Model selection and prediction of outcomes in recent onset schizophrenia patients who undergo cognitive training.
Model selection and prediction of outcomes in recent onset schizophrenia patients who undergo cognitive training.
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DOI：
10.1016/j.scog.2017.10.001
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Vinogradov S
中科院分区：
文献类型：
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作者：
Ramsay IS;Ma S;Fisher M;Loewy RL;Ragland JD;Niendam T;Carter CS;Vinogradov S
预测精神病患者的治疗结果仍然是一项挑战，但在追求个性化药物的过程中变得越来越重要。精神分裂症患者有认知缺陷，听觉处理和工作记忆的有针对性的认知训练(TCT)已被证明可以改善其中一些障碍；但对预测认知改善的基线患者特征知之甚少。在这里，我们使用一种名为最小绝对收缩和选择算子(LASSO)的模型选择和回归方法来检验新发精神分裂症患者接受TCT治疗后认知改善的预测因素。对随机接受TCT治疗的43名新近发病的精神分裂症患者进行了基线评估，评估指标包括认知、症状、功能、病程和人口统计学变量。对于模型的选择和回归，我们进行了LASSO的10倍交叉验证。我们使用线性模型进行统计推断，对这些结果进行了跟踪。使用皮尔逊相关方法，没有发现个体变量与全球认知的改善相关，包括所有变量的线性模型也被发现没有显著意义。然而，套索模型确定了基线全球认知、教育和性别，该模型预测了TCT后全球认知的改善。这些发现为精神分裂症患者的个性化认知训练提供了指导。
Predicting treatment outcomes in psychiatric populations remains a challenge, but is increasingly important in the pursuit of personalized medicine. Patients with schizophrenia have deficits in cognition, and targeted cognitive training (TCT) of auditory processing and working memory has been shown to improve some of these impairments; but little is known about the baseline patient characteristics predictive of cognitive improvement. Here we use a model selection and regression approach called least absolute shrinkage and selection operator (LASSO) to examine predictors of cognitive improvement in response to TCT for patients with recent onset schizophrenia. Forty-three individuals with recent onset schizophrenia randomized to undergo TCT were assessed at baseline on measures of cognition, symptoms, functioning, illness duration, and demographic variables. We carried out 10-fold cross-validation of LASSO for model selection and regression. We followed up on these results using linear models for statistical inference. No individual variable was found to correlate with improvement in global cognition using a Pearson correlation approach, and a linear model including all variables was also found not to be significant. However, the LASSO model identified baseline global cognition, education, and gender in a model predictive of improvement on global cognition following TCT. These findings offer guidelines for personalized approaches to cognitive training for patients with schizophrenia.