1
|
Zhu K, Chang J, Zhang S, Li Y, Zuo J, Ni H, Xie B, Yao J, Xu Z, Bian S, Yan T, Wu X, Chen S, Jin W, Wang Y, Xu P, Song P, Wu Y, Shen C, Zhu J, Yu Y, Dong F. The enhanced connectivity between the frontoparietal, somatomotor network and thalamus as the most significant network changes of chronic low back pain. Neuroimage 2024; 290:120558. [PMID: 38437909 DOI: 10.1016/j.neuroimage.2024.120558] [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: 10/28/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
The prolonged duration of chronic low back pain (cLBP) inevitably leads to changes in the cognitive, attentional, sensory and emotional processing brain regions. Currently, it remains unclear how these alterations are manifested in the interplay between brain functional and structural networks. This study aimed to predict the Oswestry Disability Index (ODI) in cLBP patients using multimodal brain magnetic resonance imaging (MRI) data and identified the most significant features within the multimodal networks to aid in distinguishing patients from healthy controls (HCs). We constructed dynamic functional connectivity (dFC) and structural connectivity (SC) networks for all participants (n = 112) and employed the Connectome-based Predictive Modeling (CPM) approach to predict ODI scores, utilizing various feature selection thresholds to identify the most significant network change features in dFC and SC outcomes. Subsequently, we utilized these significant features for optimal classifier selection and the integration of multimodal features. The results revealed enhanced connectivity among the frontoparietal network (FPN), somatomotor network (SMN) and thalamus in cLBP patients compared to HCs. The thalamus transmits pain-related sensations and emotions to the cortical areas through the dorsolateral prefrontal cortex (dlPFC) and primary somatosensory cortex (SI), leading to alterations in whole-brain network functionality and structure. Regarding the model selection for the classifier, we found that Support Vector Machine (SVM) best fit these significant network features. The combined model based on dFC and SC features significantly improved classification performance between cLBP patients and HCs (AUC=0.9772). Finally, the results from an external validation set support our hypotheses and provide insights into the potential applicability of the model in real-world scenarios. Our discovery of enhanced connectivity between the thalamus and both the dlPFC (FPN) and SI (SMN) provides a valuable supplement to prior research on cLBP.
Collapse
Affiliation(s)
- Kun Zhu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Jianchao Chang
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Siya Zhang
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; School of Basic Medical Sciences, Anhui Medical University, Hefei, PR China
| | - Yan Li
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Junxun Zuo
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Haoyu Ni
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Bingyong Xie
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Jiyuan Yao
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Zhibin Xu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Sicheng Bian
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Tingfei Yan
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Xianyong Wu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Orthopedics, Anqing First People's Hospital of Anhui Medical University, Anqing, PR China
| | - Senlin Chen
- Department of Orthopedics, Dongcheng branch of The First Affiliated Hospital of Anhui Medical University (Feidong People's Hospital), Hefei, PR China
| | - Weiming Jin
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Ying Wang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Peng Xu
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Peiwen Song
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Yuanyuan Wu
- Department of Medical Imaging, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Cailiang Shen
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China
| | - Fulong Dong
- Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; Department of Spine Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, PR China; School of Basic Medical Sciences, Anhui Medical University, Hefei, PR China.
| |
Collapse
|
2
|
Palacios-Ariza MA, Morales-Mendoza E, Murcia J, Arias-Duarte R, Lara-Castellanos G, Cely-Jiménez A, Rincón-Acuña JC, Araúzo-Bravo MJ, McDouall J. Prediction of patient admission and readmission in adults from a Colombian cohort with bipolar disorder using artificial intelligence. Front Psychiatry 2023; 14:1266548. [PMID: 38179255 PMCID: PMC10764573 DOI: 10.3389/fpsyt.2023.1266548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Bipolar disorder (BD) is a chronically progressive mental condition, associated with a reduced quality of life and greater disability. Patient admissions are preventable events with a considerable impact on global functioning and social adjustment. While machine learning (ML) approaches have proven prediction ability in other diseases, little is known about their utility to predict patient admissions in this pathology. Aim To develop prediction models for hospital admission/readmission within 5 years of diagnosis in patients with BD using ML techniques. Methods The study utilized data from patients diagnosed with BD in a major healthcare organization in Colombia. Candidate predictors were selected from Electronic Health Records (EHRs) and included sociodemographic and clinical variables. ML algorithms, including Decision Trees, Random Forests, Logistic Regressions, and Support Vector Machines, were used to predict patient admission or readmission. Survival models, including a penalized Cox Model and Random Survival Forest, were used to predict time to admission and first readmission. Model performance was evaluated using accuracy, precision, recall, F1 score, area under the receiver operating characteristic curve (AUC) and concordance index. Results The admission dataset included 2,726 BD patients, with 354 admissions, while the readmission dataset included 352 patients, with almost half being readmitted. The best-performing model for predicting admission was the Random Forest, with an accuracy score of 0.951 and an AUC of 0.98. The variables with the greatest predictive power in the Recursive Feature Elimination (RFE) importance analysis were the number of psychiatric emergency visits, the number of outpatient follow-up appointments and age. Survival models showed similar results, with the Random Survival Forest performing best, achieving an AUC of 0.95. However, the prediction models for patient readmission had poorer performance, with the Random Forest model being again the best performer but with an AUC below 0.70. Conclusion ML models, particularly the Random Forest model, outperformed traditional statistical techniques for admission prediction. However, readmission prediction models had poorer performance. This study demonstrates the potential of ML techniques in improving prediction accuracy for BD patient admissions.
Collapse
Affiliation(s)
| | - Esteban Morales-Mendoza
- Fundación Universitaria Sanitas, Gerencia y Gestión Sanitaria Research Group, Instituto de Gerencia y Gestión Sanitaria (IGGS), Bogotá, Colombia
| | - Jossie Murcia
- Fundación Universitaria Sanitas, Gerencia y Gestión Sanitaria Research Group, Instituto de Gerencia y Gestión Sanitaria (IGGS), Bogotá, Colombia
| | - Rafael Arias-Duarte
- Psicopatología y Sociedad Research Group, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
| | - Germán Lara-Castellanos
- Psicopatología y Sociedad Research Group, Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia
| | | | | | - Marcos J. Araúzo-Bravo
- Keralty, Bogotá, Colombia
- Computational Biology and Systems Biomedicine, Biodonostia Health Research Institute, San Sebastián, Spain
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Basque Country (UPV/EHU), Leioa, Spain
| | - Jorge McDouall
- Sanitas Crea Research Group, Fundación Universitaria Sanitas, Bogotá, Colombia
| |
Collapse
|