Dataset Information

Classifying Major Depressive Disorder and Response to Deep Brain Stimulation Over Time by Analyzing Facial Expressions.

ABSTRACT:

Objective

Major depressive disorder (MDD) is a common psychiatric disorder that leads to persistent changes in mood and interest among other signs and symptoms. We hypothesized that convolutional neural network (CNN) based automated facial expression recognition, pre-trained on an enormous auxiliary public dataset, could provide improve generalizable approach to MDD automatic assessment from videos, and classify remission or response to treatment.

Methods

We evaluated a novel deep neural network framework on 365 video interviews (88 hours) from a cohort of 12 depressed patients before and after deep brain stimulation (DBS) treatment. Seven basic emotions were extracted with a Regional CNN detector and an Imagenet pre-trained CNN, both of which were trained on large-scale public datasets (comprising over a million images). Facial action units were also extracted with the Openface toolbox. Statistics of the temporal evolution of these image features over each recording were extracted and used to classify MDD remission and response to DBS treatment.

Results

An Area Under the Curve of 0.72 was achieved using leave-one-subject-out cross-validation for remission classification and 0.75 for response to treatment.

Conclusion

This work demonstrates the potential for the classification of MDD remission and response to DBS treatment from passively acquired video captured during unstructured, unscripted psychiatric interviews.

Significance

This novel MDD evaluation could be used to augment current psychiatric evaluations and allow automatic, low-cost, frequent use when an expert isn't readily available or the patient is unwilling or unable to engage. Potentially, the framework may also be applied to other psychiatric disorders.

SUBMITTER: Jiang Z

PROVIDER: S-EPMC7891869 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Background: Major Depressive Disorder (MDD) is a moderately heritable disorder with a high lifetime prevalence. At present, laboratory blood tests to support MDD diagnosis are not available. Methods: We used a classifier approach on blood gene expression profiles of a unique set of non-medicated subjects (MDD patients and controls) to select genes of which expression is predictive for disease status. To reveal blood gene expression changes related to MDD disease, we applied a powerful ex vivo stimulus to the blood, i.e. incubation with lipopolysaccharide (LPS; 10 ng/ml blood). Results: Based on LPS-stimulated blood gene expression using whole-genome microarrays in 42 subjects (primary cohort; 21 MDD patients (mean age 42.3 years), 21 healthy controls (mean age 41.9 years)), we identified a set of genes (CAPRIN1, CLEC4A, KRT23, MLC1, PLSCR1, PROK2, ZBTB16) that serves as a molecular signature of MDD. These findings were validated for the primary cohort using an independent quantitative PCR method (P = 0.007). The difference between depressive patients and controls was confirmed (P = 0.019) in a replication cohort of 13 patients with MDD (mean age 42.8 years) and 14 controls (mean age 45.6 years). The MDD-signature score comprised of expression levels of 7 genes could discriminate depressive patients from controls with sensitivity of 76.9% and specificity of 71.8%. Conclusions: We show for the first time that molecular analysis of stimulated blood cells can be used as an endophenotype for MDD diagnosis, which is a milestone in establishing biomarkers for neuropsychiatric disorders with moderate heritability in general. Our results may provide a new entry point for following and predicting treatment outcome, as well as prediction of severity and recurrence of MDD. In total, 33 MDD patients and 34 healthy controls were analyzed using basal gene expression in whole blood, and gene expression from whole blood that was stimulated with LPS for 5-6 h, using microarrays. Patients were arbitrarily selected from all patients to serve as primary cohort (nMDD = 21 (MDD01-MDD21); nControls = 21 (Con01-Con21)), or replication cohort (nMDD = 12 (MDD22-MDD35); nControls = 13 (Con22-Con37)) using microarrays. This submission does not include Samples CON21_LPS or CON30_LPS.

Project description:BackgroundMajor Depressive Disorder (MDD) is associated with interoceptive deficits expressed throughout the body, particularly the facial musculature. According to the facial feedback hypothesis, afferent feedback from the facial muscles suffices to alter the emotional experience. Thus, manipulating the facial muscles could provide a new "mind-body" intervention for MDD. This article provides a conceptual overview of functional electrical stimulation (FES), a novel neuromodulation-based treatment modality that can be potentially used in the treatment of disorders of disrupted brain connectivity, such as MDD.MethodsA focused literature search was performed for clinical studies of FES as a modulatory treatment for mood symptoms. The literature is reviewed in a narrative format, integrating theories of emotion, facial expression, and MDD.ResultsA rich body of literature on FES supports the notion that peripheral muscle manipulation in patients with stroke or spinal cord injury may enhance central neuroplasticity, restoring lost sensorimotor function. These neuroplastic effects suggest that FES may be a promising innovative intervention for psychiatric disorders of disrupted brain connectivity, such as MDD. Recent pilot data on repetitive FES applied to the facial muscles in healthy participants and patients with MDD show early promise, suggesting that FES may attenuate the negative interoceptive bias associated with MDD by enhancing positive facial feedback. Neurobiologically, the amygdala and nodes of the emotion-to-motor transformation loop may serve as potential neural targets for facial FES in MDD, as they integrate proprioceptive and interoceptive inputs from muscles of facial expression and fine-tune their motor output in line with socio-emotional context.ConclusionsManipulating facial muscles may represent a mechanistically novel treatment strategy for MDD and other disorders of disrupted brain connectivity that is worthy of investigation in phase II/III trials.