MRI-based age prediction using hidden Markov models

A review on brain age prediction models

Brain age in neuroimaging has emerged over the last decade and reflects the estimated age based on the brain MRI scan from a person. As a person ages, their brain structure will change, and these changes will be exclusive to males and females and will differ for each. White matter and grey matter density have a deeper relationship with brain aging. Hence, if the white matter and grey matter concentrations vary, the rate at which the brain ages will also vary. Neurodegenerative illnesses can be detected using the biomarker known as brain age. The development of deep learning has made it possible to analyze structural neuroimaging data in new ways, notably by predicting brain ages. We introduce the techniques and possible therapeutic uses of brain age prediction in this cutting-edge review. Creating a machine learning regression model to analyze age-related changes in brain structure among healthy individuals is a typical procedure in studies focused on brain aging. Subsequently, this model is employed to forecast the aging of brains in new individuals. The concept of the "brain-age gap" refers to the difference between an individual's predicted brain age and their actual chronological age. This score may serve as a gauge of the general state of the brain's health while also reflecting neuroanatomical disorders. It may help differential diagnosis, prognosis, and therapy decisions as well as early identification of brain-based illnesses. The following is a summary of the many forecasting techniques utilized over the past 11 years to estimate brain age. The study's conundrums and potential outcomes of the brain age predicted by current models will both be covered.

Dose-dependent relationship between social drinking and brain aging

Low-level alcohol consumption is commonly perceived as being inconsequential or even beneficial for overall health, with some reports suggesting that it may protect against dementia or cardiovascular risks. However, these potential benefits do not preclude the concurrent possibility of negative health outcomes related to alcohol consumption. To examine whether casual, non-heavy drinking is associated with premature brain aging, we utilized the Brain-Age Regression Analysis and Computational Utility Software package to predict brain age in a community sample of adults [n = 240, mean age 35.1 (±10.7) years, 48% male, 49% African American]. Accelerated brain aging was operationalized as the difference between predicted and chronological age ("brain age gap"). Multiple regression analysis revealed a significant association between previous 90-day alcohol consumption and brain age gap (β = 0.014, p = 0.023). We replicated these results in an independent cohort [n = 231 adults, mean age 34.3 (±11.1) years, 55% male, 28% African American: β = 0.014, p = 0.002]. Our results suggest that even low-level alcohol consumption is associated with premature brain aging. The clinical significance of these findings remains to be investigated.

Brain Age Estimation From MRI Using Cascade Networks With Ranking Loss

Chronological age of healthy people is able to be predicted accurately using deep neural networks from neuroimaging data, and the predicted brain age could serve as a biomarker for detecting aging-related diseases. In this paper, a novel 3D convolutional network, called two-stage-age-network (TSAN), is proposed to estimate brain age from T1-weighted MRI data. Compared with existing methods, TSAN has the following improvements. First, TSAN uses a two-stage cascade network architecture, where the first-stage network estimates a rough brain age, then the second-stage network estimates the brain age more accurately from the discretized brain age by the first-stage network. Second, to our knowledge, TSAN is the first work to apply novel ranking losses in brain age estimation, together with the traditional mean square error (MSE) loss. Third, densely connected paths are used to combine feature maps with different scales. The experiments with 6586 MRIs showed that TSAN could provide accurate brain age estimation, yielding mean absolute error (MAE) of 2.428 and Pearson's correlation coefficient (PCC) of 0.985, between the estimated and chronological ages. Furthermore, using the brain age gap between brain age and chronological age as a biomarker, Alzheimer's disease (AD) and Mild Cognitive Impairment (MCI) can be distinguished from healthy control (HC) subjects by support vector machine (SVM). Classification AUC in AD/HC and MCI/HC was 0.904 and 0.823, respectively. It showed that brain age gap is an effective biomarker associated with risk of dementia, and has potential for early-stage dementia risk screening. The codes and trained models have been released on GitHub: https://github.com/Milan-BUAA/TSAN-brain-age-estimation.

In vivo biomarkers of structural and functional brain development and aging in humans

Brain aging is a major determinant of aging. Along with the aging population, prevalence of neurodegenerative diseases is increasing, therewith placing economic and social burden on individuals and society. Individual rates of brain aging are shaped by genetics, epigenetics, and prenatal environmental. Biomarkers of biological brain aging are needed to predict individual trajectories of aging and the risk for age-associated neurological impairments for developing early preventive and interventional measures. We review current advances of in vivo biomarkers predicting individual brain age. Telomere length and epigenetic clock, two important biomarkers that are closely related to the mechanistic aging process, have only poor deterministic and predictive accuracy regarding individual brain aging due to their high intra- and interindividual variability. Phenotype-related biomarkers of global cognitive function and brain structure provide a much closer correlation to age at the individual level. During fetal and perinatal life, autonomic activity is a unique functional marker of brain development. The cognitive and structural biomarkers also boast high diagnostic specificity for determining individual risks for neurodegenerative diseases.

Association vs. Prediction: The Impact of Cortical Surface Smoothing and Parcellation on Brain Age

Association and prediction studies of the brain target the biological consequences of aging and their impact on brain function. Such studies are conducted using different smoothing levels and parcellations at the preprocessing stage, on which their results are dependent. However, the impact of these parameters on the relationship between association values and prediction accuracy is not established. In this study, we used cortical thickness and its relationship with age to investigate how different smoothing and parcellation levels affect the detection of age-related brain correlates as well as brain age prediction accuracy. Our main measures were resel numbers—resolution elements—and age-related variance explained. Using these common measures enabled us to directly compare parcellation and smoothing effects in both association and prediction studies. In our sample of N = 608 participants with age range 18–88, we evaluated age-related cortical thickness changes as well as brain age prediction. We found a negative relationship between prediction performance and correlation values for both parameters. Our results also quantify the relationship between delta age estimates obtained based on different processing parameters. Furthermore, with the direct comparison of the two approaches, we highlight the importance of correct choice of smoothing and parcellation parameters in each task, and how they can affect the results of the analysis in opposite directions.

Brain Age Prediction of Children Using Routine Brain MR Images via Deep Learning

Predicting brain age of children accurately and quantitatively can give help in brain development analysis and brain disease diagnosis. Traditional methods to estimate brain age based on 3D magnetic resonance (MR), T1 weighted imaging (T1WI), and diffusion tensor imaging (DTI) need complex preprocessing and extra scanning time, decreasing clinical practice, especially in children. This research aims at proposing an end-to-end AI system based on deep learning to predict the brain age based on routine brain MR imaging. We spent over 5 years enrolling 220 stacked 2D routine clinical brain MR T1-weighted images of healthy children aged 0 to 5 years old and randomly divided those images into training data including 176 subjects and test data including 44 subjects. Data augmentation technology, which includes scaling, image rotation, translation, and gamma correction, was employed to extend the training data. A 10-layer 3D convolutional neural network (CNN) was designed for predicting the brain age of children and it achieved reliable and accurate results on test data with a mean absolute deviation (MAE) of 67.6 days, a root mean squared error (RMSE) of 96.1 days, a mean relative error (MRE) of 8.2%, a correlation coefficient (R) of 0.985, and a coefficient of determination (R 2) of 0.971. Specially, the performance on predicting the age of children under 2 years old with a MAE of 28.9 days, a RMSE of 37.0 days, a MRE of 7.8%, a R of 0.983, and a R 2 of 0.967 is much better than that over 2 with a MAE of 110.0 days, a RMSE of 133.5 days, a MRE of 8.2%, a R of 0.883, and a R 2 of 0.780.

Estimating brain age based on a uniform healthy population with deep learning and structural magnetic resonance imaging

Numerous studies have established that estimated brain age constitutes a valuable biomarker that is predictive of cognitive decline and various neurological diseases. In this work, we curate a large-scale brain MRI data set of healthy individuals, on which we train a uniform deep learning model for brain age estimation. We demonstrate an age estimation accuracy on a hold-out test set (mean absolute error = 4.06 years, r = 0.970) and an independent life span evaluation data set (mean absolute error = 4.21 years, r = 0.960). We further demonstrate the utility of the estimated age in a life span aging analysis of cognitive functions. In summary, we achieve age estimation performance comparable to previous studies, but with a more heterogenous data set confirming the efficacy of this deep learning framework. We also evaluated training with varying age distributions. The analysis of regional contributions to our brain age predictions through multiple analyses, and confirmation of the association of divergence between the estimated and chronological brain age with neuropsychological measures, may be useful in the development and evaluation of similar imaging biomarkers.

Multimodal Sparse Classifier for Adolescent Brain Age Prediction

The study of healthy brain development helps to better understand both brain transformation and connectivity patterns, which happen during childhood to adulthood. This study presents a sparse machine learning solution across whole-brain functional connectivity measures of three datasets, derived from resting state functional magnetic resonance imaging (rs-fMRI) and two task fMRI data including a working memory n-back task (nb-fMRI) and an emotion identification task (em-fMRI). The fMRI data are collected from the Philadelphia Neurodevelopmental Cohort (PNC) for the prediction of brain age in adolescents. Due to extremely large variable-to-instance ratio of PNC data, a high-dimensional matrix with several irrelevant and highly correlated features is generated, and hence a sparse learning approach is necessary to extract effective features from fMRI data. We propose a sparse learner based on the residual errors along the estimation of an inverse problem for extreme learning machine (ELM). Our proposed method is able to overcome the overlearning problem by pruning several redundant features and their corresponding output weights. The proposed multimodal sparse ELM classifier based on residual errors is highly competitive in terms of classification accuracy compared to its counterparts such as conventional ELM, and sparse Bayesian learning ELM.

Anatomical context improves deep learning on the brain age estimation task

Deep learning has shown remarkable improvements in the analysis of medical images without the need for engineered features. In this work, we hypothesize that deep learning is complementary to traditional feature estimation. We propose a network design to include traditional structural imaging features alongside deep convolutional ones and illustrate this approach on the task of imaging-based age prediction in two separate contexts: T1-weighted brain magnetic resonance imaging (MRI) (N = 5121, ages 4-96, healthy controls) and computed tomography (CT) of the head (N = 1313, ages 1-97, healthy controls). In brain MRI, we can predict age with a mean absolute error of 4.08 years by combining raw images along with engineered structural features, compared to 5.00 years using image-derived features alone and 8.23 years using structural features alone. In head CT, we can predict age with a median absolute error of 9.99 years combining features, compared to 11.02 years with image-derived features alone and 13.28 years with structural features alone. These results show that we can complement traditional feature estimation using deep learning to improve prediction tasks. As the field of medical image processing continues to integrate deep learning, it will be important to use the new techniques to complement traditional imaging features instead of fully displacing them.

Ten Years of BrainAGE as a Neuroimaging Biomarker of Brain Aging: What Insights Have We Gained?

With the aging population, prevalence of neurodegenerative diseases is increasing, thus placing a growing burden on individuals and the whole society. However, individual rates of aging are shaped by a great variety of and the interactions between environmental, genetic, and epigenetic factors. Establishing biomarkers of the neuroanatomical aging processes exemplifies a new trend in neuroscience in order to provide risk-assessments and predictions for age-associated neurodegenerative and neuropsychiatric diseases at a single-subject level. The "Brain Age Gap Estimation (BrainAGE)" method constitutes the first and actually most widely applied concept for predicting and evaluating individual brain age based on structural MRI. This review summarizes all studies published within the last 10 years that have established and utilized the BrainAGE method to evaluate the effects of interaction of genes, environment, life burden, diseases, or life time on individual neuroanatomical aging. In future, BrainAGE and other brain age prediction approaches based on structural or functional markers may improve the assessment of individual risks for neurological, neuropsychiatric and neurodegenerative diseases as well as aid in developing personalized neuroprotective treatments and interventions.

Age Prediction Based on Brain MRI Image: A Survey

Human age prediction is an interesting and applicable issue in different fields. It can be based on various criteria such as face image, DNA methylation, chest plate radiographs, knee radiographs, dental images and etc. Most of the age prediction researches have mainly been based on images. Since the image processing and Machine Learning (ML) techniques have grown up, the investigations were led to use them in age prediction problem. The implementations would be used in different fields, especially in medical applications. Brain Age Estimation (BAE) has attracted more attention in recent years and it would be so helpful in early diagnosis of some neurodegenerative diseases such as Alzheimer, Parkinson, Huntington, etc. BAE is performed on Magnetic Resonance Imaging (MRI) images to compute the brain ages. Studies based on brain MRI shows that there is a relation between accelerated aging and accelerated brain atrophy. This refers to the effects of neurodegenerative diseases on brain structure while making the whole of it older. This paper reviews and summarizes the main approaches for age prediction based on brain MRI images including preprocessing methods, useful tools used in different research works and the estimation algorithms. We categorize the BAE methods based on two factors, first the way of processing MRI images, which includes pixel-based, surface-based, or voxel-based methods and second, the generation of ML algorithms that includes traditional or Deep Learning (DL) methods. The modern techniques as DL methods help MRI based age prediction to get results that are more accurate. In recent years, more precise and statistical ML approaches have been utilized with the help of related tools for simplifying computations and getting accurate results. Pros and cons of each research and the challenges in each work are expressed and some guidelines and deliberations for future research are suggested.

An age estimation method using brain local features for T1-weighted images

Previous statistical analysis studies using large-scale brain magnetic resonance (MR) image databases have examined that brain tissues have age-related morphological changes. This fact indicates that one can estimate the age of a subject from his/her brain MR image by evaluating morphological changes with healthy aging. This paper proposes an age estimation method using local features extracted from T1-weighted MR images. The brain local features are defined by volumes of brain tissues parcellated into local regions defined by the automated anatomical labeling atlas. The proposed method selects optimal local regions to improve the performance of age estimation. We evaluate performance of the proposed method using 1,146 T1-weighted images from a Japanese MR image database. We also discuss the medical implication of selected optimal local regions.

Premature brain aging in humans exposed to maternal nutrient restriction during early gestation

BACKGROUND

Prenatal exposure to undernutrition is widespread in both developing and industrialized countries, causing irreversible damage to the developing brain, resulting in altered brain structure and decreased cognitive function during adulthood. The Dutch famine in 1944/45 was a humanitarian disaster, now enabling studies of the effects of prenatal undernutrition during gestation on brain aging in late adulthood.

METHODS

We hypothesized that study participants prenatally exposed to maternal nutrient restriction (MNR) would demonstrate altered brain structure resembling premature brain aging in late adulthood, expecting the effect being stronger in men. Utilizing the Dutch famine birth cohort (n = 118; mean age: 67.5 ± 0.9 years), this study implements an innovative biomarker for individual brain aging, using structural neuroimaging. BrainAGE was calculated using state-of-the-art pattern recognition methods, trained on an independent healthy reference sample, then applied to the Dutch famine MRI sample, to evaluate the effects of prenatal undernutrition during early gestation on individual brain aging in late adulthood.

RESULTS

Exposure to famine in early gestation was associated with BrainAGE scores indicative of an older-appearing brain in the male sample (mean difference to subjects born before famine: 4.3 years, p < 0.05). Furthermore, in explaining the observed variance in individual BrainAGE scores in the male sample, maternal age at birth, head circumference at birth, medical treatment of hypertension, history of cerebral incidences, actual heart rate, and current alcohol intake emerged to be the most influential variables (adjusted R² = 0.63, p < 0.01).

INTERPRETATION

The findings of our study on exposure to prenatal undernutrition being associated with a status of premature brain aging during late adulthood, as well as individual brain structure being shaped by birth- and late-life health characteristics, are strongly supporting the critical importance of sufficient nutrient supply during pregnancy. Interestingly, the status of premature brain aging in participants exposed to the Dutch famine during early gestation occurred in the absence of fetal growth restriction at birth as well as vascular pathology in late-life. Additionally, the neuroimaging brain aging biomarker presented in this study will further enable tracking effects of environmental influences or (preventive) treatments on individual brain maturation and aging in epidemiological and clinical studies.

Age estimation using effective brain local features from T1-weighted images

This paper proposes a simple method of selecting effective brain local features for age estimation from T1-weighted MR images. We also employ the high-resolution AAL atlas, which is defined by 1,024 local regions, to improve the accuracy of age estimation. We evaluate performance of the proposed method using 1,099 T1-weighted images from a large-scale brain MR image database of healthy Japanese, and demonstrate that the proposed method exhibits efficient performance of age estimation compared with conventional methods.

Predicting healthy older adult's brain age based on structural connectivity networks using artificial neural networks

Brain ageing is followed by changes of the connectivity of white matter (WM) and changes of the grey matter (GM) concentration. Neurodegenerative disease is more vulnerable to an accelerated brain ageing, which is associated with prospective cognitive decline and disease severity. Accurate detection of accelerated ageing based on brain network analysis has a great potential for early interventions designed to hinder atypical brain changes. To capture the brain ageing, we proposed a novel computational approach for modeling the 112 normal older subjects (aged 50-79 years) brain age by connectivity analyses of networks of the brain. Our proposed method applied principal component analysis (PCA) to reduce the redundancy in network topological parameters. Back propagation artificial neural network (BPANN) improved by hybrid genetic algorithm (GA) and Levenberg-Marquardt (LM) algorithm is established to model the relation among principal components (PCs) and brain age. The predicted brain age is strongly correlated with chronological age (r=0.8). The model has mean absolute error (MAE) of 4.29 years. Therefore, we believe the method can provide a possible way to quantitatively describe the typical and atypical network organization of human brain and serve as a biomarker for presymptomatic detection of neurodegenerative diseases in the future.

A Bayesian approach for relaxation times estimation in MRI

Relaxation time estimation in MRI field can be helpful in clinical diagnosis. In particular, T1 and T2 changes can be related to tissues modification, being an effective tool for detecting the presence of several pathologies and measure their development, thus their estimation is a useful research field. Currently, most techniques work pixel-wise, and transfer the noise reduction task to post processing filters. A novel method for estimating spin-spin and spin-lattice relaxation times is proposed. The approach exploits Markov Random Field theory for modeling the unknown data and implements an a posteriori estimator in the Bayesian framework. The effect is the joint parameters estimation and noise reduction. Proposed methodology, with respect to already existing techniques, is able to provide effective results while preserving details also in case of few acquisitions or severe signal to noise ratio. The algorithm has been tested on both simulated and real datasets.

Development of a brain MRI-based hidden Markov model for dementia recognition

BACKGROUND

Dementia is an age-related cognitive decline which is indicated by an early degeneration of cortical and sub-cortical structures. Characterizing those morphological changes can help to understand the disease development and contribute to disease early prediction and prevention. But modeling that can best capture brain structural variability and can be valid in both disease classification and interpretation is extremely challenging. The current study aimed to establish a computational approach for modeling the magnetic resonance imaging (MRI)-based structural complexity of the brain using the framework of hidden Markov models (HMMs) for dementia recognition.

METHODS

Regularity dimension and semi-variogram were used to extract structural features of the brains, and vector quantization method was applied to convert extracted feature vectors to prototype vectors. The output VQ indices were then utilized to estimate parameters for HMMs. To validate its accuracy and robustness, experiments were carried out on individuals who were characterized as non-demented and mild Alzheimer's diseased. Four HMMs were constructed based on the cohort of non-demented young, middle-aged, elder and demented elder subjects separately. Classification was carried out using a data set including both non-demented and demented individuals with a wide age range.

RESULTS

The proposed HMMs have succeeded in recognition of individual who has mild Alzheimer's disease and achieved a better classification accuracy compared to other related works using different classifiers. Results have shown the ability of the proposed modeling for recognition of early dementia.

CONCLUSION

The findings from this research will allow individual classification to support the early diagnosis and prediction of dementia. By using the brain MRI-based HMMs developed in our proposed research, it will be more efficient, robust and can be easily used by clinicians as a computer-aid tool for validating imaging bio-markers for early prediction of dementia.

Predicting cognitive data from medical images using sparse linear regression

We present a new framework for predicting cognitive or other continuous-variable data from medical images. Current methods of probing the connection between medical images and other clinical data typically use voxel-based mass univariate approaches. These approaches do not take into account the multivariate, network-based interactions between the various areas of the brain and do not give readily interpretable metrics that describe how strongly cognitive function is related to neuroanatomical structure. On the other hand, high-dimensional machine learning techniques do not typically provide a direct method for discovering which parts of the brain are used for making predictions. We present a framework, based on recent work in sparse linear regression, that addresses both drawbacks of mass univariate approaches, while preserving the direct spatial interpretability that they provide. In addition, we present a novel optimization algorithm that adapts the conjugate gradient method for sparse regression on medical imaging data. This algorithm produces coefficients that are more interpretable than existing sparse regression techniques.