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Диагностика шизофрении по данным различных модальностей: биомаркеры и методы машинного обучения (обзор)

Диагностика шизофрении по данным различных модальностей: биомаркеры и методы машинного обучения (обзор)

М.Г. Шараев, И.К. Малашенкова, А.В. Масленникова, Н.В. Захарова, А.В. Бернштейн, Е.В. Бурнаев, Г.Ш. Мамедова, С.А. Крынский, Д.П. Огурцов, Е.А. Кондратьева, П.В. Дружинина, М.О. Зубрихина, А.Ю. Архипов, В.Б. Стрелец, В.Л. Ушаков
Ключевые слова: МРТ/фМРТ при шизофрении; ЭЭГ при шизофрении; иммунология при шизофрении; биомаркеры шизофрении; интерпретируемые модели машинного обучения; машинное обучение в диагностике.
2022, том 14, номер 5, стр. 53.

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Шизофрения является социально значимым психическим расстройством, зачастую приводящим к тяжелым формам инвалидности. Диагностика, выбор тактики лечения и реабилитации в клинической психиатрии в большей степени основаны на оценке поведенческих паттернов, данных социодемографических и других исследований, таких как клинические наблюдения и нейро­психологическое тестирование, включая обследование пациентов врачом-психиатром, самоотчеты и опросники. Во многом такие данные носят субъективный характер, и поэтому в последние годы появилось значительное количество работ, посвященных поиску объективных характеристик (показателей, биомаркеров) процессов, протекающих в организме человека и отражающихся в поведенческих и психоневрологических паттернах пациентов. Такие биомаркеры основаны на результатах инструментальных и лабораторных исследований (нейровизуализационных, электрофизиологических, биохимических, иммунологических, генетических и др.) и успешно используются в нейронауках для понимания механизмов возникновения и развития патологий нервной системы.

В настоящее время в связи с появлением новых эффективных нейровизуализационных, лабораторных и других методов исследования, а также с развитием современных методов анализа данных, машинного обучения и искусственного интеллекта проводится большое количество научных и клинических исследований, посвященных поиску биомаркеров, которые имеют диагностическую и прогностическую значимость при использовании их в клинической практике для объективизации процессов постановки и уточнения диагноза, выбора и оптимизации тактики лечения и реабилитации, а также для построения прогноза течения и исхода заболевания.

В данном обзоре проведен анализ работ, в которых описаны корреляты между установленным врачами диагнозом шизофрении, а также различными проявлениями психического расстройства (его подтипом, вариантом течения, степенью тяжести, наблюдаемыми симптомами и др.) и объективно измеряемыми характеристиками/количественными индикаторами (анатомическими, функциональными, иммунологическими, генетическими и др.), получаемыми при инструментальных и лабораторных обследованиях пациентов.

Значительная часть рассмотренных работ посвящена коррелятам/биомаркерам шизофрении, основанным на данных структурной и функциональной (в состоянии покоя и при когнитивной нагрузке) МРТ, ЭЭГ, трактографии и на иммунологических данных. Найденные корреляты/биомаркеры отражают анатомические нарушения в конкретных областях мозга, нарушения функциональной активности регионов мозга и их взаимосвязей, особенности микроструктуры белого вещества головного мозга и уровни связности между трактами различных структур, изменения электрической активности в различных областях мозга в разных спектральных диапазонах ЭЭГ, а также изменения в естественном и адаптивном звеньях иммунитета.

В обзоре рассмотрены современные методы анализа данных и машинного обучения для поиска биомаркеров шизофрении по данным различных модальностей и их использование при построении и интерпретации предиктивных диагностических моделей шизофрении.

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