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      Diagnostic value of structural and diffusion imaging measures in schizophrenia

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          Abstract

          Objectives

          Many studies have attempted to discriminate patients with schizophrenia from healthy controls by machine learning using structural or functional MRI. We included both structural and diffusion MRI (dMRI) and performed random forest (RF) and support vector machine (SVM) in this study.

          Methods

          We evaluated the performance of classifying schizophrenia using RF method and SVM with 504 features (volume and/or fractional anisotropy and trace) from 184 brain regions. We enrolled 47 patients and 23 age- and sex-matched healthy controls and resampled our data into a balanced dataset using a Synthetic Minority Oversampling Technique method. We randomly permuted the classification of all participants as a patient or healthy control 100 times and ran the RF and SVM with leave one out cross validation for each permutation. We then compared the sensitivity and specificity of the original dataset and the permuted dataset.

          Results

          Classification using RF with 504 features showed a significantly higher rate of performance compared to classification by chance: sensitivity (87.6% vs. 47.0%) and specificity (95.9 vs. 48.4%) performed by RF, sensitivity (89.5% vs. 48.0%) and specificity (94.5% vs. 47.1%) performed by SVM.

          Conclusions

          Machine learning using RF and SVM with both volume and diffusion measures can discriminate patients with schizophrenia with a high degree of performance. Further replications are required.

          Highlights

          • Schizophrenia was classified with dMRI and volume data by random forest and support vector machine.

          • Both machine learning methods show high classification performance.

          • There was no significant difference of classification between two methods.

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          Most cited references46

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          Using Support Vector Machine to identify imaging biomarkers of neurological and psychiatric disease: a critical review.

          Standard univariate analysis of neuroimaging data has revealed a host of neuroanatomical and functional differences between healthy individuals and patients suffering a wide range of neurological and psychiatric disorders. Significant only at group level however these findings have had limited clinical translation, and recent attention has turned toward alternative forms of analysis, including Support-Vector-Machine (SVM). A type of machine learning, SVM allows categorisation of an individual's previously unseen data into a predefined group using a classification algorithm, developed on a training data set. In recent years, SVM has been successfully applied in the context of disease diagnosis, transition prediction and treatment prognosis, using both structural and functional neuroimaging data. Here we provide a brief overview of the method and review those studies that applied it to the investigation of Alzheimer's disease, schizophrenia, major depression, bipolar disorder, presymptomatic Huntington's disease, Parkinson's disease and autistic spectrum disorder. We conclude by discussing the main theoretical and practical challenges associated with the implementation of this method into the clinic and possible future directions. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            Architecture and intrinsic connections of the prefrontal cortex in the rhesus monkey.

            An investigation of the architectonic organization and intrinsic connections of the prefrontal cortex was conducted in rhesus monkeys. Cytoarchitectonic analysis indicates that in the prefrontal cortex there are two trends of gradual change in laminar characteristics that can be traced from limbic periallocortex towards isocortical areas. The stepwise change in laminar features is characterized by the emergence and gradual increase in the width of granular layer IV, by an increase in the size of pyramidal cells in layers III and V, and by a higher cell-packing density in the supragranular layers. Myeloarchitectonic analysis reveals that the limbic areas are poorly myelinated, adjacent areas have a diffuse myelin content confined to the deep layers, and in isocortices the myelinated fibers are distributed in organized horizontal bands (of Bail-larger) and a vertical plexus. Using the above architectonic criteria, we observed that one of the architectonic trends takes a radial basoventral course from the periallocortex in the caudal orbitofrontal region to the adjacent proisocortex and then to area 13. The next stage of architectonic regions includes orbital areas 12, 11, and 14, which is followed by area 10, lateral area 12, and the rostral part of ventral area 46. The last group includes the caudal part of ventral area 46 and ventral area 8. The other trend takes a mediodorsal course from the periallocortex around the rostral portion of the corpus callosum to the adjacent proisocortical areas 24, 25, and 32 and then to the medially situated isocortical areas 9, 10, and 14. The next stage includes lateral areas 10 and 9 and the rostral part of dorsal area 46. The last group includes the caudal part of dorsal area 46 and dorsal area 8. The interconnections of subdivisions of the basoventral and mediodorsal cortices were studied with the aid of anterograde and retrograde tracers. Within each trend a given area projects in two directions: to adjoining regions belonging to succeeding architectonic stages on the one hand, and to nearby regions from the preceding architectonic stage on the other. In each direction there is more than one region involved in this projection system, paralleling the radial nature of architectonic change. Periallo- and proisocortices have widespread intrinsic connections, whereas isocortices situated at a distance from limbic areas, such as area 8, have restricted connections. Most interconnections are limited to areas within the same architectonic trend. However, there are links between cortices from the two trends, and these seem to occur between areas that are at a similar stage of architectonic differentiation.(ABSTRACT TRUNCATED AT 400 WORDS)
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              A review of diffusion tensor imaging studies in schizophrenia.

              Both post-mortem and neuroimaging studies have contributed significantly to what we know about the brain and schizophrenia. MRI studies of volumetric reduction in several brain regions in schizophrenia have confirmed early speculations that the brain is disordered in schizophrenia. There is also a growing body of evidence suggesting that a disturbance in connectivity between different brain regions, rather than abnormalities within the separate regions themselves, are responsible for the clinical symptoms and cognitive dysfunctions observed in this disorder. Thus an interest in white matter fiber tracts, subserving anatomical connections between distant, as well as proximal, brain regions, is emerging. This interest coincides with the recent advent of diffusion tensor imaging (DTI), which makes it possible to evaluate the organization and coherence of white matter fiber tracts. This is an important advance as conventional MRI techniques are insensitive to fiber tract direction and organization, and have not consistently demonstrated white matter abnormalities. DTI may, therefore, provide important new information about neural circuitry, and it is increasingly being used in neuroimaging studies of psychopathological disorders. Of note, in the past five years 18 DTI studies in schizophrenia have been published, most describing white matter abnormalities. Questions still remain, however, regarding what we are measuring that is abnormal in this disease, and how measures obtained using one method correspond to those obtained using other methods? Below we review the basic principles involved in MR-DTI, followed by a review of the different methods used to evaluate diffusion. Finally, we review MR-DTI findings in schizophrenia.
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                Author and article information

                Contributors
                Journal
                Neuroimage Clin
                Neuroimage Clin
                NeuroImage : Clinical
                Elsevier
                2213-1582
                12 February 2018
                2018
                12 February 2018
                : 18
                : 467-474
                Affiliations
                [a ]Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
                [b ]Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
                [c ]Department of psychiatry, Korean Armed Forces Capital Hospital, Bundang-gu, Republic of Korea
                [d ]VA Boston Healthcare System, Brockton Division, Brockton, MA, USA
                [e ]Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
                Author notes
                [* ]Corresponding author at: Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston street, Boston, MA, USA, 02215. kubicki@ 123456bwh.harvard.edu
                Article
                S2213-1582(18)30041-X
                10.1016/j.nicl.2018.02.007
                5987843
                29876254
                c79c7cc1-d0a6-4708-8650-4eb027ffe521
                © 2018 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 6 July 2017
                : 3 February 2018
                : 5 February 2018
                Categories
                Regular Article

                classification,diffusion mri,random forest,support vector machine,schizophrenia

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