title: Predicting the Naturalistic Course of Major Depressive Disorder Using Clinical and Multimodal Neuroimaging Information: A Multivariate Pattern Recognition Study.
abstract: BACKGROUND
  A chronic course of major depressive disorder (MDD) is associated with profound alterations in brain volumes and emotional and cognitive processing. However, no neurobiological markers have been identified that prospectively predict MDD course trajectories. This study evaluated the prognostic value of different neuroimaging modalities, clinical characteristics, and their combination to classify MDD course trajectories.
  
  
  METHODS
  One hundred eighteen MDD patients underwent structural and functional magnetic resonance imaging (MRI) (emotional facial expressions and executive functioning) and were clinically followed-up at 2 years. Three MDD trajectories (chronic n = 23, gradual improving n = 36, and fast remission n = 59) were identified based on Life Chart Interview measuring the presence of symptoms each month. Gaussian process classifiers were employed to evaluate prognostic value of neuroimaging data and clinical characteristics (including baseline severity, duration, and comorbidity).
  
  
  RESULTS
  Chronic patients could be discriminated from patients with more favorable trajectories from neural responses to various emotional faces (up to 73% accuracy) but not from structural MRI and functional MRI related to executive functioning. Chronic patients could also be discriminated from remitted patients based on clinical characteristics (accuracy 69%) but not when age differences between the groups were taken into account. Combining different task contrasts or data sources increased prediction accuracies in some but not all cases.
  
  
  CONCLUSIONS
  Our findings provide evidence that the prediction of naturalistic course of depression over 2 years is improved by considering neuroimaging data especially derived from neural responses to emotional facial expressions. Neural responses to emotional salient faces more accurately predicted outcome than clinical data.
authors.affiliation: Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. Electronic address: l.schmaal@ggzingeest.nl.
authors.forename: Lianne
authors.initials: L
authors.lastname: Schmaal
authors.affiliation: Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands; Department of Neuroimaging, Institute of Psychiatry, King's College London, United Kingdom.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Marquand
authors.affiliation: Department of Psychiatry and the EMGO(+) Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Didi
authors.initials: D
authors.lastname: Rhebergen
authors.affiliation: Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: van Tol
authors.affiliation: Neuroimaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Mood and Anxiety Disorders, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Henricus G
authors.initials: HG
authors.lastname: Ruhé
authors.affiliation: Department of Psychiatry (NJvdW), Leiden University Medical Center, Leiden University, Leiden, The Netherlands.
authors.forename: Nic J A
authors.initials: NJ
authors.lastname: van der Wee
authors.affiliation: Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.affiliation: Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry and the EMGO(+) Institute for Health and Care Research, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D018450:Disease Progression; D005149:Facial Expression; D000066499:Facial Recognition / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011379:Prognosis
keywords: Clinical information; Course trajectory; Magnetic resonance imaging; Major depressive disorder; Prediction; Probabilistic pattern recognition analysis