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      Multimodal brain connectome-based prediction of suicide risk in people with late-life depression

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          Abstract

          Suicidal ideation, plans and behavior are particularly serious health issues among the older population, resulting in a higher likelihood of deaths than in any other age group. The increasing prevalence of depression in late life reflects the urgent need for efficient screening of suicide risk in people with late-life depression. Employing a cross-sectional design, we performed connectome-based predictive modelling using whole-brain resting-state functional connectivity and white matter structural connectivity data to predict suicide risk in late-life depression patients ( N = 37 non-suicidal patients, N = 24 patients with suicidal ideation/plan, N = 30 patients who attempted suicide). Suicide risk was measured using three standardized questionnaires. Brain connectivity profiles were used to classify three groups in our dataset and two independent datasets using machine learning. We found that brain patterns could predict suicide risk in the late-life depression population, with the explained variance up to 30.34%. The functional and structural connectivity profiles improved the classification-prediction accuracy compared with using questionnaire scores alone and could be applied to identify depressed patients who had higher suicide risk in two independent datasets. Our findings suggest that multimodal brain connectivity could capture individual differences in suicide risk among late-life depression patients. Our predictive models might be further tested to help clinicians identify patients who need detailed assessments and interventions. The trial registration number for this study is ChiCTR2200066356.

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          Most cited references51

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          Resting-state connectivity biomarkers define neurophysiological subtypes of depression

          Using functional MRI in a large multisite sample of more that 1,000 patients, four distinct neurophysiological biotypes of depression are defined. These biotypes are used to develop diagnostic classifiers that distinguish patients with depression from controls in separate multisite validation and replication cohorts, and can predict patient responsiveness to therapy.
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            Using connectome-based predictive modeling to predict individual behavior from brain connectivity

            This protocol describes how to develop linear models to predict individual behavior from brain connectivity data with proper cross-validation, and how to use an online tool to visualize the most predictive features of the models.
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              A decade of test-retest reliability of functional connectivity: A systematic review and meta-analysis

              Background: Once considered mere noise, fMRI-based functional connectivity has become a major neuroscience tool in part due to early studies demonstrating its reliability. These fundamental studies revealed only the tip of the iceberg; over the past decade, many test-retest reliability studies have continued to add nuance to our understanding of this complex topic. A summary of these diverse and at times contradictory perspectives is needed. Objectives: We aimed to summarize the existing knowledge regarding test-retest reliability of functional connectivity at the most basic unit of analysis: the individual edge level. This entailed (1) a meta-analytic estimate of reliability and (2) a review of factors influencing reliability. Methods: A search of Scopus was conducted to identify studies that estimated edge-level test-retest reliability. To facilitate comparisons across studies, eligibility was restricted to studies measuring reliability via the intraclass correlation coefficient (ICC). The meta-analysis included a random effects pooled estimate of mean edge-level ICC, with studies nested within datasets. The review included a narrative summary of factors influencing edge-level ICC. Results: From an initial pool of 212 studies, 44 studies were identified for the qualitative review and 25 studies for quantitative meta-analysis. On average, individual edges exhibited a “poor” ICC of 0.29 (95% CI=0.23 to 0.36). The most reliable measurements tended to involve: (1) stronger, within-network, cortical edges, (2) eyes open, awake, and active recordings, (3) more within-subject data, (4) shorter test-retest intervals, (5) no artifact correction (likely due in part to reliable artifact), and (6) full correlation-based connectivity with shrinkage. Conclusion: This study represents the first meta-analysis and systematic review investigating test-retest reliability of edge-level functional connectivity. Key findings suggest there is room for improvement, but care should be taken to avoid promoting reliability at the expense of validity. By pooling existing knowledge regarding this key facet of accuracy, this study supports broader efforts to improve inferences in the field.
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                Author and article information

                Contributors
                Journal
                Nature Mental Health
                Nat. Mental Health
                Springer Science and Business Media LLC
                2731-6076
                February 2023
                February 17 2023
                : 1
                : 2
                : 100-113
                Article
                10.1038/s44220-022-00007-7
                f1da1272-eed0-4767-b662-0784569f0590
                © 2023

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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