title: Classifying Schizophrenia Using Multimodal Multivariate Pattern Recognition Analysis: Evaluating the Impact of Individual Clinical Profiles on the Neurodiagnostic Performance.
abstract: Previous studies have shown that structural brain changes are among the best-studied candidate markers for schizophrenia (SZ) along with functional connectivity (FC) alterations of resting-state (RS) patterns. This study aimed to investigate effects of clinical and sociodemographic variables on the classification by applying multivariate pattern analysis (MVPA) to both gray matter (GM) volume and FC measures in patients with SZ and healthy controls (HC). RS and structural magnetic resonance imaging data (sMRI) from 74 HC and 71 SZ patients were obtained from a Mind Research Network COBRE dataset available via COINS (http://coins.mrn.org/dx). We used a MVPA framework using support-vector machines embedded in a repeated, nested cross-validation to generate a multi-modal diagnostic system and evaluate its generalizability. The dependence of neurodiagnostic performance on clinical and sociodemographic variables was evaluated. The RS classifier showed a slightly higher accuracy (70.5%) compared to the structural classifier (69.7%). The combination of sMRI and RS outperformed single MRI modalities classification by reaching 75% accuracy. The RS based moderator analysis revealed that the neurodiagnostic performance was driven by older SZ patients with an earlier illness onset and more pronounced negative symptoms. In contrast, there was no linear relationship between the clinical variables and neuroanatomically derived group membership measures. This study achieved higher accuracy distinguishing HC from SZ patients by fusing 2 imaging modalities. In addition the results of RS based moderator analysis showed that age of patients, as well as their age at the illness onset were the most important clinical features.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; These authors contributed equally.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cabral
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany; These authors contributed equally. Lana.Kambeitz-Ilankovic@med.uni-muenchen.de.
authors.forename: Lana
authors.initials: L
authors.lastname: Kambeitz-Ilankovic
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Joseph
authors.initials: J
authors.lastname: Kambeitz
authors.affiliation: The Mind Research Network, The University of New Mexico, Albuquerque, NM.
authors.forename: Vince D
authors.initials: VD
authors.lastname: Calhoun
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Dominic B
authors.initials: DB
authors.lastname: Dwyer
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Sebastian
authors.initials: S
authors.lastname: von Saldern
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Maria F
authors.initials: MF
authors.lastname: Urquijo
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Peter
authors.initials: P
authors.lastname: Falkai
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany;
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Koutsouleris
mesh_terms: D000328:Adult; D063132:Connectome / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D012559:Schizophrenia / Q000145:classification* / Q000473:pathology / Q000503:physiopathology; D060388:Support Vector Machine
keywords: brain imaging; clinical symptoms; multimodal; pattern recognition; schizophrenia