Classification of multiple sclerosis patients based on structural disconnection: A robust feature selection approach

Simona Schiavi, Alberto Azzari, Antonella Mensi, Nicole Graziano, Alessandro Daducci, Manuele Bicego, Matilde Inglese, Maria Petracca

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background and Purpose: Although structural disconnection represents the hallmark of multiple sclerosis (MS) pathophysiology, classification attempts based on structural connectivity have achieved low accuracy levels. Here, we set out to fill this gap, exploring the performance of supervised classifiers on features derived from microstructure informed tractography and selected applying a novel robust approach. Methods: Using microstructure informed tractography with diffusion MRI data, we created quantitative connectomes of 55 MS patients and 24 healthy controls. We then used a robust approach—based on two classical methods of feature selection— to select relevant features from three network representations (whole connectivity matrices, node strength, and local efficiency). Classification accuracy of the selected features was tested with five different classifiers, while their meaningfulness was tested via correlation with clinical scales. As a comparison, the same classifiers were run on features selected with the standard procedure in network analysis (thresholding). Results: Our procedure identified 11 features for the whole net, five for local efficiency, and seven for node strength. For all classifiers, the accuracy was in the range 64.5%-91.1%, with features extracted from the whole net reaching the maximum, and overcoming results obtained with the standard procedure in all cases. Correlations with clinical scales were identified across functional domains, from motor and cognitive abilities to fatigue and depression. Conclusion: Applying a robust feature selection procedure to quantitative structural connectomes, we were able to classify MS patients with excellent accuracy, while providing information on the white matter connections and gray matter regions more affected by MS pathology.

Original languageEnglish
Pages (from-to)647-655
Number of pages9
JournalJournal of Neuroimaging
Issue number4
StatePublished - 1 Jul 2022


  • classification
  • machine learning
  • microstructure informed tractography
  • multiple sclerosis
  • quantitative structural connectivity
  • robust feature selection


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