Machine Learning Predicts Treatment Response in Bipolar & Major Depressive Disorders

Abstract

Diagnosis of bipolar disorder (BD) patients with complex symptoms presents a challenge to clinicians. Patients tend to spend more time in a depressive state than a manic state. In such complex cases, the current Diagnostic and Statistical Manual (DSM), which is not based on pathophysiology, can lead to misdiagnosis as major depressive disorder (MDD) and an imperfect or even harmful medication response. A biologically-based classification algorithm is needed to improve the accuracy of diagnosis. Osuch et al. (2018) presented a kernel support vector machine (SVM) algorithm to predict the medication-class of response from new patient samples whose diagnoses were unclear. Here we also utilize the kernel support vector machine (SVM) algorithm but with a few novel contributions. We applied the robust, fully automated neuromark independent component analysis (ICA) framework to extract comparable features in a multi-dataset setting and learn a kernel function for support vector machine (SVM) on multiple feature subspaces. The neuromark framework successfully replicates the prior result with 95.45% accuracy (sensitivity 90.24%, specificity 92.3%). To further evaluate the generalizability of our approach, we incorporated two additional datasets comprising bipolar disorder (BD) and major depressive disorder (MDD) patients. We validated the trained algorithm on these datasets, resulting in a testing accuracy of up to 89% (sensitivity 0.88, specificity 0.89) without using site or scanner harmonization techniques. We also translated the model to predict improvement scores of major depressive disorder (MDD) with up to 70% accuracy. This approach reveals some salient biological markers of medication-class of response within mood disorders. HighlightsO_LIWe demonstrate a DSM-free approach for predicting treatment response from resting-state functional magnetic resonance imaging (fMRI) data. C_LIO_LIWe identify several replicable biomarkers using the approach. C_LIO_LIOur work has potential for clinical application by replacing trial-and-error in treating complex psychiatric disorders. C_LI