White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Seoul National University
  • Kyoto Prefectural University of Medicine
  • University Hospital of Bellvitge
  • CIBER - Center for Biomedical Research Network
  • University of Barcelona
  • University of Toronto
  • Yale University
  • University of Calgary
  • Harvard University
  • National Institute of Mental Health and Neuro Sciences (NIMHANS)
  • IRCCS Fondazione Santa Lucia - Roma
  • Hospital Clinic of Barcelona
  • August Pi i Sunyer Biomedical Research Institute
  • Universidade de São Paulo
  • Pontifical Catholic University of São Paulo
  • Vita-Salute San Raffaele University
  • Humboldt University of Berlin
  • Karolinska Institutet
  • MSH Medical School Hamburg
  • University of Zurich
  • Radboud University Nijmegen
  • Karakter Child and Adolescent Psychiatry University Centre
  • University of Coimbra
  • Kunming Medical University
  • Chiba University
  • Osaka University
  • University of Minho
  • Clinical Academic Center of Braga
  • Yeshiva University
  • Columbia University
  • SAMRC Genomics of Brain Disorders Unit
  • Møre And Romsdal Hospital Trust
  • Haukeland universitets­sjukehus
  • University of Bergen
  • University of Michigan, Ann Arbor
  • Oxford Health NHS Foundation Trust
  • Shanghai Jiao Tong University
  • Levvel
  • Amsterdam University Medical Centers (UMC)
  • University of Mississippi
  • Keck School of Medicine at University of Southern California
  • University of Oxford
  • University of British Columbia
  • Vrije Universiteit Amsterdam (VU)

Abstract

White matter pathways, typically studied with diffusion tensor imaging (DTI), have been implicated in the neurobiology of obsessive-compulsive disorder (OCD). However, due to limited sample sizes and the predominance of single-site studies, the generalizability of OCD classification based on diffusion white matter estimates remains unclear. Here, we tested classification accuracy using the largest OCD DTI dataset to date, involving 1336 adult participants (690 OCD patients and 646 healthy controls) and 317 pediatric participants (175 OCD patients and 142 healthy controls) from 18 international sites within the ENIGMA OCD Working Group. We used an automatic machine learning pipeline (with feature engineering and selection, and model optimization) and examined the cross-site generalizability of the OCD classification models using leave-one-site-out cross-validation. Our models showed low-to-moderate accuracy in classifying (1) “OCD vs. healthy controls” (Adults, receiver operator characteristic-area under the curve = 57.19 ± 3.47 in the replication set; Children, 59.8 ± 7.39), (2) “unmedicated OCD vs. healthy controls” (Adults, 62.67 ± 3.84; Children, 48.51 ± 10.14), and (3) “medicated OCD vs. unmedicated OCD” (Adults, 76.72 ± 3.97; Children, 72.45 ± 8.87). There was significant site variability in model performance (cross-validated ROC AUC ranges 51.6–79.1 in adults; 35.9–63.2 in children). Machine learning interpretation showed that diffusivity measures of the corpus callosum, internal capsule, and posterior thalamic radiation contributed to the classification of OCD from HC. The classification performance appeared greater than the model trained on grey matter morphometry in the prior ENIGMA OCD study (our study includes subsamples from the morphometry study). Taken together, this study points to the meaningful multivariate patterns of white matter features relevant to the neurobiology of OCD, but with low-to-moderate classification accuracy. The OCD classification performance may be constrained by site variability and medication effects on the white matter integrity, indicating room for improvement for future research.

Details

Original languageEnglish
Pages (from-to)1063-1074
Number of pages12
JournalMolecular psychiatry
Volume29
Issue number4
Publication statusPublished - Apr 2024
Peer-reviewedYes

External IDs

PubMed 38326559
ORCID /0000-0002-1753-7811/work/173516981
ORCID /0000-0003-1477-5395/work/173517036