Multisite Machine Learning Analysis Provides a Robust Structural Imaging Signature of Schizophrenia Detectable Across Diverse Patient Populations and Within Individuals.

Journal: Schizophrenia bulletin
Published Date:

Abstract

Past work on relatively small, single-site studies using regional volumetry, and more recently machine learning methods, has shown that widespread structural brain abnormalities are prominent in schizophrenia. However, to be clinically useful, structural imaging biomarkers must integrate high-dimensional data and provide reproducible results across clinical populations and on an individual person basis. Using advanced multi-variate analysis tools and pooled data from case-control imaging studies conducted at 5 sites (941 adult participants, including 440 patients with schizophrenia), a neuroanatomical signature of patients with schizophrenia was found, and its robustness and reproducibility across sites, populations, and scanners, was established for single-patient classification. Analyses were conducted at multiple scales, including regional volumes, voxelwise measures, and complex distributed patterns. Single-subject classification was tested for single-site, pooled-site, and leave-site-out generalizability. Regional and voxelwise analyses revealed a pattern of widespread reduced regional gray matter volume, particularly in the medial prefrontal, temporolimbic and peri-Sylvian cortex, along with ventricular and pallidum enlargement. Multivariate classification using pooled data achieved a cross-validated prediction accuracy of 76% (AUC = 0.84). Critically, the leave-site-out validation of the detected schizophrenia signature showed accuracy/AUC range of 72-77%/0.73-0.91, suggesting a robust generalizability across sites and patient cohorts. Finally, individualized patient classifications displayed significant correlations with clinical measures of negative, but not positive, symptoms. Taken together, these results emphasize the potential for structural neuroimaging data to provide a robust and reproducible imaging signature of schizophrenia. A web-accessible portal is offered to allow the community to obtain individualized classifications of magnetic resonance imaging scans using the methods described herein.

Authors

  • Martin Rozycki
    Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia.
  • Theodore D Satterthwaite
    Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
  • Nikolaos Koutsouleris
    Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
  • Guray Erus
    Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Jimit Doshi
    Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, PA, USA.
  • Daniel H Wolf
    Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
  • Yong Fan
    CPB/ECMO Children's Hospital, Zhejiang University School of Medicine, 310052 Hangzhou, Zhejiang, China.
  • Raquel E Gur
    Brain Behavior Laboratory, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
  • Ruben C Gur
    Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
  • Eva M Meisenzahl
    Department of Psychiatry and Psychotherapy, Heinrich Heine University Dusseldorf, Dusseldorf, Germany.
  • Chuanjun Zhuo
    Tianjin Anning Hospital, Tianjin, China.
  • Hong Yin
    Department of Mathematics, School of Information, Renmin University of China, No.59 Zhong Guan Cun Avenue, Hai Dian District, Beijing, 100872, China. yinxiaohong82@hotmail.com.
  • Hao Yan
    Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas 75235.
  • Weihua Yue
    Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Sixth Hospital, Peking University, Beijing, China.
  • Dai Zhang
    Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Sixth Hospital, Peking University, Beijing, China.
  • Christos Davatzikos
    Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.