Convolutional Neural Networks for Neuroimaging in Parkinson's Disease: Is Preprocessing Needed?

Recent progress in the applications of presynaptic dopaminergic positron emission tomography imaging in parkinsonism

Nowadays, presynaptic dopaminergic positron emission tomography, which assesses deficiencies in dopamine synthesis, storage, and transport, is widely utilized for early diagnosis and differential diagnosis of parkinsonism. This review provides a comprehensive summary of the latest developments in the application of presynaptic dopaminergic positron emission tomography imaging in disorders that manifest parkinsonism. We conducted a thorough literature search using reputable databases such as PubMed and Web of Science. Selection criteria involved identifying peer-reviewed articles published within the last 5 years, with emphasis on their relevance to clinical applications. The findings from these studies highlight that presynaptic dopaminergic positron emission tomography has demonstrated potential not only in diagnosing and differentiating various Parkinsonian conditions but also in assessing disease severity and predicting prognosis. Moreover, when employed in conjunction with other imaging modalities and advanced analytical methods, presynaptic dopaminergic positron emission tomography has been validated as a reliable in vivo biomarker. This validation extends to screening and exploring potential neuropathological mechanisms associated with dopaminergic depletion. In summary, the insights gained from interpreting these studies are crucial for enhancing the effectiveness of preclinical investigations and clinical trials, ultimately advancing toward the goals of neuroregeneration in parkinsonian disorders.

Bridging Imaging and Clinical Scores in Parkinson's Progression via Multimodal Self-Supervised Deep Learning

Neurodegenerative diseases pose a formidable challenge to medical research, demanding a nuanced understanding of their progressive nature. In this regard, latent generative models can effectively be used in a data-driven modeling of different dimensions of neurodegeneration, framed within the context of the manifold hypothesis. This paper proposes a joint framework for a multi-modal, common latent generative model to address the need for a more comprehensive understanding of the neurodegenerative landscape in the context of Parkinson's disease (PD). The proposed architecture uses coupled variational autoencoders (VAEs) to joint model a common latent space to both neuroimaging and clinical data from the Parkinson's Progression Markers Initiative (PPMI). Alternative loss functions, different normalization procedures, and the interpretability and explainability of latent generative models are addressed, leading to a model that was able to predict clinical symptomatology in the test set, as measured by the unified Parkinson's disease rating scale (UPDRS), with R2 up to 0.86 for same-modality and 0.441 cross-modality (using solely neuroimaging). The findings provide a foundation for further advancements in the field of clinical research and practice, with potential applications in decision-making processes for PD. The study also highlights the limitations and capabilities of the proposed model, emphasizing its direct interpretability and potential impact on understanding and interpreting neuroimaging patterns associated with PD symptomatology.

Automated identification of uncertain cases in deep learning-based classification of dopamine transporter SPECT to improve clinical utility and acceptance

PURPOSE

Deep convolutional neural networks (CNN) are promising for automatic classification of dopamine transporter (DAT)-SPECT images. Reporting the certainty of CNN-based decisions is highly desired to flag cases that might be misclassified and, therefore, require particularly careful inspection by the user. The aim of the current study was to design and validate a CNN-based system for the identification of uncertain cases.

METHODS

A network ensemble (NE) combining five CNNs was trained for binary classification of [123I]FP-CIT DAT-SPECT images as "normal" or "neurodegeneration-typical reduction" with high accuracy (NE for classification, NEfC). An uncertainty detection module (UDM) was obtained by combining two additional NE, one trained for detection of "reduced" DAT-SPECT with high sensitivity, the other with high specificity. A case was considered "uncertain" if the "high sensitivity" NE and the "high specificity" NE disagreed. An internal "development" dataset of 1740 clinical DAT-SPECT images was used for training (n = 1250) and testing (n = 490). Two independent datasets with different image characteristics were used for testing only (n = 640, 645). Three established approaches for uncertainty detection were used for comparison (sigmoid, dropout, model averaging).

RESULTS

In the test data from the development dataset, the NEfC achieved 98.0% accuracy. 4.3% of all test cases were flagged as "uncertain" by the UDM: 2.5% of the correctly classified cases and 90% of the misclassified cases. NEfC accuracy among "certain" cases was 99.8%. The three comparison methods were less effective in labelling misclassified cases as "uncertain" (40-80%). These findings were confirmed in both additional test datasets.

CONCLUSION

The UDM allows reliable identification of uncertain [123I]FP-CIT SPECT with high risk of misclassification. We recommend that automatic classification of [123I]FP-CIT SPECT images is combined with an UDM to improve clinical utility and acceptance. The proposed UDM method ("high sensitivity versus high specificity") might be useful also for DAT imaging with other ligands and for other binary classification tasks.

Parkinson's disease diagnosis using deep learning: A bibliometric analysis and literature review

Parkinson's Disease (PD) is a progressive neurodegenerative illness triggered by decreased dopamine secretion. Deep Learning (DL) has gained substantial attention in PD diagnosis research, with an increase in the number of published papers in this discipline. PD detection using DL has presented more promising outcomes as compared with common machine learning approaches. This article aims to conduct a bibliometric analysis and a literature review focusing on the prominent developments taking place in this area. To achieve the target of the study, we retrieved and analyzed the available research papers in the Scopus database. Following that, we conducted a bibliometric analysis to inspect the structure of keywords, authors, and countries in the surveyed studies by providing visual representations of the bibliometric data using VOSviewer software. The study also provides an in-depth review of the literature focusing on different indicators of PD, deployed approaches, and performance metrics. The outcomes indicate the firm development of PD diagnosis using DL approaches over time and a large diversity of studies worldwide. Additionally, the literature review presented a research gap in DL approaches related to incremental learning, particularly in relation to big data analysis.

A review of machine learning and deep learning algorithms for Parkinson's disease detection using handwriting and voice datasets

Parkinson's Disease (PD) is a prevalent neurodegenerative disorder with significant clinical implications. Early and accurate diagnosis of PD is crucial for timely intervention and personalized treatment. In recent years, Machine Learning (ML) and Deep Learning (DL) techniques have emerged as promis-ing tools for improving PD diagnosis. This review paper presents a detailed analysis of the current state of ML and DL-based PD diagnosis, focusing on voice, handwriting, and wave spiral datasets. The study also evaluates the effectiveness of various ML and DL algorithms, including classifiers, on these datasets and highlights their potential in enhancing diagnostic accuracy and aiding clinical decision-making. Additionally, the paper explores the identifi-cation of biomarkers using these techniques, offering insights into improving the diagnostic process. The discussion encompasses different data formats and commonly employed ML and DL methods in PD diagnosis, providing a comprehensive overview of the field. This review serves as a roadmap for future research, guiding the development of ML and DL-based tools for PD detection. It is expected to benefit both the scientific community and medical practitioners by advancing our understanding of PD diagnosis and ultimately improving patient outcomes.

Diagnostic performance of artificial intelligence-assisted PET imaging for Parkinson's disease: a systematic review and meta-analysis

Artificial intelligence (AI)-assisted PET imaging is emerging as a promising tool for the diagnosis of Parkinson's disease (PD). We aim to systematically review the diagnostic accuracy of AI-assisted PET in detecting PD. The Ovid MEDLINE, Ovid Embase, Web of Science, and IEEE Xplore databases were systematically searched for related studies that developed an AI algorithm in PET imaging for diagnostic performance from PD and were published by August 17, 2023. Binary diagnostic accuracy data were extracted for meta-analysis to derive outcomes of interest: area under the curve (AUC). 23 eligible studies provided sufficient data to construct contingency tables that allowed the calculation of diagnostic accuracy. Specifically, 11 studies were identified that distinguished PD from normal control, with a pooled AUC of 0.96 (95% CI: 0.94-0.97) for presynaptic dopamine (DA) and 0.90 (95% CI: 0.87-0.93) for glucose metabolism (18F-FDG). 13 studies were identified that distinguished PD from the atypical parkinsonism (AP), with a pooled AUC of 0.93 (95% CI: 0.91 - 0.95) for presynaptic DA, 0.79 (95% CI: 0.75-0.82) for postsynaptic DA, and 0.97 (95% CI: 0.96-0.99) for 18F-FDG. Acceptable diagnostic performance of PD with AI algorithms-assisted PET imaging was highlighted across the subgroups. More rigorous reporting standards that take into account the unique challenges of AI research could improve future studies.

Applications of machine learning and deep learning in SPECT and PET imaging: General overview, challenges and future prospects

The integration of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging techniques with machine learning (ML) algorithms, including deep learning (DL) models, is a promising approach. This integration enhances the precision and efficiency of current diagnostic and treatment strategies while offering invaluable insights into disease mechanisms. In this comprehensive review, we delve into the transformative impact of ML and DL in this domain. Firstly, a brief analysis is provided of how these algorithms have evolved and which are the most widely applied in this domain. Their different potential applications in nuclear imaging are then discussed, such as optimization of image adquisition or reconstruction, biomarkers identification, multimodal fusion and the development of diagnostic, prognostic, and disease progression evaluation systems. This is because they are able to analyse complex patterns and relationships within imaging data, as well as extracting quantitative and objective measures. Furthermore, we discuss the challenges in implementation, such as data standardization and limited sample sizes, and explore the clinical opportunities and future horizons, including data augmentation and explainable AI. Together, these factors are propelling the continuous advancement of more robust, transparent, and reliable systems.

Electrical Stimulation Induced Current Distribution in Peripheral Nerves Varies Significantly with the Extent of Nerve Damage: A Computational Study Utilizing Convolutional Neural Network and Realistic Nerve Models

Electrical stimulation of the peripheral nervous system is a promising therapeutic option for several conditions; however, its effects on tissue and the safety of the stimulation remain poorly understood. In order to devise stimulation protocols that enhance therapeutic efficacy without the risk of causing tissue damage, we constructed computational models of peripheral nerve and stimulation cuffs based on extremely high-resolution cross-sectional images of the nerves using the most recent advances in computing power and machine learning techniques. We developed nerve models using nonstimulated (healthy) and over-stimulated (damaged) rat sciatic nerves to explore how nerve damage affects the induced current density distribution. Using our in-house computational, quasi-static, platform, and the Admittance Method (AM), we estimated the induced current distribution within the nerves and compared it for healthy and damaged nerves. We also estimated the extent of localized cell damage in both healthy and damaged nerve samples. When the nerve is damaged, as demonstrated principally by the decreased nerve fiber packing, the current penetrates deeper into the over-stimulated nerve than in the healthy sample. As safety limits for electrical stimulation of peripheral nerves still refer to the Shannon criterion to distinguish between safe and unsafe stimulation, the capability this work demonstrated is an important step toward the development of safety criteria that are specific to peripheral nerve and make use of the latest advances in computational bioelectromagnetics and machine learning, such as Python-based AM and CNN-based nerve image segmentation.

Quantifying Differences Between Affine and Nonlinear Spatial Normalization of FP-CIT Spect Images

Spatial normalization helps us to compare quantitatively two or more input brain scans. Although using an affine normalization approach preserves the anatomical structures, the neuroimaging field is more common to find works that make use of nonlinear transformations. The main reason is that they facilitate a voxel-wise comparison, not only when studying functional images but also when comparing MRI scans given that they fit better to a reference template. However, the amount of bias introduced by the nonlinear transformations can potentially alter the final outcome of a diagnosis especially when studying functional scans for neurological disorders like Parkinson's Disease. In this context, we have tried to quantify the bias introduced by the affine and the nonlinear spatial registration of FP-CIT SPECT volumes of healthy control subjects and patients with PD. For that purpose, we calculated the deformation fields of each participant and applied these deformation fields to a 3D-grid. As the space between the edges of small cubes comprising the grid change, we can quantify which parts from the brain have been enlarged, compressed or just remain the same. When the nonlinear approach is applied, scans from PD patients show a region near their striatum very similar in shape to that of healthy subjects. This artificially increases the interclass separation between patients with PD and healthy subjects as the local intensity is decreased in the latter region, and leads machine learning systems to biased results due to the artificial information introduced by these deformations.

MVPAlab: A machine learning decoding toolbox for multidimensional electroencephalography data

BACKGROUND AND OBJECTIVE

The study of brain function has recently expanded from classical univariate to multivariate analyses. These multivariate, machine learning-based algorithms afford neuroscientists extracting more detailed and richer information from the data. However, the implementation of these procedures is usually challenging, especially for researchers with no coding experience. To address this problem, we have developed MVPAlab, a MATLAB-based, flexible decoding toolbox for multidimensional electroencephalography and magnetoencephalography data.

METHODS

The MVPAlab Toolbox implements several machine learning algorithms to compute multivariate pattern analyses, cross-classification, temporal generalization matrices and feature and frequency contribution analyses. It also provides access to an extensive set of preprocessing routines for, among others, data normalization, data smoothing, dimensionality reduction and supertrial generation. To draw statistical inferences at the group level, MVPAlab includes a non-parametric cluster-based permutation approach.

RESULTS

A sample electroencephalography dataset was compiled to test all the MVPAlab main functionalities. Significant clusters (p<0.01) were found for the proposed decoding analyses and different configurations, proving the software capability for discriminating between different experimental conditions.

CONCLUSIONS

This toolbox has been designed to include an easy-to-use and intuitive graphic user interface and data representation software, which makes MVPAlab a very convenient tool for users with few or no previous coding experience. In addition, MVPAlab is not for beginners only, as it implements several high and low-level routines allowing more experienced users to design their own projects in a highly flexible manner.

Tiled Sparse Coding in Eigenspaces for Image Classification

The automation in the diagnosis of medical images is currently a challenging task. The use of Computer Aided Diagnosis (CAD) systems can be a powerful tool for clinicians, especially in situations when hospitals are overflowed. These tools are usually based on artificial intelligence (AI), a field that has been recently revolutionized by deep learning approaches. blackThese alternatives usually obtain a large performance based on complex solutions, leading to a high computational cost and the need of having large databases. In this work, we propose a classification framework based on sparse coding. Images are blackfirst partitioned into different tiles, and a dictionary is built after applying PCA to these tiles. The original signals are then transformed as a linear combination of the elements of the dictionary. blackThen, they are reconstructed by iteratively deactivating the elements associated with each component. Classification is finally performed employing as features the subsequent reconstruction errors. Performance is evaluated in a real context where distinguishing between four different pathologies: control versus bacterial pneumonia versus viral pneumonia versus COVID-19. blackOur system differentiates between pneumonia patients and controls with an accuracy of 97.74%, whereas in the 4-class context the accuracy is 86.73%. The excellent results and the pioneering use of sparse coding in this scenario evidence that our proposal can assist clinicians when their workload is high.

Application of Deep Learning Models for Automated Identification of Parkinson's Disease: A Review (2011-2021)

Parkinson’s disease (PD) is the second most common neurodegenerative disorder affecting over 6 million people globally. Although there are symptomatic treatments that can increase the survivability of the disease, there are no curative treatments. The prevalence of PD and disability-adjusted life years continue to increase steadily, leading to a growing burden on patients, their families, society and the economy. Dopaminergic medications can significantly slow down the progression of PD when applied during the early stages. However, these treatments often become less effective with the disease progression. Early diagnosis of PD is crucial for immediate interventions so that the patients can remain self-sufficient for the longest period of time possible. Unfortunately, diagnoses are often late, due to factors such as a global shortage of neurologists skilled in early PD diagnosis. Computer-aided diagnostic (CAD) tools, based on artificial intelligence methods, that can perform automated diagnosis of PD, are gaining attention from healthcare services. In this review, we have identified 63 studies published between January 2011 and July 2021, that proposed deep learning models for an automated diagnosis of PD, using various types of modalities like brain analysis (SPECT, PET, MRI and EEG), and motion symptoms (gait, handwriting, speech and EMG). From these studies, we identify the best performing deep learning model reported for each modality and highlight the current limitations that are hindering the adoption of such CAD tools in healthcare. Finally, we propose new directions to further the studies on deep learning in the automated detection of PD, in the hopes of improving the utility, applicability and impact of such tools to improve early detection of PD globally.

Explainable AI to improve acceptance of convolutional neural networks for automatic classification of dopamine transporter SPECT in the diagnosis of clinically uncertain parkinsonian syndromes

Purpose

Deep convolutional neural networks (CNN) provide high accuracy for automatic classification of dopamine transporter (DAT) SPECT images. However, CNN are inherently black-box in nature lacking any kind of explanation for their decisions. This limits their acceptance for clinical use. This study tested layer-wise relevance propagation (LRP) to explain CNN-based classification of DAT-SPECT in patients with clinically uncertain parkinsonian syndromes.

Methods

The study retrospectively included 1296 clinical DAT-SPECT with visual binary interpretation as “normal” or “reduced” by two experienced readers as standard-of-truth. A custom-made CNN was trained with 1008 randomly selected DAT-SPECT. The remaining 288 DAT-SPECT were used to assess classification performance of the CNN and to test LRP for explanation of the CNN-based classification.

Results

Overall accuracy, sensitivity, and specificity of the CNN were 95.8%, 92.8%, and 98.7%, respectively. LRP provided relevance maps that were easy to interpret in each individual DAT-SPECT. In particular, the putamen in the hemisphere most affected by nigrostriatal degeneration was the most relevant brain region for CNN-based classification in all reduced DAT-SPECT. Some misclassified DAT-SPECT showed an “inconsistent” relevance map more typical for the true class label.

Conclusion

LRP is useful to provide explanation of CNN-based decisions in individual DAT-SPECT and, therefore, can be recommended to support CNN-based classification of DAT-SPECT in clinical routine. Total computation time of 3 s is compatible with busy clinical workflow. The utility of “inconsistent” relevance maps to identify misclassified cases requires further investigation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00259-021-05569-9.

Applications of deep learning techniques for automated multiple sclerosis detection using magnetic resonance imaging: A review

Multiple Sclerosis (MS) is a type of brain disease which causes visual, sensory, and motor problems for people with a detrimental effect on the functioning of the nervous system. In order to diagnose MS, multiple screening methods have been proposed so far; among them, magnetic resonance imaging (MRI) has received considerable attention among physicians. MRI modalities provide physicians with fundamental information about the structure and function of the brain, which is crucial for the rapid diagnosis of MS lesions. Diagnosing MS using MRI is time-consuming, tedious, and prone to manual errors. Research on the implementation of computer aided diagnosis system (CADS) based on artificial intelligence (AI) to diagnose MS involves conventional machine learning and deep learning (DL) methods. In conventional machine learning, feature extraction, feature selection, and classification steps are carried out by using trial and error; on the contrary, these steps in DL are based on deep layers whose values are automatically learn. In this paper, a complete review of automated MS diagnosis methods performed using DL techniques with MRI neuroimaging modalities is provided. Initially, the steps involved in various CADS proposed using MRI modalities and DL techniques for MS diagnosis are investigated. The important preprocessing techniques employed in various works are analyzed. Most of the published papers on MS diagnosis using MRI modalities and DL are presented. The most significant challenges facing and future direction of automated diagnosis of MS using MRI modalities and DL techniques are also provided.

The Role of Neural Network for the Detection of Parkinson's Disease: A Scoping Review

Background: Parkinson’s Disease (PD) is a chronic neurodegenerative disorder that has been ranked second after Alzheimer’s disease worldwide. Early diagnosis of PD is crucial to combat against PD to allow patients to deal with it properly. However, there is no medical test(s) available to diagnose PD conclusively. Therefore, computer-aided diagnosis (CAD) systems offered a better solution to make the necessary data-driven decisions and assist the physician. Numerous studies were conducted to propose CAD to diagnose PD in the early stages. No comprehensive reviews have been conducted to summarize the role of AI tools to combat PD. Objective: The study aimed to explore and summarize the applications of neural networks to diagnose PD. Methods: PRISMA Extension for Scoping Reviews (PRISMA-ScR) was followed to conduct this scoping review. To identify the relevant studies, both medical databases (e.g., PubMed) and technical databases (IEEE) were searched. Three reviewers carried out the study selection and extracted the data from the included studies independently. Then, the narrative approach was adopted to synthesis the extracted data. Results: Out of 1061 studies, 91 studies satisfied the eligibility criteria in this review. About half of the included studies have implemented artificial neural networks to diagnose PD. Numerous studies included focused on the freezing of gait (FoG). Biomedical voice and signal datasets were the most commonly used data types to develop and validate these models. However, MRI- and CT-scan images were also utilized in the included studies. Conclusion: Neural networks play an integral and substantial role in combating PD. Many possible applications of neural networks were identified in this review, however, most of them are limited up to research purposes.

Machine Learning for the Diagnosis of Parkinson's Disease: A Review of Literature

Diagnosis of Parkinson's disease (PD) is commonly based on medical observations and assessment of clinical signs, including the characterization of a variety of motor symptoms. However, traditional diagnostic approaches may suffer from subjectivity as they rely on the evaluation of movements that are sometimes subtle to human eyes and therefore difficult to classify, leading to possible misclassification. In the meantime, early non-motor symptoms of PD may be mild and can be caused by many other conditions. Therefore, these symptoms are often overlooked, making diagnosis of PD at an early stage challenging. To address these difficulties and to refine the diagnosis and assessment procedures of PD, machine learning methods have been implemented for the classification of PD and healthy controls or patients with similar clinical presentations (e.g., movement disorders or other Parkinsonian syndromes). To provide a comprehensive overview of data modalities and machine learning methods that have been used in the diagnosis and differential diagnosis of PD, in this study, we conducted a literature review of studies published until February 14, 2020, using the PubMed and IEEE Xplore databases. A total of 209 studies were included, extracted for relevant information and presented in this review, with an investigation of their aims, sources of data, types of data, machine learning methods and associated outcomes. These studies demonstrate a high potential for adaptation of machine learning methods and novel biomarkers in clinical decision making, leading to increasingly systematic, informed diagnosis of PD.

Deep learning based automated diagnosis of bone metastases with SPECT thoracic bone images

SPECT nuclear medicine imaging is widely used for treating, diagnosing, evaluating and preventing various serious diseases. The automated classification of medical images is becoming increasingly important in developing computer-aided diagnosis systems. Deep learning, particularly for the convolutional neural networks, has been widely applied to the classification of medical images. In order to reliably classify SPECT bone images for the automated diagnosis of metastasis on which the SPECT imaging solely focuses, in this paper, we present several deep classifiers based on the deep networks. Specifically, original SPECT images are cropped to extract the thoracic region, followed by a geometric transformation that contributes to augment the original data. We then construct deep classifiers based on the widely used deep networks including VGG, ResNet and DenseNet by fine-tuning their parameters and structures or self-defining new network structures. Experiments on a set of real-world SPECT bone images show that the proposed classifiers perform well in identifying bone metastasis with SPECT imaging. It achieves 0.9807, 0.9900, 0.9830, 0.9890, 0.9802 and 0.9933 for accuracy, precision, recall, specificity, F-1 score and AUC, respectively, on the test samples from the augmented dataset without normalization.

An Explainable Machine Learning Model for Early Detection of Parkinson's Disease using LIME on DaTSCAN Imagery

Parkinson's Disease (PD) is a degenerative and progressive neurological condition. Early diagnosis can improve treatment for patients and is performed through dopaminergic imaging techniques like the SPECT DaTSCAN. In this study, we propose a machine learning model that accurately classifies any given DaTSCAN as having Parkinson's disease or not, in addition to providing a plausible reason for the prediction. This kind of reasoning is done through the use of visual indicators generated using Local Interpretable Model-Agnostic Explainer (LIME) methods. DaTSCANs were drawn from the Parkinson's Progression Markers Initiative database and trained on a CNN (VGG16) using transfer learning, yielding an accuracy of 95.2%, a sensitivity of 97.5%, and a specificity of 90.9%. Keeping model interpretability of paramount importance, especially in the healthcare field, this study utilises LIME explanations to distinguish PD from non-PD, using visual superpixels on the DaTSCANs. It could be concluded that the proposed system, in union with its measured interpretability and accuracy may effectively aid medical workers in the early diagnosis of Parkinson's Disease.

A Methodology to Differentiate Parkinson's Disease and Aging Speech Based on Glottal Flow Acoustic Analysis

Speech is controlled by axial neuromotor systems, therefore, it is highly sensitive to the effects of neurodegenerative illnesses such as Parkinson's Disease (PD). Patients suffering from PD present important alterations in speech, which are manifested in phonation, articulation, prosody, and fluency. These alterations may be evaluated using statistical methods on features obtained from glottal, spectral, cepstral, or fractal descriptions of speech. This work introduces an evaluation paradigm based on Information Theory (IT) to differentiate the effects of PD and aging on glottal amplitude distributions. The study is conducted on a database including 48 PD patients (24 males, 24 females), 48 age-matched healthy controls (HC, 24 males, 24 females), and 48 mid-age normative subjects (NS, 24 males, 24 females). It may be concluded from the study that Hierarchical Clustering (HiCl) methods produce a clear separation between the phonation of PD patients from NS subjects (accuracy of 89.6% for both male and female subsets), but the separation between PD patients and HC subjects is less efficient (accuracy of 75.0% for the male subset and 70.8% for the female subset). Conversely, using feature selection and Support Vector Machine (SVM) classification, the differentiation between PD and HC is substantially improved (accuracy of 94.8% for the male subset and 92.8% for the female subset). This improvement was mainly boosted by feature selection, at a cost of information and generalization losses. The results point to the possibility that speech deterioration may affect HC phonation with aging, reducing its difference to PD phonation.

Morphological Characterization of Functional Brain Imaging by Isosurface Analysis in Parkinson’s Disease

Finding new biomarkers to model Parkinson’s Disease (PD) is a challenge not only to help discerning between Healthy Control (HC) subjects and patients with potential PD but also as a way to measure quantitatively the loss of dopaminergic neurons mainly concentrated at substantia nigra. Within this context, this work presented here tries to provide a set of imaging features based on morphological characteristics extracted from I[Formula: see text]-Ioflupane SPECT scans to discern between HC and PD participants in a balanced set of [Formula: see text] scans from Parkinson’s Progression Markers Initiative (PPMI) database. These features, obtained from isosurfaces of each scan at different intensity levels, have been classified through the use of classical Machine Learning classifiers such as Support-Vector-Machines (SVM) or Naïve Bayesian and compared with the results obtained using a Multi-Layer Perceptron (MLP).

The proposed system, based on a Mann–Whitney–Wilcoxon U-Test for feature selection and the SVM approach, yielded a [Formula: see text] balanced accuracy when the performance was evaluated using a [Formula: see text]-fold cross-validation. This proves the reliability of these biomarkers, especially those related to sphericity, center of mass, number of vertices, 2D-projected perimeter or the 2D-projected eccentricity, among others, but including both internal and external isosurfaces.

Middle-Level Features for the Explanation of Classification Systems by Sparse Dictionary Methods

Machine learning (ML) systems are affected by a pervasive lack of transparency. The eXplainable Artificial Intelligence (XAI) research area addresses this problem and the related issue of explaining the behavior of ML systems in terms that are understandable to human beings. In many explanation of XAI approaches, the output of ML systems are explained in terms of low-level features of their inputs. However, these approaches leave a substantive explanatory burden with human users, insofar as the latter are required to map low-level properties into more salient and readily understandable parts of the input. To alleviate this cognitive burden, an alternative model-agnostic framework is proposed here. This framework is instantiated to address explanation problems in the context of ML image classification systems, without relying on pixel relevance maps and other low-level features of the input. More specifically, one obtains sets of middle-level properties of classification inputs that are perceptually salient by applying sparse dictionary learning techniques. These middle-level properties are used as building blocks for explanations of image classifications. The achieved explanations are parsimonious, for their reliance on a limited set of middle-level image properties. And they can be contrastive, because the set of middle-level image properties can be used to explain why the system advanced the proposed classification over other antagonist classifications. In view of its model-agnostic character, the proposed framework is adaptable to a variety of other ML systems and explanation problems.

Detection of Mild Cognitive Impairment Using Convolutional Neural Network: Temporal-Feature Maps of Functional Near-Infrared Spectroscopy

Mild cognitive impairment (MCI) is the clinical precursor of Alzheimer's disease (AD), which is considered the most common neurodegenerative disease in the elderly. Some MCI patients tend to remain stable over time and do not evolve to AD. It is essential to diagnose MCI in its early stages and provide timely treatment to the patient. In this study, we propose a neuroimaging approach to identify MCI using a deep learning method and functional near-infrared spectroscopy (fNIRS). For this purpose, fifteen MCI subjects and nine healthy controls (HCs) were asked to perform three mental tasks: N-back, Stroop, and verbal fluency (VF) tasks. Besides examining the oxygenated hemoglobin changes (ΔHbO) in the region of interest, ΔHbO maps at 13 specific time points (i.e., 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, and 65 s) during the tasks and seven temporal feature maps (i.e., two types of mean, three types of slope, kurtosis, and skewness) in the prefrontal cortex were investigated. A four-layer convolutional neural network (CNN) was applied to identify the subjects into either MCI or HC, individually, after training the CNN model with ΔHbO maps and temporal feature maps above. Finally, we used the 5-fold cross-validation approach to evaluate the performance of the CNN. The results of temporal feature maps exhibited high classification accuracies: The average accuracies for the N-back task, Stroop task, and VFT, respectively, were 89.46, 87.80, and 90.37%. Notably, the highest accuracy of 98.61% was achieved from the ΔHbO slope map during 20-60 s interval of N-back tasks. Our results indicate that the fNIRS imaging approach based on temporal feature maps is a promising diagnostic method for early detection of MCI and can be used as a tool for clinical doctors to identify MCI from their patients.

A convolutional neural network-based system to classify patients using FDG PET/CT examinations

BACKGROUND

As the number of PET/CT scanners increases and FDG PET/CT becomes a common imaging modality for oncology, the demands for automated detection systems on artificial intelligence (AI) to prevent human oversight and misdiagnosis are rapidly growing. We aimed to develop a convolutional neural network (CNN)-based system that can classify whole-body FDG PET as 1) benign, 2) malignant or 3) equivocal.

METHODS

This retrospective study investigated 3485 sequential patients with malignant or suspected malignant disease, who underwent whole-body FDG PET/CT at our institute. All the cases were classified into the 3 categories by a nuclear medicine physician. A residual network (ResNet)-based CNN architecture was built for classifying patients into the 3 categories. In addition, we performed a region-based analysis of CNN (head-and-neck, chest, abdomen, and pelvic region).

RESULTS

There were 1280 (37%), 1450 (42%), and 755 (22%) patients classified as benign, malignant and equivocal, respectively. In the patient-based analysis, CNN predicted benign, malignant and equivocal images with 99.4, 99.4, and 87.5% accuracy, respectively. In region-based analysis, the prediction was correct with the probability of 97.3% (head-and-neck), 96.6% (chest), 92.8% (abdomen) and 99.6% (pelvic region), respectively.

CONCLUSION

The CNN-based system reliably classified FDG PET images into 3 categories, indicating that it could be helpful for physicians as a double-checking system to prevent oversight and misdiagnosis.

Parkinsonism Differently Affects the Single Neuronal Activity in the Primary and Supplementary Motor Areas in Monkeys: An Investigation in Linear and Nonlinear Domains

The changes in neuronal firing activity in the primary motor cortex (M1) and supplementary motor area (SMA) were compared in monkeys rendered parkinsonian by treatment with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The neuronal dynamic was characterized using mathematical tools defined in different frameworks (rate, oscillations or complex patterns). Then, and for each cortical area, multivariate and discriminate analyses were further performed on these features to identify those important to differentiate between the normal and the pathological neuronal activity. Our results show a different order in the importance of the features to discriminate the pathological state in each cortical area which suggests that the M1 and the SMA exhibit dissimilarities in their neuronal alterations induced by parkinsonism. Our findings highlight the need for multiple mathematical frameworks to best characterize the pathological neuronal activity related to parkinsonism. Future translational studies are warranted to investigate the causal relationships between cortical region-specificities, dominant pathological hallmarks and symptoms.

Local field potential dynamics in the primate cortex in relation to parkinsonism reveled by machine learning: A comparison between the primary motor cortex and the supplementary area

The present study compares the cortical local field potentials (LFPs) in the primary motor cortex (M1) and the supplementary motor area (SMA) of non-human primates rendered Parkinsonian with administration of dopaminergic neurotoxin, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. The dynamic of the LFPs was investigated under several mathematical frameworks and machine learning was used to discriminate the recordings based on these features between healthy, parkinsonian with off-medication and parkinsonian with on-medication states. The importance of each feature in the discrimination process was further investigated. The dynamic of the LFPs in M1 and SMA was affected regarding its variability (time domain analysis), oscillatory activities (frequency domain analysis) and complex patterns (non-linear domain analysis). Machine learning algorithms achieved accuracy near 0.90 for comparisons between conditions. The TreeBagger algorithm provided best accuracy. The relative importance of these features differed with the cortical location, condition and treatment. Overall, the most important features included beta oscillation, fractal dimension, gamma oscillation, entropy and asymmetry of amplitude fluctuation. The importance of features in discriminating between normal and pathological states, and on- or off-medication states depends on the pair-comparison and it is region-specific. These findings are discussed regarding the refinement of current models for movement disorders and the development of on-demand therapies.

Parkinson's Disease Detection Using Isosurfaces-Based Features and Convolutional Neural Networks

Computer aided diagnosis systems based on brain imaging are an important tool to assist in the diagnosis of Parkinson's disease, whose ultimate goal is the detection by automatic recognizing of patterns that characterize the disease. In recent times Convolutional Neural Networks (CNN) have proved to be amazingly useful for that task. The drawback, however, is that 3D brain images contain a huge amount of information that leads to complex CNN architectures. When these architectures become too complex, classification performances often degrades because the limitations of the training algorithm and overfitting. Thus, this paper proposes the use of isosurfaces as a way to reduce such amount of data while keeping the most relevant information. These isosurfaces are then used to implement a classification system which uses two of the most well-known CNN architectures, LeNet and AlexNet, to classify DaTScan images with an average accuracy of 95.1% and AUC = 97%, obtaining comparable (slightly better) values to those obtained for most of the recently proposed systems. It can be concluded therefore that the computation of isosurfaces reduces the complexity of the inputs significantly, resulting in high classification accuracies with reduced computational burden.

Studying the Manifold Structure of Alzheimer's Disease: A Deep Learning Approach Using Convolutional Autoencoders

Many classical machine learning techniques have been used to explore Alzheimer's disease (AD), evolving from image decomposition techniques such as principal component analysis toward higher complexity, non-linear decomposition algorithms. With the arrival of the deep learning paradigm, it has become possible to extract high-level abstract features directly from MRI images that internally describe the distribution of data in low-dimensional manifolds. In this work, we try a new exploratory data analysis of AD based on deep convolutional autoencoders. We aim at finding links between cognitive symptoms and the underlying neurodegeneration process by fusing the information of neuropsychological test outcomes, diagnoses, and other clinical data with the imaging features extracted solely via a data-driven decomposition of MRI. The distribution of the extracted features in different combinations is then analyzed and visualized using regression and classification analysis, and the influence of each coordinate of the autoencoder manifold over the brain is estimated. The imaging-derived markers could then predict clinical variables with correlations above 0.6 in the case of neuropsychological evaluation variables such as the MMSE or the ADAS11 scores, achieving a classification accuracy over 80% for the diagnosis of AD.

Imaging Biomarkers for the Diagnosis and Prognosis of Neurodegenerative Diseases. The Example of Amyotrophic Lateral Sclerosis

The term amyotrophic lateral sclerosis (ALS) comprises a heterogeneous group of fatal neurodegenerative disorders of largely unknown etiology characterized by the upper motor neurons (UMN) and/or lower motor neurons (LMN) degeneration. The development of brain imaging biomarkers is essential to advance in the diagnosis, stratification and monitoring of ALS, both in the clinical practice and clinical trials. In this review, the characteristics of an optimal imaging biomarker and common pitfalls in biomarkers evaluation will be discussed. Moreover, the development and application of the most promising brain magnetic resonance (MR) imaging biomarkers will be reviewed. Finally, the integration of both qualitative and quantitative multimodal brain MR biomarkers in a structured report will be proposed as a support tool for ALS diagnosis and stratification.