Utilizing structural MRI and unsupervised clustering to differentiate schizophrenia and Alzheimer's disease in late-onset psychosis.

TitleUtilizing structural MRI and unsupervised clustering to differentiate schizophrenia and Alzheimer's disease in late-onset psychosis.
Publication TypeJournal Article
Year of Publication2025
AuthorsHojjati SHani, Chen K, Chiang GC, Kuceyeski A, Wang XH, Razlighi QR, Pahlajani S, Glodzik L, Tanzi EB, Reinhardt M, Butler TA
JournalBehav Brain Res
Volume480
Pagination115386
Date Published2025 Mar 05
ISSN1872-7549
KeywordsAge of Onset, Aged, Alzheimer Disease, Brain, Cluster Analysis, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Psychotic Disorders, Schizophrenia
Abstract

Late-onset psychosis (LOP) represents a highly heterogeneous and understudied condition, with potential origins ranging from atypically late onset of schizophrenia (SCZ) to Alzheimer's Disease (AD). Despite the clinical necessity of differentiating these conditions to guide effective treatment, achieving an accurate diagnosis remains challenging. This study aimed to utilize data-driven analyses of structural magnetic resonance imaging (MRI) to distinguish between these diagnostic possibilities. Utilizing publicly available datasets of MRI scans from 699 healthy control (HC) participants and 469 patients diagnosed with SCZ or AD, our analysis focused on bilateral subcortical volumetric measures in the caudate, hippocampus, putamen, and amygdala. We first trained an unsupervised K-means clustering algorithm based on SCZ and AD patients and achieved a clustering accuracy of 81 % and an area under curvature (AUC) of 0.79 in distinguishing between these two groups. Subsequently, we calculated the Euclidean distance between the AD and SCZ cluster centroids for each of ten patients with unexplained onset of psychosis after age 45 from a clinical MRI registry. Six patients were classified as AD and four as SCZ. Our findings revealed that among LOP participants, those classified in the SCZ cluster exhibited significantly greater right putamen volumes compared to those in the AD cluster (p < 0.0025). There were also intriguing clinical differences. While we do not have diagnostic biomarker information to confirm these classifications, this study sheds light on the heterogeneity of psychoses in late life and illustrates the potential use of widely available structural MRI and data-driven methods to enhance diagnostic accuracy and treatment outcomes for LOP patients.

DOI10.1016/j.bbr.2024.115386
Alternate JournalBehav Brain Res
PubMed ID39644998
PubMed Central IDPMC12040479
Grant ListP30 AG072980 / AG / NIA NIH HHS / United States