Tubío-Fungueiriño Maria, Cernadas Eva, Fernández-Delgado Manuel, Arrojo Manuel, Bertolin Sara, Real Eva, Menchon José Manuel, Carracedo Angel, Alonso Pino, Fernández-Prieto Montse, Segalàs Cinto
Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Pública Galega Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
Centro Singular de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain.
Span J Psychiatry Ment Health. 2025 Jan-Mar;18(1):51-57. doi: 10.1016/j.sjpmh.2024.11.001. Epub 2024 Nov 15.
Obsessive compulsive disorder is associated with affected executive functioning, including memory, cognitive flexibility, and organizational strategies. As it was reported in previous studies, patients with preserved executive functions respond better to pharmacological treatment, while others need to keep trying different pharmacological strategies.
In this work we used machine learning techniques to predict pharmacological response (OCD patients' symptomatology reduction) based on executive functioning and clinical variables. Among those variables we used anxiety, depression and obsessive-compulsive symptoms scores by applying State-Trait Anxiety Inventory, Hamilton Depression Rating Scale and Yale-Brown Obsessive Compulsive Scale respectively, while Rey-Osterrieth Complex Figure Test was used to assess organisation skills and non-verbal memory; Digits' subtests from Wechsler Adult Intelligence Scale-IV were used to assess short-term memory and working memory; and Raven's Progressive Matrices were applied to assess problem solving and abstract reasoning.
As a result of our analyses, we created a reliable algorithm that predicts Y-BOCS score after 12 weeks based on patients' clinical characteristics (sex at birth, age, pharmacological strategy, depressive and obsessive-compulsive symptoms, years passed since diagnostic and Raven's Progressive Matrices score) and Digits' scores. A high correlation (0.846) was achieved in predicted and true values.
The present study proves the viability to predict if a patient would respond or not to a certain pharmacological strategy with high reliability based on sociodemographics, clinical variables and cognitive functions as short-term memory and working memory. These results are promising to develop future prediction models to help clinical decision making.
强迫症与受影响的执行功能有关,包括记忆、认知灵活性和组织策略。正如先前研究报道的那样,执行功能保留的患者对药物治疗反应更好,而其他患者则需要不断尝试不同的药物治疗策略。
在这项研究中,我们使用机器学习技术,基于执行功能和临床变量预测药物反应(强迫症患者症状减轻情况)。在这些变量中,我们分别应用状态-特质焦虑量表、汉密尔顿抑郁量表和耶鲁-布朗强迫症量表来获取焦虑、抑郁和强迫症状评分,同时使用雷-奥斯特里茨复杂图形测验来评估组织能力和非言语记忆;使用韦氏成人智力量表第四版的数字分测验来评估短期记忆和工作记忆;并应用瑞文渐进矩阵测验来评估问题解决能力和抽象推理能力。
通过我们的分析,我们创建了一种可靠的算法,该算法基于患者的临床特征(出生时性别、年龄、药物治疗策略、抑郁和强迫症状、诊断后经过的年数以及瑞文渐进矩阵测验得分)和数字分测验得分来预测12周后的耶鲁-布朗强迫症量表得分。预测值与真实值之间具有高度相关性(0.846)。
本研究证明了基于社会人口统计学、临床变量以及短期记忆和工作记忆等认知功能,以高可靠性预测患者是否会对某种药物治疗策略产生反应的可行性。这些结果为开发未来的预测模型以帮助临床决策提供了希望。