Identifying psychosis spectrum youth using support vector machines and cerebral blood perfusion as measured by arterial spin labeled fMRI

Altered cerebral blood flow (CBF), as measured by arterial spin labelling (ASL), has been observed in several psychiatric conditions, but is a generally underutilized MRI technique, especially in the study of psychosis spectrum (PS) symptoms. We aimed to determine group differences in ASL resting state functional connectivity (rsFC) between PS and non-PS youth, and the reliability of a support vector machine (SVM) classifier trained on ASL rsFC features to differentiate PS and non-PS youth, especially compared to blood oxygen level dependent (BOLD) fMRI. 1146 youth aged 8–22 with ASL and BOLD data from the Philadelphia Neurodevelopmental Cohort were analyzed. Widespread ASL hyperconnectivity was found in the left cuneus, precuneus, and dorsolateral prefrontal cortex, and hypoconnectivity was found in the left cingulate cortex and orbitofrontal area (multiple linear regression, FDR corrected). An SVM trained on ASL and BOLD features outperformed either modality alone (AUC(BOTH) = 0.72 versus AUC(ASL) = 0.68 and AUC(BOLD) = 0.67). Classification performance and precision improved when the non-PS group had no psychiatric comorbidities. The relative success of the classifier suggests ASL rsFC changes exist in PS individuals that differ from BOLD rsFC changes, and extends previous findings of CBF dysregulation in PS.