Abstract
Normative modeling is an emerging and innovative framework for mapping individual differences at the level of a single subject or observation in relation to a reference model. It involves charting centiles of variation across a population in terms of mappings between biology and behavior which can then be used to make statistical inferences at the level of the individual. The fields of computational psychiatry and clinical neuroscience have been slow to transition away from patient versus “healthy” control analytic approaches, likely due to a lack of tools designed to properly model biological heterogeneity of mental disorders. Normative modeling provides a solution to address this issue and moves analysis away from case-control comparisons that rely on potentially noisy clinical labels. In this article, we define a standardized protocol to guide users through, from start to finish, normative modeling analysis using the Predictive Clinical Neuroscience toolkit (PCNtoolkit). We describe the input data selection process, provide intuition behind the various modeling choices, and conclude by demonstrating several examples of down-stream analyses the normative model results may facilitate, such as stratification of high-risk individuals, subtyping, and behavioral predictive modeling. The protocol takes approximately 1-3 hours to complete.
Competing Interest Statement
CFB is director and shareholder of SBGNeuro Ltd. HGR received speakers honorarium from Lundbeck and Janssen. The other authors report no conflicts of interest.
Footnotes
Editorial summary This protocol guides the user through normative modeling analysis using the Predictive Clinical Neuroscience toolkit (PCNtoolkit), enabling individual differences to be mapped at the level of a single subject or observation in relation to a reference model.
Tweet New protocol by @being_saige for normative modeling analysis using the Predictive Clinical Neuroscience toolkit (PCNtoolkit) - an emerging and innovative framework for mapping individual differences at the level of a single subject or observation in relation to a reference model, moving computational psychiatry analyses away from noisy case-control comparisons.
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Key reference(s) using this protocol
Marquand, A.F., Kia, S.M., Zabihi, M. et al. Conceptualizing mental disorders as deviations from normative functioning. Mol Psychiatry 24, 1415–1424 (2019). https://doi.org/10.1038/s41380-019-0441-1
Zabihi, M., Floris, D.L., Kia, S.M. et al. Fractionating autism based on neuroanatomical normative modeling. Transl Psychiatry 10, 384 (2020). https://doi.org/10.1038/s41398-020-01057-0
Wolfers T, Doan NT, Kaufmann T, et al. Mapping the Heterogeneous Phenotype of Schizophrenia and Bipolar Disorder Using Normative Models. JAMA Psychiatry. 2018;75(11):1146–1155. doi:10.1001/jamapsychiatry.2018.2467