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Identifying a predictive model of cognitive impairment in bipolar disorder patients: a machine learning study

Published online by Cambridge University Press:  19 July 2023

C. Monopoli*
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit
L. Fortaner-Uyà
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
F. Calesella
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
F. Colombo
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
B. Bravi
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
E. Maggioni
Affiliation:
Politecnico di Milano, Department of Electronics - Information and Bioengineering Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
E. Tassi
Affiliation:
Politecnico di Milano, Department of Electronics - Information and Bioengineering
I. Bollettini
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit
S. Poletti
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
F. Benedetti
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
B. Vai
Affiliation:
IRCCS San Raffaele Hospital, Psychiatry and Clinical Psychobiology Unit University Vita-Salute San Raffaele
*
*Corresponding author.

Abstract

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Introduction

Bipolar patients (BP) frequently have cognitive deficits, that impact on prognosis and quality of life. Finding biomarkers for this condition is essential to improve patients’ healthcare. Given the association between cognitive dysfunctions and structural brain abnormalities, we used a machine learning approach to identify patients with cognitive deficits.

Objectives

The aim of this study was to assess if structural neuroimaging data could identify patients with cognitive impairments in several domains using a machine learning framework.

Methods

Diffusion tensor imaging and T1-weighted images of 150 BP were acquired and both grey matter voxel-based morphometry (VBM) and tract-based white matter fractional anisotropy (FA) measures were extracted. Support vector machine (SVM) models were trained through a 10-fold nested cross-validation with subsampling. VBM and FA maps were entered separately and in combination as input features to discriminate BP with and without deficits in six cognitive domains, assessed through the Brief Assessment of Cognition in Schizophrenia.

Results

The best classification performance for each cognitive domain is illustrated in Table 1. FA was the most relevant neuroimaging modality for the prediction of verbal memory, verbal fluency, and executive functions deficits, whereas VBM was more predictive for working memory and motor speed domains.Table 1.Performance of best classification models.

Input featureBalance Accuracy (%)Specificity (%)Sensitivity (%)
Verbal MemoryFA60.1751.3143
Verbal FluencyFA57.676253.33
Executive functionsFA6063.3356.67
Working MemoryVBM56.505657
Motor speedVBM53.5047.6759.33
Attention and processing speedVBM + FA58.3349.1767.5

Conclusions

Overall, the tested SVM models showed a good predictive performance. Although only partially, our results suggest that different structural neuroimaging data can predict cognitive deficits in BP with accuracy higher than chance level. Unexpectedly, only for the attention and processing speed domain the best model was obtained combining the structural features. Future research may promote data fusion methods to develop better predictive models.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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