Haas Shalaila S, Antonucci Linda A, Wenzel Julian, Ruef Anne, Biagianti Bruno, Paolini Marco, Rauchmann Boris-Stephan, Weiske Johanna, Kambeitz Joseph, Borgwardt Stefan, Brambilla Paolo, Meisenzahl Eva, Salokangas Raimo K R, Upthegrove Rachel, Wood Stephen J, Koutsouleris Nikolaos, Kambeitz-Ilankovic Lana
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany.
Neuropsychopharmacology. 2021 Mar;46(4):828-835. doi: 10.1038/s41386-020-00877-4. Epub 2020 Oct 7.
Two decades of studies suggest that computerized cognitive training (CCT) has an effect on cognitive improvement and the restoration of brain activity. Nevertheless, individual response to CCT remains heterogenous, and the predictive potential of neuroimaging in gauging response to CCT remains unknown. We employed multivariate pattern analysis (MVPA) on whole-brain resting-state functional connectivity (rsFC) to (neuro)monitor clinical outcome defined as psychosis-likeness change after 10-hours of CCT in recent onset psychosis (ROP) patients. Additionally, we investigated if sensory processing (SP) change during CCT is associated with individual psychosis-likeness change and cognitive gains after CCT. 26 ROP patients were divided into maintainers and improvers based on their SP change during CCT. A support vector machine (SVM) classifier separating 56 healthy controls (HC) from 35 ROP patients using rsFC (balanced accuracy of 65.5%, P < 0.01) was built in an independent sample to create a naturalistic model representing the HC-ROP hyperplane. This model was out-of-sample cross-validated in the ROP patients from the CCT trial to assess associations between rsFC pattern change, cognitive gains and SP during CCT. Patients with intact SP threshold at baseline showed improved attention despite psychosis status on the SVM hyperplane at follow-up (p < 0.05). Contrarily, the attentional gains occurred in the ROP patients who showed impaired SP at baseline only if rsfMRI diagnosis status shifted to the healthy-like side of the SVM continuum. Our results reveal the utility of MVPA for elucidating treatment response neuromarkers based on rsFC-SP change and pave the road to more personalized interventions.
二十年的研究表明,计算机化认知训练(CCT)对认知改善和大脑活动恢复有影响。然而,个体对CCT的反应仍然存在异质性,神经影像学在评估对CCT反应方面的预测潜力仍然未知。我们对全脑静息态功能连接(rsFC)进行多变量模式分析(MVPA),以(神经)监测近期发病精神病(ROP)患者在接受10小时CCT后定义为类精神病变化的临床结果。此外,我们研究了CCT期间感觉加工(SP)的变化是否与个体类精神病变化以及CCT后的认知改善相关。26名ROP患者根据他们在CCT期间的SP变化分为维持者和改善者。在一个独立样本中建立了一个支持向量机(SVM)分类器,使用rsFC将56名健康对照(HC)与35名ROP患者区分开来(平衡准确率为65.5%,P < 0.01),以创建一个代表HC-ROP超平面的自然模型。该模型在CCT试验的ROP患者中进行样本外交叉验证,以评估rsFC模式变化、认知改善和CCT期间SP之间的关联。基线时SP阈值完整的患者在随访时,尽管在SVM超平面上处于精神病状态,但注意力得到改善(p < 0.05)。相反,只有当静息态功能磁共振成像(rsfMRI)诊断状态转移到SVM连续体的健康样一侧时,基线时SP受损的ROP患者才会出现注意力改善。我们的结果揭示了MVPA在基于rsFC-SP变化阐明治疗反应神经标志物方面的效用,并为更个性化的干预铺平了道路。