Psychopathology Assessment Methods Revisited: On Translational Cross-Validation of Clinical Self-Evaluation Scale and fMRI

Drozdstoy Stoyanov, Sevdalina Kandilarova, Stefan Borgwardt, Rolf-Dieter Stieglitz, Kenneth Hugdahl, Stefan Kostianev

We present in this article a study design that combines clinical self-assessment scale, simultaneously administered with fMRI data acquisition. We have used a standard block-design with two different conditions. Each active block consisted of four text statements (items), alternating diagnostically specific (DS) blocks comprising items from von Zerssen depression scale and diagnostically neutral (DN) blocks with items from a questionnaire about general interests. All items were rated on four degree Likert scale, and patients provided responses with corresponding four buttons during the fMRI session. Our results demonstrated that in healthy controls, contrasting the two types of stimuli yielded no residual activations, e.g., the DS did not produce significantly different activations compared to the DN stimuli. Furthermore, the correlation analyses did not find a relationship between brain activations and the total score of the DS statements in this group. However, contrasting the DS stimuli to the DN stimuli in the patients produced significant residual activations in several brain regions: right pre- and postcentral gyrus (including right supramarginal gyrus), left middle frontal gyrus, triangular part of the left inferior frontal gyrus and middle temporal gyrus. The left precuneus demonstrated correlations with the patients' DS score. In the between-group comparisons, we found residual activations in the right pre- and postcentral gyrus, right supplementary motor area, medial segment of the right precentral gyrus, right superior parietal lobule, left middle frontal gyrus, left superior frontal gyrus, left occipital pole. Our results confirm the possibility of translational cross-validation of a clinical psychological test (von Zerssen's depression scale) and fMRI. At this stage, however, we can only confirm the sensitivity of the method (its ability to distinguish healthy controls from depressed patients), but we cannot conclude anything about its specificity (distinction from different psychopathology conditions).