MCADNNet: Recognizing Stages of Cognitive Impairment through Efficient Convolutional fMRI and MRI Neural Network Topology Models

The application value of Rs-fMRI-based machine learning models for differentiating mild cognitive impairment from Alzheimer's disease: a systematic review and meta-analysis

BACKGROUND

Various machine learning (ML) models based on resting-state functional MRI (Rs-fMRI) have been developed to facilitate differential diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, the diagnostic accuracy of such models remains understudied. Therefore, we conducted this systematic review and meta-analysis to explore the diagnostic accuracy of Rs-fMRI-based radiomics in differentiating MCI from AD.

METHODS

PubMed, Embase, Cochrane, and Web of Science were searched from inception up to February 8, 2024, to identify relevant studies. Meta-analysis was conducted using a bivariate mixed-effects model, and sub-group analyses were carried out by the types of ML tasks (binary classification and multi-class classification tasks).

FINDINGS

In total, 23 studies, comprising 5,554 participants were enrolled in the study. In the binary classification tasks (twenty studies), the diagnostic accuracy of the ML model for AD was 0.99 (95%CI: 0.34 ~ 1.00), with a sensitivity of 0.94 (95%CI: 0.89 ~ 0.97) and a specificity of 0.98 (95%CI: 0.95 ~ 1.00). In the multi-class classification tasks (six studies), the diagnostic accuracy of the ML model was 0.98 (95%CI: 0.98 ~ 0.99) for NC, 0.96 (95%CI: 0.96 ~ 0.96) for early mild cognitive impairment (EMCI), 0.97 (95%CI: 0.96 ~ 0.97) for late mild cognitive impairment (LMCI), and 0.95 (95%CI: 0.95 ~ 0.95) for AD.

CONCLUSIONS

The Rs-fMRI-based ML model can be adapted to multi-class classification tasks. Therefore, multi-center studies with large samples are needed to develop intelligent application tools to promote the development of intelligent ML models for disease diagnosis.

Toward an intelligent computing system for the early diagnosis of Alzheimer's disease based on the modular hybrid growing neural gas

Objective

The proportion of older people will soon include nearly a quarter of the world population. This leads to an increased prevalence of non-communicable diseases such as Alzheimer's disease (AD), a progressive neurodegenerative disorder and the most common dementia. mild cognitive impairment (MCI) can be considered its prodromal stage. The early diagnosis of AD is a huge issue. We face it by solving these classification tasks: MCI-AD and cognitively normal (CN)-MCI-AD.

Methods

An intelligent computing system has been developed and implemented to face both challenges. A non-neural preprocessing module was followed by a processing one based on a hybrid and ontogenetic neural architecture, the modular hybrid growing neural gas (MyGNG). The MyGNG is hierarchically organized, with a growing neural gas (GNG) for clustering followed by a perceptron for labeling. For each task, 495 and 819 patients from the Alzheimer's disease neuroimaging initiative (ADNI) database were used, respectively, each with 211 characteristics.

Results

Encouraging results have been obtained in the MCI-AD classification task, reaching values of area under the curve (AUC) of 0.96 and sensitivity of 0.91, whereas 0.86 and 0.9 in CN-MCI-AD. Furthermore, a comparative study with popular machine learning (ML) models was also performed for each of these tasks.

Conclusions

The MyGNG proved to be a better computational solution than the other ML methods analyzed. Also, it had a similar performance to other deep learning schemes with neuroimaging. Our findings suggest that our proposal may be an interesting computing solution for the early diagnosis of AD.

Prevalence of Dementia and Cognitive Impairment in East Africa Region: A Scoping Review of Population-Based Studies and Call for Further Research

Background

Population-based research on the prevalence and determinants of dementia, Alzheimer's disease, and cognitive impairment is scarce in East Africa.

Objective

To provide an overview of community- and population-based studies among older adults on the prevalence of dementia and cognitive impairment in East Africa, and identify research gaps.

Methods

We carried out a literature search using three electronic databases (PubMed, Scopus, Google Scholar) using pertinent search terms.

Results

After screening 445 publications, we identified four publications on the population-based prevalence of dementia, and three on cognitive impairment. Prevalence rates varied from 6- 23% for dementia, and 7- 44% for cognitive impairment, among participants aged≥50-70 years. Old age and a lower education level were risk factors for dementia and cognitive impairment. Physical inactivity, lack of a ventilated kitchen, and history of central nervous system infections and chronic headache were associated with increased odds of dementia. Female sex, depression, having no spouse, increased lifetime alcohol consumption, low income, rural residence, and low family support were associated with increased odds of cognitive impairment. Potential misclassification and non-standardized data collection methods are research gaps that should be addressed in future studies.

Conclusions

Establishing collaborative networks and partnering with international research institutions may enhance the capacity for conducting population-based studies on dementia and cognitive impairment in East Africa. Longitudinal studies may provide valuable insights on incidence, as well as potential risk and protective factors of dementia and cognitive impairment, and may inform the development of targeted interventions including preventive strategies in the region.

A Deep Learning-Based Ensemble Method for Early Diagnosis of Alzheimer's Disease using MRI Images

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.

Predictive modelling of brain disorders with magnetic resonance imaging: A systematic review of modelling practices, transparency, and interpretability in the use of convolutional neural networks

Brain disorders comprise several psychiatric and neurological disorders which can be characterized by impaired cognition, mood alteration, psychosis, depressive episodes, and neurodegeneration. Clinical diagnoses primarily rely on a combination of life history information and questionnaires, with a distinct lack of discriminative biomarkers in use for psychiatric disorders. Symptoms across brain conditions are associated with functional alterations of cognitive and emotional processes, which can correlate with anatomical variation; structural magnetic resonance imaging (MRI) data of the brain are therefore an important focus of research, particularly for predictive modelling. With the advent of large MRI data consortia (such as the Alzheimer's Disease Neuroimaging Initiative) facilitating a greater number of MRI-based classification studies, convolutional neural networks (CNNs)-deep learning models well suited to image processing tasks-have become increasingly popular for research into brain conditions. This has resulted in a myriad of studies reporting impressive predictive performances, demonstrating the potential clinical value of deep learning systems. However, methodologies can vary widely across studies, making them difficult to compare and/or reproduce, potentially limiting their clinical application. Here, we conduct a qualitative systematic literature review of 55 studies carrying out CNN-based predictive modelling of brain disorders using MRI data and evaluate them based on three principles-modelling practices, transparency, and interpretability. We propose several recommendations to enhance the potential for the integration of CNNs into clinical care.

PVTAD: ALZHEIMER'S DISEASE DIAGNOSIS USING PYRAMID VISION TRANSFORMER APPLIED TO WHITE MATTER OF T1-WEIGHTED STRUCTURAL MRI DATA

Alzheimer's disease (AD) is a neurodegenerative disorder, and timely diagnosis is crucial for early interventions. AD is known to have disruptive local and global brain neural connections that may be instrumental in understanding and extracting specific biomarkers. Previous machine-learning approaches are mostly based on convolutional neural network (CNN) and standard vision transformer (ViT) models which may not sufficiently capture the multidimensional local and global patterns that may be indicative of AD. Therefore, in this paper, we propose a novel approach called PVTAD to classify AD and cognitively normal (CN) cases using pretrained pyramid vision transformer (PVT) and white matter (WM) of T1-weighted structural MRI (sMRI) data. Our approach combines the advantages of CNN and standard ViT to extract both local and global features indicative of AD from the WM coronal middle slices. We performed experiments on subjects with T1-weighed MPRAGE sMRI scans from the ADNI dataset. Our results demonstrate that the PVTAD achieves an average accuracy of 97.7% and F1-score of 97.6%, outperforming the single and parallel CNN and standard ViT architectures based on sMRI data for AD vs. CN classification.

fMRI-Based Alzheimer's Disease Detection Using the SAS Method with Multi-Layer Perceptron Network

In the present scenario, Alzheimer's Disease (AD) is one of the incurable neuro-degenerative disorders, which accounts for nearly 60% to 70% of dementia cases. Currently, several machine-learning approaches and neuroimaging modalities are utilized for diagnosing AD. Among the available neuroimaging modalities, functional Magnetic Resonance Imaging (fMRI) is extensively utilized for studying brain activities related to AD. However, analyzing complex brain structures in fMRI is a time-consuming and complex task; so, a novel automated model was proposed in this manuscript for early diagnosis of AD using fMRI images. Initially, the fMRI images are acquired from an online dataset: Alzheimer's Disease Neuroimaging Initiative (ADNI). Further, the quality of the acquired fMRI images was improved by implementing a normalization technique. Then, the Segmentation by Aggregating Superpixels (SAS) method was implemented for segmenting the brain regions (AD, Normal Controls (NC), Mild Cognitive Impairment (MCI), Early Mild Cognitive Impairment (EMCI), Late Mild Cognitive Impairment (LMCI), and Significant Memory Concern (SMC)) from the denoised fMRI images. From the segmented brain regions, feature vectors were extracted by employing Gabor and Gray Level Co-Occurrence Matrix (GLCM) techniques. The obtained feature vectors were dimensionally reduced by implementing Honey Badger Optimization Algorithm (HBOA) and fed to the Multi-Layer Perceptron (MLP) model for classifying the fMRI images as AD, NC, MCI, EMCI, LMCI, and SMC. The extensive investigation indicated that the presented model attained 99.44% of classification accuracy, 88.90% of Dice Similarity Coefficient (DSC), 90.82% of Jaccard Coefficient (JC), and 88.43% of Hausdorff Distance (HD). The attained results are better compared with the conventional segmentation and classification models.

Automatic Detection of Alzheimer's Disease using Deep Learning Models and Neuro-Imaging: Current Trends and Future Perspectives

Deep learning algorithms have a huge influence on tackling research issues in the field of medical image processing. It acts as a vital aid for the radiologists in producing accurate results toward effective disease diagnosis. The objective of this research is to highlight the importance of deep learning models in the detection of Alzheimer's Disease (AD). The main objective of this research is to analyze different deep learning methods used for detecting AD. This study examines 103 research articles published in various research databases. These articles have been selected based on specific criteria to find the most relevant findings in the field of AD detection. The review was carried out based on deep learning techniques such as Convolutional Neural Networks (CNNs), Recurrent Neural Networks (RNNs), and Transfer Learning (TL). To propose accurate methods for the detection, segmentation, and severity grading of AD, the radiological features need to be examined in greater depth. This review attempts to analyze different deep learning methods applied for AD detection using neuroimaging modalities like Positron Emission Tomography (PET), Magnetic Resonance Imaging (MRI), etc. The focus of this review is restricted to deep learning works based on radiological imaging data for AD detection. There are a few works that have utilized other biomarkers to understand the effect of AD. Also, articles published in English were alone considered for analysis. This work concludes by highlighting the key research issues towards effective AD detection. Though several methods have yielded promising results in AD detection, the progression from Mild Cognitive Impairment (MCI) to AD need to be analyzed in greater depth using DL models.

OViTAD: Optimized Vision Transformer to Predict Various Stages of Alzheimer's Disease Using Resting-State fMRI and Structural MRI Data

Advances in applied machine learning techniques for neuroimaging have encouraged scientists to implement models to diagnose brain disorders such as Alzheimer's disease at early stages. Predicting the exact stage of Alzheimer's disease is challenging; however, complex deep learning techniques can precisely manage this. While successful, these complex architectures are difficult to interrogate and computationally expensive. Therefore, using novel, simpler architectures with more efficient pattern extraction capabilities, such as transformers, is of interest to neuroscientists. This study introduced an optimized vision transformer architecture to predict the group membership by separating healthy adults, mild cognitive impairment, and Alzheimer's brains within the same age group (>75 years) using resting-state functional (rs-fMRI) and structural magnetic resonance imaging (sMRI) data aggressively preprocessed by our pipeline. Our optimized architecture, known as OViTAD is currently the sole vision transformer-based end-to-end pipeline and outperformed the existing transformer models and most state-of-the-art solutions. Our model achieved F1-scores of 97%±0.0 and 99.55%±0.39 from the testing sets for the rs-fMRI and sMRI modalities in the triple-class prediction experiments. Furthermore, our model reached these performances using 30% fewer parameters than a vanilla transformer. Furthermore, the model was robust and repeatable, producing similar estimates across three runs with random data splits (we reported the averaged evaluation metrics). Finally, to challenge the model, we observed how it handled increasing noise levels by inserting varying numbers of healthy brains into the two dementia groups. Our findings suggest that optimized vision transformers are a promising and exciting new approach for neuroimaging applications, especially for Alzheimer's disease prediction.

Functional magnetic resonance imaging, deep learning, and Alzheimer's disease: A systematic review

Alzheimer's disease (AD) is currently diagnosed using a mixture of psychological tests and clinical observations. However, these diagnoses are not perfect, and additional diagnostic tools (e.g., MRI) can help improve our understanding of AD as well as our ability to detect the disease. Accordingly, a large amount of research has been invested into innovative diagnostic methods for AD. Functional MRI (fMRI) is a form of neuroimaging technology that has been used to diagnose AD; however, fMRI is incredibly noisy, complex, and thus lacks clinical use. Nonetheless, recent innovations in deep learning technology could enable the simplified and streamlined analysis of fMRI. Deep learning is a form of artificial intelligence that uses computer algorithms based on human neural networks to solve complex problems. For example, in fMRI research, deep learning models can automatically denoise images and classify AD by detecting patterns in participants' brain scans. In this systematic review, we investigate how fMRI (specifically resting-state fMRI) and deep learning methods are used to diagnose AD. In turn, we outline the common deep neural network, preprocessing, and classification methods used in the literature. We also discuss the accuracy, strengths, limitations, and future direction of fMRI deep learning methods. In turn, we aim to summarize the current field for new researchers, suggest specific areas for future research, and highlight the potential of fMRI to aid AD diagnoses.

Mapping and understanding of correlated electroencephalogram (EEG) responses to the newsvendor problem

Decision-making is one of the most critical activities of human beings. To better understand the underlying neurocognitive mechanism while making decisions under an economic context, we designed a decision-making paradigm based on the newsvendor problem (NP) with two scenarios: low-profit margins as the more challenging scenario and high-profit margins as the less difficult one. The EEG signals were acquired from healthy humans while subjects were performing the task. We adopted the Correlated Component Analysis (CorrCA) method to identify linear combinations of EEG channels that maximize the correlation across subjects ([Formula: see text]) or trials ([Formula: see text]). The inter-subject or inter-trial correlation values (ISC or ITC) of the first three components were estimated to investigate the modulation of the task difficulty on subjects' EEG signals and respective correlations. We also calculated the alpha- and beta-band power of the projection components obtained by the CorrCA to assess the brain responses across multiple task periods. Finally, the CorrCA forward models, which represent the scalp projections of the brain activities by the maximally correlated components, were further translated into source distributions of underlying cortical activity using the exact Low Resolution Electromagnetic Tomography Algorithm (eLORETA). Our results revealed strong and significant correlations in EEG signals among multiple subjects and trials during the more difficult decision-making task than the easier one. We also observed that the NP decision-making and feedback tasks desynchronized the normalized alpha and beta powers of the CorrCA components, reflecting the engagement state of subjects. Source localization results furthermore suggested several sources of neural activities during the NP decision-making process, including the dorsolateral prefrontal cortex, anterior PFC, orbitofrontal cortex, posterior cingulate cortex, and somatosensory association cortex.

SSPNet: An interpretable 3D-CNN for classification of schizophrenia using phase maps of resting-state complex-valued fMRI data

Convolutional neural networks (CNNs) have shown promising results in classifying individuals with mental disorders such as schizophrenia using resting-state fMRI data. However, complex-valued fMRI data is rarely used since additional phase data introduces high-level noise though it is potentially useful information for the context of classification. As such, we propose to use spatial source phase (SSP) maps derived from complex-valued fMRI data as the CNN input. The SSP maps are not only less noisy, but also more sensitive to spatial activation changes caused by mental disorders than magnitude maps. We build a 3D-CNN framework with two convolutional layers (named SSPNet) to fully explore the 3D structure and voxel-level relationships from the SSP maps. Two interpretability modules, consisting of saliency map generation and gradient-weighted class activation mapping (Grad-CAM), are incorporated into the well-trained SSPNet to provide additional information helpful for understanding the output. Experimental results from classifying schizophrenia patients (SZs) and healthy controls (HCs) show that the proposed SSPNet significantly improved accuracy and AUC compared to CNN using magnitude maps extracted from either magnitude-only (by 23.4 and 23.6% for DMN) or complex-valued fMRI data (by 10.6 and 5.8% for DMN). SSPNet captured more prominent HC-SZ differences in saliency maps, and Grad-CAM localized all contributing brain regions with opposite strengths for HCs and SZs within SSP maps. These results indicate the potential of SSPNet as a sensitive tool that may be useful for the development of brain-based biomarkers of mental disorders.

Multiscale structural mapping of Alzheimer's disease neurodegeneration

The recently described biological framework of Alzheimer's disease (AD) emphasizes three types of pathology to characterize this disorder, referred to as the 'amyloid/tau/neurodegeneration' (A-T-N) status. The 'neurodegenerative' component is typically defined by atrophy measures derived from structural magnetic resonance imaging (MRI) such as hippocampal volume. Neurodegeneration measures from imaging are associated with disease symptoms and prognosis. Thus, sensitive image-based quantification of neurodegeneration in AD has an important role in a range of clinical and research operations. Although hippocampal volume is a sensitive metric of neurodegeneration, this measure is impacted by several clinical conditions other than AD and therefore lacks specificity. In contrast, selective regional cortical atrophy, known as the 'cortical signature of AD' provides greater specificity to AD pathology. Although atrophy is apparent even in the preclinical stages of the disease, it is possible that increased sensitivity to degeneration could be achieved by including tissue microstructural properties in the neurodegeneration measure. However, to facilitate clinical feasibility, such information should be obtainable from a single, short, noninvasive imaging protocol. We propose a multiscale MRI procedure that advances prior work through the quantification of features at both macrostructural (morphometry) and microstructural (tissue properties obtained from multiple layers of cortex and subcortical white matter) scales from a single structural brain image (referred to as 'multi-scale structural mapping'; MSSM). Vertex-wise partial least squares (PLS) regression was used to compress these multi-scale structural features. When contrasting patients with AD to cognitively intact matched older adults, the MSSM procedure showed substantially broader regional group differences including areas that were not statistically significant when using cortical thickness alone. Further, with multiple machine learning algorithms and ensemble procedures, we found that MSSM provides accurate detection of individuals with AD dementia (AUROC = 0.962, AUPRC = 0.976) and individuals with mild cognitive impairment (MCI) that subsequently progressed to AD dementia (AUROC = 0.908, AUPRC = 0.910). The findings demonstrate the critical advancement of neurodegeneration quantification provided through multiscale mapping. Future work will determine the sensitivity of this technique for accurately detecting individuals with earlier impairment and biomarker positivity in the absence of impairment.

The colors of our brain: an integrated approach for dimensionality reduction and explainability in fMRI through color coding (i-ECO)

Several systematic reviews have highlighted the role of multiple sources in the investigation of psychiatric illness. For what concerns fMRI, the focus of recent literature preferentially lies on three lines of research, namely: functional connectivity, network analysis and spectral analysis. Data was gathered from the UCLA Consortium for Neuropsychiatric Phenomics. The sample was composed by 130 neurotypicals, 50 participants diagnosed with Schizophrenia, 49 with Bipolar disorder and 43 with ADHD. Single fMRI scans were reduced in their dimensionality by a novel method (i-ECO) averaging results per Region of Interest and through an additive color method (RGB): local connectivity values (Regional Homogeneity), network centrality measures (Eigenvector Centrality), spectral dimensions (fractional Amplitude of Low-Frequency Fluctuations). Average images per diagnostic group were plotted and described. The discriminative power of this novel method for visualizing and analyzing fMRI results in an integrative manner was explored through the usage of convolutional neural networks. The new methodology of i-ECO showed between-groups differences that could be easily appreciated by the human eye. The precision-recall Area Under the Curve (PR-AUC) of our models was > 84.5% for each diagnostic group as evaluated on the test-set – 80/20 split. In conclusion, this study provides evidence for an integrative and easy-to-understand approach in the analysis and visualization of fMRI results. A high discriminative power for psychiatric conditions was reached. This proof-of-work study may serve to investigate further developments over more extensive datasets covering a wider range of psychiatric diagnoses.

Data-driven approaches to neuroimaging biomarkers for neurological and psychiatric disorders: emerging approaches and examples

PURPOSE OF REVIEW

The 'holy grail' of clinical applications of neuroimaging to neurological and psychiatric disorders via personalized biomarkers has remained mostly elusive, despite considerable effort. However, there are many reasons to continue to be hopeful, as the field has made remarkable advances over the past few years, fueled by a variety of converging technical and data developments.

RECENT FINDINGS

We discuss a number of advances that are accelerating the push for neuroimaging biomarkers including the advent of the 'neuroscience big data' era, biomarker data competitions, the development of more sophisticated algorithms including 'guided' data-driven approaches that facilitate automation of network-based analyses, dynamic connectivity, and deep learning. Another key advance includes multimodal data fusion approaches which can provide convergent and complementary evidence pointing to possible mechanisms as well as increase predictive accuracy.

SUMMARY

The search for clinically relevant neuroimaging biomarkers for neurological and psychiatric disorders is rapidly accelerating. Here, we highlight some of these aspects, provide recent examples from studies in our group, and link to other ongoing work in the field. It is critical that access and use of these advanced approaches becomes mainstream, this will help propel the community forward and facilitate the production of robust and replicable neuroimaging biomarkers.

Single and Combined Neuroimaging Techniques for Alzheimer's Disease Detection

Alzheimer's disease (AD) consists of the gradual process of decreasing volume and quality of neuron connection in the brain, which consists of gradual synaptic integrity and loss of cognitive functions. In recent years, there has been significant attention in AD classification and early detection with machine learning algorithms. There are different neuroimaging techniques for capturing data and using it for the classification task. Input data as images will help machine learning models to detect different biomarkers for AD classification. This marker has a more critical role for AD detection than other diseases because beta-amyloid can extract complex structures with some metal ions. Most researchers have focused on using 3D and 4D convolutional neural networks for AD classification due to reasonable amounts of data. Also, combination neuroimaging techniques like functional magnetic resonance imaging and positron emission tomography for AD detection have recently gathered much attention. However, gathering a combination of data can be expensive, complex, and tedious. For time consumption reasons, most patients prefer to throw one of the neuroimaging techniques. So, in this review article, we have surveyed different research studies with various neuroimaging techniques and ML methods to see the effect of using combined data as input. The result has shown that the use of the combination method would increase the accuracy of AD detection. Also, according to the sensitivity metrics from different machine learning methods, MRI and fMRI showed promising results.