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Environmental disasters such as super typhoons can severely disrupt daily life and may trigger PTSD in exposed individuals. White matter alterations have been observed in patients with PTSD. Fixel\u2010based analysis (FBA), a recently developed diffusion MRI technique, allows detailed assessment of white matter microstructure. This study aimed to evaluate the potential of FBA as an imaging biomarker in typhoon survivors, reducing the subjective bias associated with clinical symptom scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Whole\u2010brain diffusion MRI data from the PTSD group (\n                      <jats:italic>n<\/jats:italic>\n                      = 27), trauma\u2010exposed controls (TEC,\n                      <jats:italic>n =<\/jats:italic>\n                      33), and healthy controls (HC,\n                      <jats:italic>n =<\/jats:italic>\n                      30) were analyzed to identify white matter fiber tracts showing abnormalities in FBA metrics, including fiber density (FD), fiber cross\u2010section (FC), and fiber density\u2013cross section (FDC). The study then examined whether these FBA\u2010derived features, when combined with machine learning, could improve the identification of potential PTSD biomarkers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the HC group, patients with PTSD showed increased fiber density (FD) in the right frontopontine tract and right middle longitudinal fascicle, as well as higher fiber density\u2013cross section (FDC) values in the bilateral frontopontine tract and left thalamo\u2010premotor tract (Bonferroni correction, p &lt; 0.05\/18 = 0.003). To differentiate PTSD from TEC, binary and multiclass machine learning models with five\u2010fold cross\u2010validation were developed. The binary model (PTSD vs. TEC) achieved high performance (accuracy = 0.89, sensitivity = 0.97, specificity = 0.71, precision = 0.87, AUC = 0.95), whereas the multiclass model (PTSD vs. TEC vs. HC) demonstrated excellent results (macro\u2010averaged precision = 0.99, recall = 0.99, F1\u2010score = 0.99). The top 20 contributing features of the optimal model were analyzed using Shapley additive explanation (SHAP) values to illustrate model interpretability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most typhoon\u2010exposed individuals with PTSD may exhibit structural alterations in brain white matter. By combining fixel\u2010based analysis (FBA) with machine learning, this study identified diffusion markers within specific white matter tracts and demonstrated their potential diagnostic value for distinguishing PTSD from trauma\u2010exposed controls. These findings enhance our understanding of microstructural white matter changes and their spatial distribution in PTSD and also suggest potential imaging biomarkers for its diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71354","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T04:20:05Z","timestamp":1775535605000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Diagnosis Model of Typhoon\u2010Related Post\u2010Traumatic Stress Disorder Based on Fixel\u2010Based Analysis in Machine Learning"],"prefix":"10.1002","volume":"16","author":[{"given":"Yiying","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongfeng","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Jinling Hospital Medical School of Nanjing University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Jinling Hospital Medical School of Nanjing University  Nanjing Jiangsu China"},{"name":"Department of Radiology The First Affiliated Hospital of Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Jinling Hospital Medical School of Nanjing University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Jinling Hospital Medical School of Nanjing University  Nanjing Jiangsu China"},{"name":"School of Psychology Nanjing Normal University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Second Xiangya Hospital Central South University; China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute On Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health  Changsha China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangming","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Jinling Hospital Medical School of Nanjing University  Nanjing Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2019.05.015"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.10.019"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2022.100429"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2021.102587"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2021.665070"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amp.2022.01.020"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neulet.2016.02.041"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22044"},{"key":"e_1_2_11_10_1","unstructured":"Dhollander T. andA.Connelly.2016. \u201cA Novel Iterative Approach to Reap the Benefits of Multi\u2010Tissue CSD From Just Single\u2010Shell (+ b = 0) Diffusion MRI Data.\u201d In24th Annual Meeting of the International Society for Magnetic Resonance in Medicine 3010 ISMRM."},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Publishing.2013.Diagnostic and Statistical Manual of Mental Disorders. 591\u2013643 American Psychiatric Publishing.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22483"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2019.05.009"},{"key":"e_1_2_11_14_1","unstructured":"Michael B.F. 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