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oai:recercat.cat:11351/111262025-11-12T20:53:00Zcom_2072_451665com_2072_378040col_2072_451666

Improved estimation of the risk of manic relapse by combining clinical and brain scan data Palau, Pol Solanes Font, Aleix Madre, Mercè SAEZ-FRANCAS, NAIA Sarró, Salvador Moro, Noemi [Palau P] FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. Benito Menni Complex Assistencial en Salut Mental (CASM), Hospital General de Granollers, Germanes Hospitalàries, Granollers, Spain. Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain. [Solanes A] Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. Serveis de Psiquiatria i de Medicina Forense, Universitat Autònoma de Barcelona, Barcelona, Spain. [Madre M] FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Saez-Francas N] FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. Hospital Sant Rafael, Germanes Hospitalàries, Barcelona, Spain. [Sarró S] FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. [Moro N] FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain. Benito Menni Complex Assistencial en Salut Mental (CASM), Hospital General de Granollers, Germanes Hospitalàries, Granollers, Spain Hospital General de Granollers Trastorn bipolar Ressonància magnètica Malalties - Recaiguda PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Bipolar and Related Disorders::Bipolar Disorder ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Magnetic Resonance Imaging PHENOMENA AND PROCESSES::Mathematical Concepts::Algorithms::Artificial Intelligence::Machine Learning PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastorno bipolar y trastornos relacionados::trastorno bipolar TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::tomografía::imagen por resonancia magnética FENÓMENOS Y PROCESOS::conceptos matemáticos::algoritmos::inteligencia artificial::aprendizaje automático Bipolar disorder; MRI; Manic relapse Trastorno bipolar; Resonancia magnética; Recaída maníaca Desordre bipolar; Ressonància magnètica; Recaiguda maníaca Introduction: Estimating the risk of manic relapse could help the psychiatrist individually adjust the treatment to the risk. Some authors have attempted to estimate this risk from baseline clinical data. Still, no studies have assessed whether the estimation could improve by adding structural magnetic resonance imaging (MRI) data. We aimed to evaluate it. Material and methods: We followed a cohort of 78 patients with a manic episode without mixed symptoms (bipolar type I or schizoaffective disorder) at 2-4-6-9-12-15-18 months and up to 10 years. Within a cross-validation scheme, we created and evaluated a Cox lasso model to estimate the risk of manic relapse using both clinical and MRI data. Results: The model successfully estimated the risk of manic relapse (Cox regression of the time to relapse as a function of the estimated risk: hazard ratio (HR)=2.35, p=0.027; area under the curve (AUC)=0.65, expected calibration error (ECE)<0.2). The most relevant variables included in the model were the diagnosis of schizoaffective disorder, poor impulse control, unusual thought content, and cerebellum volume decrease. The estimations were poorer when we used clinical or MRI data separately. Conclusion: Combining clinical and MRI data may improve the risk of manic relapse estimation after a manic episode. We provide a website that estimates the risk according to the model to facilitate replication by independent groups before translation to clinical settings. 2024-02-27T09:07:33Z 2024-02-27T09:07:33Z 2023-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Palau P, Solanes A, Madre M, Saez-Francas N, Sarró S, Moro N, et al. Improved estimation of the risk of manic relapse by combining clinical and brain scan data. Span J Psychiatry Ment Health. 2023 Oct-Dec;16(4):235-43. https://hdl.handle.net/11351/11126 10.1016/j.rpsm.2023.01.001 37839962 eng Spanish Journal of Psychiatry and Mental Health;16(4) https://doi.org/10.1016/j.rpsm.2023.01.001 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Elsevier Scientia