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Yao L, Shono Y, Nowinski C, Dworak EM, Kaat A, Chen S, Lovett R, Ho E, Curtis L, Wolf M, Gershon R, Benavente JY. Prediction of cognitive impairment using higher order item response theory and machine learning models. Front Psychiatry 2024; 14:1297952. [PMID: 38495777 PMCID: PMC10940331 DOI: 10.3389/fpsyt.2023.1297952] [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: 09/20/2023] [Accepted: 11/17/2023] [Indexed: 03/19/2024] Open
Abstract
Timely detection of cognitive impairment (CI) is critical for the wellbeing of elderly individuals. The MyCog assessment employs two validated iPad-based measures from the NIH Toolbox® for Assessment of Neurological and Behavioral Function (NIH Toolbox). These measures assess pivotal cognitive domains: Picture Sequence Memory (PSM) for episodic memory and Dimensional Change Card Sort Test (DCCS) for cognitive flexibility. The study involved 86 patients and explored diverse machine learning models to enhance CI prediction. This encompassed traditional classifiers and neural-network-based methods. After 100 bootstrap replications, the Random Forest model stood out, delivering compelling results: precision at 0.803, recall at 0.758, accuracy at 0.902, F1 at 0.742, and specificity at 0.951. Notably, the model incorporated a composite score derived from a 2-parameter higher order item response theory (HOIRT) model that integrated DCCS and PSM assessments. The study's pivotal finding underscores the inadequacy of relying solely on a fixed composite score cutoff point. Instead, it advocates for machine learning models that incorporate HOIRT-derived scores and encompass relevant features such as age. Such an approach promises more effective predictive models for CI, thus advancing early detection and intervention among the elderly.
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Affiliation(s)
- Lihua Yao
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Yusuke Shono
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States
| | - Cindy Nowinski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Elizabeth M. Dworak
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Aaron Kaat
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shirley Chen
- Transitional Year Residency, Aurora St. Luke's Medical Center, Milwaukee, WI, United States
| | - Rebecca Lovett
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Emily Ho
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Laura Curtis
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Michael Wolf
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Richard Gershon
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Julia Yoshino Benavente
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Salami A, Andreu-Perez J, Gillmeister H. Finding neural correlates of depersonalisation/derealisation disorder via explainable CNN-based analysis guided by clinical assessment scores. Artif Intell Med 2024; 149:102755. [PMID: 38462269 DOI: 10.1016/j.artmed.2023.102755] [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: 03/23/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 03/12/2024]
Abstract
Mental health disorders are typically diagnosed based on subjective reports (e.g., through questionnaires) followed by clinical interviews to evaluate the self-reported symptoms. Therefore, considering the interconnected nature of psychiatric disorders, their accurate diagnosis is a real challenge without indicators of underlying physiological dysfunction. Depersonalisation/derealisation disorder (DPD) is an example of dissociative disorder affecting 1-2 % of the population. DPD is characterised mainly by persistent disembodiment, detachment from surroundings, and feelings of emotional numbness, which can significantly impact patients' quality of life. The underlying neural correlates of DPD have been investigated for years to understand and help with a more accurate and in-time diagnosis of the disorder. However, in terms of EEG studies, which hold great importance due to their convenient and inexpensive nature, the literature has often been based on hypotheses proposed by experts in the field, which require prior knowledge of the disorder. In addition, participants' labelling in research experiments is often derived from the outcome of the Cambridge Depersonalisation Scale (CDS), a subjective assessment to quantify the level of depersonalisation/derealisation, the threshold and reliability of which might be challenged. As a result, we aimed to propose a novel end-to-end EEG processing pipeline based on deep neural networks for DPD biomarker discovery, which requires no prior handcrafted labelled data. Alternatively, it can assimilate knowledge from clinical outcomes like CDS as well as data-driven patterns that differentiate individual brain responses. In addition, the structure of the proposed model targets the uncertainty in CDS scores by using them as prior information only to guide the unsupervised learning task in a multi-task learning scenario. A comprehensive evaluation has been done to confirm the significance of the proposed deep structure, including new ways of network visualisation to investigate spectral, spatial, and temporal information derived in the learning process. We argued that the proposed EEG analytics could also be applied to investigate other psychological and mental disorders currently indicated on the basis of clinical assessment scores. The code to reproduce the results presented in this paper is openly accessible at https://github.com/AbbasSalami/DPD_Analysis.
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Affiliation(s)
- Abbas Salami
- School of Computer Science and Electronic Engineering, University of Essex, Colchester CO4 3SQ, UK.
| | - Javier Andreu-Perez
- School of Computer Science and Electronic Engineering, University of Essex, Colchester CO4 3SQ, UK; Centre for Computational Intelligence, Smart Health Technologies Group, Institute of Public Health and Wellbeing, University of Essex, Colchester CO4 3SQ, UK; Simbad2, Department of Computer Science, University of Jaén, 23071 Jaen, Spain; Biomedical Research Institute of Malaga (IBIMA), 29590 Málaga, Spain.
| | - Helge Gillmeister
- Centre for Computational Intelligence, Smart Health Technologies Group, Institute of Public Health and Wellbeing, University of Essex, Colchester CO4 3SQ, UK; Department of Psychology, University of Essex, Colchester CO4 3SQ, UK.
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Lu Z, Wang J, Wang F, Wu Z. Application of graph frequency attention convolutional neural networks in depression treatment response. Front Psychiatry 2023; 14:1244208. [PMID: 38045613 PMCID: PMC10690947 DOI: 10.3389/fpsyt.2023.1244208] [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: 06/22/2023] [Accepted: 10/06/2023] [Indexed: 12/05/2023] Open
Abstract
Depression, a prevalent global mental health disorder, necessitates precise treatment response prediction for the improvement of personalized care and patient prognosis. The Graph Convolutional Neural Networks (GCNs) have emerged as a promising technique for handling intricate signals and classification tasks owing to their end-to-end neural architecture and nonlinear processing capabilities. In this context, this article proposes a model named the Graph Frequency Attention Convolutional Neural Network (GFACNN). Primarily, the model transforms the EEG signals into graphs to depict the connections between electrodes and brain regions, while integrating a frequency attention module to accentuate brain rhythm information. The proposed approach delves into the application of graph neural networks in the classification of EEG data, aiming to evaluate the response to antidepressant treatment and discern between treatment-resistant and treatment-responsive cases. Experimental results obtained from an EEG dataset at Peking University People's Hospital demonstrate the notable performance of GFACNN in distinguishing treatment responses among depression patients, surpassing deep learning methodologies including CapsuleNet and GoogLeNet. This highlights the efficacy of graph neural networks in leveraging the connections within EEG signal data. Overall, GFACNN exhibits potential for the classification of depression EEG signals, thereby potentially aiding clinical diagnosis and treatment.
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Affiliation(s)
| | | | - Fengqin Wang
- College of Physics and Electronics Science, Hubei Normal University, Huangshi, China
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Zitouni MS, Lih Oh S, Vicnesh J, Khandoker A, Acharya UR. Automated recognition of major depressive disorder from cardiovascular and respiratory physiological signals. Front Psychiatry 2022; 13:970993. [PMID: 36569627 PMCID: PMC9780587 DOI: 10.3389/fpsyt.2022.970993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Major Depressive Disorder (MDD) is a neurohormonal disorder that causes persistent negative thoughts, mood and feelings, often accompanied with suicidal ideation (SI). Current clinical diagnostic approaches are solely based on psychiatric interview questionnaires. Thus, a computational intelligence tool for the automated detection of MDD with and without suicidal ideation is presented in this study. Since MDD is proven to affect cardiovascular and respiratory systems, the aim of the study is to automatically identify the disorder severity in MDD patients using corresponding multi-modal physiological signals, including electrocardiogram (ECG), finger photoplethysmography (PPG) and respiratory signals (RSP). Data from 88 subjects were used in this study, out of which 25 were MDD patients without SI (MDDSI-), 18 MDD patients with SI (MDDSI+), and 45 normal subjects. Multi-modal physiological signals were acquired from each subject, including ECG, RSP, and PPG signals, and then pre-processed. Discrete wavelet transform (DWT) was applied to the signals, which were decomposed up to six levels, and then eleven nonlinear features were extracted. The features were ranked according to the analysis of variance test and Marginal Fisher Analysis was employed to reduce the feature set, after which the reduced features were ranked again to select the most discriminatory features. Support vector machine with polynomial radial basis function (SVM-RBF) as well as k-nearest neighbor (KNN) classifiers were used to classify the significant features. The performance of the classifiers was evaluated in a 10-fold cross validation scheme. The best performance achieved for the classification of MDDSI+ patients was up to 85.2%, by using selected features from the obtained multi-modal signals with SVM-RBF, while it was up to 96.6% for the detection of MDD patients against healthy subjects. This work is a step toward the utilization of automated tools in diagnostics and monitoring of MDD patients in a personalized and wearable healthcare system.
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Affiliation(s)
- M. Sami Zitouni
- College of Engineering & IT, University of Dubai, Dubai, United Arab Emirates
- Health Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Shu Lih Oh
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Jahmunah Vicnesh
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
| | - Ahsan Khandoker
- Health Engineering Innovation Center, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
| | - U. Rajendra Acharya
- School of Engineering, Ngee Ann Polytechnic, Singapore, Singapore
- Department Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan
- International Research Organization for Advanced Science and Technology, Kumamoto University, Kumamoto, Japan
- Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore
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Höller Y, Jónsdóttir ST, Hannesdóttir AH, Ólafsson RP. EEG-responses to mood induction interact with seasonality and age. Front Psychiatry 2022; 13:950328. [PMID: 36016970 PMCID: PMC9396338 DOI: 10.3389/fpsyt.2022.950328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
The EEG is suggested as a potential diagnostic and prognostic biomarker for seasonal affective disorder (SAD). As a pre-clinical form of SAD, seasonality is operationalized as seasonal variation in mood, appetite, weight, sleep, energy, and socializing. Importantly, both EEG biomarkers and seasonality interact with age. Inducing sad mood to assess cognitive vulnerability was suggested to improve the predictive value of summer assessments for winter depression. However, no EEG studies have been conducted on induced sad mood in relation to seasonality, and no studies so far have controlled for age. We recorded EEG and calculated bandpower in 114 participants during rest and during induced sad mood in summer. Participants were grouped by age and based on a seasonality score as obtained with the seasonal pattern assessment questionnaire (SPAQ). Participants with high seasonality scores showed significantly larger changes in EEG power from rest to sad mood induction, specifically in the alpha frequency range (p = 0.027), compared to participants with low seasonality scores. Furthermore, seasonality interacted significantly with age (p < 0.001), with lower activity in individuals with high seasonality scores that were older than 50 years but the opposite pattern in individuals up to 50 years. Effects of sad mood induction on brain activity are related to seasonality and can therefore be consider as potential predicting biomarkers for SAD. Future studies should control for age as a confounding factor, and more studies are needed to elaborate on the characteristics of EEG biomarkers in participants above 50 years.
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Affiliation(s)
- Yvonne Höller
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland
| | - Sara Teresa Jónsdóttir
- Faculty of Psychology, University of Akureyri, Akureyri, Iceland.,Faculty of Psychology, University of Iceland, Reykjavík, Iceland
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