J Affect Disord 2021 12 23;295:148-155. Epub 2021 Aug 23.
Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, Jiangsu 210009, China; The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, Jiangsu 210009, China; Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, China; Research Center for Brain Health, Pazhou Lab, Guangzhou, Guangdong 510330, China. Electronic address:
Background: Objective biomarkers are crucial for overcoming the clinical dilemma in major depressive disorder (MDD), and the individualized diagnosis is essential to facilitate the precise medicine for MDD.
Methods: Sleep disturbance-related magnetic resonance imaging (MRI) features was identified in the internal dataset (92 MDD patients) using the relevance vector regression algorithm, which was further verified in 460 MDD patients of an independent, multicenter dataset. Subsequently, using these MRI features, the eXtreme Gradient Boosting classification model was constructed in the current multicenter dataset (460 MDD patients and 470 normal controls). Meanwhile, the association between classification outputs and the severity of depressive symptoms was also investigated.
Results: In MDD patients, the combination of gray matter density and fractional amplitude of low-frequency fluctuation can accurately predict individual sleep disturbance score that was calculated by the sum of item 4 score, item 5 score, and item 6 score of the 17-Item Hamilton Rating Scale for Depression (HAMD-17) (R = 0.158 in the internal dataset; R = 0.110 in multicenter dataset). Furthermore, the classification model based on these MRI features distinguished MDD patients from normal controls with 86.3% accuracy (area under the curve = 0.937). Importantly, the classification outputs significantly correlated with HAMD-17 scores in MDD patients.
Limitation: Lacking some specialized tools to assess the personal sleep quality, e.g. Pittsburgh Sleep Quality Index.
Conclusion: Neuroimaging features can reflect accurately individual sleep disturbance manifestation and serve as potential diagnostic biomarkers of MDD.