The role of catastrophizing in anxiety and depression symptom scores among knee osteoarthritis patients: a multimodal assessment with EEG and machine learning.

Overview

1. Mental Health Department, Santa Casa de São Paulo School of Medical Sciences,Dona Veridiana Street 55, 3o. Floor, Higienópolis, São Paulo, SP Brazil
2. Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo,São Paulo, SP Brazil
3. Departamento de Medicina Legal, BioéticaMedicina do Trabalho e Medicina Física e Reabilitação do da Faculdade de Medicina da Universidade de São Paulo (FMUSP),São Paulo, Brazil
4. Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School,Boston, USA

Abstract

To examine dimensional associations between anxiety- and depression-related symptom severity, pain catastrophizing, and resting-state EEG features in patients with knee osteoarthritis (KOA). Resting-state EEG spectral power (delta, theta, alpha, beta) was analysed in 62 KOA patients from the DEFINE cohort. Emotional symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS), along with the Pain Catastrophizing Scale (PCS) and clinical–demographic variables. Multivariate regression analyses identified significant predictors, while linear and tree-based machine learning models were used post hoc to explore whether multivariate and non-linear approaches converged with the regression findings. Catastrophizing was independently and significantly associated with both anxiety and depression symptom scores across regression and exploratory machine learning models. For depression, a multifactorial pattern was additionally observed: higher bilateral parietal delta power, greater catastrophizing, lower education, and greater body weight showed independent associations with more severe symptom scores. Machine learning analyses indicated that EEG features were weak standalone correlates but showed modest complementary associations when combined with clinical variables. Pain catastrophizing was consistently associated with both anxiety and depression symptom scores, and resting-state EEG features showed limited but complementary associations with depressive symptom scores in KOA. Importantly, these associations were observed within a sample presenting predominantly subclinical HADS scores, and findings should be interpreted as reflecting dimensional associations within a rehabilitation cohort rather than clinical anxiety or depressive disorder.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

The paper's code and data availability statement is in the Data section.

Tracing map

A tracing map links a paper to the code its authors published: this paper has none (its code is available on request), so it has no map.

Data

No dataset and no data link were found in the paper.

Data availability

The datasets and code generated and analyzed during the current study are intellectual property of the authors and cannot be made publicly available. However, anonymized datasets and the machine learning model code may be shared with qualified researchers upon reasonable request to the corresponding author.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 2, 28 September 2026

• Publisher: n/a → Springer Science+Business Media

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 5 authors, 6 keywords, 11 MeSH terms, 1 funder, 43 references.

Cite

This paper

Vieira, J., Imamura, M., Battistella, L. R., Fregni, F., & Marques, L. M. (2026). The role of catastrophizing in anxiety and depression symptom scores among knee osteoarthritis patients: a multimodal assessment with EEG and machine learning. Experimental brain research, 244(8), 168. https://doi.org/10.1007/s00221-026-07368-w

Similar papers

The papers with a page that share the most with this one: the tools found in their code, their categories, datasets, cited references and authors, the rarest counting most.

[1] doi:10.1002/hbm.70628 [code]

EEG Biomarkers for Affective Disorders Diagnosis: An Evaluation and Validation Study.

Journal: Human brain mapping

In common: depression, EEG, clinical / translational, 2 references

[2] doi:10.1016/j.neuroimage.2026.122002

EEG-based clustering shows distinct separation of chronic pain patients before spinal cord stimulation surgery.

Journal: NeuroImage

In common: pain, EEG, clinical / translational, 2 references

[3] doi:10.34133/research.1298 [code]

Multisite Chronic Pain Reveals Neuro-Immune-Metabolic Dysregulation across Rheumatoid Arthritis and Depression.

Journal: Research (Washington, D.C.)

In common: pain, depression, clinical / translational, 1 reference

[4] doi:10.1007/s00221-026-07266-1

Working memory load and search efficiency in conventional monitor-based 2D versus 3D virtual settings: analysis of response times and parietal induced alpha activity in a modified Sternberg task.

Journal: Experimental brain research

In common: EEG, 3 references

[5] doi:10.3390/life16060924

Gut Modulators Alter BDNF/Cortisol Axis in Severe Obesity: Additional Secondary Outcomes from a Triple-Blind Randomized Trial.

Journal: Life (Basel, Switzerland)

In common: depression, clinical / translational, other condition, 1 reference

[6] doi:10.1371/journal.pbio.3003948 [code]

Neural encoding of pain is robust within but unstable between individuals.

Journal: PLoS biology

In common: pain, EEG, 2 references

[7] doi:10.1038/s41398-026-03928-4

Modulatory effects of ketamine on EEG source-based resting state connectivity in treatment resistant depression.

Journal: Translational psychiatry

In common: depression, EEG, clinical / translational, 1 reference

[8] doi:10.1038/s41398-026-04055-w [code]

Diminished variability of alpha and beta band-limited power as a neural signature in schizophrenia.

Journal: Translational psychiatry

In common: EEG, clinical / translational, 2 references

[9] doi:10.3389/fneur.2026.1791834 [code]

Minimum data requirements and automated preprocessing for reliable EEG biomarkers in Rett syndrome.

Journal: Frontiers in neurology

In common: EEG, clinical / translational, other condition, 2 references

[10] doi:10.1038/s41467-026-73878-4 [code]

Neural Response to Familiar Names Predicts Outcome of Comatose ICU Patients: A Prospective Observational Cohort Study.

Journal: Nature communications

In common: EEG, clinical / translational, other condition, 2 references

Contribute

The authors of this paper can claim it, correct its record and validate its tracing map, and the maintainers of its code (its owner, or a public member of its organization) correct what it says of their repository; anyone signed in can ask for its removal. Every request goes to OSCR's own machine, which answers it; your account page follows them.

Request its removal

To ask OSCR to remove this record, the copies of its authors' scripts or its tracing map, use the removal request page: signed in, you say who you are, what to remove and why, then review and confirm the request. Published rules decide every request (how).

Discussion: questions and error reports about this paper and its code, from signed-in readers and its authors. It opens with sign-in.

Reproductions: reports from readers who ran the authors' code: what they reproduced, with which environment, commit and data. It opens with sign-in.

Activity: what happens around this paper: new versions of its record, its map's validation, discussions and reproductions. It opens with sign-in.