Clustering of antipsychotic-naïve patients with schizophrenia based on functional connectivity from resting-state electroencephalography

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Schizophrenia is associated with aberrations in the Default Mode Network (DMN), but the clinical implications remain unclear. We applied data-driven, unsupervised machine learning based on resting-state electroencephalography (rsEEG) functional connectivity within the DMN to cluster antipsychotic-naïve patients with first-episode schizophrenia. The identified clusters were investigated with respect to psychopathological profile and cognitive deficits. Thirty-seven antipsychotic-naïve, first-episode patients with schizophrenia (mean age 24.4 (5.4); 59.5% males) and 97 matched healthy controls (mean age 24.0 (5.1); 52.6% males) underwent assessments of rsEEG, psychopathology, and cognition. Source-localized, frequency-dependent functional connectivity was estimated using Phase Lag Index (PLI). The DMN-PLI was factorized for each frequency band using principal component analysis. Clusters of patients were identified using a Gaussian mixture model and neurocognitive and psychopathological profiles of identified clusters were explored. We identified two clusters of patients based on the theta band (4–8 Hz), and two clusters based on the beta band (12–30 Hz). Baseline psychopathology could predict theta clusters with an accuracy of 69.4% (p = 0.003), primarily driven by negative symptoms. Five a priori selected cognitive functions conjointly predicted the beta clusters with an accuracy of 63.6% (p = 0.034). The two beta clusters displayed higher and lower DMN connectivity, respectively, compared to healthy controls. In conclusion, the functional connectivity within the DMN provides a novel, data-driven means to stratify patients into clinically relevant clusters. The results support the notion of biological subgroups in schizophrenia and endorse the application of data-driven methods to recognize pathophysiological patterns at earliest stage of this syndrome.
OriginalsprogEngelsk
TidsskriftEuropean Archives of Psychiatry and Clinical Neuroscience
Vol/bind273
Udgave nummer8
Sider (fra-til)1785-1796
ISSN0940-1334
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This study was supported by grants from the Lundbeck Foundation (ID: R25-A2701 and ID: R155-2013–16,337). EVD received funding from the Dutch Organization for Health Research and Development (ZonMW) Mental Health Program under Grant Agreement No. 60–63,600-98–711, and a UMC Utrecht Rudolf Magnus Fellowship. LKH was supported by the Danish Pioneer Centre for AI, DNRF grant number P1.

Funding Information:
BHE has received lecture fees and/or is part of Advisory Boards of Bristol-Myers Squibb, Eli Lilly and Company, Janssen-Cilag, Otsuka Pharma Scandinavia AB, Takeda Pharmaceutical Company, Boehringer Ingelheim, and Lundbeck Pharma A/S. BYG is the leader of a Lundbeck Foundation Centre of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), which is partially financed by an independent grant from the Lundbeck Foundation based on international review and partially financed by the Mental Health Services in the Capital Region of Denmark, the University of Copenhagen, and other foundations. All grants are the property of the Mental Health Services in the Capital Region of Denmark and administrated by them. She has no other conflicts to disclose. NB is employed by H. Lundbeck A/S. KBB received lecture fee from Lundbeck Pharma A/S. The remaining authors have nothing to disclose.

Publisher Copyright:
© 2023, The Author(s).

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