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The progression of disorder-specific brain pattern expression in schizophrenia over 9 years.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Lieslehto, Johannes  ORCID logo  https://orcid.org/0000-0001-8258-8458
Jääskeläinen, Erika 
Kiviniemi, Vesa 
Haapea, Marianne 

Abstract

Age plays a crucial role in the performance of schizophrenia vs. controls (SZ-HC) neuroimaging-based machine learning (ML) models as the accuracy of identifying first-episode psychosis from controls is poor compared to chronic patients. Resolving whether this finding reflects longitudinal progression in a disorder-specific brain pattern or a systematic but non-disorder-specific deviation from a normal brain aging (BA) trajectory in schizophrenia would help the clinical translation of diagnostic ML models. We trained two ML models on structural MRI data: an SZ-HC model based on 70 schizophrenia patients and 74 controls and a BA model (based on 561 healthy individuals, age range = 66 years). We then investigated the two models' predictions in the naturalistic longitudinal Northern Finland Birth Cohort 1966 (NFBC1966) following 29 schizophrenia and 61 controls for nine years. The SZ-HC model's schizophrenia-specificity was further assessed by utilizing independent validation (62 schizophrenia, 95 controls) and depression samples (203 depression, 203 controls). We found better performance at the NFBC1966 follow-up (sensitivity = 75.9%, specificity = 83.6%) compared to the baseline (sensitivity = 58.6%, specificity = 86.9%). This finding resulted from progression in disorder-specific pattern expression in schizophrenia and was not explained by concomitant acceleration of brain aging. The disorder-specific pattern's progression reflected longitudinal changes in cognition, outcomes, and local brain changes, while BA captured treatment-related and global brain alterations. The SZ-HC model was also generalizable to independent schizophrenia validation samples but classified depression as control subjects. Our research underlines the importance of taking account of longitudinal progression in a disorder-specific pattern in schizophrenia when developing ML classifiers for different age groups.

Description

Keywords

5202 Biological Psychology, 32 Biomedical and Clinical Sciences, 52 Psychology, Depression, Mental Health, Schizophrenia, Brain Disorders, Serious Mental Illness, Clinical Research, Mental Illness, Neurosciences, Mental health

Journal Title

NPJ Schizophr

Conference Name

Journal ISSN

2334-265X
2334-265X

Volume Title

7

Publisher

Springer Science and Business Media LLC