Data-driven cluster selection for subcortical shape and cortical thickness predicts recovery from depressive symptoms

Patients with major depressive disorder (MDD) who do not achieve full symptomatic recovery after antidepressant treatment have a higher risk of relapse. Compared to pharmacotherapies, electroconvulsive therapy (ECT) more rapidly produces a greater extent of response in severely depressed patients. However, prediction of which candidates are most likely to improve after ECT remains challenging. Using structural MRI data from 42 ECT patients scanned prior to ECT treatment, we developed a random forest classifier based on data-driven shape cluster selection and cortical thickness features to predict remission. Right hemisphere hippocampal shape and right inferior temporal cortical thickness was most predictive of remission, with the predicted probability of recovery decreasing when these regions were thicker prior to treatment. Remission was predicted with an average 73% balanced accuracy. Classification of MRI data may help identify treatment-responsive patients and aid in clinical decision-making. Our results show promise for the development of personalized treatment strategies.