Identifying first-episode drug naive patients with schizophrenia with or without auditory verbal hallucinations using whole-brain functional connectivity: A pattern analysis study

Many studies have focused on patients with schizophrenia with or without auditory verbal hallucinations (AVHs), but due to the complexity of schizophrenia, biologically based diagnosis of patients with schizophrenia remains unsolved. The objectives of this study are to classify between first-episode drug-naive patients with schizophrenia and healthy controls, and to classify between patients with and without AVHs. Resting state fMRI data from 41 patients with schizophrenia (22 with and 19 without AVHs) and 23 normal controls (NC) were included to compute functional connectivity between brain regions. Classifiers based on support vector machine (SVM) were developed to classify patients with schizophrenia from NC, as well as between the two subgroups of patients. The classification accuracy was evaluated with a leave-one-out cross-validation (LOOCV) strategy. The accuracy in discriminating both subgroups of patients from NC was 81.3%, with 92.0% (sensitivity) and 65.2% (specificity) for the patients and NC, respectively. The classification accuracy in discriminating patients with and without AVHs was 75.6%, with 77.3% (sensitivity) and 73.9% (specificity) for patients with and without AVHs, respectively. The results suggest that functional connectivity provided good discriminative power not only for identifying patients with schizophrenia among NC, but also in discriminating patients with schizophrenia with and without AVHs.