Brain texture as a marker of transdiagnostic clinical profiles in patients with recent-onset psychosis and depression

Prediction models of brain texture changes in recent-onset psychosis (ROP) and recent-onset depression (ROD) have lately been proposed. The validation of these models transdiagnostically at the individual level and the investigation of the variability in clinical profiles are still missing. Established prevention and treatment approaches focus on specific diagnoses and do not address the heterogeneity and manifold potential outcomes of patients. We aimed to investigate the utility of brain texture changes for a) identification of the psychopathological state (ROP and ROD) and b) the association of individualized brain texture maps with clinical symptom severity and outcome profiles. We developed transdiagnostic models based on structural MRI data on 116 patients with ROD, 122 patients with ROP, and 197 healthy controls (HC) from the Personalised pROgNostic tools for early psychosIs mAnagement (PRONIA) study by applying explainable artificial intelligence and clustering analysis. We investigated the contrast texture feature as the key feature for the identification of a general psychopathological state. The discrimination power of the trained prediction model was > 72% and validated in a second independent age and sex-matched sample of 137 ROP, 94 ROD, and 159 HC. Clustering analysis was implemented to map the texture brain changes produced from an explainable artificial intelligence algorithm, in a group fashion. The explained individualized brain contrast map grouped into 8 homogeneous clusters. In each group, we investigated the association between the explained brain contrast texture map and clinical symptom severity as well as outcome profiles. Different patterns in the explained brain contrast texture map showed unique associations of brain alterations with clinical symptom severity and clinical outcomes, i.e., age, positive, negative and depressive symptoms, and functionality. In some clusters, the mean explained brain contrast texture map values and/or brain contrast texture voxels significantly contribute to the classification decision significantly predicted PANSS scores, functionality and change in functionality over time. In conclusion, we created homogeneous clusters which statistically significant predict the clinical severity and outcome profile.