Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis
The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 13...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229353/ https://www.ncbi.nlm.nih.gov/pubmed/31791912 http://dx.doi.org/10.1016/j.nicl.2019.102108 |
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author | Collin, Guusje Nieto-Castanon, Alfonso Shenton, Martha E. Pasternak, Ofer Kelly, Sinead Keshavan, Matcheri S. Seidman, Larry J. McCarley, Robert W. Niznikiewicz, Margaret A Li, Huijun Zhang, Tianhong Tang, Yingying Stone, William S. Wang, Jijun Whitfield-Gabrieli, Susan |
author_facet | Collin, Guusje Nieto-Castanon, Alfonso Shenton, Martha E. Pasternak, Ofer Kelly, Sinead Keshavan, Matcheri S. Seidman, Larry J. McCarley, Robert W. Niznikiewicz, Margaret A Li, Huijun Zhang, Tianhong Tang, Yingying Stone, William S. Wang, Jijun Whitfield-Gabrieli, Susan |
author_sort | Collin, Guusje |
collection | PubMed |
description | The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At Risk for Psychosis (SHARP) program. Based on outcome at one-year follow-up, participants were separated into three outcome categories including good outcome (symptom remission, N = 71), intermediate outcome (ongoing CHR symptoms, N = 30), and poor outcome (conversion to psychosis or treatment-refractory, N = 36). Validated clinical predictors from the psychosis-risk calculator were combined with measures of resting-state functional connectivity. Using multinomial logistic regression analysis and leave-one-out cross-validation, a clinical-only prediction model did not achieve a significant level of outcome prediction (F(1) = 0.32, p = .154). An imaging-only model yielded a significant prediction model (F(1) = 0.41, p = .016), but a combined model including both clinical and connectivity measures showed the best performance (F(1) = 0.46, p < .001). Influential predictors in this model included functional decline, verbal learning performance, a family history of psychosis, default-mode and frontoparietal within-network connectivity, and between-network connectivity among language, salience, dorsal attention, sensorimotor, and cerebellar networks. These findings suggest that brain changes reflected by alterations in functional connectivity may be useful for outcome prediction in the prodromal stage. |
format | Online Article Text |
id | pubmed-7229353 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-72293532020-05-20 Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis Collin, Guusje Nieto-Castanon, Alfonso Shenton, Martha E. Pasternak, Ofer Kelly, Sinead Keshavan, Matcheri S. Seidman, Larry J. McCarley, Robert W. Niznikiewicz, Margaret A Li, Huijun Zhang, Tianhong Tang, Yingying Stone, William S. Wang, Jijun Whitfield-Gabrieli, Susan Neuroimage Clin Articles from the Special Issue on on "Imaging-based biomarkers in psychiatry – diagnosis, prognosis, outcomes" edited by Claire Wilcox and Vince Calhoun The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At Risk for Psychosis (SHARP) program. Based on outcome at one-year follow-up, participants were separated into three outcome categories including good outcome (symptom remission, N = 71), intermediate outcome (ongoing CHR symptoms, N = 30), and poor outcome (conversion to psychosis or treatment-refractory, N = 36). Validated clinical predictors from the psychosis-risk calculator were combined with measures of resting-state functional connectivity. Using multinomial logistic regression analysis and leave-one-out cross-validation, a clinical-only prediction model did not achieve a significant level of outcome prediction (F(1) = 0.32, p = .154). An imaging-only model yielded a significant prediction model (F(1) = 0.41, p = .016), but a combined model including both clinical and connectivity measures showed the best performance (F(1) = 0.46, p < .001). Influential predictors in this model included functional decline, verbal learning performance, a family history of psychosis, default-mode and frontoparietal within-network connectivity, and between-network connectivity among language, salience, dorsal attention, sensorimotor, and cerebellar networks. These findings suggest that brain changes reflected by alterations in functional connectivity may be useful for outcome prediction in the prodromal stage. Elsevier 2019-11-20 /pmc/articles/PMC7229353/ /pubmed/31791912 http://dx.doi.org/10.1016/j.nicl.2019.102108 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Articles from the Special Issue on on "Imaging-based biomarkers in psychiatry – diagnosis, prognosis, outcomes" edited by Claire Wilcox and Vince Calhoun Collin, Guusje Nieto-Castanon, Alfonso Shenton, Martha E. Pasternak, Ofer Kelly, Sinead Keshavan, Matcheri S. Seidman, Larry J. McCarley, Robert W. Niznikiewicz, Margaret A Li, Huijun Zhang, Tianhong Tang, Yingying Stone, William S. Wang, Jijun Whitfield-Gabrieli, Susan Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title | Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title_full | Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title_fullStr | Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title_full_unstemmed | Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title_short | Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
title_sort | brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis |
topic | Articles from the Special Issue on on "Imaging-based biomarkers in psychiatry – diagnosis, prognosis, outcomes" edited by Claire Wilcox and Vince Calhoun |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229353/ https://www.ncbi.nlm.nih.gov/pubmed/31791912 http://dx.doi.org/10.1016/j.nicl.2019.102108 |
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