Improved estimation of the risk of manic relapse by combining clinical and brain scan data

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• dc.contributor.author Palau, Pol
• dc.contributor.author Amann, Benedikt Lorenz
• dc.contributor.author Martín Subero, Marta
• dc.contributor.author Radua, Joaquim
• dc.date.accessioned 2024-05-31T06:14:35Z
• dc.date.available 2024-05-31T06:14:35Z
• dc.date.issued 2023
• dc.description.abstract Introduction: Estimating the risk of manic relapse could help the psychiatrist individually adjust the treatment to the risk. Some authors have attempted to estimate this risk from baseline clinical data. Still, no studies have assessed whether the estimation could improve by adding structural magnetic resonance imaging (MRI) data. We aimed to evaluate it. Material and methods: We followed a cohort of 78 patients with a manic episode without mixed symptoms (bipolar type I or schizoaffective disorder) at 2-4-6-9-12-15-18 months and up to 10 years. Within a cross-validation scheme, we created and evaluated a Cox lasso model to estimate the risk of manic relapse using both clinical and MRI data. Results: The model successfully estimated the risk of manic relapse (Cox regression of the time to relapse as a function of the estimated risk: hazard ratio (HR)=2.35, p=0.027; area under the curve (AUC)=0.65, expected calibration error (ECE)<0.2). The most relevant variables included in the model were the diagnosis of schizoaffective disorder, poor impulse control, unusual thought content, and cerebellum volume decrease. The estimations were poorer when we used clinical or MRI data separately. Conclusion: Combining clinical and MRI data may improve the risk of manic relapse estimation after a manic episode. We provide a website that estimates the risk according to the model to facilitate replication by independent groups before translation to clinical settings.
• dc.description.sponsorship We would like to thank the Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación, the Spanish Ministry of Science, Innovation, and Universities, the European Regional Development Fund (ERDF/FEDER), European Social Fund, “Investing in your future,” “A way of making Europe” (projects: PI07/1278, PI10/02622, PI14/00292, PI/15/02242, and PI19/00394; contracts: CP14/00041 to JR, CM15/00024 to MMS, CD19/00232 to S-AL, and CPII19/00009 to JR). EJC-R was supported by the Swiss National Science Foundation (SNSF, Ambizione grant PZ00P2_185814). NV thanks the BITRECS project, which has received funding from the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 754550 and from “La Caixa” Foundation (ID 100010434), under the agreement LCF/PR/GN18/50310006. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. B.L. Amann received Research three grants (PI07/1278, PI10/02622 and PI/15/ 02242) and a mobility grant (BA21/00002) from the Instituto de Salud Carlos III-Subdirección General de Evaluación y Fomento de la Investigación, Plan Nacional 2008-2011 and 2013-2016.
• dc.format.mimetype application/pdf
• dc.identifier.citation Palau P, Solanes A, Madre M, Saez-Francas N, Sarró S, Moro N, et al. Improved estimation of the risk of manic relapse by combining clinical and brain scan data. Span J Psychiatry Ment Health. 2023 Oct-Dec;16(4):235-43. DOI: 10.1016/j.rpsm.2023.01.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.rpsm.2023.01.001
• dc.identifier.issn 2950-2853
• dc.identifier.uri http://hdl.handle.net/10230/60295
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Span J Psychiatry Ment Health. 2023 Oct-Dec;16(4):235-43
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/754550
• dc.rights © 2023 The Author(s). Published by Elsevier España, S.L.U. on behalf of Sociedad Española de Psiquiatría y Salud Mental (SEPSM). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Bipolar disorder
• dc.subject.keyword MRI
• dc.subject.keyword Machine-learning
• dc.subject.keyword Manic relapse
• dc.subject.keyword Risk estimation
• dc.title Improved estimation of the risk of manic relapse by combining clinical and brain scan data
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion