Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia

Abstract Predicting patient response to antipsychotic medication is a major challenge in schizophrenia treatment. This study investigates the predictive role of gray matter (GM) in short- and long-term treatment outcomes in drug-naive patients with first-episode schizophrenia (FES). A cohort of 104...

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Main Authors: Xiaodong Guo, Enpeng Zhou, Xianghe Wang, Bingjie Huang, Tianqi Gao, Chengcheng Pu, Xin Yu
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Schizophrenia
Online Access:https://doi.org/10.1038/s41537-025-00557-6
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author Xiaodong Guo
Enpeng Zhou
Xianghe Wang
Bingjie Huang
Tianqi Gao
Chengcheng Pu
Xin Yu
author_facet Xiaodong Guo
Enpeng Zhou
Xianghe Wang
Bingjie Huang
Tianqi Gao
Chengcheng Pu
Xin Yu
author_sort Xiaodong Guo
collection DOAJ
description Abstract Predicting patient response to antipsychotic medication is a major challenge in schizophrenia treatment. This study investigates the predictive role of gray matter (GM) in short- and long-term treatment outcomes in drug-naive patients with first-episode schizophrenia (FES). A cohort of 104 drug-naive FES was recruited. Before initiating treatment, T1-weighted anatomical images were captured. The Positive and Negative Syndrome Scale and the Personal and Social Performance Scale were adopted to assess clinical symptoms and social function. At the 3-month follow-up, patients were categorized into remission and non-remission groups. At 1-year follow-up, patients were categorized into the rehabilitation and non-rehabilitation groups. Machine learning algorithms were applied to predict treatment outcomes based on GM volume, cortical thickness, and gyrification index, and the model performance was evaluated. Widespread regions, such as the superior temporal gyrus, middle frontal gyrus, supramarginal gyrus, the posterior central gyrus, anterior cingulate gyrus, and parahippocampal gyrus showed substantial predictive value for 3-month treatment efficacy (74.32% accuracy). The inferior frontal gyrus, anterior cingulate gyrus, and inferior occipital gyrus demonstrated significant predictive power for treatment outcome at 1-year follow-up (70.31% accuracy). We developed a machine learning model to predict individual responses to antipsychotic treatments, which could positively impact clinical treatment protocols for schizophrenia.
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spelling doaj-art-65e600351b4e4b43b54a5350a75e924d2025-02-02T12:29:20ZengNature PortfolioSchizophrenia2754-69932025-02-011111810.1038/s41537-025-00557-6Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophreniaXiaodong Guo0Enpeng Zhou1Xianghe Wang2Bingjie Huang3Tianqi Gao4Chengcheng Pu5Xin Yu6Peking University Sixth HospitalPeking University Sixth HospitalPeking University Sixth HospitalPeking University Sixth HospitalPeking University Sixth HospitalPeking University Sixth HospitalPeking University Sixth HospitalAbstract Predicting patient response to antipsychotic medication is a major challenge in schizophrenia treatment. This study investigates the predictive role of gray matter (GM) in short- and long-term treatment outcomes in drug-naive patients with first-episode schizophrenia (FES). A cohort of 104 drug-naive FES was recruited. Before initiating treatment, T1-weighted anatomical images were captured. The Positive and Negative Syndrome Scale and the Personal and Social Performance Scale were adopted to assess clinical symptoms and social function. At the 3-month follow-up, patients were categorized into remission and non-remission groups. At 1-year follow-up, patients were categorized into the rehabilitation and non-rehabilitation groups. Machine learning algorithms were applied to predict treatment outcomes based on GM volume, cortical thickness, and gyrification index, and the model performance was evaluated. Widespread regions, such as the superior temporal gyrus, middle frontal gyrus, supramarginal gyrus, the posterior central gyrus, anterior cingulate gyrus, and parahippocampal gyrus showed substantial predictive value for 3-month treatment efficacy (74.32% accuracy). The inferior frontal gyrus, anterior cingulate gyrus, and inferior occipital gyrus demonstrated significant predictive power for treatment outcome at 1-year follow-up (70.31% accuracy). We developed a machine learning model to predict individual responses to antipsychotic treatments, which could positively impact clinical treatment protocols for schizophrenia.https://doi.org/10.1038/s41537-025-00557-6
spellingShingle Xiaodong Guo
Enpeng Zhou
Xianghe Wang
Bingjie Huang
Tianqi Gao
Chengcheng Pu
Xin Yu
Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
Schizophrenia
title Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
title_full Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
title_fullStr Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
title_full_unstemmed Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
title_short Machine learning-based prediction of antipsychotic efficacy from brain gray matter structure in drug-naive first-episode schizophrenia
title_sort machine learning based prediction of antipsychotic efficacy from brain gray matter structure in drug naive first episode schizophrenia
url https://doi.org/10.1038/s41537-025-00557-6
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