# Statistical and Machine Learning Methods for Integrating Clinical and Multimodal Imaging Data to Select Optimal Antidepressant Treatment

> **NIH NIH K01** · GEORGE WASHINGTON UNIVERSITY · 2021 · $160,963

## Abstract

Summary: The public health burden of major depressive disorder (MDD) is immense and current approaches
for selecting antidepressant treatment have had limited success. By some estimates, fewer than one in three
MDD patients will respond to their prescribed antidepressant and the quest for a treatment that will work is
typically characterized by a lengthy course of trial-and-error. The need to identify patient characteristics
(biomarkers) that can be used to objectively select personalized antidepressant treatment is clear.
Accordingly, large clinical studies like the NIMH-funded Establishing Moderators and Biosignatures of
Antidepressant Response for Clinical Care (EMBARC) study have collected massive amounts of baseline
measures including those from various neuroimaging sources in the hope that some can be used to guide
antidepressant treatment selection. These data bring with them many statistical challenges that have yet to be
effectively addressed. These challenges include (1) dealing with high-dimensionality, (2) handling data
missingness, and (3) determining how best to simultaneously model relationships between measures from
multiple imaging modalities and the response of interest. The goal of this project is to acquire the essential
training and experience to make significant progress in this area by addressing each of these challenges. Aim
1 of this project will employ state-of-the-art ensemble machine learning algorithms and targeted estimation to
identify moderators of antidepressant treatment effect using scalar clinical, demographic, and summary
neuroimaging data from clinical trials of antidepressant treatments, including EMBARC. Strategies for handling
missing data in this context will also be investigated and guidelines on best practices will be proposed. Aim 2
will extend the methods used in Aim 1 and develop user-friendly software to directly incorporate high-
dimensional multimodal neuroimaging data into treatment decision rules. Included in this aim will be an
investigation into best practices for handling missing high-dimensional imaging data in the context of estimating
treatment decision rules. Aim 3 will employ the novel methods developed in Aim 2 and the estimated
treatment decision rules will be evaluated and compared with those developed in Aim 1. I have put together a
training program that directly supports the completion of these research aims. It includes instruction,
mentoring, and hands-on-experience (1) in psychopathology and the neural basis for psychiatric disorders and
treatment for those disorders; (2) in the use of neuroimaging data to understand depression and response to
antidepressant treatment; (3) in the use of modern algorithms to store, process, manipulate, and analyze big
biomedical data like those arising in multimodal neuroimaging studies. This K01 Mentored Research Scientist
Development Award will provide the training, time, and resources to be able to make substantial progress in
addressing this i...

## Key facts

- **NIH application ID:** 10241351
- **Project number:** 5K01MH113850-04
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Adam Ciarleglio
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $160,963
- **Award type:** 5
- **Project period:** 2018-09-15 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241351

## Citation

> US National Institutes of Health, RePORTER application 10241351, Statistical and Machine Learning Methods for Integrating Clinical and Multimodal Imaging Data to Select Optimal Antidepressant Treatment (5K01MH113850-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10241351. Licensed CC0.

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