Transdiagnostic subtyping of males with developmental disorders using cortical characteristics
Transdiagnostic subtyping of males with developmental disorders using cortical characteristics
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DOI：
10.1016/j.nicl.2020.102288
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发表时间：
2020-01-01
影响因子：
4.2
通讯作者：
Aoki, Yuta Y.
中科院分区：
文献类型：
--
作者：
Itahashi, Takashi;Fujino, Junya;Aoki, Yuta Y.
背景：自闭症谱系障碍（ASD）和注意力缺陷/多动障碍（ADHD）在生物学上具有异质性，并且经常共存。由于诊断内异质性和重叠诊断对研究人员和临床医生具有挑战性，因此迫切需要识别独立于诊断的生物同质亚组。分析了99例原发性ASD，平均年龄= 31.7 +/- 8.0，49例原发性ADHD;平均年龄= 31.7 +/- 9.6）和105例神经典型对照（NTC;平均年龄= 30.6 +/- 6.8）。我们使用功能图谱提取平均皮质厚度（CT）和表面积（SA）值。然后，我们进行异质性通过差异分析（HYDROGEN）转诊断聚类和分类的个人。检测了亚型之间诊断可能性和临床症状的差异。敏感性分析测试的稳定性的亚型和成员的数量排除13名参与者诊断为ASD和ADHD，并通过使用不同的atlas.Results：在CT和SA，HYDRONIC确定了两个亚型。ASD或ADHD的可能性与属于这两种亚型中任何一种的可能性没有显著差异。在基于CT或SA的分析中，亚型之间的临床特征没有差异。结论：尽管脑源性亚型与诊断组不匹配，但CT或SA均能成功且稳定地对发育障碍个体进行亚型分型。
Background: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are biologically heterogeneous and often co-occur. As within-diagnosis heterogeneity and overlapping diagnoses are challenging for researchers and clinicians, identifying biologically homogenous subgroups, independent of diagnosis, is an urgent need.Methods: MRI data from 148 adult males with developmental disorders (99 primary ASD, mean age = 31.7 +/- 8.0, 49 primary ADHD; mean age = 31.7 +/- 9.6) and 105 neurotypical controls (NTC; mean age = 30.6 +/- 6.8) were analyzed. We extracted mean cortical thickness (CT) and surface area (SA) values using a functional atlas. Then, we conducted HeterogeneitY through DiscRiminant Analysis (HYDRA) to transdiagnostically cluster and classify individuals. Differences in diagnostic likelihood and clinical symptoms between subtypes were tested. Sensitivity analyses tested the stability of the number of subtypes and their membership by excluding 13 participants diagnosed with both ASD and ADHD and by using a different atlas.Results: In relation to both CT and SA, HYDRA identified two subtypes. The likelihood of ASD or ADHD was not significantly different from the chance of belonging to any of these two subtypes. Clinical characteristics did not differ between subtypes in either CT or SA based analyses. The high consistency in membership was replicated when utilizing a different atlas or excluding people with dual diagnoses in CT (dice coefficients > 0.94) and in SA (> 0.88).Conclusion: Although the brain-derived subtypes do not match diagnostic groups, individuals with developmental disorders were successfully and stably subtyped using either CT or SA.