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Abstract AimsElevated blood pressure (BP) is a prevalent modifiable risk factor for cardiovascular diseases and contributes to cognitive decline in late life. Despite the fact that functional changes may precede irreversible structural damage and emerge in an ongoing manner, studies have been predominantly informed by brain structure and group-level inferences. Here, we aim to delineate neurobiological correlates of BP at an individual level using machine learning and functional connectivity. Methods and resultsBased on whole-brain functional connectivity from the UK Biobank, we built a machine learning model to identify neural representations for individuals’ past (∼8.9 years before scanning, N = 35 882), current (N = 31 367), and future (∼2.4 years follow-up, N = 3 138) BP levels within a repeated cross-validation framework. We examined the impact of multiple potential covariates, as well as assessed these models’ generalizability across various contexts.The predictive models achieved significant correlations between predicted and actual systolic/diastolic BP and pulse pressure while controlling for multiple confounders. Predictions for participants not on antihypertensive medication were more accurate than for currently medicated patients. Moreover, the models demonstrated robust generalizability across contexts in terms of ethnicities, imaging centres, medication status, participant visits, gender, age, and body mass index. The identified connectivity patterns primarily involved the cerebellum, prefrontal, anterior insula, anterior cingulate cortex, supramarginal gyrus, and precuneus, which are key regions of the central autonomic network, and involved in cognition processing and susceptible to neurodegeneration in Alzheimer’s disease. Results also showed more involvement of default mode and frontoparietal networks in predicting future BP levels and in medicated participants. ConclusionThis study, based on the largest neuroimaging sample currently available and using machine learning, identifies brain signatures underlying BP, providing evidence for meaningful BP-associated neural representations in connectivity profiles. 

Abstract Resting-state functional connectivity (RSFC) has been widely adopted for individualized trait prediction. However, multiple confounding factors may impact the predicted brain-behavior relationships. In this study, we investigated the impact of 4 confounding factors including time series length, functional connectivity (FC) type, brain parcellation choice, and variance of the predicted target. The data from Human Connectome Project including 1,206 healthy subjects were employed, with 3 cognitive traits including fluid intelligence, working memory, and picture vocabulary ability as the prediction targets. We compared the prediction performance under different settings of these 4 factors using partial least square regression. Results demonstrated appropriate time series length (300 time points) and brain parcellation (independent component analysis, ICA100/200) can achieve better prediction performance without too much time consumption. FC calculated by Pearson, Spearman, and Partial correlation achieves higher accuracy and lower time cost than mutual information and coherence. Cognitive traits with larger variance among subjects can be better predicted due to the well elaboration of individual variability. In addition, the beneficial effects of increasing scan duration to prediction partially arise from the improved test–retest reliability of RSFC. Taken together, the study highlights the importance of determining these factors in RSFC-based prediction, which can facilitate standardization of RSFC-based prediction pipelines going forward.