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Estudillo Romero A, Migliaccio R, Batrancourt B, Jannin P, Baxter JSH. Analysis of convolutional neural networks for fronto-temporal dementia biomarker discovery. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03197-w. [PMID: 38874653 DOI: 10.1007/s11548-024-03197-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE Frontotemporal lobe dementia (FTD) results from the degeneration of the frontal and temporal lobes. It can manifest in several different ways, leading to the definition of variants characterised by their distinctive symptomatologies. As these variants are detected based on their symptoms, it can be unclear if they represent different types of FTD or different symptomatological axes. The goal of this paper is to investigate this question with a constrained cohort of FTD patients in order to see if the heterogeneity within this cohort can be inferred from medical images rather than symptom severity measurements. METHODS An ensemble of convolutional neural networks (CNNs) is used to classify diffusion tensor images collected from two databases consisting of 72 patients with behavioural variant FTD and 120 healthy controls. FTD biomarkers were found using voxel-based analysis on the sensitivities of these CNNs. Sparse principal components analysis (sPCA) is then applied on the sensitivities arising from the patient cohort in order to identify the axes along which the patients express these biomarkers. Finally, this is correlated with their symptom severity measurements in order to interpret the clinical presentation of each axis. RESULTS The CNNs result in sensitivities and specificities between 83 and 92%. As expected, our analysis determines that all the robust biomarkers arise from the frontal and temporal lobes. sPCA identified four axes in terms of biomarker expression which are correlated with symptom severity measurements. CONCLUSION Our analysis confirms that behavioural variant FTD is not a singular type or spectrum of FTD, but rather that it has multiple symptomatological axes that relate to distinct regions of the frontal and temporal lobes. This analysis suggests that medical images can be used to understand the heterogeneity of FTD patients and the underlying anatomical changes that lead to their different clinical presentations.
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Affiliation(s)
- Alfonso Estudillo Romero
- Laboratoire Traitement du Signal et de l'Image (LTSI, INSERM UMR 1099), Université de Rennes, Rennes, France
| | - Raffaella Migliaccio
- Frontal Functions and Pathology Laboratory (FrontLab), Institut du Cerveau, Paris, France
| | - Bénédicte Batrancourt
- Frontal Functions and Pathology Laboratory (FrontLab), Institut du Cerveau, Paris, France
| | - Pierre Jannin
- Laboratoire Traitement du Signal et de l'Image (LTSI, INSERM UMR 1099), Université de Rennes, Rennes, France
| | - John S H Baxter
- Laboratoire Traitement du Signal et de l'Image (LTSI, INSERM UMR 1099), Université de Rennes, Rennes, France.
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Wu Y, Wang X, Fang Y. Predicting mild cognitive impairment in older adults: A machine learning analysis of the Alzheimer's Disease Neuroimaging Initiative. Geriatr Gerontol Int 2024; 24 Suppl 1:96-101. [PMID: 37734954 DOI: 10.1111/ggi.14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/09/2023] [Accepted: 08/31/2023] [Indexed: 09/23/2023]
Abstract
AIM Mild cognitive impairment (MCI) in older adults is potentially devastating, but an accurate prediction model is still lacking. We hypothesized that neuropsychological tests and MRI-related markers could predict the onset of MCI early. METHODS We analyzed data from 306 older adults who were cognitive normal (CN) attending the Alzheimer's Disease Neuroimaging Initiative sequentially (474 pairs of visits) within 3 years. There were 231 pairs of MCI conversion (CN to MCI), and 242 pairs of CN maintenance (CN to CN). Variables on demographic, neuropsychological tests, genetic, and MRI-related markers were collected. Machine learning was used to construct MCI prediction models, comparing the area under the receiver operating characteristic curve (AUC) as the primary metric of performance. Important predictors were ranked for the optimal model. RESULTS The baseline age of the study sample was 74.8 years old. The best-performing model (gradient boosting decision tree) with 13 variables predicted MCI with an AUC of 0.819, and the rank of variable importance showed that intracranial volume, hippocampal volume, and score from task 4 (word recognition) of the Alzheimer's Disease Assessment Scale were important predictors of MCI. CONCLUSIONS With the help of machine learning, fewer neuropsychological tests and MRI-related markers are required to accurately predict MCI within 3 years, thereby facilitating targeted intervention. Geriatr Gerontol Int 2024; 24: 96-101.
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Affiliation(s)
- Yafei Wu
- School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen, China
| | - Xing Wang
- School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
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Ma D, Stocks J, Rosen H, Kantarci K, Lockhart SN, Bateman JR, Craft S, Gurcan MN, Popuri K, Beg MF, Wang L. Differential diagnosis of frontotemporal dementia subtypes with explainable deep learning on structural MRI. Front Neurosci 2024; 18:1331677. [PMID: 38384484 PMCID: PMC10879283 DOI: 10.3389/fnins.2024.1331677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024] Open
Abstract
Background Frontotemporal dementia (FTD) represents a collection of neurobehavioral and neurocognitive syndromes that are associated with a significant degree of clinical, pathological, and genetic heterogeneity. Such heterogeneity hinders the identification of effective biomarkers, preventing effective targeted recruitment of participants in clinical trials for developing potential interventions and treatments. In the present study, we aim to automatically differentiate patients with three clinical phenotypes of FTD, behavioral-variant FTD (bvFTD), semantic variant PPA (svPPA), and nonfluent variant PPA (nfvPPA), based on their structural MRI by training a deep neural network (DNN). Methods Data from 277 FTD patients (173 bvFTD, 63 nfvPPA, and 41 svPPA) recruited from two multi-site neuroimaging datasets: the Frontotemporal Lobar Degeneration Neuroimaging Initiative and the ARTFL-LEFFTDS Longitudinal Frontotemporal Lobar Degeneration databases. Raw T1-weighted MRI data were preprocessed and parcellated into patch-based ROIs, with cortical thickness and volume features extracted and harmonized to control the confounding effects of sex, age, total intracranial volume, cohort, and scanner difference. A multi-type parallel feature embedding framework was trained to classify three FTD subtypes with a weighted cross-entropy loss function used to account for unbalanced sample sizes. Feature visualization was achieved through post-hoc analysis using an integrated gradient approach. Results The proposed differential diagnosis framework achieved a mean balanced accuracy of 0.80 for bvFTD, 0.82 for nfvPPA, 0.89 for svPPA, and an overall balanced accuracy of 0.84. Feature importance maps showed more localized differential patterns among different FTD subtypes compared to groupwise statistical mapping. Conclusion In this study, we demonstrated the efficiency and effectiveness of using explainable deep-learning-based parallel feature embedding and visualization framework on MRI-derived multi-type structural patterns to differentiate three clinically defined subphenotypes of FTD: bvFTD, nfvPPA, and svPPA, which could help with the identification of at-risk populations for early and precise diagnosis for intervention planning.
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Affiliation(s)
- Da Ma
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jane Stocks
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Howard Rosen
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, United States
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | - Samuel N. Lockhart
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - James R. Bateman
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Suzanne Craft
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Metin N. Gurcan
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karteek Popuri
- Department of Computer Science, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, BC, Canada
| | - Lei Wang
- Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, United States
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Fathi S, Ahmadi A, Dehnad A, Almasi-Dooghaee M, Sadegh M. A Deep Learning-Based Ensemble Method for Early Diagnosis of Alzheimer's Disease using MRI Images. Neuroinformatics 2024; 22:89-105. [PMID: 38042764 PMCID: PMC10917836 DOI: 10.1007/s12021-023-09646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/04/2023]
Abstract
Recently, the early diagnosis of Alzheimer's disease has gained major attention due to the growing prevalence of the disease and the resulting costs imposed on individuals and society. The main objective of this study was to propose an ensemble method based on deep learning for the early diagnosis of AD using MRI images. The methodology of this study consisted of collecting the dataset, preprocessing, creating the individual and ensemble models, evaluating the models based on ADNI data, and validating the trained model based on the local dataset. The proposed method was an ensemble approach selected through a comparative analysis of various ensemble scenarios. Finally, the six best individual CNN-based classifiers were selected to combine and constitute the ensemble model. The evaluation showed an accuracy rate of 98.57, 96.37, 94.22, 99.83, 93.88, and 93.92 for NC/AD, NC/EMCI, EMCI/LMCI, LMCI/AD, four-way and three-way classification groups, respectively. The validation results on the local dataset revealed an accuracy of 88.46 for three-way classification. Our performance results were higher than most reviewed studies and comparable with others. Although comparative analysis showed superior results of ensemble methods against individual architectures, there were no significant differences among various ensemble approaches. The validation results revealed the low performance of individual models in practice. In contrast, the ensemble method showed promising results. However, further studies on various and larger datasets are required to validate the generalizability of the model.
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Affiliation(s)
- Sina Fathi
- Department of Health Information Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Surrey Business School, University of Surrey, Guildford Surrey, GU2 7XH, UK.
| | - Afsaneh Dehnad
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Almasi-Dooghaee
- Neurology Department, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Melika Sadegh
- Neurology Department, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Cabrera-León Y, Báez PG, Fernández-López P, Suárez-Araujo CP. Neural Computation-Based Methods for the Early Diagnosis and Prognosis of Alzheimer's Disease Not Using Neuroimaging Biomarkers: A Systematic Review. J Alzheimers Dis 2024; 98:793-823. [PMID: 38489188 DOI: 10.3233/jad-231271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background The growing number of older adults in recent decades has led to more prevalent geriatric diseases, such as strokes and dementia. Therefore, Alzheimer's disease (AD), as the most common type of dementia, has become more frequent too. Background Objective: The goals of this work are to present state-of-the-art studies focused on the automatic diagnosis and prognosis of AD and its early stages, mainly mild cognitive impairment, and predicting how the research on this topic may change in the future. Methods Articles found in the existing literature needed to fulfill several selection criteria. Among others, their classification methods were based on artificial neural networks (ANNs), including deep learning, and data not from brain signals or neuroimaging techniques were used. Considering our selection criteria, 42 articles published in the last decade were finally selected. Results The most medically significant results are shown. Similar quantities of articles based on shallow and deep ANNs were found. Recurrent neural networks and transformers were common with speech or in longitudinal studies. Convolutional neural networks (CNNs) were popular with gait or combined with others in modular approaches. Above one third of the cross-sectional studies utilized multimodal data. Non-public datasets were frequently used in cross-sectional studies, whereas the opposite in longitudinal ones. The most popular databases were indicated, which will be helpful for future researchers in this field. Conclusions The introduction of CNNs in the last decade and their superb results with neuroimaging data did not negatively affect the usage of other modalities. In fact, new ones emerged.
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Affiliation(s)
- Ylermi Cabrera-León
- Instituto Universitario de Cibernética, Empresa y Sociedad, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Patricio García Báez
- Departamento de Ingeniería Informática y de Sistemas, Escuela Superior de Ingeniería y Tecnología, Universidad de La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Pablo Fernández-López
- Instituto Universitario de Cibernética, Empresa y Sociedad, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Carmen Paz Suárez-Araujo
- Instituto Universitario de Cibernética, Empresa y Sociedad, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
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Borchert RJ, Azevedo T, Badhwar A, Bernal J, Betts M, Bruffaerts R, Burkhart MC, Dewachter I, Gellersen HM, Low A, Lourida I, Machado L, Madan CR, Malpetti M, Mejia J, Michopoulou S, Muñoz-Neira C, Pepys J, Peres M, Phillips V, Ramanan S, Tamburin S, Tantiangco HM, Thakur L, Tomassini A, Vipin A, Tang E, Newby D, Ranson JM, Llewellyn DJ, Veldsman M, Rittman T. Artificial intelligence for diagnostic and prognostic neuroimaging in dementia: A systematic review. Alzheimers Dement 2023; 19:5885-5904. [PMID: 37563912 DOI: 10.1002/alz.13412] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/18/2023] [Accepted: 06/02/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Artificial intelligence (AI) and neuroimaging offer new opportunities for diagnosis and prognosis of dementia. METHODS We systematically reviewed studies reporting AI for neuroimaging in diagnosis and/or prognosis of cognitive neurodegenerative diseases. RESULTS A total of 255 studies were identified. Most studies relied on the Alzheimer's Disease Neuroimaging Initiative dataset. Algorithmic classifiers were the most commonly used AI method (48%) and discriminative models performed best for differentiating Alzheimer's disease from controls. The accuracy of algorithms varied with the patient cohort, imaging modalities, and stratifiers used. Few studies performed validation in an independent cohort. DISCUSSION The literature has several methodological limitations including lack of sufficient algorithm development descriptions and standard definitions. We make recommendations to improve model validation including addressing key clinical questions, providing sufficient description of AI methods and validating findings in independent datasets. Collaborative approaches between experts in AI and medicine will help achieve the promising potential of AI tools in practice. HIGHLIGHTS There has been a rapid expansion in the use of machine learning for diagnosis and prognosis in neurodegenerative disease Most studies (71%) relied on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset with no other individual dataset used more than five times There has been a recent rise in the use of more complex discriminative models (e.g., neural networks) that performed better than other classifiers for classification of AD vs healthy controls We make recommendations to address methodological considerations, addressing key clinical questions, and validation We also make recommendations for the field more broadly to standardize outcome measures, address gaps in the literature, and monitor sources of bias.
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Affiliation(s)
- Robin J Borchert
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Tiago Azevedo
- Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - AmanPreet Badhwar
- Department of Pharmacology and Physiology, University of Montreal, Montreal, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie (CRIUGM), Montreal, Canada
| | - Jose Bernal
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Matthew Betts
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Center for Behavioral Brain Sciences, University of Magdeburg, Magdeburg, Germany
| | - Rose Bruffaerts
- Computational Neurology, Experimental Neurobiology Unit, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | | | - Ilse Dewachter
- Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium
| | - Helena M Gellersen
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Luiza Machado
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Maura Malpetti
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Jhony Mejia
- Department of Biomedical Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Sofia Michopoulou
- Imaging Physics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Carlos Muñoz-Neira
- Research into Memory, Brain sciences and dementia Group (ReMemBr Group), Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Artificial Intelligence & Computational Neuroscience Group (AICN Group), Sheffield Institute for Translational Neuroscience (SITraN), Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Jack Pepys
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Marion Peres
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Siddharth Ramanan
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Lokendra Thakur
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Broad Institute of MIT and Harvard, Cambridge, UK
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Alessandro Tomassini
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Eugene Tang
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Danielle Newby
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK
- Alan Turing Institute, London, UK
| | - Michele Veldsman
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Bucholc M, James C, Khleifat AA, Badhwar A, Clarke N, Dehsarvi A, Madan CR, Marzi SJ, Shand C, Schilder BM, Tamburin S, Tantiangco HM, Lourida I, Llewellyn DJ, Ranson JM. Artificial intelligence for dementia research methods optimization. Alzheimers Dement 2023; 19:5934-5951. [PMID: 37639369 DOI: 10.1002/alz.13441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 08/31/2023]
Abstract
Artificial intelligence (AI) and machine learning (ML) approaches are increasingly being used in dementia research. However, several methodological challenges exist that may limit the insights we can obtain from high-dimensional data and our ability to translate these findings into improved patient outcomes. To improve reproducibility and replicability, researchers should make their well-documented code and modeling pipelines openly available. Data should also be shared where appropriate. To enhance the acceptability of models and AI-enabled systems to users, researchers should prioritize interpretable methods that provide insights into how decisions are generated. Models should be developed using multiple, diverse datasets to improve robustness, generalizability, and reduce potentially harmful bias. To improve clarity and reproducibility, researchers should adhere to reporting guidelines that are co-produced with multiple stakeholders. If these methodological challenges are overcome, AI and ML hold enormous promise for changing the landscape of dementia research and care. HIGHLIGHTS: Machine learning (ML) can improve diagnosis, prevention, and management of dementia. Inadequate reporting of ML procedures affects reproduction/replication of results. ML models built on unrepresentative datasets do not generalize to new datasets. Obligatory metrics for certain model structures and use cases have not been defined. Interpretability and trust in ML predictions are barriers to clinical translation.
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Affiliation(s)
- Magda Bucholc
- Cognitive Analytics Research Lab, School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, UK
| | - Charlotte James
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ahmad Al Khleifat
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - AmanPreet Badhwar
- Multiomics Investigation of Neurodegenerative Diseases (MIND) Lab, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
- Institut de génie biomédical, Université de Montréal, Montréal, Quebec, Canada
- Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Quebec, Canada
| | - Natasha Clarke
- Multiomics Investigation of Neurodegenerative Diseases (MIND) Lab, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada
| | - Amir Dehsarvi
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences, and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Sarah J Marzi
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Cameron Shand
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Brian M Schilder
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | | | - David J Llewellyn
- University of Exeter Medical School, Exeter, UK
- The Alan Turing Institute, London, UK
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Newby D, Orgeta V, Marshall CR, Lourida I, Albertyn CP, Tamburin S, Raymont V, Veldsman M, Koychev I, Bauermeister S, Weisman D, Foote IF, Bucholc M, Leist AK, Tang EYH, Tai XY, Llewellyn DJ, Ranson JM. Artificial intelligence for dementia prevention. Alzheimers Dement 2023; 19:5952-5969. [PMID: 37837420 PMCID: PMC10843720 DOI: 10.1002/alz.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION A wide range of modifiable risk factors for dementia have been identified. Considerable debate remains about these risk factors, possible interactions between them or with genetic risk, and causality, and how they can help in clinical trial recruitment and drug development. Artificial intelligence (AI) and machine learning (ML) may refine understanding. METHODS ML approaches are being developed in dementia prevention. We discuss exemplar uses and evaluate the current applications and limitations in the dementia prevention field. RESULTS Risk-profiling tools may help identify high-risk populations for clinical trials; however, their performance needs improvement. New risk-profiling and trial-recruitment tools underpinned by ML models may be effective in reducing costs and improving future trials. ML can inform drug-repurposing efforts and prioritization of disease-modifying therapeutics. DISCUSSION ML is not yet widely used but has considerable potential to enhance precision in dementia prevention. HIGHLIGHTS Artificial intelligence (AI) is not widely used in the dementia prevention field. Risk-profiling tools are not used in clinical practice. Causal insights are needed to understand risk factors over the lifespan. AI will help personalize risk-management tools for dementia prevention. AI could target specific patient groups that will benefit most for clinical trials.
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Affiliation(s)
- Danielle Newby
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, W1T 7BN, UK
| | - Charles R Marshall
- Preventive Neurology Unit, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 4NS, UK
- Department of Neurology, Royal London Hospital, London, E1 1BB, UK
| | - Ilianna Lourida
- Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK
- University of Exeter Medical School, Exeter, EX1 2HZ, UK
| | - Christopher P Albertyn
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AF, UK
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, 37129, Italy
| | - Vanessa Raymont
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Michele Veldsman
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
| | - Ivan Koychev
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Sarah Bauermeister
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK
| | - David Weisman
- Abington Neurological Associates, Abington, PA 19001, USA
| | - Isabelle F Foote
- Preventive Neurology Unit, Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, E1 4NS, UK
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO 80309, USA
| | - Magda Bucholc
- Cognitive Analytics Research Lab, School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, BT48 7JL, UK
| | - Anja K Leist
- Institute for Research on Socio-Economic Inequality (IRSEI), Department of Social Sciences, University of Luxembourg, L-4365, Luxembourg
| | - Eugene Y H Tang
- Population Health Sciences Institute, Newcastle University, Newcastle, NE2 4AX, UK
| | - Xin You Tai
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, OX3 9DU, UK
- Division of Clinical Neurology, John Radcliffe Hospital, Oxford University Hospitals Trust, Oxford, OX3 9DU, UK
| | | | - David J. Llewellyn
- University of Exeter Medical School, Exeter, EX1 2HZ, UK
- The Alan Turing Institute, London, NW1 2DB, UK
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Wu Y, Wang X, Gu C, Zhu J, Fang Y. Investigating predictors of progression from mild cognitive impairment to Alzheimer's disease based on different time intervals. Age Ageing 2023; 52:afad182. [PMID: 37740920 PMCID: PMC10518045 DOI: 10.1093/ageing/afad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is the early stage of AD, and about 10-12% of MCI patients will progress to AD every year. At present, there are no effective markers for the early diagnosis of whether MCI patients will progress to AD. This study aimed to develop machine learning-based models for predicting the progression from MCI to AD within 3 years, to assist in screening and prevention of high-risk populations. METHODS Data were collected from the Alzheimer's Disease Neuroimaging Initiative, a representative sample of cognitive impairment population. Machine learning models were applied to predict the progression from MCI to AD, using demographic, neuropsychological test and MRI-related biomarkers. Data were divided into training (56%), validation (14%) and test sets (30%). AUC (area under ROC curve) was used as the main evaluation metric. Key predictors were ranked utilising their importance. RESULTS The AdaBoost model based on logistic regression achieved the best performance (AUC: 0.98) in 0-6 month prediction. Scores from the Functional Activities Questionnaire, Modified Preclinical Alzheimer Cognitive Composite with Trails test and ADAS11 (Unweighted sum of 11 items from The Alzheimer's Disease Assessment Scale-Cognitive Subscale) were key predictors. CONCLUSION Through machine learning, neuropsychological tests and MRI-related markers could accurately predict the progression from MCI to AD, especially in a short period time. This is of great significance for clinical staff to screen and diagnose AD, and to intervene and treat high-risk MCI patients early.
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Affiliation(s)
- Yafei Wu
- School of Public Health, Xiamen University, Xiamen, Fujian, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Xing Wang
- School of Public Health, Xiamen University, Xiamen, Fujian, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Chenming Gu
- School of Public Health, Xiamen University, Xiamen, Fujian, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Junmin Zhu
- School of Public Health, Xiamen University, Xiamen, Fujian, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
| | - Ya Fang
- School of Public Health, Xiamen University, Xiamen, Fujian, China
- Key Laboratory of Health Technology Assessment of Fujian Province, Xiamen University, Xiamen, Fujian, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, Fujian, China
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10
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Mazzeo S, Lassi M, Padiglioni S, Vergani AA, Moschini V, Scarpino M, Giacomucci G, Burali R, Morinelli C, Fabbiani C, Galdo G, Amato LG, Bagnoli S, Emiliani F, Ingannato A, Nacmias B, Sorbi S, Grippo A, Mazzoni A, Bessi V. PRedicting the EVolution of SubjectIvE Cognitive Decline to Alzheimer's Disease With machine learning: the PREVIEW study protocol. BMC Neurol 2023; 23:300. [PMID: 37573339 PMCID: PMC10422810 DOI: 10.1186/s12883-023-03347-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/28/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND As disease-modifying therapies (DMTs) for Alzheimer's disease (AD) are becoming a reality, there is an urgent need to select cost-effective tools that can accurately identify patients in the earliest stages of the disease. Subjective Cognitive Decline (SCD) is a condition in which individuals complain of cognitive decline with normal performances on neuropsychological evaluation. Many studies demonstrated a higher prevalence of Alzheimer's pathology in patients diagnosed with SCD as compared to the general population. Consequently, SCD was suggested as an early symptomatic phase of AD. We will describe the study protocol of a prospective cohort study (PREVIEW) that aim to identify features derived from easily accessible, cost-effective and non-invasive assessment to accurately detect SCD patients who will progress to AD dementia. METHODS We will include patients who self-referred to our memory clinic and are diagnosed with SCD. Participants will undergo: clinical, neurologic and neuropsychological examination, estimation of cognitive reserve and depression, evaluation of personality traits, APOE and BDNF genotyping, electroencephalography and event-related potential recording, lumbar puncture for measurement of Aβ42, t-tau, and p-tau concentration and Aβ42/Aβ40 ratio. Recruited patients will have follow-up neuropsychological examinations every two years. Collected data will be used to train a machine learning algorithm to define the risk of being carriers of AD and progress to dementia in patients with SCD. DISCUSSION This is the first study to investigate the application of machine learning to predict AD in patients with SCD. Since all the features we will consider can be derived from non-invasive and easily accessible assessments, our expected results may provide evidence for defining cost-effective and globally scalable tools to estimate the risk of AD and address the needs of patients with memory complaints. In the era of DMTs, this will have crucial implications for the early identification of patients suitable for treatment in the initial stages of AD. TRIAL REGISTRATION NUMBER (TRN) NCT05569083.
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Affiliation(s)
- Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Michael Lassi
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Sonia Padiglioni
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Regional Referral Centre for Relational Criticalities - Tuscany Region, Florence, Italy
| | - Alberto Arturo Vergani
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Valentina Moschini
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
| | | | - Carmen Morinelli
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | | | - Giulia Galdo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
| | - Lorenzo Gaetano Amato
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
| | - Filippo Emiliani
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Alberto Mazzoni
- The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliera-Universitaria Careggi, Largo Brambilla 3, Florence, 50134, Italy.
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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Li Q, Yang X, Xu J, Guo Y, He X, Hu H, Lyu T, Marra D, Miller A, Smith G, DeKosky S, Boyce RD, Schliep K, Shenkman E, Maraganore D, Wu Y, Bian J. Early prediction of Alzheimer's disease and related dementias using real-world electronic health records. Alzheimers Dement 2023; 19:3506-3518. [PMID: 36815661 PMCID: PMC10976442 DOI: 10.1002/alz.12967] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/31/2022] [Accepted: 01/05/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION This study aims to explore machine learning (ML) methods for early prediction of Alzheimer's disease (AD) and related dementias (ADRD) using the real-world electronic health records (EHRs). METHODS A total of 23,835 ADRD and 1,038,643 control patients were identified from the OneFlorida+ Research Consortium. Two ML methods were used to develop the prediction models. Both knowledge-driven and data-driven approaches were explored. Four computable phenotyping algorithms were tested. RESULTS The gradient boosting tree (GBT) models trained with the data-driven approach achieved the best area under the curve (AUC) scores of 0.939, 0.906, 0.884, and 0.854 for early prediction of ADRD 0, 1, 3, or 5 years before diagnosis, respectively. A number of important clinical and sociodemographic factors were identified. DISCUSSION We tested various settings and showed the predictive ability of using ML approaches for early prediction of ADRD with EHRs. The models can help identify high-risk individuals for early informed preventive or prognostic clinical decisions.
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Affiliation(s)
- Qian Li
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Xi Yang
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jie Xu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Xing He
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Hui Hu
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Tianchen Lyu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - David Marra
- Department of Psychology, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Amber Miller
- Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Steven DeKosky
- Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Richard D. Boyce
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Karen Schliep
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Demetrius Maraganore
- Department of Neurology, School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Yonghui Wu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida, USA
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Ford E, Milne R, Curlewis K. Ethical issues when using digital biomarkers and artificial intelligence for the early detection of dementia. WILEY INTERDISCIPLINARY REVIEWS. DATA MINING AND KNOWLEDGE DISCOVERY 2023; 13:e1492. [PMID: 38439952 PMCID: PMC10909482 DOI: 10.1002/widm.1492] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 03/06/2024]
Abstract
Dementia poses a growing challenge for health services but remains stigmatized and under-recognized. Digital technologies to aid the earlier detection of dementia are approaching market. These include traditional cognitive screening tools presented on mobile devices, smartphone native applications, passive data collection from wearable, in-home and in-car sensors, as well as machine learning techniques applied to clinic and imaging data. It has been suggested that earlier detection and diagnosis may help patients plan for their future, achieve a better quality of life, and access clinical trials and possible future disease modifying treatments. In this review, we explore whether digital tools for the early detection of dementia can or should be deployed, by assessing them against the principles of ethical screening programs. We conclude that while the importance of dementia as a health problem is unquestionable, significant challenges remain. There is no available treatment which improves the prognosis of diagnosed disease. Progression from early-stage disease to dementia is neither given nor currently predictable. Available technologies are generally not both minimally invasive and highly accurate. Digital deployment risks exacerbating health inequalities due to biased training data and inequity in digital access. Finally, the acceptability of early dementia detection is not established, and resources would be needed to ensure follow-up and support for those flagged by any new system. We conclude that early dementia detection deployed at scale via digital technologies does not meet standards for a screening program and we offer recommendations for moving toward an ethical mode of implementation. This article is categorized under:Application Areas > Health CareCommercial, Legal, and Ethical Issues > Ethical ConsiderationsTechnologies > Artificial Intelligence.
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Affiliation(s)
- Elizabeth Ford
- Department of Primary Care and Public HealthBrighton and Sussex Medical SchoolBrightonUK
| | - Richard Milne
- Kavli Centre for Ethics, Science and the PublicUniversity of CambridgeCambridgeUK
- Engagement and SocietyWellcome Connecting ScienceCambridgeUK
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Srinivasan S, Butters E, Collins-Jones L, Su L, O’Brien J, Bale G. Illuminating neurodegeneration: a future perspective on near-infrared spectroscopy in dementia research. NEUROPHOTONICS 2023; 10:023514. [PMID: 36788803 PMCID: PMC9917719 DOI: 10.1117/1.nph.10.2.023514] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
SIGNIFICANCE Dementia presents a global healthcare crisis, and neuroimaging is the main method for developing effective diagnoses and treatments. Yet currently, there is a lack of sensitive, portable, and low-cost neuroimaging tools. As dementia is associated with vascular and metabolic dysfunction, near-infrared spectroscopy (NIRS) has the potential to fill this gap. AIM This future perspective aims to briefly review the use of NIRS in dementia to date and identify the challenges involved in realizing the full impact of NIRS for dementia research, including device development, study design, and data analysis approaches. APPROACH We briefly appraised the current literature to assess the challenges, giving a critical analysis of the methods used. To assess the sensitivity of different NIRS device configurations to the brain with atrophy (as is common in most forms of dementia), we performed an optical modeling analysis to compare their cortical sensitivity. RESULTS The first NIRS dementia study was published in 1996, and the number of studies has increased over time. In general, these studies identified diminished hemodynamic responses in the frontal lobe and altered functional connectivity in dementia. Our analysis showed that traditional (low-density) NIRS arrays are sensitive to the brain with atrophy (although we see a mean decrease of 22% in the relative brain sensitivity with respect to the healthy brain), but there is a significant improvement (a factor of 50 sensitivity increase) with high-density arrays. CONCLUSIONS NIRS has a bright future in dementia research. Advances in technology - high-density devices and intelligent data analysis-will allow new, naturalistic task designs that may have more clinical relevance and increased reproducibility for longitudinal studies. The portable and low-cost nature of NIRS provides the potential for use in clinical and screening tests.
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Affiliation(s)
- Sruthi Srinivasan
- University of Cambridge, Department of Engineering, Electrical Engineering, Cambridge, United Kingdom
| | - Emilia Butters
- University of Cambridge, Department of Engineering, Electrical Engineering, Cambridge, United Kingdom
- University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom
| | - Liam Collins-Jones
- University College London, Department of Medical Physics, London, United Kingdom
| | - Li Su
- University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom
- University of Sheffield, Department of Neuroscience, Sheffield, United Kingdom
| | - John O’Brien
- University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom
| | - Gemma Bale
- University of Cambridge, Department of Engineering, Electrical Engineering, Cambridge, United Kingdom
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
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Bucholc M, James C, Al Khleifat A, Badhwar A, Clarke N, Dehsarvi A, Madan CR, Marzi SJ, Shand C, Schilder BM, Tamburin S, Tantiangco HM, Lourida I, Llewellyn DJ, Ranson JM. Artificial Intelligence for Dementia Research Methods Optimization. ARXIV 2023:arXiv:2303.01949v1. [PMID: 36911275 PMCID: PMC10002770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Machine learning (ML) has been extremely successful in identifying key features from high-dimensional datasets and executing complicated tasks with human expert levels of accuracy or greater. METHODS We summarize and critically evaluate current applications of ML in dementia research and highlight directions for future research. RESULTS We present an overview of ML algorithms most frequently used in dementia research and highlight future opportunities for the use of ML in clinical practice, experimental medicine, and clinical trials. We discuss issues of reproducibility, replicability and interpretability and how these impact the clinical applicability of dementia research. Finally, we give examples of how state-of-the-art methods, such as transfer learning, multi-task learning, and reinforcement learning, may be applied to overcome these issues and aid the translation of research to clinical practice in the future. DISCUSSION ML-based models hold great promise to advance our understanding of the underlying causes and pathological mechanisms of dementia.
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Affiliation(s)
- Magda Bucholc
- Cognitive Analytics Research Lab, School of Computing, Engineering & Intelligent Systems, Ulster University, Derry, UK
| | - Charlotte James
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ahmad Al Khleifat
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - AmanPreet Badhwar
- Multiomics Investigation of Neurodegenerative Diseases (MIND) Lab, Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
- Institut de génie biomédical, Université de Montréal, Montréal, Canada
- Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Natasha Clarke
- Multiomics Investigation of Neurodegenerative Diseases (MIND) Lab, Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Canada
| | - Amir Dehsarvi
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences, and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Sarah J. Marzi
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Cameron Shand
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Brian M. Schilder
- UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | | | - David J. Llewellyn
- University of Exeter Medical School, Exeter, UK
- The Alan Turing Institute, London, UK
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Maclagan LC, Abdalla M, Harris DA, Stukel TA, Chen B, Candido E, Swartz RH, Iaboni A, Jaakkimainen RL, Bronskill SE. Can Patients with Dementia Be Identified in Primary Care Electronic Medical Records Using Natural Language Processing? JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2023; 7:42-58. [PMID: 36910911 PMCID: PMC9995630 DOI: 10.1007/s41666-023-00125-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/23/2022] [Accepted: 01/07/2023] [Indexed: 01/24/2023]
Abstract
Dementia and mild cognitive impairment can be underrecognized in primary care practice and research. Free-text fields in electronic medical records (EMRs) are a rich source of information which might support increased detection and enable a better understanding of populations at risk of dementia. We used natural language processing (NLP) to identify dementia-related features in EMRs and compared the performance of supervised machine learning models to classify patients with dementia. We assembled a cohort of primary care patients aged 66 + years in Ontario, Canada, from EMR notes collected until December 2016: 526 with dementia and 44,148 without dementia. We identified dementia-related features by applying published lists, clinician input, and NLP with word embeddings to free-text progress and consult notes and organized features into thematic groups. Using machine learning models, we compared the performance of features to detect dementia, overall and during time periods relative to dementia case ascertainment in health administrative databases. Over 900 dementia-related features were identified and grouped into eight themes (including symptoms, social, function, cognition). Using notes from all time periods, LASSO had the best performance (F1 score: 77.2%, sensitivity: 71.5%, specificity: 99.8%). Model performance was poor when notes written before case ascertainment were included (F1 score: 14.4%, sensitivity: 8.3%, specificity 99.9%) but improved as later notes were added. While similar models may eventually improve recognition of cognitive issues and dementia in primary care EMRs, our findings suggest that further research is needed to identify which additional EMR components might be useful to promote early detection of dementia. Supplementary Information The online version contains supplementary material available at 10.1007/s41666-023-00125-6.
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Affiliation(s)
| | - Mohamed Abdalla
- Department of Computer Science, University of Toronto, Toronto, Canada
| | - Daniel A. Harris
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Therese A. Stukel
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Branson Chen
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
| | - Elisa Candido
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
| | - Richard H. Swartz
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Andrea Iaboni
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - R. Liisa Jaakkimainen
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Susan E. Bronskill
- ICES, G1-06, 2075 Bayview Avenue, Toronto, M4N 3M5 Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Women’s College Research Institute, Women’s College Hospital, Toronto, Canada
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Hu J, Wang Y, Guo D, Qu Z, Sui C, He G, Wang S, Chen X, Wang C, Liu X. Diagnostic performance of magnetic resonance imaging-based machine learning in Alzheimer's disease detection: a meta-analysis. Neuroradiology 2023; 65:513-527. [PMID: 36477499 DOI: 10.1007/s00234-022-03098-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Advanced machine learning (ML) algorithms can assist rapid medical image recognition and realize automatic, efficient, noninvasive, and convenient diagnosis. We aim to further evaluate the diagnostic performance of ML to distinguish patients with probable Alzheimer's disease (AD) from normal older adults based on structural magnetic resonance imaging (MRI). METHODS The Medline, Embase, and Cochrane Library databases were searched for relevant literature published up until July 2021. We used the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool and Checklist for Artificial Intelligence in Medical Imaging (CLAIM) to evaluate all included studies' quality and potential bias. Random-effects models were used to calculate pooled sensitivity and specificity, and the Deeks' test was used to assess publication bias. RESULTS We included 24 models based on different brain features extracted by ML algorithms in 19 papers. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve for ML in detecting AD were 0.85 (95%CI 0.81-0.89), 0.88 (95%CI 0.84-0.91), 7.15 (95%CI 5.40-9.47), 0.17 (95%CI 0.12-0.22), 43.34 (95%CI 26.89-69.84), and 0.93 (95%CI 0.91-0.95). CONCLUSION ML using structural MRI data performed well in diagnosing probable AD patients and normal elderly. However, more high-quality, large-scale prospective studies are needed to further enhance the reliability and generalizability of ML for clinical applications before it can be introduced into clinical practice.
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Affiliation(s)
- Jiayi Hu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Yashan Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Dingjie Guo
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Zihan Qu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Chuanying Sui
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Guangliang He
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Song Wang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Xiaofei Chen
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China.
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun, 130021, Jilin, China.
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Chu CS, Wang DY, Liang CK, Chou MY, Hsu YH, Wang YC, Liao MC, Chu WT, Lin YT. Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults. J Alzheimers Dis 2023; 92:875-886. [PMID: 36847001 DOI: 10.3233/jad-220999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly. OBJECTIVE This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis. METHODS A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed. RESULTS Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0% . The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation. CONCLUSION The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Non-Invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Di-Yuan Wang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Geriatric Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan
| | - Ying-Hsin Hsu
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Kaohsiung City, Taiwan.,Chia Nan University, Tainan, Taiwan, Tainan City, Taiwan
| | - Yu-Chun Wang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wei-Ta Chu
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taipei City, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan, Yanpu Township, Pingtung County, Taiwan
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18
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Dar SA, Imtiaz N. Classification of neuroimaging data in Alzheimer's disease using particle swarm optimization: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-12. [PMID: 36719791 DOI: 10.1080/23279095.2023.2169886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM Particle swarm optimization (PSO) is an algorithm that involves the optimization of Non-linear and Multidimensional problems to reach the best solutions with minimal parameterization. This metaheuristic model has frequently been used in the Pathological domain. This optimization model has been used in diverse forms while predicting Alzheimer's disease. It is a robust algorithm that works on linear and multi-modal data while predicting Alzheimer's disease. PSO techniques have been in action for quite some time for detecting various diseases and this paper systematically reviews the papers on various kinds of PSO techniques. METHODS To perform the systematic review, PRISMA guidelines were followed and a Boolean search ("particle swarm optimization" OR "PSO") AND Neuroimaging AND (Alzheimer's disease prediction OR classification OR diagnosis) were performed. The query was run in 4-reputed databases: Google Scholar, Scopus, Science Direct, and Wiley publications. RESULTS For the final analysis, 10 papers were incorporated for qualitative and quantitative synthesis. PSO has shown a dominant character while handling the uni-modal as well as the multi-modal data while predicting the conversion from MCI to Alzheimer's. It can be seen from the table that almost all the 10 reviewed papers had MRI-driven data. The accuracy rate was accentuated while adding other modalities or Neurocognitive measures. CONCLUSIONS Through this algorithm, we are providing an opportunity to other researchers to compare this algorithm with other state-of-the-art algorithms, while seeing the classification accuracy, with the aim of early prediction and progression of MCI into Alzheimer's disease.
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Affiliation(s)
- Suhail Ahmad Dar
- Department of Psychology, Aligarh Muslim University, Aligarh, India
| | - Nasheed Imtiaz
- Department of Psychology, Aligarh Muslim University, Aligarh, India
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19
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Zhou K, Piao S, Liu X, Luo X, Chen H, Xiang R, Geng D. A novel cascade machine learning pipeline for Alzheimer's disease identification and prediction. Front Aging Neurosci 2023; 14:1073909. [PMID: 36726800 PMCID: PMC9884698 DOI: 10.3389/fnagi.2022.1073909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023] Open
Abstract
Introduction Alzheimer's disease (AD) is a progressive and irreversible brain degenerative disorder early. Among all diagnostic strategies, hippocampal atrophy is considered a promising diagnostic method. In order to proactively detect patients with early Alzheimer's disease, we built an Alzheimer's segmentation and classification (AL-SCF) pipeline based on machine learning. Methods In our study, we collected coronal T1 weighted images that include 187 patients with AD and 230 normal controls (NCs). Our pipeline began with the segmentation of the hippocampus by using a modified U2-net. Subsequently, we extracted 851 radiomics features and selected 37 features most relevant to AD by the Hierarchical clustering method and Least Absolute Shrinkage and Selection Operator (LASSO) algorithm. At last, four classifiers were implemented to distinguish AD from NCs, and the performance of the models was evaluated by accuracy, specificity, sensitivity, and area under the curve. Results Our proposed pipeline showed excellent discriminative performance of classification with AD vs NC in the training set (AUC=0.97, 95% CI: (0.96-0.98)). The model was also verified in the validation set with Dice=0.93 for segmentation and accuracy=0.95 for classification. Discussion The AL-SCF pipeline can automate the process from segmentation to classification, which may assist doctors with AD diagnosis and develop individualized medical plans for AD in clinical practice.
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Affiliation(s)
- Kun Zhou
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Sirong Piao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao Liu
- School of Computer and Information Technology, Beijing Jiaotong University, Beijing, China
| | - Xiao Luo
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Hongyi Chen
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Rui Xiang
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Daoying Geng
- Academy for Engineering and Technology, Fudan University, Shanghai, China,Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China,*Correspondence: Daoying Geng,
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20
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Dimakopoulos GA, Vrahatis AG, Exarchos TP, Ntanasi E, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Vlamos P. Application of Machine Learning Techniques in the HELIAD Study Data for the Development of Diagnostic Models in MCI and Dementia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:187-192. [PMID: 37486493 DOI: 10.1007/978-3-031-31982-2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
The increase in the population's life expectancy leads to an increase in the incidence of dementia and, therefore, in diseases such as Alzheimer's. Towards this direction, the HELIAD1 study is the first large-scale epidemiological study aimed at assessing epidemiological data on dementia, mild mental decline, and other neuropsychiatric disorders associated with old age. This is a huge study with several computational challenges, most of which can be addressed by machine learning processes. The objectives of this study were to detect patterns in the HELIAD clinical data that classify with high accuracy various levels of cognitive impairment by training ML algorithms and hence apply derived model on future clinical data to predict with the same accuracy the class variable. We propose a machine learning method based on RUSBoost classifier to identify a critical subset of biomarkers that classify accurately between neurological patients with mild cognitive impairment (MCI) or dementia of the Alzheimer's type (DAT) and the cognitively healthy control (CHC) group. In this study we used a highly skewed (imbalanced) dataset with most observations (majority class) belonging to the CHC group. The method proposed predicts accurately the clinical diagnosis label and effectively classifies the neurological patients from the CHC class. In particular, the classification accuracy (actual vs predicted) for the three classes of the clinical diagnosis was 97%, 78%, and 91% for control, MCI, and dementia class, respectively.
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Affiliation(s)
- George A Dimakopoulos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Aristidis G Vrahatis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Themis P Exarchos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece
| | - Eva Ntanasi
- Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
- Department of Neurology, Columbia University, New York, NY, USA
| | - Panagiotis Vlamos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, Corfu, Greece.
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21
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Chen J, Patil KR, Yeo BTT, Eickhoff SB. Leveraging Machine Learning for Gaining Neurobiological and Nosological Insights in Psychiatric Research. Biol Psychiatry 2023; 93:18-28. [PMID: 36307328 DOI: 10.1016/j.biopsych.2022.07.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/06/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022]
Abstract
Much attention is currently devoted to developing diagnostic classifiers for mental disorders. Complementing these efforts, we highlight the potential of machine learning to gain biological insights into the psychopathology and nosology of mental disorders. Studies to this end have mainly used brain imaging data, which can be obtained noninvasively from large cohorts and have repeatedly been argued to reveal potentially intermediate phenotypes. This may become particularly relevant in light of recent efforts to identify magnetic resonance imaging-derived biomarkers that yield insight into pathophysiological processes as well as to refine the taxonomy of mental illness. In particular, the accuracy of machine learning models may be used as dependent variables to identify features relevant to pathophysiology. Moreover, such approaches may help disentangle the dimensional (within diagnosis) and often overlapping (across diagnoses) symptomatology of psychiatric illness. We also point out a multiview perspective that combines data from different sources, bridging molecular and system-level information. Finally, we summarize recent efforts toward a data-driven definition of subtypes or disease entities through unsupervised and semisupervised approaches. The latter, blending unsupervised and supervised concepts, may represent a particularly promising avenue toward dissecting heterogeneous categories. Finally, we raise several technical and conceptual aspects related to the reviewed approaches. In particular, we discuss common pitfalls pertaining to flawed input data or analytic procedures that would likely lead to unreliable outputs.
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Affiliation(s)
- Ji Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China; Department of Psychiatry, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany.
| | - Kaustubh R Patil
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine-universität Düsseldorf, Düsseldorf, Germany
| | - B T Thomas Yeo
- Centre for Sleep and Cognition & Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; Integrative Sciences & Engineering Programme, National University of Singapore, Singapore; Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Simon B Eickhoff
- Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany; Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine-universität Düsseldorf, Düsseldorf, Germany
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22
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Elgammal YM, Zahran MA, Abdelsalam MM. A new strategy for the early detection of alzheimer disease stages using multifractal geometry analysis based on K-Nearest Neighbor algorithm. Sci Rep 2022; 12:22381. [PMID: 36572791 PMCID: PMC9792538 DOI: 10.1038/s41598-022-26958-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 12/22/2022] [Indexed: 12/27/2022] Open
Abstract
Alzheimer's Disease (AD) is considered one of the most diseases that much prevalent among elderly people all over the world. AD is an incurable neurodegenerative disease affecting cognitive functions and were characterized by progressive and collective functions deteriorating. Remarkably, early detection of AD is essential for the development of new and invented treatment strategies. As Dementia causes irreversible damage to the brain neurons and leads to changes in its structure that can be described adequately within the framework of multifractals. Hence, the present work focus on developing a promising and efficient computing technique to pre-process and classify the AD disease especially in the early stages using multifractal geometry to extract the most changeable features due to AD. Then, A machine learning classification algorithm (K-Nearest Neighbor) has been implemented in order to classify and detect the main four early stages of AD. Two datasets have been used to ensure the validation of the proposed methodology. The proposed technique has achieved 99.4% accuracy and 100% sensitivity. The comparative results show that the proposed classification technique outperforms is recent techniques in terms of performance measures.
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Affiliation(s)
- Yasmina M Elgammal
- Theoretical Physics Group, Physics Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - M A Zahran
- Theoretical Physics Group, Physics Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Mohamed M Abdelsalam
- Computers Engineering and Control Systems Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt.
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23
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Lampe L, Niehaus S, Huppertz HJ, Merola A, Reinelt J, Mueller K, Anderl-Straub S, Fassbender K, Fliessbach K, Jahn H, Kornhuber J, Lauer M, Prudlo J, Schneider A, Synofzik M, Danek A, Diehl-Schmid J, Otto M, Villringer A, Egger K, Hattingen E, Hilker-Roggendorf R, Schnitzler A, Südmeyer M, Oertel W, Kassubek J, Höglinger G, Schroeter ML. Comparative analysis of machine learning algorithms for multi-syndrome classification of neurodegenerative syndromes. Alzheimers Res Ther 2022; 14:62. [PMID: 35505442 PMCID: PMC9066923 DOI: 10.1186/s13195-022-00983-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 02/24/2022] [Indexed: 12/12/2022]
Abstract
Importance The entry of artificial intelligence into medicine is pending. Several methods have been used for the predictions of structured neuroimaging data, yet nobody compared them in this context. Objective Multi-class prediction is key for building computational aid systems for differential diagnosis. We compared support vector machine, random forest, gradient boosting, and deep feed-forward neural networks for the classification of different neurodegenerative syndromes based on structural magnetic resonance imaging. Design, setting, and participants Atlas-based volumetry was performed on multi-centric T1-weighted MRI data from 940 subjects, i.e., 124 healthy controls and 816 patients with ten different neurodegenerative diseases, leading to a multi-diagnostic multi-class classification task with eleven different classes. Interventions N.A. Main outcomes and measures Cohen’s kappa, accuracy, and F1-score to assess model performance. Results Overall, the neural network produced both the best performance measures and the most robust results. The smaller classes however were better classified by either the ensemble learning methods or the support vector machine, while performance measures for small classes were comparatively low, as expected. Diseases with regionally specific and pronounced atrophy patterns were generally better classified than diseases with widespread and rather weak atrophy. Conclusions and relevance Our study furthermore underlines the necessity of larger data sets but also calls for a careful consideration of different machine learning methods that can handle the type of data and the classification task best.
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24
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Medical Data Classification Assisted by Machine Learning Strategy. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9699612. [PMID: 36124172 PMCID: PMC9482495 DOI: 10.1155/2022/9699612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022]
Abstract
With the development of science and technology, data plays an increasingly important role in our daily life. Therefore, much attention has been paid to the field of data mining. Data classification is the premise of data mining, and how well the data is classified directly affects the performance of subsequent models. In particular, in the medical field, data classification can help accurately determine the location of patients' lesions and reduce the workload of doctors in the treatment process. However, medical data has the characteristics of high noise, strong correlation, and high data dimension, which brings great challenges to the traditional classification model. Therefore, it is very important to design an advanced model to improve the effect of medical data classification. In this context, this paper first introduces the structure and characteristics of the convolutional neural network (CNN) model and then demonstrates its unique advantages in medical data processing, especially in data classification. Secondly, we design a new kind of medical data classification model based on the CNN model. Finally, the simulation results show that the proposed method achieves higher classification accuracy with faster model convergence speed and the lower training error when compared with conventional machine leaning methods, which has demonstrated the effectiveness of the new method in respect to medical data classification.
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25
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Gao Y, Zhao X, Huang J, Wang S, Chen X, Li M, Sun F, Wang G, Zhong Y. Abnormal regional homogeneity in right caudate as a potential neuroimaging biomarker for mild cognitive impairment: A resting-state fMRI study and support vector machine analysis. Front Aging Neurosci 2022; 14:979183. [PMID: 36118689 PMCID: PMC9475111 DOI: 10.3389/fnagi.2022.979183] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Mild cognitive impairment (MCI) is a heterogeneous syndrome characterized by cognitive impairment on neurocognitive tests but accompanied by relatively intact daily activities. Due to high variation and no objective methods for diagnosing and treating MCI, guidance on neuroimaging is needed. The study has explored the neuroimaging biomarkers using the support vector machine (SVM) method to predict MCI. Methods In total, 53 patients with MCI and 68 healthy controls were involved in scanning resting-state functional magnetic resonance imaging (rs-fMRI). Neurocognitive testing and Structured Clinical Interview, such as Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) test, Activity of Daily Living (ADL) Scale, Hachinski Ischemic Score (HIS), Clinical Dementia Rating (CDR), Montreal Cognitive Assessment (MoCA), and Hamilton Rating Scale for Depression (HRSD), were utilized to assess participants' cognitive state. Neuroimaging data were analyzed with the regional homogeneity (ReHo) and SVM methods. Results Compared with healthy comparisons (HCs), ReHo of patients with MCI was decreased in the right caudate. In addition, the SVM classification achieved an overall accuracy of 68.6%, sensitivity of 62.26%, and specificity of 58.82%. Conclusion The results suggest that abnormal neural activity in the right cerebrum may play a vital role in the pathophysiological process of MCI. Moreover, the ReHo in the right caudate may serve as a neuroimaging biomarker for MCI, which can provide objective guidance on diagnosing and managing MCI in the future.
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Affiliation(s)
- Yujun Gao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xinfu Zhao
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - JiChao Huang
- Affiliated Shuyang Hospital, Nanjing University of Chinese Medicine, Suqian, China
| | - Sanwang Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuan Chen
- Department of Psychiatry, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Mingzhe Li
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Fengjiao Sun
- Medical Research Center, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Fengjiao Sun
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
- Gaohua Wang
| | - Yi Zhong
- Department of Neuroscience, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- NHC Key Laboratory of Mental Health, Peking University Sixth Hospital, Peking University Institute of Mental Health, Peking University, Beijing, China
- Yi Zhong
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26
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Jang JW, Kim J, Park SW, Kasani PH, Kim Y, Kim S, Kim SJ, Na DL, Moon SH, Seo SW, Seong JK. Machine learning-based automatic estimation of cortical atrophy using brain computed tomography images. Sci Rep 2022; 12:14740. [PMID: 36042322 PMCID: PMC9427760 DOI: 10.1038/s41598-022-18696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 08/17/2022] [Indexed: 11/09/2022] Open
Abstract
Cortical atrophy is measured clinically according to established visual rating scales based on magnetic resonance imaging (MRI). Although brain MRI is the primary imaging marker for neurodegeneration, computed tomography (CT) is also widely used for the early detection and diagnosis of dementia. However, they are seldom investigated. Therefore, we developed a machine learning algorithm for the automatic estimation of cortical atrophy on brain CT. Brain CT images (259 Alzheimer’s dementia and 55 cognitively normal subjects) were visually rated by three neurologists and used for training. We constructed an algorithm by combining the convolutional neural network and regularized logistic regression (RLR). Model performance was then compared with that of neurologists, and feature importance was measured. RLR provided fast and reliable automatic estimations of frontal atrophy (75.2% accuracy, 93.6% sensitivity, 67.2% specificity, and 0.87 area under the curve [AUC]), posterior atrophy (79.6% accuracy, 87.2% sensitivity, 75.9% specificity, and 0.88 AUC), right medial temporal atrophy (81.2% accuracy, 84.7% sensitivity, 79.6% specificity, and 0.88 AUC), and left medial temporal atrophy (77.7% accuracy, 91.1% sensitivity, 72.3% specificity, and 0.90 AUC). We concluded that RLR-based automatic estimation of brain CT provided a comprehensive rating of atrophy that can potentially support physicians in real clinical settings.
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Affiliation(s)
- Jae-Won Jang
- Department of Neurology, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Republic of Korea
| | - Jeonghun Kim
- Department of Biomedical Engineering, Korea University, Seoul, Republic of Korea
| | - Sang-Won Park
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Republic of Korea
| | - Payam Hosseinzadeh Kasani
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.,Department of Medical Bigdata Convergence, Kangwon National University, Chuncheon, Republic of Korea
| | - Yeshin Kim
- Department of Neurology, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Seongheon Kim
- Department of Neurology, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.,Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Soo-Jong Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Joon-Kyung Seong
- Department of Biomedical Engineering, Korea University, Seoul, Republic of Korea.
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27
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Wang H, Sheng L, Xu S, Jin Y, Jin X, Qiao S, Chen Q, Xing W, Zhao Z, Yan J, Mao G, Xu X. Develop a diagnostic tool for dementia using machine learning and non-imaging features. Front Aging Neurosci 2022; 14:945274. [PMID: 36092811 PMCID: PMC9461143 DOI: 10.3389/fnagi.2022.945274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEarly identification of Alzheimer’s disease or mild cognitive impairment can help guide direct prevention and supportive treatments, improve outcomes, and reduce medical costs. Existing advanced diagnostic tools are mostly based on neuroimaging and suffer from certain problems in cost, reliability, repeatability, accessibility, ease of use, and clinical integration. To address these problems, we developed, evaluated, and implemented an early diagnostic tool using machine learning and non-imaging factors.Methods and resultsA total of 654 participants aged 65 or older from the Nursing Home in Hangzhou, China were identified. Information collected from these patients includes dementia status and 70 demographic, cognitive, socioeconomic, and clinical features. Logistic regression, support vector machine (SVM), neural network, random forest, extreme gradient boosting (XGBoost), least absolute shrinkage and selection operator (LASSO), and best subset models were trained, tuned, and internally validated using a novel double cross validation algorithm and multiple evaluation metrics. The trained models were also compared and externally validated using a separate dataset with 1,100 participants from four communities in Zhejiang Province, China. The model with the best performance was then identified and implemented online with a friendly user interface. For the nursing dataset, the top three models are the neural network (AUROC = 0.9435), XGBoost (AUROC = 0.9398), and SVM with the polynomial kernel (AUROC = 0.9213). With the community dataset, the best three models are the random forest (AUROC = 0.9259), SVM with linear kernel (AUROC = 0.9282), and SVM with polynomial kernel (AUROC = 0.9213). The F1 scores and area under the precision-recall curve showed that the SVMs, neural network, and random forest were robust on the unbalanced community dataset. Overall the SVM with the polynomial kernel was found to be the best model. The LASSO and best subset models identified 17 features most relevant to dementia prediction, mostly from cognitive test results and socioeconomic characteristics.ConclusionOur non-imaging-based diagnostic tool can effectively predict dementia outcomes. The tool can be conveniently incorporated into clinical practice. Its online implementation allows zero barriers to its use, which enhances the disease’s diagnosis, improves the quality of care, and reduces costs.
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Affiliation(s)
- Huan Wang
- Department of Biostatistics, The George Washington University, Washington, DC, United States
| | - Li Sheng
- Department of Mathematics, Drexel University, Philadelphia, PA, United States
| | - Shanhu Xu
- Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Yu Jin
- Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoqing Jin
- Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Song Qiao
- Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Qingqing Chen
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wenmin Xing
- Zhejiang Provincial Key Lab of Geriatrics & Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Zhenlei Zhao
- Zhejiang Provincial Key Lab of Geriatrics & Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Jing Yan
- Zhejiang Provincial Key Lab of Geriatrics & Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Jing Yan,
| | - Genxiang Mao
- Zhejiang Provincial Key Lab of Geriatrics & Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Genxiang Mao,
| | - Xiaogang Xu
- Zhejiang Provincial Key Lab of Geriatrics & Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
- Xiaogang Xu,
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Multiple Cognitive and Behavioral Factors Link Association Between Brain Structure and Functional Impairment of Daily Instrumental Activities in Older Adults. J Int Neuropsychol Soc 2022; 28:673-686. [PMID: 34308821 DOI: 10.1017/s1355617721000916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Functional impairment in daily activity is a cornerstone in distinguishing the clinical progression of dementia. Multiple indicators based on neuroimaging and neuropsychological instruments are used to assess the levels of impairment and disease severity; however, it remains unclear how multivariate patterns of predictors uniquely predict the functional ability and how the relative importance of various predictors differs. METHOD In this study, 881 older adults with subjective cognitive complaints, mild cognitive impairment (MCI), and dementia with Alzheimer's type completed brain structural magnetic resonance imaging (MRI), neuropsychological assessment, and a survey of instrumental activities of daily living (IADL). We utilized the partial least square (PLS) method to identify latent components that are predictive of IADL. RESULTS The result showed distinct brain components (gray matter density of cerebellar, medial temporal, subcortical, limbic, and default network regions) and cognitive-behavioral components (general cognitive abilities, processing speed, and executive function, episodic memory, and neuropsychiatric symptoms) were predictive of IADL. Subsequent path analysis showed that the effect of brain structural components on IADL was largely mediated by cognitive and behavioral components. When comparing hierarchical regression models, the brain structural measures minimally added the explanatory power of cognitive and behavioral measures on IADL. CONCLUSION Our finding suggests that cerebellar structure and orbitofrontal cortex, alongside with medial temporal lobe, play an important role in the maintenance of functional status in older adults with or without dementia. Moreover, the significance of brain structural volume affects real-life functional activities via disruptions in multiple cognitive and behavioral functions.
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Chen T, Su P, Shen Y, Chen L, Mahmud M, Zhao Y, Antoniou G. A dominant set-informed interpretable fuzzy system for automated diagnosis of dementia. Front Neurosci 2022; 16:867664. [PMID: 35979331 PMCID: PMC9376621 DOI: 10.3389/fnins.2022.867664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Dementia is an incurable neurodegenerative disease primarily affecting the older population, for which the World Health Organisation has set to promoting early diagnosis and timely management as one of the primary goals for dementia care. While a range of popular machine learning algorithms and their variants have been applied for dementia diagnosis, fuzzy systems, which have been known effective in dealing with uncertainty and offer to explicitly reason how a diagnosis can be inferred, sporadically appear in recent literature. Given the advantages of a fuzzy rule-based model, which could potentially result in a clinical decision support system that offers understandable rules and a transparent inference process to support dementia diagnosis, this paper proposes a novel fuzzy inference system by adapting the concept of dominant sets that arise from the study of graph theory. A peeling-off strategy is used to iteratively extract from the constructed edge-weighted graph a collection of dominant sets. Each dominant set is further converted into a parameterized fuzzy rule, which is finally optimized in a supervised adaptive network-based fuzzy inference framework. An illustrative example is provided that demonstrates the interpretable rules and the transparent reasoning process of reaching a decision. Further systematic experiments conducted on data from the Open Access Series of Imaging Studies (OASIS) repository, also validate its superior performance over alternative methods.
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Affiliation(s)
- Tianhua Chen
- Department of Computer Science, School of Computing and Engineering, University of Huddersfield, Huddersfield, United Kingdom
| | - Pan Su
- School of Control and Computer Engineering, North China Electric Power University, Beijing, China
| | - Yinghua Shen
- School of Economics and Business Administration, Chongqing University, Chongqing, China
| | - Lu Chen
- Institute of Big Data Science and Industry, Shanxi University, Taiyuan, China
| | - Mufti Mahmud
- Department of Computer Science, Nottingham Trent University, Nottingham, United Kingdom
| | - Yitian Zhao
- Cixi Institute of Biomedical Engineering, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, China
| | - Grigoris Antoniou
- Department of Computer Science, School of Computing and Engineering, University of Huddersfield, Huddersfield, United Kingdom
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Supervised Learning Models for the Preliminary Detection of COVID-19 in Patients Using Demographic and Epidemiological Parameters. INFORMATION 2022. [DOI: 10.3390/info13070330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The World Health Organization labelled the new COVID-19 breakout a public health crisis of worldwide concern on 30 January 2020, and it was named the new global pandemic in March 2020. It has had catastrophic consequences on the world economy and well-being of people and has put a tremendous strain on already-scarce healthcare systems globally, particularly in underdeveloped countries. Over 11 billion vaccine doses have already been administered worldwide, and the benefits of these vaccinations will take some time to appear. Today, the only practical approach to diagnosing COVID-19 is through the RT-PCR and RAT tests, which have sometimes been known to give unreliable results. Timely diagnosis and implementation of precautionary measures will likely improve the survival outcome and decrease the fatality rates. In this study, we propose an innovative way to predict COVID-19 with the help of alternative non-clinical methods such as supervised machine learning models to identify the patients at risk based on their characteristic parameters and underlying comorbidities. Medical records of patients from Mexico admitted between 23 January 2020 and 26 March 2022, were chosen for this purpose. Among several supervised machine learning approaches tested, the XGBoost model achieved the best results with an accuracy of 92%. It is an easy, non-invasive, inexpensive, instant and accurate way of forecasting those at risk of contracting the virus. However, it is pretty early to deduce that this method can be used as an alternative in the clinical diagnosis of coronavirus cases.
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Choudhury A. Toward an Ecologically Valid Conceptual Framework for the Use of Artificial Intelligence in Clinical Settings: Need for Systems Thinking, Accountability, Decision-making, Trust, and Patient Safety Considerations in Safeguarding the Technology and Clinicians. JMIR Hum Factors 2022; 9:e35421. [PMID: 35727615 PMCID: PMC9257623 DOI: 10.2196/35421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/26/2022] [Accepted: 05/20/2022] [Indexed: 01/29/2023] Open
Abstract
The health care management and the medical practitioner literature lack a descriptive conceptual framework for understanding the dynamic and complex interactions between clinicians and artificial intelligence (AI) systems. As most of the existing literature has been investigating AI's performance and effectiveness from a statistical (analytical) standpoint, there is a lack of studies ensuring AI's ecological validity. In this study, we derived a framework that focuses explicitly on the interaction between AI and clinicians. The proposed framework builds upon well-established human factors models such as the technology acceptance model and expectancy theory. The framework can be used to perform quantitative and qualitative analyses (mixed methods) to capture how clinician-AI interactions may vary based on human factors such as expectancy, workload, trust, cognitive variables related to absorptive capacity and bounded rationality, and concerns for patient safety. If leveraged, the proposed framework can help to identify factors influencing clinicians' intention to use AI and, consequently, improve AI acceptance and address the lack of AI accountability while safeguarding the patients, clinicians, and AI technology. Overall, this paper discusses the concepts, propositions, and assumptions of the multidisciplinary decision-making literature, constituting a sociocognitive approach that extends the theories of distributed cognition and, thus, will account for the ecological validity of AI.
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Affiliation(s)
- Avishek Choudhury
- Industrial and Management Systems Engineering, Benjamin M Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV, United States
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Zhou Y, Si X, Chao YP, Chen Y, Lin CP, Li S, Zhang X, Sun Y, Ming D, Li Q. Automated Classification of Mild Cognitive Impairment by Machine Learning With Hippocampus-Related White Matter Network. Front Aging Neurosci 2022; 14:866230. [PMID: 35774112 PMCID: PMC9237212 DOI: 10.3389/fnagi.2022.866230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Detection of mild cognitive impairment (MCI) is essential to screen high risk of Alzheimer’s disease (AD). However, subtle changes during MCI make it challenging to classify in machine learning. The previous pathological analysis pointed out that the hippocampus is the critical hub for the white matter (WM) network of MCI. Damage to the white matter pathways around the hippocampus is the main cause of memory decline in MCI. Therefore, it is vital to biologically extract features from the WM network driven by hippocampus-related regions to improve classification performance. Methods Our study proposes a method for feature extraction of the whole-brain WM network. First, 42 MCI and 54 normal control (NC) subjects were recruited using diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI), and T1-weighted (T1w) imaging. Second, mean diffusivity (MD) and fractional anisotropy (FA) were calculated from DTI, and the whole-brain WM networks were obtained. Third, regions of interest (ROIs) with significant functional connectivity to the hippocampus were selected for feature extraction, and the hippocampus (HIP)-related WM networks were obtained. Furthermore, the rank sum test with Bonferroni correction was used to retain significantly different connectivity between MCI and NC, and significant HIP-related WM networks were obtained. Finally, the classification performances of these three WM networks were compared to select the optimal feature and classifier. Results (1) For the features, the whole-brain WM network, HIP-related WM network, and significant HIP-related WM network are significantly improved in turn. Also, the accuracy of MD networks as features is better than FA. (2) For the classification algorithm, the support vector machine (SVM) classifier with radial basis function, taking the significant HIP-related WM network in MD as a feature, has the optimal classification performance (accuracy = 89.4%, AUC = 0.954). (3) For the pathologic mechanism, the hippocampus and thalamus are crucial hubs of the WM network for MCI. Conclusion Feature extraction from the WM network driven by hippocampus-related regions provides an effective method for the early diagnosis of AD.
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Affiliation(s)
- Yu Zhou
- School of Microelectronics, Tianjin University, Tianjin, China
| | - Xiaopeng Si
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
- Institute of Applied Psychology, Tianjin University, Tianjin, China
- *Correspondence: Xiaopeng Si,
| | - Yi-Ping Chao
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Yuanyuan Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Sicheng Li
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Xingjian Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Yulin Sun
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, China
- Dong Ming,
| | - Qiang Li
- School of Microelectronics, Tianjin University, Tianjin, China
- Qiang Li,
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33
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Kucikova L, Danso S, Jia L, Su L. Computational Psychiatry and Computational Neurology: Seeking for Mechanistic Modeling in Cognitive Impairment and Dementia. Front Comput Neurosci 2022; 16:865805. [PMID: 35645752 PMCID: PMC9130488 DOI: 10.3389/fncom.2022.865805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Ludmila Kucikova
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
| | - Samuel Danso
- Edinburgh Dementia Prevention and Centre for Clinical Brain Sciences, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
| | - Lina Jia
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Su
- Department of Neuroscience, Sheffield Institute for Translational Neuroscience, Insigneo Institute for in silico Medicine, University of Sheffield, Sheffield, United Kingdom
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Li Su
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34
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Tabarestani S, Eslami M, Cabrerizo M, Curiel RE, Barreto A, Rishe N, Vaillancourt D, DeKosky ST, Loewenstein DA, Duara R, Adjouadi M. A Tensorized Multitask Deep Learning Network for Progression Prediction of Alzheimer’s Disease. Front Aging Neurosci 2022; 14:810873. [PMID: 35601611 PMCID: PMC9120529 DOI: 10.3389/fnagi.2022.810873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
With the advances in machine learning for the diagnosis of Alzheimer’s disease (AD), most studies have focused on either identifying the subject’s status through classification algorithms or on predicting their cognitive scores through regression methods, neglecting the potential association between these two tasks. Motivated by the need to enhance the prospects for early diagnosis along with the ability to predict future disease states, this study proposes a deep neural network based on modality fusion, kernelization, and tensorization that perform multiclass classification and longitudinal regression simultaneously within a unified multitask framework. This relationship between multiclass classification and longitudinal regression is found to boost the efficacy of the final model in dealing with both tasks. Different multimodality scenarios are investigated, and complementary aspects of the multimodal features are exploited to simultaneously delineate the subject’s label and predict related cognitive scores at future timepoints using baseline data. The main intent in this multitask framework is to consolidate the highest accuracy possible in terms of precision, sensitivity, F1 score, and area under the curve (AUC) in the multiclass classification task while maintaining the highest similarity in the MMSE score as measured through the correlation coefficient and the RMSE for all time points under the prediction task, with both tasks, run simultaneously under the same set of hyperparameters. The overall accuracy for multiclass classification of the proposed KTMnet method is 66.85 ± 3.77. The prediction results show an average RMSE of 2.32 ± 0.52 and a correlation of 0.71 ± 5.98 for predicting MMSE throughout the time points. These results are compared to state-of-the-art techniques reported in the literature. A discovery from the multitasking of this consolidated machine learning framework is that a set of hyperparameters that optimize the prediction results may not necessarily be the same as those that would optimize the multiclass classification. In other words, there is a breakpoint beyond which enhancing further the results of one process could lead to the downgrading in accuracy for the other.
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Affiliation(s)
- Solale Tabarestani
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
- *Correspondence: Solale Tabarestani,
| | - Mohammad Eslami
- Harvard Ophthalmology AI Lab and Harvard Medical School, Schepens Eye Research Institute, Massachusetts Eye and Ear, Boston, MA, United States
| | - Mercedes Cabrerizo
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
| | - Rosie E. Curiel
- Center for Cognitive Neuroscience and Aging, Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, United States
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
| | - Armando Barreto
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
| | - Naphtali Rishe
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
| | - David Vaillancourt
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Steven T. DeKosky
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
- Department of Neurology, University of Florida, Gainesville, FL, United States
| | - David A. Loewenstein
- Center for Cognitive Neuroscience and Aging, Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, United States
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Ranjan Duara
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Malek Adjouadi
- Center for Advanced Technology and Education, Florida International University, Miami, FL, United States
- Florida Alzheimer’s Disease Research Center, University of Florida, Gainesville, FL, United States
- Malek Adjouadi,
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Javaid H, Kumarnsit E, Chatpun S. Age-Related Alterations in EEG Network Connectivity in Healthy Aging. Brain Sci 2022; 12:brainsci12020218. [PMID: 35203981 PMCID: PMC8870284 DOI: 10.3390/brainsci12020218] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 02/01/2023] Open
Abstract
Emerging studies have reported that functional brain networks change with increasing age. Graph theory is applied to understand the age-related differences in brain behavior and function, and functional connectivity between the regions is examined using electroencephalography (EEG). The effect of normal aging on functional networks and inter-regional synchronization during the working memory (WM) state is not well known. In this study, we applied graph theory to investigate the effect of aging on network topology in a resting state and during performing a visual WM task to classify aging EEG signals. We recorded EEGs from 20 healthy middle-aged and 20 healthy elderly subjects with their eyes open, eyes closed, and during a visual WM task. EEG signals were used to construct the functional network; nodes are represented by EEG electrodes; and edges denote the functional connectivity. Graph theory matrices including global efficiency, local efficiency, clustering coefficient, characteristic path length, node strength, node betweenness centrality, and assortativity were calculated to analyze the networks. We applied the three classifiers of K-nearest neighbor (KNN), a support vector machine (SVM), and random forest (RF) to classify both groups. The analyses showed the significantly reduced network topology features in the elderly group. Local efficiency, global efficiency, and clustering coefficient were significantly lower in the elderly group with the eyes-open, eyes-closed, and visual WM task states. KNN achieved its highest accuracy of 98.89% during the visual WM task and depicted better classification performance than other classifiers. Our analysis of functional network connectivity and topological characteristics can be used as an appropriate technique to explore normal age-related changes in the human brain.
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Affiliation(s)
- Hamad Javaid
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
| | - Ekkasit Kumarnsit
- Physiology Program, Division of Health and Applied Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand;
- Biosignal Research Centre for Health, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
| | - Surapong Chatpun
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
- Biosignal Research Centre for Health, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand
- Institute of Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
- Correspondence:
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Zhang Y, Teng Q, Qing L, Liu Y, He X. Lightweight deep residual network for alzheimer’s disease classification using sMRI slices. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-211247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Alzheimer’s disease (AD) is a degenerative brain disease and the most common cause of dementia. In recent years, with the widespread application of artificial intelligence in the medical field, various deep learning-based methods have been applied for AD detection using sMRI images. Many of these networks achieved AD vs HC (Healthy Control) classification accuracy of up to 90%but with a large number of computational parameters and floating point operations (FLOPs). In this paper, we adopt a novel ghost module, which uses a series of cheap operations of linear transformation to generate more feature maps, embedded into our designed ResNet architecture for task of AD vs HC classification. According to experiments on the OASIS dataset, our lightweight network achieves an optimistic accuracy of 97.92%and its total parameters are dozens of times smaller than state-of-the-art deep learning networks. Our proposed AD classification network achieves better performance while the computational cost is reduced significantly.
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Affiliation(s)
- Yanteng Zhang
- College of Electronics and Information Engineering, Sichuan University, Chengdu, Sichuan, P R China
| | - Qizhi Teng
- College of Electronics and Information Engineering, Sichuan University, Chengdu, Sichuan, P R China
| | - Linbo Qing
- College of Electronics and Information Engineering, Sichuan University, Chengdu, Sichuan, P R China
| | - Yan Liu
- Department of Neurology, Chengdu Third People’s Hospital, Chengdu, Sichuan, P R China
| | - Xiaohai He
- College of Electronics and Information Engineering, Sichuan University, Chengdu, Sichuan, P R China
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Cwiek A, Rajtmajer SM, Wyble B, Honavar V, Grossner E, Hillary FG. Feeding the machine: Challenges to reproducible predictive modeling in resting-state connectomics. Netw Neurosci 2022; 6:29-48. [PMID: 35350584 PMCID: PMC8942606 DOI: 10.1162/netn_a_00212] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/08/2021] [Indexed: 11/04/2022] Open
Abstract
In this critical review, we examine the application of predictive models, for example, classifiers, trained using machine learning (ML) to assist in interpretation of functional neuroimaging data. Our primary goal is to summarize how ML is being applied and critically assess common practices. Our review covers 250 studies published using ML and resting-state functional MRI (fMRI) to infer various dimensions of the human functional connectome. Results for holdout ("lockbox") performance was, on average, ∼13% less accurate than performance measured through cross-validation alone, highlighting the importance of lockbox data, which was included in only 16% of the studies. There was also a concerning lack of transparency across the key steps in training and evaluating predictive models. The summary of this literature underscores the importance of the use of a lockbox and highlights several methodological pitfalls that can be addressed by the imaging community. We argue that, ideally, studies are motivated both by the reproducibility and generalizability of findings as well as the potential clinical significance of the insights. We offer recommendations for principled integration of machine learning into the clinical neurosciences with the goal of advancing imaging biomarkers of brain disorders, understanding causative determinants for health risks, and parsing heterogeneous patient outcomes.
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Affiliation(s)
- Andrew Cwiek
- Department of Psychology, Pennsylvania State University, University Park, PA, USA.,Social Life and Engineering Sciences Imaging Center, Pennsylvania State University, University Park, PA, USA
| | - Sarah M Rajtmajer
- College of Information Sciences and Technology, Pennsylvania State University, University Park, PA, USA.,Rock Ethics Institute, Pennsylvania State University, University Park, PA, USA
| | - Bradley Wyble
- Department of Psychology, Pennsylvania State University, University Park, PA, USA
| | - Vasant Honavar
- College of Information Sciences and Technology, Pennsylvania State University, University Park, PA, USA.,Institute for Computational and Data Sciences, Pennsylvania State University, University Park, PA, USA
| | - Emily Grossner
- Department of Psychology, Pennsylvania State University, University Park, PA, USA.,Social Life and Engineering Sciences Imaging Center, Pennsylvania State University, University Park, PA, USA
| | - Frank G Hillary
- Department of Psychology, Pennsylvania State University, University Park, PA, USA.,Social Life and Engineering Sciences Imaging Center, Pennsylvania State University, University Park, PA, USA
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Statsenko Y, Habuza T, Smetanina D, Simiyu GL, Uzianbaeva L, Neidl-Van Gorkom K, Zaki N, Charykova I, Al Koteesh J, Almansoori TM, Belghali M, Ljubisavljevic M. Brain Morphometry and Cognitive Performance in Normal Brain Aging: Age- and Sex-Related Structural and Functional Changes. Front Aging Neurosci 2022; 13:713680. [PMID: 35153713 PMCID: PMC8826453 DOI: 10.3389/fnagi.2021.713680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The human brain structure undergoes considerable changes throughout life. Cognitive function can be affected either negatively or positively. It is challenging to segregate normal brain aging from the accelerated one. OBJECTIVE To work out a descriptive model of brain structural and functional changes in normal aging. MATERIALS AND METHODS By using voxel-based morphometry and lesion segmentation along with linear statistics and machine learning (ML), we analyzed the structural changes in the major brain compartments and modeled the dynamics of neurofunctional performance throughout life. We studied sex differences in lifelong dynamics of brain volumetric data with Mann-Whitney U-test. We tested the hypothesis that performance in some cognitive domains might decline as a linear function of age while other domains might have a non-linear dependence on it. We compared the volumetric changes in the major brain compartments with the dynamics of psychophysiological performance in 4 age groups. Then, we tested linear models of structural and functional decline for significant differences between the slopes in age groups with the T-test. RESULTS White matter hyperintensities (WMH) are not the major structural determinant of the brain normal aging. They should be viewed as signs of a disease. There is a sex difference in the speed and/or in the onset of the gray matter atrophy. It either starts earlier or goes faster in males. Marked sex difference in the proportion of total cerebrospinal fluid (CSF) and intraventricular CSF (iCSF) justifies that elderly men are more prone to age-related brain atrophy than women of the same age. CONCLUSION The article gives an overview and description of the conceptual structural changes in the brain compartments. The obtained data justify distinct patterns of age-related changes in the cognitive functions. Cross-life slowing of decision-making may follow the linear tendency of enlargement of the interhemispheric fissure because the center of task switching and inhibitory control is allocated within the medial wall of the frontal cortex, and its atrophy accounts for the expansion of the fissure. Free online tool at https://med-predict.com illustrates the tests and study results.
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Affiliation(s)
- Yauhen Statsenko
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tetiana Habuza
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Darya Smetanina
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gillian Lylian Simiyu
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Liaisan Uzianbaeva
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States
- Department of Obstetrics and Gynecology, Bronxcare Hospital System, Bronx, NY, United States
| | - Klaus Neidl-Van Gorkom
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nazar Zaki
- Big Data Analytics Center, United Arab Emirates University, Al Ain, United Arab Emirates
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Inna Charykova
- Laboratory of Psychology, Republican Scientific-Practical Center of Sports, Minsk, Belarus
| | - Jamal Al Koteesh
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Radiology, Tawam Hospital, Al Ain, United Arab Emirates
| | - Taleb M. Almansoori
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maroua Belghali
- Department of Health and Physical Education, College of Education, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Milos Ljubisavljevic
- Department of Physiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Swain S, Bhushan B, Dhiman G, Viriyasitavat W. Appositeness of Optimized and Reliable Machine Learning for Healthcare: A Survey. ARCHIVES OF COMPUTATIONAL METHODS IN ENGINEERING : STATE OF THE ART REVIEWS 2022; 29:3981-4003. [PMID: 35342282 PMCID: PMC8939887 DOI: 10.1007/s11831-022-09733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/09/2022] [Indexed: 05/04/2023]
Abstract
Machine Learning (ML) has been categorized as a branch of Artificial Intelligence (AI) under the Computer Science domain wherein programmable machines imitate human learning behavior with the help of statistical methods and data. The Healthcare industry is one of the largest and busiest sectors in the world, functioning with an extensive amount of manual moderation at every stage. Most of the clinical documents concerning patient care are hand-written by experts, selective reports are machine-generated. This process elevates the chances of misdiagnosis thereby, imposing a risk to a patient's life. Recent technological adoptions for automating manual operations have witnessed extensive use of ML in its applications. The paper surveys the applicability of ML approaches in automating medical systems. The paper discusses most of the optimized statistical ML frameworks that encourage better service delivery in clinical aspects. The universal adoption of various Deep Learning (DL) and ML techniques as the underlying systems for a variety of wellness applications, is delineated by challenges and elevated by myriads of security. This work tries to recognize a variety of vulnerabilities occurring in medical procurement, admitting the concerns over its predictive performance from a privacy point of view. Finally providing possible risk delimiting facts and directions for active challenges in the future.
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Affiliation(s)
- Subhasmita Swain
- Department of Computer Science and Engineering, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Bharat Bhushan
- Department of Computer Science and Engineering, School of Engineering and Technology, Sharda University, Greater Noida, India
| | - Gaurav Dhiman
- Department of Computer Science, Government Bikram College of Commerce, Patiala, India
- University Centre for Research and Development, Department of Computer Science and Engineering, Chandigarh University, Gharuan, Mohali, India
- Department of Computer Science and Engineering, Graphic Era Deemed to be University, Dehradun, India
| | - Wattana Viriyasitavat
- Department of Statistics, Faculty of Commerce and Accountancy, Chulalongkorn Business School, Bangkok, Thailand
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Wang X, Ezeana CF, Wang L, Puppala M, Huang Y, He Y, Yu X, Yin Z, Zhao H, Lai EC, Wong STC. Risk factors and machine learning model for predicting hospitalization outcomes in geriatric patients with dementia. ALZHEIMER'S & DEMENTIA: TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2022; 8:e12351. [PMID: 36204350 PMCID: PMC9520763 DOI: 10.1002/trc2.12351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/26/2022]
Abstract
Introduction Geriatric patients with dementia incur higher healthcare costs and longer hospital stays than other geriatric patients. We aimed to identify risk factors for hospitalization outcomes that could be mitigated early to improve outcomes and impact overall quality of life. Methods We identified risk factors, that is, demographics, hospital complications, pre‐admission, and post‐admission risk factors including medical history and comorbidities, affecting hospitalization outcomes determined by hospital stays and discharge dispositions. Over 150 clinical and demographic factors of 15,678 encounters (8407 patients) were retrieved from our institution's data warehouse. We further narrowed them down to twenty factors through feature selection engineering by using analysis of variance (ANOVA) and Glmnet. We developed an explainable machine‐learning model to predict hospitalization outcomes among geriatric patients with dementia. Results Our model is based on stacking ensemble learning and achieved accuracy of 95.6% and area under the curve (AUC) of 0.757. It outperformed prevalent methods of risk assessment for encounters of patients with Alzheimer's disease dementia (ADD) (4993), vascular dementia (VD) (4173), Parkinson's disease with dementia (PDD) (3735), and other unspecified dementias (OUD) (2777). Top identified hospitalization outcome risk factors, mostly from medical history, include encephalopathy, number of medical problems at admission, pressure ulcers, urinary tract infections, falls, admission source, age, race, anemia, etc., with several overlaps in multi‐dementia groups. Discussion Our model identified several predictive factors that can be modified or intervened so that efforts can be made to prevent recurrence or mitigate their adverse effects. Knowledge of the modifiable risk factors would help guide early interventions for patients at high risk for poor hospitalization outcome as defined by hospital stays longer than seven days, undesirable discharge disposition, or both. The interventions include starting specific protocols on modifiable risk factors like encephalopathy, falls, and infections, where non‐existent or not routine, to improve hospitalization outcomes of geriatric patients with dementia. Highlights A total 15,678 encounters of Geriatrics with dementia with a final 20 risk factors. Developed a predictive model for hospitalization outcomes for multi‐dementia types. Risk factors for each type were identified including those amenable to interventions. Top factors are encephalopathy, pressure ulcers, urinary tract infection (UTI), falls, and admission source. With accuracy of 95.6%, our ensemble predictive model outperforms other models.
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Affiliation(s)
- Xin Wang
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Chika F. Ezeana
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Lin Wang
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Mamta Puppala
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | | | - Yunjie He
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Xiaohui Yu
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Zheng Yin
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Hong Zhao
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
| | - Eugene C. Lai
- Neurological Institute Houston Methodist Hospital Houston Texas USA
| | - Stephen T. C. Wong
- T.T. & W.F. Chao Center for BRAIN Houston Methodist Academic Institute Houston Methodist Hospital Houston Texas USA
- Brain and Mind Research Institute Weill Cornell Medical College New York USA
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Meysami S, Raji CA, Mendez MF. Quantified Brain Magnetic Resonance Imaging Volumes Differentiate Behavioral Variant Frontotemporal Dementia from Early-Onset Alzheimer's Disease. J Alzheimers Dis 2022; 87:453-461. [PMID: 35253765 PMCID: PMC9123600 DOI: 10.3233/jad-215667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The differentiation of behavioral variant frontotemporal dementia (bvFTD) from early-onset Alzheimer's disease (EOAD) by clinical criteria can be inaccurate. The volumetric quantification of clinically available magnetic resonance (MR) brain scans may facilitate early diagnosis of these neurodegenerative dementias. OBJECTIVE To determine if volumetric quantification of brain MR imaging can identify persons with bvFTD from EOAD. METHODS 3D T1 MR brain scans of 20 persons with bvFTD and 45 with EOAD were compared using Neuroreader to measure subcortical, and lobar volumes, and Volbrain for hippocampal subfields. Analyses included: 1) discriminant analysis with leave one out cross-validation; 2) input of predicted probabilities from this process into a receiver operator characteristic (ROC) analysis; and 3) Automated linear regression to identify predictive regions. RESULTS Both groups were comparable in age and sex with no statistically significant differences in symptom duration. bvFTD had lower volume percentiles in frontal lobes, thalamus, and putamen. EOAD had lower parietal lobe volumes. ROC analyses showed 99.3% accuracy with Neuroreader percentiles and 80.2% with subfields. The parietal lobe was the most predictive percentile. Although there were differences in hippocampal (particularly left CA2-CA3) subfields, it did not add to the discriminant analysis. CONCLUSION Percentiles from an MR based volumetric quantification can help differentiate between bvFTD from EOAD in routine clinical care. Use of hippocampal subfield volumes does not enhance the diagnostic separation of these two early-onset dementias.
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Affiliation(s)
- Somayeh Meysami
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Cyrus A. Raji
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University, St. Louis, MO, USA
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Mario F. Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- V.A. Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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Detecting Cognitive Impairment Status Using Keystroke Patterns and Physical Activity Data among the Older Adults: A Machine Learning Approach. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1302989. [PMID: 34966518 PMCID: PMC8712156 DOI: 10.1155/2021/1302989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
Cognitive impairment has a significantly negative impact on global healthcare and the community. Holding a person's cognition and mental retention among older adults is improbable with aging. Early detection of cognitive impairment will decline the most significant impact of extended disease to permanent mental damage. This paper aims to develop a machine learning model to detect and differentiate cognitive impairment categories like severe, moderate, mild, and normal by analyzing neurophysical and physical data. Keystroke and smartwatch have been used to extract individuals' neurophysical and physical data, respectively. An advanced ensemble learning algorithm named Gradient Boosting Machine (GBM) is proposed to classify the cognitive severity level (absence, mild, moderate, and severe) based on the Standardised Mini-Mental State Examination (SMMSE) questionnaire scores. The statistical method "Pearson's correlation" and the wrapper feature selection technique have been used to analyze and select the best features. Then, we have conducted our proposed algorithm GBM on those features. And the result has shown an accuracy of more than 94%. This paper has added a new dimension to the state-of-the-art to predict cognitive impairment by implementing neurophysical data and physical data together.
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Massetti N, Russo M, Franciotti R, Nardini D, Mandolini G, Granzotto A, Bomba M, Delli Pizzi S, Mosca A, Scherer R, Onofrj M, Sensi SL. A Machine Learning-Based Holistic Approach to Predict the Clinical Course of Patients within the Alzheimer's Disease Spectrum. J Alzheimers Dis 2021; 85:1639-1655. [PMID: 34958014 DOI: 10.3233/jad-210573] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a neurodegenerative condition driven by multifactorial etiology. Mild cognitive impairment (MCI) is a transitional condition between healthy aging and dementia. No reliable biomarkers are available to predict the conversion from MCI to AD. OBJECTIVE To evaluate the use of machine learning (ML) on a wealth of data offered by the Alzheimer's Disease Neuroimaging Initiative (ADNI) and Alzheimer's Disease Metabolomics Consortium (ADMC) database in the prediction of the MCI to AD conversion. METHODS We implemented an ML-based Random Forest (RF) algorithm to predict conversion from MCI to AD. Data related to the study population (587 MCI subjects) were analyzed by RF as separate or combined features and assessed for classification power. Four classes of variables were considered: neuropsychological test scores, AD-related cerebrospinal fluid (CSF) biomarkers, peripheral biomarkers, and structural magnetic resonance imaging (MRI) variables. RESULTS The ML-based algorithm exhibited 86% accuracy in predicting the AD conversion of MCI subjects. When assessing the features that helped the most, neuropsychological test scores, MRI data, and CSF biomarkers were the most relevant in the MCI to AD prediction. Peripheral parameters were effective when employed in association with neuropsychological test scores. Age and sex differences modulated the prediction accuracy. AD conversion was more effectively predicted in females and younger subjects. CONCLUSION Our findings support the notion that AD-related neurodegenerative processes result from the concerted activity of multiple pathological mechanisms and factors that act inside and outside the brain and are dynamically affected by age and sex.
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Affiliation(s)
- Noemi Massetti
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Mirella Russo
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Raffaella Franciotti
- Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | | | | | - Alberto Granzotto
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy.,Sue and Bill Gross Stem Cell Research Center, University of California - Irvine, Irvine, CA, USA
| | - Manuela Bomba
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Stefano Delli Pizzi
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Alessandra Mosca
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Reinhold Scherer
- Brain-Computer Interfaces and Neural Engineering Laboratory, School of Computer Science and Electronic Engineering, University of Essex, Colchester, United Kingdom
| | - Marco Onofrj
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy
| | - Stefano L Sensi
- Center for Advanced Studies and Technology - CAST, University G. d'Annunzio of Chieti-Pescara, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Italy.,Institute for Mind Impairments and Neurological Disorders - iMIND, University of California - Irvine, Irvine, CA, USA
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Machine learning approaches for parsing comorbidity/heterogeneity in antisociality and substance use disorders: A primer. PERSONALITY NEUROSCIENCE 2021; 4:e6. [PMID: 34909565 PMCID: PMC8640675 DOI: 10.1017/pen.2021.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022]
Abstract
By some accounts, as many as 93% of individuals diagnosed with antisocial personality disorder (ASPD) or psychopathy also meet criteria for some form of substance use disorder (SUD). This high level of comorbidity, combined with an overlapping biopsychosocial profile, and potentially interacting features, has made it difficult to delineate the shared/unique characteristics of each disorder. Moreover, while rarely acknowledged, both SUD and antisociality exist as highly heterogeneous disorders in need of more targeted parcellation. While emerging data-driven nosology for psychiatric disorders (e.g., Research Domain Criteria (RDoC), Hierarchical Taxonomy of Psychopathology (HiTOP)) offers the opportunity for a more systematic delineation of the externalizing spectrum, the interrogation of large, complex neuroimaging-based datasets may require data-driven approaches that are not yet widely employed in psychiatric neuroscience. With this in mind, the proposed article sets out to provide an introduction into machine learning methods for neuroimaging that can help parse comorbid, heterogeneous externalizing samples. The modest machine learning work conducted to date within the externalizing domain demonstrates the potential utility of the approach but remains highly nascent. Within the paper, we make suggestions for how future work can make use of machine learning methods, in combination with emerging psychiatric nosology systems, to further diagnostic and etiological understandings of the externalizing spectrum. Finally, we briefly consider some challenges that will need to be overcome to encourage further progress in the field.
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Das S, Panigrahi P, Chakrabarti S. Corpus Callosum Atrophy in Detection of Mild and Moderate Alzheimer's Disease Using Brain Magnetic Resonance Image Processing and Machine Learning Techniques. J Alzheimers Dis Rep 2021; 5:771-788. [PMID: 34870103 PMCID: PMC8609489 DOI: 10.3233/adr-210314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 01/25/2023] Open
Abstract
Background: The total number of people with dementia is projected to reach 82 million in 2030 and 152 in 2050. Early and accurate identification of the underlying causes of dementia, such as Alzheimer’s disease (AD) is of utmost importance. A large body of research has shown that imaging techniques are most promising technologies to improve subclinical and early diagnosis of dementia. Morphological changes, especially atrophy in various structures like cingulate gyri, caudate nucleus, hippocampus, frontotemporal lobe, etc., have been established as markers for AD. Being the largest white matter structure with a high demand of blood supply from several main arterial systems, anatomical alterations of the corpus callosum (CC) may serve as potential indication neurodegenerative disease. Objective: To detect mild and moderate AD using brain magnetic resonance image (MRI) processing and machine learning techniques. Methods: We have performed automatic detection and segmentation of the CC and calculated its morphological features to feed into a multivariate pattern analysis using support vector machine (SVM) learning techniques. Results: Our results using large patients’ cohort show CC atrophy-based features are capable of distinguishing healthy and mild/moderate AD patients. Our classifiers obtain more than 90%sensitivity and specificity in differentiating demented patients from healthy cohorts and importantly, achieved more than 90%sensitivity and > 80%specificity in detecting mild AD patients. Conclusion: Results from this analysis are encouraging and advocate development of an image analysis software package to detect dementia from brain MRI using morphological alterations of the CC.
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Affiliation(s)
- Subhrangshu Das
- Structural Biology and Bioinformatics Division, Council for Scientific and Industrial Research (CSIR) - Indian Institute of Chemical Biology (IICB), Kolkata, West Bengal, India
| | - Priyanka Panigrahi
- Structural Biology and Bioinformatics Division, Council for Scientific and Industrial Research (CSIR) - Indian Institute of Chemical Biology (IICB), Kolkata, West Bengal, India.,Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Saikat Chakrabarti
- Structural Biology and Bioinformatics Division, Council for Scientific and Industrial Research (CSIR) - Indian Institute of Chemical Biology (IICB), Kolkata, West Bengal, India.,Academy of Scientific and Innovative Research, Ghaziabad, Uttar Pradesh, India
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Intelligent environment for advanced brain imaging: multi-agent system for an automated Alzheimer diagnosis. EVOLUTIONARY INTELLIGENCE 2021. [DOI: 10.1007/s12065-020-00420-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rowe TW, Katzourou IK, Stevenson-Hoare JO, Bracher-Smith MR, Ivanov DK, Escott-Price V. Machine learning for the life-time risk prediction of Alzheimer's disease: a systematic review. Brain Commun 2021; 3:fcab246. [PMID: 34805994 PMCID: PMC8598986 DOI: 10.1093/braincomms/fcab246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/30/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022] Open
Abstract
Alzheimer’s disease is a neurodegenerative disorder and the most common form of dementia. Early diagnosis may assist interventions to delay onset and reduce the progression rate of the disease. We systematically reviewed the use of machine learning algorithms for predicting Alzheimer’s disease using single nucleotide polymorphisms and instances where these were combined with other types of data. We evaluated the ability of machine learning models to distinguish between controls and cases, while also assessing their implementation and potential biases. Articles published between December 2009 and June 2020 were collected using Scopus, PubMed and Google Scholar. These were systematically screened for inclusion leading to a final set of 12 publications. Eighty-five per cent of the included studies used the Alzheimer's Disease Neuroimaging Initiative dataset. In studies which reported area under the curve, discrimination varied (0.49–0.97). However, more than half of the included manuscripts used other forms of measurement, such as accuracy, sensitivity and specificity. Model calibration statistics were also found to be reported inconsistently across all studies. The most frequent limitation in the assessed studies was sample size, with the total number of participants often numbering less than a thousand, whilst the number of predictors usually ran into the many thousands. In addition, key steps in model implementation and validation were often not performed or unreported, making it difficult to assess the capability of machine learning models.
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Affiliation(s)
- Thomas W Rowe
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | | | | | - Matthew R Bracher-Smith
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - Dobril K Ivanov
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Valentina Escott-Price
- UK Dementia Research Institute, Cardiff University, Cardiff, UK.,Division of Psychological Medicine and Clinical Neurosciences, School of Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
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The Feasibility of Differentiating Lewy Body Dementia and Alzheimer's Disease by Deep Learning Using ECD SPECT Images. Diagnostics (Basel) 2021; 11:diagnostics11112091. [PMID: 34829438 PMCID: PMC8624770 DOI: 10.3390/diagnostics11112091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/27/2021] [Accepted: 11/10/2021] [Indexed: 12/22/2022] Open
Abstract
The correct differential diagnosis of dementia has an important impact on patient treatment and follow-up care strategies. Tc-99m-ECD SPECT imaging, which is low cost and accessible in general clinics, is used to identify the two common types of dementia, Alzheimer's disease (AD) and Lewy body dementia (LBD). Two-stage transfer learning technology and reducing model complexity based on the ResNet-50 model were performed using the ImageNet data set and ADNI database. To improve training accuracy, the three-dimensional image was reorganized into three sets of two-dimensional images for data augmentation and ensemble learning, then the performance of various deep learning models for Tc-99m-ECD SPECT images to distinguish AD/normal cognition (NC), LBD/NC, and AD/LBD were investigated. In the AD/NC, LBD/NC, and AD/LBD tasks, the AUC values were around 0.94, 0.95, and 0.74, regardless of training models, with an accuracy of 90%, 87%, and 71%, and F1 scores of 89%, 86%, and 76% in the best cases. The use of transfer learning and a modified model resulted in better prediction results, increasing the accuracy by 32% for AD/NC. The proposed method is practical and could rapidly utilize a deep learning model to automatically extract image features based on a small number of SPECT brain perfusion images in general clinics to objectively distinguish AD and LBD.
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De Luna A, Marcia RF. Data-Limited Deep Learning Methods for Mild Cognitive Impairment Classification in Alzheimer's Disease Patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:2641-2646. [PMID: 34891795 DOI: 10.1109/embc46164.2021.9630598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mild Cognitive Impairment (MCI) is the stage between the declining of normal brain function and the more serious decline of dementia. Alzheimer's disease (AD) is one of the leading forms of dementia. Although MCI does not always lead to AD, an early diagnosis of MCI may be helpful in finding those with early signs of AD. The Alzheimer's Disease Neuroimaging Initiative (ADNI) has utilized magnetic resonance imaging (MRI) for the diagnosis of MCI and AD. MCI can be separated into two types: Early MCI (EMCI) and Late MCI (LMCI). Furthermore, MRI results can be separated into three views of axial, coronal and sagittal planes. In this work, we perform binary classifications between healthy people and the two types of MCI based on limited MRI images using deep learning approaches. Specifically, we implement and compare two various convolutional neural network (CNN) architectures. The MRIs of 516 patients were used in this study: 172 control normal (CN), 172 EMCI patients and 172 LMCI patients. For this data set, 50% of the images were used for training, 20% for validation, and the remaining 30% for testing. The results showed that the best classification for one model was between CN and LMCI for the coronal view with an accuracy of 79.67%. In addition, we achieved 67.85% accuracy for the second proposed model for the same classification group.
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Oliveira E Carmo L, van den Merkhof A, Olczak J, Gordon M, Jutte PC, Jaarsma RL, IJpma FFA, Doornberg JN, Prijs J. An increasing number of convolutional neural networks for fracture recognition and classification in orthopaedics : are these externally validated and ready for clinical application? Bone Jt Open 2021; 2:879-885. [PMID: 34669518 PMCID: PMC8558452 DOI: 10.1302/2633-1462.210.bjo-2021-0133] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aims The number of convolutional neural networks (CNN) available for fracture detection and classification is rapidly increasing. External validation of a CNN on a temporally separate (separated by time) or geographically separate (separated by location) dataset is crucial to assess generalizability of the CNN before application to clinical practice in other institutions. We aimed to answer the following questions: are current CNNs for fracture recognition externally valid?; which methods are applied for external validation (EV)?; and, what are reported performances of the EV sets compared to the internal validation (IV) sets of these CNNs? Methods The PubMed and Embase databases were systematically searched from January 2010 to October 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The type of EV, characteristics of the external dataset, and diagnostic performance characteristics on the IV and EV datasets were collected and compared. Quality assessment was conducted using a seven-item checklist based on a modified Methodologic Index for NOn-Randomized Studies instrument (MINORS). Results Out of 1,349 studies, 36 reported development of a CNN for fracture detection and/or classification. Of these, only four (11%) reported a form of EV. One study used temporal EV, one conducted both temporal and geographical EV, and two used geographical EV. When comparing the CNN’s performance on the IV set versus the EV set, the following were found: AUCs of 0.967 (IV) versus 0.975 (EV), 0.976 (IV) versus 0.985 to 0.992 (EV), 0.93 to 0.96 (IV) versus 0.80 to 0.89 (EV), and F1-scores of 0.856 to 0.863 (IV) versus 0.757 to 0.840 (EV). Conclusion The number of externally validated CNNs in orthopaedic trauma for fracture recognition is still scarce. This greatly limits the potential for transfer of these CNNs from the developing institute to another hospital to achieve similar diagnostic performance. We recommend the use of geographical EV and statements such as the Consolidated Standards of Reporting Trials–Artificial Intelligence (CONSORT-AI), the Standard Protocol Items: Recommendations for Interventional Trials–Artificial Intelligence (SPIRIT-AI) and the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis–Machine Learning (TRIPOD-ML) to critically appraise performance of CNNs and improve methodological rigor, quality of future models, and facilitate eventual implementation in clinical practice. Cite this article: Bone Jt Open 2021;2(10):879–885.
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Affiliation(s)
- Luisa Oliveira E Carmo
- Department of Orthopaedic Surgery, University Medical Centre, University of Groningen, Groningen, Groningen, Netherlands
| | - Anke van den Merkhof
- Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia.,Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Jakub Olczak
- Institute of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Max Gordon
- Institute of Clinical Sciences, Danderyd University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Paul C Jutte
- Department of Orthopaedic Surgery, University Medical Centre, University of Groningen, Groningen, Groningen, Netherlands
| | - Ruurd L Jaarsma
- Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia.,Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | - Frank F A IJpma
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, Groningen, Netherlands
| | - Job N Doornberg
- Department of Orthopaedic Surgery, University Medical Centre, University of Groningen, Groningen, Groningen, Netherlands.,Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia.,Flinders University, Bedford Park, Adelaide, South Australia, Australia.,Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, Groningen, Netherlands
| | - Jasper Prijs
- Department of Orthopaedic Surgery, University Medical Centre, University of Groningen, Groningen, Groningen, Netherlands.,Department of Orthopaedic Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, Australia.,Flinders University, Bedford Park, Adelaide, South Australia, Australia.,Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, Groningen, Netherlands
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- Machine Learning Consortium
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