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. 2022 Nov 17;8(1):100.
doi: 10.1038/s41537-022-00309-w.

Combining MRI and clinical data to detect high relapse risk after the first episode of psychosis

Aleix Solanes  1   2   3 , Gisela Mezquida  1   4   5   6 , Joost Janssen  5   7 , Silvia Amoretti  1   4   5   8 , Antonio Lobo  5   9   10 , Ana González-Pinto  5   11   12   13 , Celso Arango  5   7 , Eduard Vieta  1   5   8   14 , Josefina Castro-Fornieles  1   5   8   15 , Daniel Bergé  3   5   16 , Auria Albacete  2 , Eloi Giné  17 , Mara Parellada  5   7 , Miguel Bernardo  1   4   5   8 ; PEPs group (collaborators); Edith Pomarol-Clotet  18   19 , Joaquim Radua  20   21   22   23   24
Collaborators, Affiliations

Combining MRI and clinical data to detect high relapse risk after the first episode of psychosis

Aleix Solanes et al. Schizophrenia (Heidelb). .

Abstract

Detecting patients at high relapse risk after the first episode of psychosis (HRR-FEP) could help the clinician adjust the preventive treatment. To develop a tool to detect patients at HRR using their baseline clinical and structural MRI, we followed 227 patients with FEP for 18-24 months and applied MRIPredict. We previously optimized the MRI-based machine-learning parameters (combining unmodulated and modulated gray and white matter and using voxel-based ensemble) in two independent datasets. Patients estimated to be at HRR-FEP showed a substantially increased risk of relapse (hazard ratio = 4.58, P < 0.05). Accuracy was poorer when we only used clinical or MRI data. We thus show the potential of combining clinical and MRI data to detect which individuals are more likely to relapse, who may benefit from increased frequency of visits, and which are unlikely, who may be currently receiving unnecessary prophylactic treatments. We also provide an updated version of the MRIPredict software.

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Conflict of interest statement

Dr. Bernardo has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of AB-Biotics, Adamed, Angelini, Casen-Recordati, Janssen-Cilag, Menarini, Rovi, and Takeda. Dr. C. De-la-Camara received financial support to attend scientific meetings from Janssen, Almirall, Lilly, Lundbeck, Rovi, Esteve, Novartis, AstraZeneca, Pfizer, and Casen-Recordati. CDC has received honoraria from Sanofi and Exeltis. Dr. Parellada has received educational honoraria from Otsuka, research grants from Instituto de Salud Carlos III (ISCIII), Ministry of Health, Madrid, Spain, has received grant support from ISCIII, Horizon2020 of the European Union, CIBERSAM, Fundación Alicia Koplowitz, and Mutua Madrileña and travel grants from Otsuka, Exeltis and Janssen; she has served as a consultant for Servier, Exeltis, Fundación Alicia Koplowitz, and ISCIII. LPC has received honoraria or grants unrelated to the present work from Rubió, Rovi, and Janssen. Dr. R. Rodriguez-Jimenez has been a consultant for, spoken in activities of, or received grants from Instituto de Salud Carlos III, Fondo de Investigación Sanitaria (FIS), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid Regional Government (S2010/BMD-2422 AGES; S2017/BMD-3740), Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Ferrer, Juste, Takeda, Exeltis, Casen-Recordati, Angelini. Dr. Arango has been a consultant to or has received honoraria or grants from Acadia, Angelini, Biogen, Boehringer, Gedeon Richter, Janssen Cilag, Lundbeck, Medscape, Menarini, Minerva, Otsuka, Pfizer, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion and Takeda. Dr. Vieta has received grants and served as a consultant, advisor, or CME speaker for the following entities (work unrelated to the topic of this manuscript): AB-Biotics, Abbott, Allergan, Angelini, Dainippon Sumitomo Pharma, Galenica, Janssen, Lundbeck, Novartis, Otsuka, Sage, Sanofi-Aventis, and Takeda. The remaining authors report no financial relationships with commercial interests.

Figures

Fig. 1
Fig. 1. Main study steps.
Overall steps followed in this study.
Fig. 2
Fig. 2. MRIPredict flowchart.
Creation of the high relapse risk after the first episode of psychosis (HRR-FEP) detection tool.
Fig. 3
Fig. 3. Observed relapses depending on estimated risk group.
Kaplan–Meier curves of the observed relapse in patients estimated to be at high relapse risk after the first episode of psychosis (HRR-FEP) vs. patients at low relapse risk.
See this image and copyright information in PMC

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