Prediction of pharmacological response in OCD using machine learning techniques and clinical and neuropsychological variables.

Maria Tubío-Fungueiriño, Eva Cernadas, Manuel Fernández-Delgado, Manuel Arrojo, Sara Bertolin, Eva Real, José Manuel Menchon, Angel Carracedo, Pino Alonso, Montse Fernández-Prieto, Cinto Segalàs
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Abstract

Introduction: Obsessive compulsive disorder is associated with affected executive functioning, including memory, cognitive flexibility, and organizational strategies. As it was reported in previous studies, patients with preserved executive functions respond better to pharmacological treatment, while others need to keep trying different pharmacological strategies.

Material and methods: In this work we used machine learning techniques to predict pharmacological response (OCD patients' symptomatology reduction) based on executive functioning and clinical variables. Among those variables we used anxiety, depression and obsessive-compulsive symptoms scores by applying State-Trait Anxiety Inventory, Hamilton Depression Rating Scale and Yale-Brown Obsessive Compulsive Scale respectively, while Rey-Osterrieth Complex Figure Test was used to assess organisation skills and non-verbal memory; Digits' subtests from Wechsler Adult Intelligence Scale-IV were used to assess short-term memory and working memory; and Raven's Progressive Matrices were applied to assess problem solving and abstract reasoning.

Results: As a result of our analyses, we created a reliable algorithm that predicts Y-BOCS score after 12 weeks based on patients' clinical characteristics (sex at birth, age, pharmacological strategy, depressive and obsessive-compulsive symptoms, years passed since diagnostic and Raven's Progressive Matrices score) and Digits' scores. A high correlation (0.846) was achieved in predicted and true values.

Conclusions: The present study proves the viability to predict if a patient would respond or not to a certain pharmacological strategy with high reliability based on sociodemographics, clinical variables and cognitive functions as short-term memory and working memory. These results are promising to develop future prediction models to help clinical decision making.

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利用机器学习技术和临床及神经心理学变量预测强迫症的药物反应。
简介强迫症与执行功能受影响有关,包括记忆力、认知灵活性和组织策略。根据以往研究的报告,执行功能得到保护的患者对药物治疗的反应较好,而其他患者则需要不断尝试不同的药物治疗策略:在这项工作中,我们使用机器学习技术,根据执行功能和临床变量预测药物治疗反应(强迫症患者症状减轻)。在这些变量中,我们分别采用了国家特质焦虑量表(State-Trait Anxiety Inventory)、汉密尔顿抑郁评定量表(Hamilton Depression Rating Scale)和耶鲁-布朗强迫症量表(Yale-Brown Obsessive Compulsive Scale)来评估焦虑、抑郁和强迫症症状的得分,同时采用了雷伊-奥斯特里赫斯复杂图形测验(Rey-Osterrieth Complex Figure Test)来评估组织能力和非语言记忆;采用韦氏成人智能量表-IV的数字分测验(Digits' subtests)来评估短时记忆和工作记忆;采用瑞文渐进矩阵(Raven's Progressive Matrices)来评估问题解决能力和抽象推理能力:经过分析,我们创建了一种可靠的算法,可以根据患者的临床特征(出生时的性别、年龄、药物治疗策略、抑郁和强迫症状、诊断后的年限以及瑞文渐进矩阵得分)和Digits得分预测12周后的Y-BOCS得分。预测值与真实值的相关性很高(0.846):本研究证明,根据社会人口统计学、临床变量和认知功能(如短期记忆和工作记忆)来预测患者是否会对某种药物治疗策略产生反应是可行的,而且可靠性很高。这些结果有望开发出未来的预测模型,帮助临床决策。
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