title: Neuroanatomical classification in a population-based sample of psychotic major depression and bipolar I disorder with 1 year of diagnostic stability.
abstract: The presence of psychotic features in the course of a depressive disorder is known to increase the risk for bipolarity, but the early identification of such cases remains challenging in clinical practice. In the present study, we evaluated the diagnostic performance of a neuroanatomical pattern classification method in the discrimination between psychotic major depressive disorder (MDD), bipolar I disorder (BD-I), and healthy controls (HC) using a homogenous sample of patients at an early course of their illness. Twenty-three cases of first-episode psychotic mania (BD-I) and 19 individuals with a first episode of psychotic MDD whose diagnosis remained stable during 1 year of followup underwent 1.5 T MRI at baseline. A previously validated multivariate classifier based on support vector machine (SVM) was employed and measures of diagnostic performance were obtained for the discrimination between each diagnostic group and subsamples of age- and gender-matched controls recruited in the same neighborhood of the patients. Based on T1-weighted images only, the SVM-classifier afforded poor discrimination in all 3 pairwise comparisons: BD-I versus HC; MDD versus HC; and BD-I versus MDD. Thus, at the population level and using structural MRI only, we failed to achieve good discrimination between BD-I, psychotic MDD, and HC in this proof of concept study.
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil.
authors.forename: Mauricio H
authors.initials: MH
authors.lastname: Serpa
authors.affiliation: Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market Street, Suite 380, Philadelphia, PA 19104, USA.
authors.forename: Yangming
authors.initials: Y
authors.lastname: Ou
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil.
authors.forename: Maristela S
authors.initials: MS
authors.lastname: Schaufelberger
authors.affiliation: Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market Street, Suite 380, Philadelphia, PA 19104, USA.
authors.forename: Jimit
authors.initials: J
authors.lastname: Doshi
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil.
authors.forename: Luiz K
authors.initials: LK
authors.lastname: Ferreira
authors.affiliation: Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-27, Institute of Psychiatry, 05403-010 São Paulo, SP, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Machado-Vieira
authors.affiliation: Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, 455 Dr. Arnaldo Avenue, 01246-903 São Paulo, SP, Brazil.
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Menezes
authors.affiliation: Laboratory of Psychopharmacology and Clinical Psychophysiology (LIM-23), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, Ground Floor, LIM-23, Institute of Psychiatry, 05403-010 São Paulo, SP, Brazil.
authors.forename: Marcia
authors.initials: M
authors.lastname: Scazufca
authors.affiliation: Section of Biomedical Image Analysis (SBIA), Department of Radiology, University of Pennsylvania, 3600 Market Street, Suite 380, Philadelphia, PA 19104, USA.
authors.forename: Christos
authors.initials: C
authors.lastname: Davatzikos
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil.
authors.forename: Geraldo F
authors.initials: GF
authors.lastname: Busatto
authors.affiliation: Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-21, Nuclear Medicine Center, 05403-010 São Paulo, SP, Brazil ; Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Dr. Ovídio Pires de Campos Street, 3rd Floor, LIM-27, Institute of Psychiatry, 05403-010 São Paulo, SP, Brazil.
authors.forename: Marcus V
authors.initials: MV
authors.lastname: Zanetti
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D003865:Major Depressive Disorder / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011153:Population; D011859:Radiography