify 5 dFNC states, and characterize the dFNC features most crucial to those states with a new perturbation-based clustering explainability approach. We then extract several features typically used in hard clustering and further present a variety of unique features specially designed for use with fuzzy clustering to quantify state dynamics. We examine differences in those features between individuals with SZ and controls and further search for relationships between those features and SZ symptom severity.

Results

Importantly, we find that individuals with SZ spend more time in states of moderate anticorrelation between the anterior and posterior cingulate cortices and strong anticorrelation between the precuneus and anterior cingulate cortex. We further find that individuals with SZ tend to transition more rapidly than controls between low-magnitude and high-magnitude dFNC states.

Conclusion

We present a novel dFNC analysis framework and use it to identify effects of SZ upon network dynamics. Given the ease of implementing our framework and its enhanced insight into network dynamics, it has great potential for use in future dFNC studies.

Cross-Domain Identification of Multisite Major Depressive Disorder Using End-to-End Brain Dynamic Attention Network

Establishing objective and quantitative imaging markers at individual level can assist in accurate diagnosis of Major Depressive Disorder (MDD). However, the clinical heterogeneity of MDD and the shift to multisite data decreased identification accuracy. To address these issues, the Brain Dynamic Attention Network (BDANet) is innovatively proposed, and analyzed bimodal scans from 2055 participants of the Rest-meta-MDD consortium. The end-to-end BDANet contains two crucial components. The Dynamic BrainGraph Generator dynamically focuses and represents topological relationships between Regions of Interest, overcoming limitations of static methods. The Ensemble Classifier is constructed to obfuscate domain sources to achieve inter-domain alignment. Finally, BDANet dynamically generates sample-specific brain graphs by downstream recognition tasks. The proposed BDANet achieved an accuracy of 81.6%. The regions with high attribution for classification were mainly located in the insula, cingulate cortex and auditory cortex. The level of brain connectivity in p24 region was negatively correlated ( [Formula: see text]) with the severity of MDD. Additionally, sex differences in connectivity strength were observed in specific brain regions and functional subnetworks ( [Formula: see text] or [Formula: see text]). These findings based on a large multisite dataset support the conclusion that BDANet can better solve the problem of the clinical heterogeneity of MDD and the shift of multisite data. It also illustrates the potential utility of BDANet for personalized accurate identification, treatment and intervention of MDD.

Disrupted Dynamic Functional Network Connectivity Among Cognitive Control Networks in the Progression of Alzheimer's Disease

Background: Alzheimer's disease (AD) is the most common age-related dementia that promotes a decline in memory, thinking, and social skills. The initial stages of dementia can be associated with mild symptoms, and symptom progression to a more severe state is heterogeneous across patients. Recent work has demonstrated the potential for functional network mapping to assist in the prediction of symptomatic progression. However, this work has primarily used static functional connectivity (sFC) from resting-state functional magnetic resonance imaging. Recently, dynamic functional connectivity (dFC) has been recognized as a powerful advance in functional connectivity methodology to differentiate brain network dynamics between healthy and diseased populations. Methods: Group independent component analysis was applied to extract 17 components within the cognitive control network (CCN) from 1385 individuals across varying stages of AD symptomology. We estimated dFC among 17 components within the CCN, followed by clustering the dFCs into 3 recurring brain states, and then estimated a hidden Markov model and the occupancy rate for each subject. Then, we investigated the link between CCN dFC features and AD progression. Also, we investigated the link between sFC and AD progression and compared its results with dFC results. Results: Progression of AD symptoms was associated with increases in connectivity within the middle frontal gyrus. Also, the very mild AD (vmAD) showed less connectivity within the inferior parietal lobule (in both sFC and dFC) and between this region and the rest of CCN (in dFC analysis). Also, we found that within-middle frontal gyrus connectivity increases with AD progression in both sFC and dFC results. Finally, comparing with vmAD, we found that the normal brain spends significantly more time in a state with lower within-middle frontal gyrus connectivity and higher connectivity between the hippocampus and the rest of CCN, highlighting the importance of assessing the dynamics of brain connectivity in this disease. Conclusion: Our results suggest that AD progress not only alters the CCN connectivity strength but also changes the temporal properties in this brain network. This suggests the temporal and spatial pattern of CCN as a biomarker that differentiates different stages of AD.

A Novel Explainable Fuzzy Clustering Approach for fMRI Dynamic Functional Network Connectivity Analysis

Resting state functional magnetic resonance imaging (rs-fMRI) dynamic functional network connectivity (dFNC) analysis has illuminated brain network interactions across many neuropsychiatric disorders. A common analysis approach involves using hard clustering methods to identify transitory states of brain activity, and in response to this, other methods have been developed to quantify the importance of specific dFNC interactions to identified states. Some of these methods involve perturbing individual features and examining the number of samples that switch states. However, only a minority of samples switch states. As such, these methods actually identify the importance of dFNC features to the clustering of a subset of samples rather than the overall clustering. In this study, we present a novel approach that more capably identifies the importance of each feature to the overall clustering. Our approach uses fuzzy clustering to output probabilities of each sample belonging to states and then measures their Kullback-Leibler divergence after perturbation. We show the viability of our approach in the context of schizophrenia (SZ) default mode network analysis, identifying significant differences in state dynamics between individuals with SZ and healthy controls. We further compare our approach with an existing approach, showing that it captures the effects of perturbation upon most samples. We also find that interactions between the posterior cingulate cortex (PCC) and the anterior cingulate cortex and the PCC and precuneus are important across methods. We expect that our novel explainable clustering approach will enable further progress in rs-fMRI analysis and to other clustering applications.

Explainable Fuzzy Clustering Framework Reveals Divergent Default Mode Network Connectivity Dynamics in Schizophrenia

Dynamic functional network connectivity (dFNC) analysis of resting state functional magnetic resonance imaging data has yielded insights into many neurological and neuropsychiatric disorders. A common dFNC analysis approach uses hard clustering methods like k-means clustering to assign samples to states that summarize network dynamics. However, hard clustering methods obscure network dynamics by assuming (1) that all samples within a cluster are equally like their assigned centroids and (2) that samples closer to one another in the data space than to their centroids are well-represented by their centroids. In addition, it can be hard to compare subjects, as in some cases an individual may not manifest a state strongly enough to enter a hard cluster. Approaches that allow a dimensional approach to connectivity patterns (e.g., fuzzy clustering) can mitigate these issues. In this study, we present an explainable fuzzy clustering framework by combining fuzzy c-means clustering with several explainability metrics. We apply our framework for schizophrenia (SZ) default mode network analysis, identifying 5 states and characterizing those states with a new explainability approach. While also showing that features typically used in hard clustering can be extracted in our framework, we present a variety of unique features to quantify state dynamics and identify effects of SZ upon network dynamics. We further uncover relationships between symptom severity and interactions of the precuneus with the anterior and posterior cingulate cortex. Given the ease of implementing our framework and its enhanced insight into network dynamics, it has great potential for use in future dFNC studies.

A Novel Explainable Fuzzy Clustering Approach for fMRI Dynamic Functional Network Connectivity Analysis

Resting state functional magnetic resonance imaging (rs-fMRI) dynamic functional network connectivity (dFNC) analysis has illuminated brain network interactions across many neuropsychiatric disorders. A common analysis approach involves using hard clustering methods to identify transitory states of brain activity, and in response to this, other methods have been developed to quantify the importance of specific dFNC interactions to identified states. Some of these methods involve perturbing individual features and examining the number of samples that switch states. However, only a minority of samples switch states. As such, these methods actually identify the importance of dFNC features to the clustering of a subset of samples rather than the overall clustering. In this study, we present a novel approach that more capably identifies the importance of each feature to the overall clustering. Our approach uses fuzzy clustering to output probabilities of each sample belonging to states and then measures their Kullback-Leibler divergence after perturbation. We show the viability of our approach in the context of schizophrenia (SZ) default mode network analysis, identifying significant differences in state dynamics between individuals with SZ and healthy controls. We further compare our approach with an existing approach, showing that it captures the effects of perturbation upon most samples. We also find that interactions between the posterior cingulate cortex (PCC) and the anterior cingulate cortex and the PCC and precuneus are important across methods. We expect that our novel explainable clustering approach will enable further progress in rs-fMRI analysis and to other clustering applications.

An Unsupervised Feature Learning Approach for Elucidating Hidden Dynamics in rs-fMRI Functional Network Connectivity

Dynamic functional network connectivity (dFNC) data extracted from resting state functional magnetic resonance imaging (rs-fMRI) recordings has played a significant role in characterizing the role that brain network interactions play in a variety of brain disorders and cognitive functions. dFNC analyses frequently use clustering methods to identify states of network activity. However, it is possible that these states are dominated by a few highly influential networks or nodes, which could obscure condition-related insights that might be gained from networks or nodes less influential to the clustering. In this study, we propose a novel feature learning-based approach that could contribute to the identification of condition-related activity in formerly less influential networks or nodes. We demonstrate the viability of our approach within the context of schizophrenia (SZ), applying our approach to a dataset consisting of 151 participants with SZ and 160 controls (HCs). We find that the removal of some connectivity pairs significantly affects the underlying states and magnifies the differences between participants with SZ and HCs in each state. Given our findings, we hope that our approach will contribute to the characterization and improved diagnosis of a variety of neurological conditions and functions. Clinical Relevance- Our approach could contribute to the characterization and diagnosis of many neurological conditions.

Dynamic Functional Connectivity Predicts Treatment Response to Electroconvulsive Therapy in Major Depressive Disorder

Background: Electroconvulsive therapy (ECT) is one of the most effective treatments for major depressive disorder. Recently, there has been increasing attention to evaluate the effect of ECT on resting-state functional magnetic resonance imaging (rs-fMRI). This study aims to compare rs-fMRI of depressive disorder (DEP) patients with healthy participants, investigate whether pre-ECT dynamic functional network connectivity network (dFNC) estimated from patients rs-fMRI is associated with an eventual ECT outcome, and explore the effect of ECT on brain network states.

Method: Resting-state functional magnetic resonance imaging (fMRI) data were collected from 119 patients with depression or depressive disorder (DEP) (76 females), and 61 healthy (HC) participants (34 females), with an age mean of 52.25 (N = 180) years old. The pre-ECT and post-ECT Hamilton Depression Rating Scale (HDRS) were 25.59 ± 6.14 and 11.48 ± 9.07, respectively. Twenty-four independent components from default mode (DMN) and cognitive control network (CCN) were extracted, using group-independent component analysis from pre-ECT and post-ECT rs-fMRI. Then, the sliding window approach was used to estimate the pre-and post-ECT dFNC of each subject. Next, k-means clustering was separately applied to pre-ECT dFNC and post-ECT dFNC to assess three distinct states from each participant. We calculated the amount of time each subject spends in each state, which is called “occupancy rate” or OCR. Next, we compared OCR values between HC and DEP participants. We also calculated the partial correlation between pre-ECT OCRs and HDRS change while controlling for age, gender, and site. Finally, we evaluated the effectiveness of ECT by comparing pre- and post-ECT OCR of DEP and HC participants.

Results: The main findings include (1) depressive disorder (DEP) patients had significantly lower OCR values than the HC group in state 2, where connectivity between cognitive control network (CCN) and default mode network (DMN) was relatively higher than other states (corrected p = 0.015), (2) Pre-ECT OCR of state, with more negative connectivity between CCN and DMN components, is linked with the HDRS changes (R = 0.23 corrected p = 0.03). This means that those DEP patients who spent less time in this state showed more HDRS change, and (3) The post-ECT OCR analysis suggested that ECT increased the amount of time DEP patients spent in state 2 (corrected p = 0.03).

Conclusion: Our finding suggests that dynamic functional network connectivity (dFNC) features, estimated from CCN and DMN, show promise as a predictive biomarker of the ECT outcome of DEP patients. Also, this study identifies a possible underlying mechanism associated with the ECT effect on DEP patients.

Alzheimer's Disease Projection From Normal to Mild Dementia Reflected in Functional Network Connectivity: A Longitudinal Study

Background

Alzheimer's disease (AD) is the most common age-related problem and progresses in different stages, including mild cognitive impairment (early stage), mild dementia (middle-stage), and severe dementia (late-stage). Recent studies showed changes in functional network connectivity obtained from resting-state functional magnetic resonance imaging (rs-fMRI) during the transition from healthy aging to AD. By assuming that the brain interaction is static during the scanning time, most prior studies are focused on static functional or functional network connectivity (sFNC). Dynamic functional network connectivity (dFNC) explores temporal patterns of functional connectivity and provides additional information to its static counterpart.

Method

We used longitudinal rs-fMRI from 1385 scans (from 910 subjects) at different stages of AD (from normal to very mild AD or vmAD). We used group-independent component analysis (group-ICA) and extracted 53 maximally independent components (ICs) for the whole brain. Next, we used a sliding-window approach to estimate dFNC from the extracted 53 ICs, then group them into 3 different brain states using a clustering method. Then, we estimated a hidden Markov model (HMM) and the occupancy rate (OCR) for each subject. Finally, we investigated the link between the clinical rate of each subject with state-specific FNC, OCR, and HMM.

Results

All states showed significant disruption during progression normal brain to vmAD one. Specifically, we found that subcortical network, auditory network, visual network, sensorimotor network, and cerebellar network connectivity decrease in vmAD compared with those of a healthy brain. We also found reorganized patterns (i.e., both increases and decreases) in the cognitive control network and default mode network connectivity by progression from normal to mild dementia. Similarly, we found a reorganized pattern of between-network connectivity when the brain transits from normal to mild dementia. However, the connectivity between visual and sensorimotor network connectivity decreases in vmAD compared with that of a healthy brain. Finally, we found a normal brain spends more time in a state with higher connectivity between visual and sensorimotor networks.

Conclusion

Our results showed the temporal and spatial pattern of whole-brain FNC differentiates AD form healthy control and suggested substantial disruptions across multiple dynamic states. In more detail, our results suggested that the sensory network is affected more than other brain network, and default mode network is one of the last brain networks get affected by AD In addition, abnormal patterns of whole-brain dFNC were identified in the early stage of AD, and some abnormalities were correlated with the clinical score.