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Kalyakulina A, Yusipov I, Moskalev A, Franceschi C, Ivanchenko M. eXplainable Artificial Intelligence (XAI) in aging clock models. Ageing Res Rev 2024; 93:102144. [PMID: 38030090 DOI: 10.1016/j.arr.2023.102144] [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] [Received: 09/26/2023] [Revised: 11/07/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
XAI is a rapidly progressing field of machine learning, aiming to unravel the predictions of complex models. XAI is especially required in sensitive applications, e.g. in health care, when diagnosis, recommendations and treatment choices might rely on the decisions made by artificial intelligence systems. AI approaches have become widely used in aging research as well, in particular, in developing biological clock models and identifying biomarkers of aging and age-related diseases. However, the potential of XAI here awaits to be fully appreciated. We discuss the application of XAI for developing the "aging clocks" and present a comprehensive analysis of the literature categorized by the focus on particular physiological systems.
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Affiliation(s)
- Alena Kalyakulina
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Research Center for Trusted Artificial Intelligence, The Ivannikov Institute for System Programming of the Russian Academy of Sciences, Moscow 109004, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia.
| | - Igor Yusipov
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Research Center for Trusted Artificial Intelligence, The Ivannikov Institute for System Programming of the Russian Academy of Sciences, Moscow 109004, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Alexey Moskalev
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Claudio Franceschi
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Mikhail Ivanchenko
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia
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Yoon HS, Oh J, Kim YC. Assessing Machine Learning Models for Predicting Age with Intracranial Vessel Tortuosity and Thickness Information. Brain Sci 2023; 13:1512. [PMID: 38002472 PMCID: PMC10669197 DOI: 10.3390/brainsci13111512] [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: 09/08/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
This study aimed to develop and validate machine learning (ML) models that predict age using intracranial vessels' tortuosity and diameter features derived from magnetic resonance angiography (MRA) data. A total of 171 subjects' three-dimensional (3D) time-of-flight MRA image data were considered for analysis. After annotations of two endpoints in each arterial segment, tortuosity features such as the sum of the angle metrics, triangular index, relative length, and product of the angle distance, as well as the vessels' diameter features, were extracted and used to train and validate the ML models for age prediction. Features extracted from the right and left internal carotid arteries (ICA) and basilar arteries were considered as the inputs to train and validate six ML regression models with a four-fold cross validation. The random forest regression model resulted in the lowest root mean square error of 14.9 years and the highest average coefficient of determination of 0.186. The linear regression model showed the lowest average mean absolute percentage error (MAPE) and the highest average Pearson correlation coefficient (0.532). The mean diameter of the right ICA vessel segment was the most important feature contributing to prediction of age in two out of the four regression models considered. An ML of tortuosity descriptors and diameter features extracted from MRA data showed a modest correlation between real age and ML-predicted age. Further studies are warranted for the assessment of the model's age predictions in patients with intracranial vessel diseases.
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Affiliation(s)
| | | | - Yoon-Chul Kim
- Division of Digital Healthcare, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju 26493, Republic of Korea; (H.-S.Y.); (J.O.)
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Qian J, Li H, Wang J, He L. Recent Advances in Explainable Artificial Intelligence for Magnetic Resonance Imaging. Diagnostics (Basel) 2023; 13:1571. [PMID: 37174962 PMCID: PMC10178221 DOI: 10.3390/diagnostics13091571] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/29/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Advances in artificial intelligence (AI), especially deep learning (DL), have facilitated magnetic resonance imaging (MRI) data analysis, enabling AI-assisted medical image diagnoses and prognoses. However, most of the DL models are considered as "black boxes". There is an unmet need to demystify DL models so domain experts can trust these high-performance DL models. This has resulted in a sub-domain of AI research called explainable artificial intelligence (XAI). In the last decade, many experts have dedicated their efforts to developing novel XAI methods that are competent at visualizing and explaining the logic behind data-driven DL models. However, XAI techniques are still in their infancy for medical MRI image analysis. This study aims to outline the XAI applications that are able to interpret DL models for MRI data analysis. We first introduce several common MRI data modalities. Then, a brief history of DL models is discussed. Next, we highlight XAI frameworks and elaborate on the principles of multiple popular XAI methods. Moreover, studies on XAI applications in MRI image analysis are reviewed across the tissues/organs of the human body. A quantitative analysis is conducted to reveal the insights of MRI researchers on these XAI techniques. Finally, evaluations of XAI methods are discussed. This survey presents recent advances in the XAI domain for explaining the DL models that have been utilized in MRI applications.
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Affiliation(s)
- Jinzhao Qian
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Computer Science, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Hailong Li
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Radiology, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Junqi Wang
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lili He
- Imaging Research Center, Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Computer Science, University of Cincinnati, Cincinnati, OH 45221, USA
- Department of Radiology, College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
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Mouches P, Wilms M, Aulakh A, Langner S, Forkert ND. Multimodal brain age prediction fusing morphometric and imaging data and association with cardiovascular risk factors. Front Neurol 2022; 13:979774. [PMID: 36588902 PMCID: PMC9794870 DOI: 10.3389/fneur.2022.979774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction The difference between the chronological and biological brain age, called the brain age gap (BAG), has been identified as a promising biomarker to detect deviation from normal brain aging and to indicate the presence of neurodegenerative diseases. Moreover, the BAG has been shown to encode biological information about general health, which can be measured through cardiovascular risk factors. Current approaches for biological brain age estimation, and therefore BAG estimation, either depend on hand-crafted, morphological measurements extracted from brain magnetic resonance imaging (MRI) or on direct analysis of brain MRI images. The former can be processed with traditional machine learning models while the latter is commonly processed with convolutional neural networks (CNNs). Using a multimodal setting, this study aims to compare both approaches in terms of biological brain age prediction accuracy and biological information captured in the BAG. Methods T1-weighted MRI, containing brain tissue information, and magnetic resonance angiography (MRA), providing information about brain arteries, from 1,658 predominantly healthy adults were used. The volumes, surface areas, and cortical thickness of brain structures were extracted from the T1-weighted MRI data, while artery density and thickness within the major blood flow territories and thickness of the major arteries were extracted from MRA data. Independent multilayer perceptron and CNN models were trained to estimate the brain age from the hand-crafted features and image data, respectively. Next, both approaches were fused to assess the benefits of combining image data and hand-crafted features for brain age prediction. Results The combined model achieved a mean absolute error of 4 years between the chronological and predicted biological brain age. Among the independent models, the lowest mean absolute error was observed for the CNN using T1-weighted MRI data (4.2 years). When evaluating the BAGs obtained using the different approaches and imaging modalities, diverging associations between cardiovascular risk factors were found. For example, BAGs obtained from the CNN models showed an association with systolic blood pressure, while BAGs obtained from hand-crafted measurements showed greater associations with obesity markers. Discussion In conclusion, the use of more diverse sources of data can improve brain age estimation modeling and capture more diverse biological deviations from normal aging.
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Affiliation(s)
- Pauline Mouches
- Biomedical Engineering Program, University of Calgary, Calgary, AB, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,*Correspondence: Pauline Mouches
| | - Matthias Wilms
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Agampreet Aulakh
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Nils D. Forkert
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
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Souza R, Mouches P, Wilms M, Tuladhar A, Langner S, Forkert ND. An analysis of the effects of limited training data in distributed learning scenarios for brain age prediction. J Am Med Inform Assoc 2022; 30:112-119. [PMID: 36287916 PMCID: PMC9748540 DOI: 10.1093/jamia/ocac204] [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: 07/30/2022] [Revised: 10/08/2022] [Accepted: 10/12/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Distributed learning avoids problems associated with central data collection by training models locally at each site. This can be achieved by federated learning (FL) aggregating multiple models that were trained in parallel or training a single model visiting sites sequentially, the traveling model (TM). While both approaches have been applied to medical imaging tasks, their performance in limited local data scenarios remains unknown. In this study, we specifically analyze FL and TM performances when very small sample sizes are available per site. MATERIALS AND METHODS 2025 T1-weighted magnetic resonance imaging scans were used to investigate the effect of sample sizes on FL and TM for brain age prediction. We evaluated models across 18 scenarios varying the number of samples per site (1, 2, 5, 10, and 20) and the number of training rounds (20, 40, and 200). RESULTS Our results demonstrate that the TM outperforms FL, for every sample size examined. In the extreme case when each site provided only one sample, FL achieved a mean absolute error (MAE) of 18.9 ± 0.13 years, while the TM achieved a MAE of 6.21 ± 0.50 years, comparable to central learning (MAE = 5.99 years). DISCUSSION Although FL is more commonly used, our study demonstrates that TM is the best implementation for small sample sizes. CONCLUSION The TM offers new opportunities to apply machine learning models in rare diseases and pediatric research but also allows even small hospitals to contribute small datasets.
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Affiliation(s)
- Raissa Souza
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada
| | - Pauline Mouches
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada
| | - Matthias Wilms
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Anup Tuladhar
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Nils D Forkert
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Besson P, Rogalski E, Gill NP, Zhang H, Martersteck A, Bandt SK. Geometric deep learning reveals a structuro-temporal understanding of healthy and pathologic brain aging. Front Aging Neurosci 2022; 14:895535. [PMID: 36081894 PMCID: PMC9445244 DOI: 10.3389/fnagi.2022.895535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Brain age has historically been investigated primarily at the whole brain level. The ability to deconstruct the brain into its composite parts and explore brain age at the sub-structure level offers unique advantages. These include the exploration of dynamic and interconnected relationships between different brain structures in healthy and pathologic aging. To achieve this, individual brain structures can be rendered as surface representations on which morphologic analysis is carried out. Combining the advantages of deep learning with the strengths of surface analysis, we investigate the aging process at the individual structure level with the hypothesis being that pathologic aging does not uniformly affect the aging process of individual structures. Methods MRI data, age at scan time and diagnosis of dementia were collected from seven publicly available data repositories. The data from 17,440 unique subjects were collected, representing a total of 26,276 T1-weighted MRI accounting for longitudinal acquisitions. Surfaces were extracted for the cortex and seven subcortical structures. Deep learning networks were trained to estimate a subject's age either using several structures together or a single structure. We conducted a cross-sectional analysis to assess the difference between the predicted and actual ages for all structures between healthy subjects, individuals with mild cognitive impairment (MCI) or Alzheimer's disease dementia (ADD). We then performed a longitudinal analysis to assess the difference in the aging pace for each structure between stable healthy controls and healthy controls converting to either MCI or ADD. Findings Using an independent cohort of healthy subjects, age was well estimated for all structures. Cross-sectional analysis identified significantly larger predicted age for all structures in patients with either MCI and ADD compared to healthy subjects. Longitudinal analysis revealed varying degrees of involvement of individual subcortical structures for both age difference across groups and aging pace across time. These findings were most notable in the whole brain, cortex, hippocampus and amygdala. Conclusion Although similar patterns of abnormal aging were found related to MCI and ADD, the involvement of individual subcortical structures varied greatly and was consistently more pronounced in ADD patients compared to MCI patients.
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Affiliation(s)
- Pierre Besson
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,Advanced Neuroimaging and Surgical Epilepsy (ANISE) Lab, Northwestern University, Chicago, IL, United States
| | - Emily Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Nathan P. Gill
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Hui Zhang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Adam Martersteck
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - S. Kathleen Bandt
- Advanced Neuroimaging and Surgical Epilepsy (ANISE) Lab, Northwestern University, Chicago, IL, United States,Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States,*Correspondence: S. Kathleen Bandt,
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Mouches P, Wilms M, Rajashekar D, Langner S, Forkert ND. Multimodal biological brain age prediction using magnetic resonance imaging and angiography with the identification of predictive regions. Hum Brain Mapp 2022; 43:2554-2566. [PMID: 35138012 PMCID: PMC9057090 DOI: 10.1002/hbm.25805] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Biological brain age predicted using machine learning models based on high-resolution imaging data has been suggested as a potential biomarker for neurological and cerebrovascular diseases. In this work, we aimed to develop deep learning models to predict the biological brain age using structural magnetic resonance imaging and angiography datasets from a large database of 2074 adults (21-81 years). Since different imaging modalities can provide complementary information, combining them might allow to identify more complex aging patterns, with angiography data, for instance, showing vascular aging effects complementary to the atrophic brain tissue changes seen in T1-weighted MRI sequences. We used saliency maps to investigate the contribution of cortical, subcortical, and arterial structures to the prediction. Our results show that combining T1-weighted and angiography MR data led to a significantly improved brain age prediction accuracy, with a mean absolute error of 3.85 years comparing the predicted and chronological age. The most predictive brain regions included the lateral sulcus, the fourth ventricle, and the amygdala, while the brain arteries contributing the most to the prediction included the basilar artery, the middle cerebral artery M2 segments, and the left posterior cerebral artery. Our study proposes a framework for brain age prediction using multimodal imaging, which gives accurate predictions and allows identifying the most predictive regions for this task, which can serve as a surrogate for the brain regions that are most affected by aging.
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Affiliation(s)
- Pauline Mouches
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Biomedical Engineering Program, University of Calgary, Calgary, Alberta, Canada
| | - Matthias Wilms
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Deepthi Rajashekar
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Biomedical Engineering Program, University of Calgary, Calgary, Alberta, Canada
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Nils D Forkert
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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Bocancea DI, van Loenhoud AC, Groot C, Barkhof F, van der Flier WM, Ossenkoppele R. Measuring Resilience and Resistance in Aging and Alzheimer Disease Using Residual Methods: A Systematic Review and Meta-analysis. Neurology 2021; 97:474-488. [PMID: 34266918 PMCID: PMC8448552 DOI: 10.1212/wnl.0000000000012499] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/14/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There is a lack of consensus on how to optimally define and measure resistance and resilience in brain and cognitive aging. Residual methods use residuals from regression analysis to quantify the capacity to avoid (resistance) or cope (resilience) "better or worse than expected" given a certain level of risk or cerebral damage. We reviewed the rapidly growing literature on residual methods in the context of aging and Alzheimer disease (AD) and performed meta-analyses to investigate associations of residual method-based resilience and resistance measures with longitudinal cognitive and clinical outcomes. METHODS A systematic literature search of PubMed and Web of Science databases (consulted until March 2020) and subsequent screening led to 54 studies fulfilling eligibility criteria, including 10 studies suitable for the meta-analyses. RESULTS We identified articles using residual methods aimed at quantifying resistance (n = 33), cognitive resilience (n = 23), and brain resilience (n = 2). Critical examination of the literature revealed that there is considerable methodologic variability in how the residual measures were derived and validated. Despite methodologic differences across studies, meta-analytic assessments showed significant associations of levels of resistance (hazard ratio [HR] [95% confidence interval (CI)] 1.12 [1.07-1.17]; p < 0.0001) and levels of resilience (HR [95% CI] 0.46 [0.32-0.68]; p < 0.001) with risk of progression to dementia/AD. Resilience was also associated with rate of cognitive decline (β [95% CI] 0.05 [0.01-0.08]; p < 0.01). DISCUSSION This review and meta-analysis supports the usefulness of residual methods as appropriate measures of resilience and resistance, as they capture clinically meaningful information in aging and AD. More rigorous methodologic standardization is needed to increase comparability across studies and, ultimately, application in clinical practice.
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Affiliation(s)
- Diana I Bocancea
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Anna C van Loenhoud
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Colin Groot
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Frederik Barkhof
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Wiesje M van der Flier
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
| | - Rik Ossenkoppele
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience (D.I.B., A.C.v.L., C.G., W.M.v.d.F., R.O.), and Department of Radiology and Nuclear Medicine (F.B.), Vrije Universiteit Amsterdam, Amsterdam UMC, the Netherlands; Institutes of Neurology and Healthcare Engineering (F.B.), University College London, UK; Department of Epidemiology and Biostatistics (W.M.v.d.F.), VU University Medical Center, Amsterdam, the Netherlands; and Clinical Memory Research Unit (R.O.), Lund University, Sweden
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