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Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis.

ABSTRACT: The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At Risk for Psychosis (SHARP) program. Based on outcome at one-year follow-up, participants were separated into three outcome categories including good outcome (symptom remission, N = 71), intermediate outcome (ongoing CHR symptoms, N = 30), and poor outcome (conversion to psychosis or treatment-refractory, N = 36). Validated clinical predictors from the psychosis-risk calculator were combined with measures of resting-state functional connectivity. Using multinomial logistic regression analysis and leave-one-out cross-validation, a clinical-only prediction model did not achieve a significant level of outcome prediction (F₁ = 0.32, p = .154). An imaging-only model yielded a significant prediction model (F₁ = 0.41, p?=?.016), but a combined model including both clinical and connectivity measures showed the best performance (F₁?=?0.46, p < .001). Influential predictors in this model included functional decline, verbal learning performance, a family history of psychosis, default-mode and frontoparietal within-network connectivity, and between-network connectivity among language, salience, dorsal attention, sensorimotor, and cerebellar networks. These findings suggest that brain changes reflected by alterations in functional connectivity may be useful for outcome prediction in the prodromal stage.

SUBMITTER: Collin G

PROVIDER: S-EPMC7229353 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis.

Collin Guusje G Nieto-Castanon Alfonso A Shenton Martha E ME Pasternak Ofer O Kelly Sinead S Keshavan Matcheri S MS Seidman Larry J LJ McCarley Robert W RW Niznikiewicz Margaret A MA Li Huijun H Zhang Tianhong T Tang Yingying Y Stone William S WS Wang Jijun J Whitfield-Gabrieli Susan S

NeuroImage. Clinical 20191120

The first episode of psychosis is typically preceded by a prodromal phase with subthreshold symptoms and functional decline. Improved outcome prediction in this stage is needed to allow targeted early intervention. This study assesses a combined clinical and resting-state fMRI prediction model in 137 adolescents and young adults at Clinical High Risk (CHR) for psychosis from the Shanghai At Risk for Psychosis (SHARP) program. Based on outcome at one-year follow-up, participants were separated in ...[more]

PMID: 31791912

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Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis.

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Brain functional connectivity data enhance prediction of clinical outcome in youth at risk for psychosis.

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