An Ensemble Approach to Predict Schizophrenia Using Protein Data in the N-methyl-D-Aspartate Receptor (NMDAR) and Tryptophan Catabolic Pathways

In the wake of recent advances in artificial intelligence research, precision psychiatry using machine learning techniques represents a new paradigm. The D-amino acid oxidase (DAO) protein and its interaction partner, the D-amino acid oxidase activator (DAOA, also known as G72) protein, have been implicated as two key proteins in the N-methyl-D-aspartate receptor (NMDAR) pathway for schizophrenia. Another potential biomarker in regard to the etiology of schizophrenia is melatonin in the tryptophan catabolic pathway. To develop an ensemble boosting framework with random undersampling for determining disease status of schizophrenia, we established a prediction approach resulting from the analysis of genomic and demographic variables such as DAO levels, G72 levels, melatonin levels, age, and gender of 355 schizophrenia patients and 86 unrelated healthy individuals in the Taiwanese population. We compared our ensemble boosting framework with other state-of-the-art algorithms such as support vector machine, multilayer feedforward neural networks, logistic regression, random forests, naive Bayes, and C4.5 decision tree. The analysis revealed that the ensemble boosting model with random undersampling [area under the receiver operating characteristic curve (AUC) = 0.9242 +/- 0.0652; sensitivity = 0.8580 +/- 0.0770; specificity = 0.8594 +/- 0.0760] performed maximally among predictive models to infer the complicated relationship between schizophrenia disease status and biomarkers. In addition, we identified a causal link between DAO and G72 protein levels in influencing schizophrenia disease status. The study indicates that the ensemble boosting framework with random undersampling may provide a suitable method to establish a tool for distinguishing schizophrenia patients from healthy controls using molecules in the NMDAR and tryptophan catabolic pathways.