A Transformer-based Multi-features Fusion Model for Prediction of Conversion in Mild Cognitive Impairment

MACFNet: Detection of Alzheimer's disease via multiscale attention and cross-enhancement fusion network

BACKGROUND AND OBJECTIVE

Alzheimer's disease (AD) is a dreaded degenerative disease that results in a profound decline in human cognition and memory. Due to its intricate pathogenesis and the lack of effective therapeutic interventions, early diagnosis plays a paramount role in AD. Recent research based on neuroimaging has shown that the application of deep learning methods by multimodal neural images can effectively detect AD. However, these methods only concatenate and fuse the high-level features extracted from different modalities, ignoring the fusion and interaction of low-level features across modalities. It consequently leads to unsatisfactory classification performance.

METHOD

In this paper, we propose a novel multi-scale attention and cross-enhanced fusion network, MACFNet, which enables the interaction of multi-stage low-level features between inputs to learn shared feature representations. We first construct a novel Cross-Enhanced Fusion Module (CEFM), which fuses low-level features from different modalities through a multi-stage cross-structure. In addition, an Efficient Spatial Channel Attention (ECSA) module is proposed, which is able to focus on important AD-related features in images more efficiently and achieve feature enhancement from different modalities through two-stage residual concatenation. Finally, we also propose a multiscale attention guiding block (MSAG) based on dilated convolution, which can obtain rich receptive fields without increasing model parameters and computation, and effectively improve the efficiency of multiscale feature extraction.

RESULTS

Experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset demonstrate that our MACFNet has better classification performance than existing multimodal methods, with classification accuracies of 99.59 %, 98.85 %, 99.61 %, and 98.23 % for AD vs. CN, AD vs. MCI, CN vs. MCI and AD vs. CN vs. MCI, respectively, and specificity of 98.92 %, 97.07 %, 99.58 % and 99.04 %, and sensitivity of 99.91 %, 99.89 %, 99.63 % and 97.75 %, respectively.

CONCLUSIONS

The proposed MACFNet is a high-accuracy multimodal AD diagnostic framework. Through the cross mechanism and efficient attention, MACFNet can make full use of the low-level features of different modal medical images and effectively pay attention to the local and global information of the images. This work provides a valuable reference for multi-mode AD diagnosis.

Hybrid representation learning for cognitive diagnosis in late-life depression over 5 years with structural MRI

Late-life depression (LLD) is a highly prevalent mood disorder occurring in older adults and is frequently accompanied by cognitive impairment (CI). Studies have shown that LLD may increase the risk of Alzheimer's disease (AD). However, the heterogeneity of presentation of geriatric depression suggests that multiple biological mechanisms may underlie it. Current biological research on LLD progression incorporates machine learning that combines neuroimaging data with clinical observations. There are few studies on incident cognitive diagnostic outcomes in LLD based on structural MRI (sMRI). In this paper, we describe the development of a hybrid representation learning (HRL) framework for predicting cognitive diagnosis over 5 years based on T1-weighted sMRI data. Specifically, we first extract prediction-oriented MRI features via a deep neural network, and then integrate them with handcrafted MRI features via a Transformer encoder for cognitive diagnosis prediction. Two tasks are investigated in this work, including (1) identifying cognitively normal subjects with LLD and never-depressed older healthy subjects, and (2) identifying LLD subjects who developed CI (or even AD) and those who stayed cognitively normal over five years. We validate the proposed HRL on 294 subjects with T1-weighted MRIs from two clinically harmonized studies. Experimental results suggest that the HRL outperforms several classical machine learning and state-of-the-art deep learning methods in LLD identification and prediction tasks.