Elastic Shape Analysis of Brain Structures for Predictive Modeling of PTSD

There is increasing evidence on the importance of brain morphology in predicting and classifying mental disorders. However, the vast majority of current shape approaches rely heavily on vertex-wise analysis that may not successfully capture complexities of subcortical structures. Additionally, the past works do not include interactions between these structures and exposure factors. Predictive modeling with such interactions is of paramount interest in heterogeneous mental disorders such as PTSD, where trauma exposure interacts with brain shape changes to influence behavior. We propose a comprehensive framework that overcomes these limitations by representing brain substructures as continuous parameterized surfaces and quantifying their shape differences using elastic shape metrics. Using the elastic shape metric, we compute shape summaries of subcortical data and represent individual shapes by their principal scores. These representations allow visualization tools that help localize changes when these PCs are varied. Subsequently, these PCs, the auxiliary exposure variables, and their interactions are used for regression modeling. We apply our method to data from the Grady Trauma Project, where the goal is to predict clinical measures of PTSD using shapes of brain substructures. Our analysis revealed considerably greater predictive power under the elastic shape analysis than widely used approaches such as vertex-wise shape analysis and even volumetric analysis. It helped identify local deformations in brain shapes related to change in PTSD severity. To our knowledge, this is one of the first brain shape analysis approaches that can seamlessly integrate the pre-processing steps under one umbrella for improved accuracy and are naturally able to account for interactions between brain shape and additional covariates to yield superior predictive performance when modeling clinical outcomes.