Using Functional or Structural Magnetic Resonance Images and Personal Characteristic Data to Identify ADHD and Autism

Structural or/and functional MRI-based machine learning techniques for attention-deficit/hyperactivity disorder diagnosis: A systematic review and meta-analysis

BACKGROUND

The aim of this study was to investigate the diagnostic value of ML techniques based on sMRI or/and fMRI for ADHD.

METHODS

We conducted a comprehensive search (from database creation date to March 2024) for relevant English articles on sMRI or/and fMRI-based ML techniques for diagnosing ADHD. The pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), summary receiver operating characteristic (SROC) curve and area under the curve (AUC) were calculated to assess the diagnostic value of sMRI or/and fMRI-based ML techniques. The I2 test was used to assess heterogeneity and the source of heterogeneity was investigated by performing a meta-regression analysis. Publication bias was assessed using the Deeks funnel plot asymmetry test.

RESULTS

Forty-three studies were included in the systematic review, 27 of which were included in our meta-analysis. The pooled sensitivity and specificity of sMRI or/and fMRI-based ML techniques for the diagnosis of ADHD were 0.74 (95 % CI 0.65-0.81) and 0.75 (95 % CI 0.67-0.81), respectively. SROC curve showed that AUC was 0.81 (95 % CI 0.77-0.84). Based on these findings, the sMRI or/and fMRI-based ML techniques have relatively good diagnostic value for ADHD.

LIMITATIONS

Our meta-analysis specifically focused on ML techniques based on sMRI or/and fMRI studies. Since EEG-based ML techniques are also used for diagnosing ADHD, further systematic analyses are necessary to explore ML methods based on multimodal medical data.

CONCLUSION

sMRI or/and fMRI-based ML technique is a promising objective diagnostic method for ADHD.

Detecting Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder Using Multimodal Time-Frequency Analysis with Machine Learning Using the Electroretinogram from Two Flash Strengths

PURPOSE

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are conditions that similarly alter cognitive functioning ability and challenge the social interaction, attention, and communication skills of affected individuals. Yet these are distinct neurological conditions that can exhibit diverse characteristics which require different management strategies. It is desirable to develop tools to assist with early distinction so that appropriate early interventions and support may be tailored to an individual's specific requirements. The current diagnostic procedures for ASD and ADHD require a multidisciplinary approach and can be lengthy. This study investigated the potential of electroretinogram (ERG), an eye test measuring retinal responses to light, for rapid screening of ASD and ADHD.

METHODS

Previous studies identified differences in ERG amplitude between ASD and ADHD, but this study explored time-frequency analysis (TFS) to capture dynamic changes in the signal. ERG data from 286 subjects (146 control, 94 ASD, 46 ADHD) was analyzed using two TFS techniques.

RESULTS

Key features were selected, and machine learning models were trained to classify individuals based on their ERG response. The best model achieved 70% overall accuracy in distinguishing control, ASD, and ADHD groups.

CONCLUSION

The ERG to the stronger flash strength provided better separation and the high frequency dynamics (80-300 Hz) were more informative features than lower frequency components. To further improve classification a greater number of different flash strengths may be required along with a discrimination comparison to participants who meet both ASD and ADHD classifications and carry both diagnoses.

Autism Spectrum Disorder Detection by Hybrid Convolutional Recurrent Neural Networks from Structural and Resting State Functional MRI Images

This study aims to increase the accuracy of autism spectrum disorder (ASD) diagnosis based on cognitive and behavioral phenotypes through multiple neuroimaging modalities. We apply machine learning (ML) algorithms to classify ASD patients and healthy control (HC) participants using structural magnetic resonance imaging (s-MRI) together with resting state functional MRI (rs-f-MRI and f-MRI) data from the large multisite data repository ABIDE (autism brain imaging data exchange) and identify important brain connectivity features. The 2D f-MRI images were converted into 3D s-MRI images, and datasets were preprocessed using the Montreal Neurological Institute (MNI) atlas. The data were then denoised to remove any confounding factors. We show, by using three fusion strategies such as early fusion, late fusion, and cross fusion, that, in this implementation, hybrid convolutional recurrent neural networks achieve better performance in comparison to either convolutional neural networks (CNNs) or recurrent neural networks (RNNs). The proposed model classifies subjects as autistic or not according to how functional and anatomical connectivity metrics provide an overall diagnosis based on the autism diagnostic observation schedule (ADOS) standard. Our hybrid network achieved an accuracy of 96% by fusing s-MRI and f-MRI together, which outperforms the methods used in previous studies.

Brain disease research based on functional magnetic resonance imaging data and machine learning: a review

Brain diseases, including neurodegenerative diseases and neuropsychiatric diseases, have long plagued the lives of the affected populations and caused a huge burden on public health. Functional magnetic resonance imaging (fMRI) is an excellent neuroimaging technology for measuring brain activity, which provides new insight for clinicians to help diagnose brain diseases. In recent years, machine learning methods have displayed superior performance in diagnosing brain diseases compared to conventional methods, attracting great attention from researchers. This paper reviews the representative research of machine learning methods in brain disease diagnosis based on fMRI data in the recent three years, focusing on the most frequent four active brain disease studies, including Alzheimer's disease/mild cognitive impairment, autism spectrum disorders, schizophrenia, and Parkinson's disease. We summarize these 55 articles from multiple perspectives, including the effect of the size of subjects, extracted features, feature selection methods, classification models, validation methods, and corresponding accuracies. Finally, we analyze these articles and introduce future research directions to provide neuroimaging scientists and researchers in the interdisciplinary fields of computing and medicine with new ideas for AI-aided brain disease diagnosis.

Sampling inequalities affect generalization of neuroimaging-based diagnostic classifiers in psychiatry

BACKGROUND

The development of machine learning models for aiding in the diagnosis of mental disorder is recognized as a significant breakthrough in the field of psychiatry. However, clinical practice of such models remains a challenge, with poor generalizability being a major limitation.

METHODS

Here, we conducted a pre-registered meta-research assessment on neuroimaging-based models in the psychiatric literature, quantitatively examining global and regional sampling issues over recent decades, from a view that has been relatively underexplored. A total of 476 studies (n = 118,137) were included in the current assessment. Based on these findings, we built a comprehensive 5-star rating system to quantitatively evaluate the quality of existing machine learning models for psychiatric diagnoses.

RESULTS

A global sampling inequality in these models was revealed quantitatively (sampling Gini coefficient (G) = 0.81, p < .01), varying across different countries (regions) (e.g., China, G = 0.47; the USA, G = 0.58; Germany, G = 0.78; the UK, G = 0.87). Furthermore, the severity of this sampling inequality was significantly predicted by national economic levels (β =  - 2.75, p < .001, R²_adj = 0.40; r =  - .84, 95% CI: - .41 to - .97), and was plausibly predictable for model performance, with higher sampling inequality for reporting higher classification accuracy. Further analyses showed that lack of independent testing (84.24% of models, 95% CI: 81.0-87.5%), improper cross-validation (51.68% of models, 95% CI: 47.2-56.2%), and poor technical transparency (87.8% of models, 95% CI: 84.9-90.8%)/availability (80.88% of models, 95% CI: 77.3-84.4%) are prevailing in current diagnostic classifiers despite improvements over time. Relating to these observations, model performances were found decreased in studies with independent cross-country sampling validations (all p < .001, BF₁₀ > 15). In light of this, we proposed a purpose-built quantitative assessment checklist, which demonstrated that the overall ratings of these models increased by publication year but were negatively associated with model performance.

CONCLUSIONS

Together, improving sampling economic equality and hence the quality of machine learning models may be a crucial facet to plausibly translating neuroimaging-based diagnostic classifiers into clinical practice.

Translating precision medicine for autism spectrum disorder: A pressing need

Autism spectrum disorder (ASD) is a heterogenous group of neurodevelopmental disorders (NDDs) with a high unmet medical need. Currently, ASD is diagnosed according to behavior-based criteria that overlook clinical and genomic heterogeneity, thus repeatedly resulting in failed clinical trials. Here, we summarize the scientific evidence pointing to the pressing need to create a precision medicine framework for ASD and other NDDs. We discuss the role of omics and systems biology to characterize more homogeneous disease subtypes with different underlying pathophysiological mechanisms and to determine corresponding tailored treatments. Finally, we provide recent initiatives towards tackling the complexity in NDDs for precision medicine and cost-effective drug discovery.

Evaluation of Risk of Bias in Neuroimaging-Based Artificial Intelligence Models for Psychiatric Diagnosis: A Systematic Review

IMPORTANCE

Neuroimaging-based artificial intelligence (AI) diagnostic models have proliferated in psychiatry. However, their clinical applicability and reporting quality (ie, feasibility) for clinical practice have not been systematically evaluated.

OBJECTIVE

To systematically assess the risk of bias (ROB) and reporting quality of neuroimaging-based AI models for psychiatric diagnosis.

EVIDENCE REVIEW

PubMed was searched for peer-reviewed, full-length articles published between January 1, 1990, and March 16, 2022. Studies aimed at developing or validating neuroimaging-based AI models for clinical diagnosis of psychiatric disorders were included. Reference lists were further searched for suitable original studies. Data extraction followed the CHARMS (Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. A closed-loop cross-sequential design was used for quality control. The PROBAST (Prediction Model Risk of Bias Assessment Tool) and modified CLEAR (Checklist for Evaluation of Image-Based Artificial Intelligence Reports) benchmarks were used to systematically evaluate ROB and reporting quality.

FINDINGS

A total of 517 studies presenting 555 AI models were included and evaluated. Of these models, 461 (83.1%; 95% CI, 80.0%-86.2%) were rated as having a high overall ROB based on the PROBAST. The ROB was particular high in the analysis domain, including inadequate sample size (398 of 555 models [71.7%; 95% CI, 68.0%-75.6%]), poor model performance examination (with 100% of models lacking calibration examination), and lack of handling data complexity (550 of 555 models [99.1%; 95% CI, 98.3%-99.9%]). None of the AI models was perceived to be applicable to clinical practices. Overall reporting completeness (ie, number of reported items/number of total items) for the AI models was 61.2% (95% CI, 60.6%-61.8%), and the completeness was poorest for the technical assessment domain with 39.9% (95% CI, 38.8%-41.1%).

CONCLUSIONS AND RELEVANCE

This systematic review found that the clinical applicability and feasibility of neuroimaging-based AI models for psychiatric diagnosis were challenged by a high ROB and poor reporting quality. Particularly in the analysis domain, ROB in AI diagnostic models should be addressed before clinical application.

Population level multimodal neuroimaging correlates of attention-deficit hyperactivity disorder among children

Objectives

Leveraging a large population-level morphologic, microstructural, and functional neuroimaging dataset, we aimed to elucidate the underlying neurobiology of attention-deficit hyperactivity disorder (ADHD) in children. In addition, we evaluated the applicability of machine learning classifiers to predict ADHD diagnosis based on imaging and clinical information.

Methods

From the Adolescents Behavior Cognitive Development (ABCD) database, we included 1,798 children with ADHD diagnosis and 6,007 without ADHD. In multivariate logistic regression adjusted for age and sex, we examined the association of ADHD with different neuroimaging metrics. The neuroimaging metrics included fractional anisotropy (FA), neurite density (ND), mean-(MD), radial-(RD), and axial diffusivity (AD) of white matter (WM) tracts, cortical region thickness and surface areas from T1-MPRAGE series, and functional network connectivity correlations from resting-state fMRI.

Results

Children with ADHD showed markers of pervasive reduced microstructural integrity in white matter (WM) with diminished neural density and fiber-tracks volumes - most notable in the frontal and parietal lobes. In addition, ADHD diagnosis was associated with reduced cortical volume and surface area, especially in the temporal and frontal regions. In functional MRI studies, ADHD children had reduced connectivity among default-mode network and the central and dorsal attention networks, which are implicated in concentration and attention function. The best performing combination of feature selection and machine learning classifier could achieve a receiver operating characteristics area under curve of 0.613 (95% confidence interval = 0.580-0.645) to predict ADHD diagnosis in independent validation, using a combination of multimodal imaging metrics and clinical variables.

Conclusion

Our study highlights the neurobiological implication of frontal lobe cortex and associate WM tracts in pathogenesis of childhood ADHD. We also demonstrated possible potentials and limitations of machine learning models to assist with ADHD diagnosis in a general population cohort based on multimodal neuroimaging metrics.

Multiple measurement analysis of resting-state fMRI for ADHD classification in adolescent brain from the ABCD study

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in school-aged children. Its accurate diagnosis looks after patients' interests well with effective treatment, which is important to them and their family. Resting-state functional magnetic resonance imaging (rsfMRI) has been widely used to characterize the abnormal brain function by computing the voxel-wise measures and Pearson's correlation (PC)-based functional connectivity (FC) for ADHD diagnosis. However, exploring the powerful measures of rsfMRI to improve ADHD diagnosis remains a particular challenge. To this end, this paper proposes an automated ADHD classification framework by fusion of multiple measures of rsfMRI in adolescent brain. First, we extract the voxel-wise measures and ROI-wise time series from the brain regions of rsfMRI after preprocessing. Then, to extract the multiple functional connectivities, we compute the PC-derived FCs including the topographical information-based high-order FC (tHOFC) and dynamics-based high-order FC (dHOFC), the sparse representation (SR)-derived FCs including the group SR (GSR), the strength and similarity guided GSR (SSGSR), and sparse low-rank (SLR). Finally, these measures are combined with multiple kernel learning (MKL) model for ADHD classification. The proposed method is applied to the Adolescent Brain and Cognitive Development (ABCD) dataset. The results show that the FCs of dHOFC and SLR perform better than the others. Fusing multiple measures achieves the best classification performance (AUC = 0.740, accuracy = 0.6916), superior to those from the single measure and the previous studies. We have identified the most discriminative FCs and brain regions for ADHD diagnosis, which are consistent with those of published literature.

Machine Learning and MRI-based Diagnostic Models for ADHD: Are We There Yet?

OBJECTIVE

Machine learning (ML) has been applied to develop magnetic resonance imaging (MRI)-based diagnostic classifiers for attention-deficit/hyperactivity disorder (ADHD). This systematic review examines this literature to clarify its clinical significance and to assess the implications of the various analytic methods applied.

METHODS

A comprehensive literature search on MRI-based diagnostic classifiers for ADHD was performed and data regarding the utilized models and samples were gathered.

RESULTS

We found that, although most studies reported the classification accuracies, they varied in choice of MRI modalities, ML models, cross-validation and testing methods, and sample sizes. We found that the accuracies of cross-validation methods inflated the performance estimation compared with those of a held-out test, compromising the model generalizability. Test accuracies have increased with publication year but were not associated with training sample sizes. Improved test accuracy over time was likely due to the use of better ML methods along with strategies to deal with data imbalances.

CONCLUSION

Ultimately, large multi-modal imaging datasets, and potentially the combination with other types of data, like cognitive data and/or genetics, will be essential to achieve the goal of developing clinically useful imaging classification tools for ADHD in the future.

Machine Learning-Based Blood RNA Signature for Diagnosis of Autism Spectrum Disorder

Early diagnosis of autism spectrum disorder (ASD) is crucial for providing appropriate treatments and parental guidance from an early age. Yet, ASD diagnosis is a lengthy process, in part due to the lack of reliable biomarkers. We recently applied RNA-sequencing of peripheral blood samples from 73 American and Israeli children with ASD and 26 neurotypically developing (NT) children to identify 10 genes with dysregulated blood expression levels in children with ASD. Machine learning (ML) analyzes data by computerized analytical model building and may be applied to building diagnostic tools based on the optimization of large datasets. Here, we present several ML-generated models, based on RNA expression datasets collected during our recently published RNA-seq study, as tentative tools for ASD diagnosis. Using the random forest classifier, two of our proposed models yield an accuracy of 82% in distinguishing children with ASD and NT children. Our proof-of-concept study requires refinement and independent validation by studies with far larger cohorts of children with ASD and NT children and should thus be perceived as starting point for building more accurate ML-based tools. Eventually, such tools may potentially provide an unbiased means to support the early diagnosis of ASD.

Graph-Based Disease Prediction in Neuroimaging: Investigating the Impact of Feature Selection

In biomedical machine learning, data often appear in the form of graphs. Biological systems such as protein interactions and ecological or brain networks are instances of applications that benefit from graph representations. Geometric deep learning is an arising field of techniques that has extended deep neural networks to non-Euclidean domains such as graphs. In particular, graph convolutional neural networks have achieved advanced performance in semi-supervised learning in those domains. Over the last years, these methods have gained traction in neuroscience as they could be the key to a deeper understanding in clinical diagnosis at the systems or network level (for an individual brain but also for across a cohort of subjects). As a proof-of-principle, we study and validate a previous implementation of graph-based semi-supervised classification using a ridge classifier and graph convolutional neural networks. The models are trained on population graphs that integrate imaging and phenotypic information. Our analysis employs neuroimaging data of structural and functional connectivity for prediction of neurodevelopmental and neurodegenerative disorders. Here, we particularly study the effect of different strategies to reduce the dimensionality of the neuroimaging features on the graph nodes on the classification performance.

Structural and diffusion-weighted brain imaging predictors of attention-deficit/hyperactivity disorder and its symptomology in very young (4- to 7-year-old) children

The current study aimed to identify the key neurobiology of attention-deficit/hyperactivity disorder (ADHD), as it relates to ADHD diagnostic category and symptoms of hyperactive/impulsive behaviour and inattention. To do so, we adapted a predictive modelling approach to identify the key structural and diffusion-weighted brain imaging measures and their relative standing with respect to teacher ratings of executive function (EF) (measured by the Metacognition Index of the Behavior Rating Inventory of Executive Function [BRIEF]) and negativity and emotion regulation (ER) (measured by the Emotion Regulation Checklist [ERC]), in a critical young age range (ages 4 to 7, mean age 5.52 years, 82.2% Hispanic/Latino), where initial contact with educators and clinicians typically take place. Teacher ratings of EF and ER were predictive of both ADHD diagnostic category and symptoms of hyperactive/impulsive behaviour and inattention. Among the neural measures evaluated, the current study identified the critical importance of the largely understudied diffusion-weighted imaging measures for the underlying neurobiology of ADHD and its associated symptomology. Specifically, our analyses implicated the inferior frontal gyrus as a critical predictor of ADHD diagnostic category and its associated symptomology, above and beyond teacher ratings of EF and ER. Collectively, the current set of findings have implications for theories of ADHD, the relative utility of neurobiological measures with respect to teacher ratings of EF and ER, and the developmental trajectory of its underlying neurobiology.

Machine learning for autism spectrum disorder diagnosis using structural magnetic resonance imaging: Promising but challenging

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects approximately 1% of the population and causes significant burdens. ASD's pathogenesis remains elusive; hence, diagnosis is based on a constellation of behaviors. Structural magnetic resonance imaging (sMRI) studies have shown several abnormalities in volumetric and geometric features of the autistic brain. However, inconsistent findings prevented most contributions from being translated into clinical practice. Establishing reliable biomarkers for ASD using sMRI is crucial for the correct diagnosis and treatment. In recent years, machine learning (ML) and specifically deep learning (DL) have quickly extended to almost every sector, notably in disease diagnosis. Thus, this has led to a shift and improvement in ASD diagnostic methods, fulfilling most clinical diagnostic requirements. However, ASD discovery remains difficult. This review examines the ML-based ASD diagnosis literature over the past 5 years. A literature-based taxonomy of the research landscape has been mapped, and the major aspects of this topic have been covered. First, we provide an overview of ML's general classification pipeline and the features of sMRI. Next, representative studies are highlighted and discussed in detail with respect to methods, and biomarkers. Finally, we highlight many common challenges and make recommendations for future directions. In short, the limited sample size was the main obstacle; Thus, comprehensive data sets and rigorous methods are necessary to check the generalizability of the results. ML technologies are expected to advance significantly in the coming years, contributing to the diagnosis of ASD and helping clinicians soon.

Dopaminergic Gene Dosage Reveals Distinct Biological Partitions between Autism and Developmental Delay as Revealed by Complex Network Analysis and Machine Learning Approaches

The neurobiological mechanisms underlying Autism Spectrum Disorders (ASD) remains controversial. One factor contributing to this debate is the phenotypic heterogeneity observed in ASD, which suggests that multiple system disruptions may contribute to diverse patterns of impairment which have been reported between and within study samples. Here, we used SFARI data to address genetic imbalances affecting the dopaminergic system. Using complex network analysis, we investigated the relations between phenotypic profiles, gene dosage and gene ontology (GO) terms related to dopaminergic neurotransmission from a polygenic point-of-view. We observed that the degree of distribution of the networks matched a power-law distribution characterized by the presence of hubs, gene or GO nodes with a large number of interactions. Furthermore, we identified interesting patterns related to subnetworks of genes and GO terms, which suggested applicability to separation of clinical clusters (Developmental Delay (DD) versus ASD). This has the potential to improve our understanding of genetic variability issues and has implications for diagnostic categorization. In ASD, we identified the separability of four key dopaminergic mechanisms disrupted with regard to receptor binding, synaptic physiology and neural differentiation, each belonging to particular subgroups of ASD participants, whereas in DD a more unitary biological pattern was found. Finally, network analysis was fed into a machine learning binary classification framework to differentiate between the diagnosis of ASD and DD. Subsets of 1846 participants were used to train a Random Forest algorithm. Our best classifier achieved, on average, a diagnosis-predicting accuracy of 85.18% (sd 1.11%) on the test samples of 790 participants using 117 genes. The achieved accuracy surpassed results using genetic data and closely matched imaging approaches addressing binary diagnostic classification. Importantly, we observed a similar prediction accuracy when the classifier uses only 62 GO features. This result further corroborates the complex network analysis approach, suggesting that different genetic causes might converge to the dysregulation of the same set of biological mechanisms, leading to a similar disease phenotype. This new biology-driven ontological framework yields a less variable and more compact domain-related set of features with potential mechanistic generalization. The proposed network analysis, allowing for the determination of a clearcut biological distinction between ASD and DD (the latter presenting much lower modularity and heterogeneity), is amenable to machine learning approaches and provides an interesting avenue of research for the future.

MHATC: Autism Spectrum Disorder Identification Utilizing Multi-Head Attention Encoder Along with Temporal Consolidation Modules

Resting-state fMRI is commonly used for diagnosing Autism Spectrum Disorder (ASD) by using network-based functional connectivity. It has been shown that ASD is associated with brain regions and their inter-connections. However, discriminating based on connectivity patterns among imaging data of the control population and that of ASD patients' brains is a non-trivial task. In order to tackle said classification task, we propose a novel deep learning architecture (MHATC) consisting of multi-head attention and temporal consolidation modules for classifying an individual as a patient of ASD. The devised architecture results from an in-depth analysis of the limitations of current deep neural network solutions for similar applications. Our approach is not only robust but computationally efficient, which can allow its adoption in a variety of other research and clinical settings.

rs-fMRI and machine learning for ASD diagnosis: a systematic review and meta-analysis

Autism Spectrum Disorder (ASD) diagnosis is still based on behavioral criteria through a lengthy and time-consuming process. Much effort is being made to identify brain imaging biomarkers and develop tools that could facilitate its diagnosis. In particular, using Machine Learning classifiers based on resting-state fMRI (rs-fMRI) data is promising, but there is an ongoing need for further research on their accuracy and reliability. Therefore, we conducted a systematic review and meta-analysis to summarize the available evidence in the literature so far. A bivariate random-effects meta-analytic model was implemented to investigate the sensitivity and specificity across the 55 studies that offered sufficient information for quantitative analysis. Our results indicated overall summary sensitivity and specificity estimates of 73.8% and 74.8%, respectively. SVM stood out as the most used classifier, presenting summary estimates above 76%. Studies with bigger samples tended to obtain worse accuracies, except in the subgroup analysis for ANN classifiers. The use of other brain imaging or phenotypic data to complement rs-fMRI information seems promising, achieving higher sensitivities when compared to rs-fMRI data alone (84.7% versus 72.8%). Finally, our analysis showed AUC values between acceptable and excellent. Still, given the many limitations indicated in our study, further well-designed studies are warranted to extend the potential use of those classification algorithms to clinical settings.

Reproducible neuroimaging features for diagnosis of autism spectrum disorder with machine learning

Autism spectrum disorder (ASD) is the fourth most common neurodevelopmental disorder, with a prevalence of 1 in 160 children. Accurate diagnosis relies on experts, but such individuals are scarce. This has led to increasing interest in the development of machine learning (ML) models that can integrate neuroimaging features from functional and structural MRI (fMRI and sMRI) to help reveal central nervous system alterations characteristic of ASD. We optimized and compared the performance of 12 of the most popular and powerful ML models. Each was separately trained using 15 different combinations of fMRI and sMRI features and optimized with an unbiased model search. Deep learning models predicted ASD with the highest diagnostic accuracy and generalized well to other MRI datasets. Our model achieves state-of-the-art 80% area under the ROC curve (AUROC) in diagnosis on test data from the IMPAC dataset; and 86% and 79% AUROC on the external ABIDE I and ABIDE II datasets (with further improvement to 93% and 90% after supervised domain adaptation). The highest performing models identified reproducible putative biomarkers for accurate ASD diagnosis in accord with known ASD markers as well as novel cerebellar biomarkers. Such reproducibility lends credence to their tremendous potential for defining and using a set of truly generalizable ASD biomarkers that will advance scientific understanding of neuronal changes in ASD.

Machine Learning Techniques for the Diagnosis of Attention-Deficit/Hyperactivity Disorder from Magnetic Resonance Imaging: A Concise Review

Background

Attention-deficit/hyperactivity disorder (ADHD) is a neuro-developmental disease commonly seen in children and it is diagnosed via extensive interview procedures, behavioral studies, third-party observations, and comprehensive personal history. ADHD causes regional atrophy in brain regions and alters the pattern of functional brain connectivity networks. Automated/computerized methods based on magnetic resonance imaging (MRI) can replace subjective methods for the identification of ADHD.

Objectives

The aim of this study was to analyze various machine-learning algorithms for ADHD by feeding in vital input features extracted from functional brain connectivity and different existing methods and to review factors crucial for the diagnosis of ADHD.

Methods

This paper is a concise review of machine learning methods for the diagnosis of ADHD from MRI. Techniques for feature extraction, dimensionality reduction/feature selection, and classification, employed in the computerized techniques for the diagnosis of ADHD from MRI and the accuracy of classification offered by the individual methods, are focussed on the review.

Conclusions

Machine learning algorithms with features of functional brain connectivity networks as input, with hierarchical sparse feature elimination, exhibits the highest accuracy. Augmentation of the behavioral features does not contribute much to increased accuracy. The level of accuracy offered by the frameworks meant for the computer-aided diagnosis of ADHD, available in the literature, does not justify their feasibility in clinical practice. Computerized methods that exploit highly specific biomarkers of ADHD like brain iron concentration in Globus Pallidus, Putamen, Caudate nucleus, and thalamus as features are not available.

Autism Spectrum Disorder Studies Using fMRI Data and Machine Learning: A Review

Machine learning methods have been frequently applied in the field of cognitive neuroscience in the last decade. A great deal of attention has been attracted to introduce machine learning methods to study the autism spectrum disorder (ASD) in order to find out its neurophysiological underpinnings. In this paper, we presented a comprehensive review about the previous studies since 2011, which applied machine learning methods to analyze the functional magnetic resonance imaging (fMRI) data of autistic individuals and the typical controls (TCs). The all-round process was covered, including feature construction from raw fMRI data, feature selection methods, machine learning methods, factors for high classification accuracy, and critical conclusions. Applying different machine learning methods and fMRI data acquired from different sites, classification accuracies were obtained ranging from 48.3% up to 97%, and informative brain regions and networks were located. Through thorough analysis, high classification accuracies were found to usually occur in the studies which involved task-based fMRI data, single dataset for some selection principle, effective feature selection methods, or advanced machine learning methods. Advanced deep learning together with the multi-site Autism Brain Imaging Data Exchange (ABIDE) dataset became research trends especially in the recent 4 years. In the future, advanced feature selection and machine learning methods combined with multi-site dataset or easily operated task-based fMRI data may appear to have the potentiality to serve as a promising diagnostic tool for ASD.

Multimodal MR Images-Based Diagnosis of Early Adolescent Attention-Deficit/Hyperactivity Disorder Using Multiple Kernel Learning

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common brain diseases among children. The current criteria of ADHD diagnosis mainly depend on behavior analysis, which is subjective and inconsistent, especially for children. The development of neuroimaging technologies, such as magnetic resonance imaging (MRI), drives the discovery of brain abnormalities in structure and function by analyzing multimodal neuroimages for computer-aided diagnosis of brain diseases. This paper proposes a multimodal machine learning framework that combines the Boruta based feature selection and Multiple Kernel Learning (MKL) to integrate the multimodal features of structural and functional MRIs and Diffusion Tensor Images (DTI) for the diagnosis of early adolescent ADHD. The rich and complementary information of the macrostructural features, microstructural properties, and functional connectivities are integrated at the kernel level, followed by a support vector machine classifier for discriminating ADHD from healthy children. Our experiments were conducted on the comorbidity-free ADHD subjects and covariable-matched healthy children aged 9-10 chosen from the Adolescent Brain and Cognitive Development (ABCD) study. This paper is the first work to combine structural and functional MRIs with DTI for early adolescents of the ABCD study. The results indicate that the kernel-level fusion of multimodal features achieves 0.698 of AUC (area under the receiver operating characteristic curves) and 64.3% of classification accuracy for ADHD diagnosis, showing a significant improvement over the early feature fusion and unimodal features. The abnormal functional connectivity predictors, involving default mode network, attention network, auditory network, and sensorimotor mouth network, thalamus, and cerebellum, as well as the anatomical regions in basal ganglia, are found to encode the most discriminative information, which collaborates with macrostructure and diffusion alterations to boost the performances of disorder diagnosis.

A 3D multiscale view convolutional neural network with attention for mental disease diagnosis on MRI images

Computer Assisted Diagnosis (CAD) based on brain Magnetic Resonance Imaging (MRI) is a popular research field for the computer science and medical engineering. Traditional machine learning and deep learning methods were employed in the classification of brain MRI images in the previous studies. However, the current algorithms rarely take into consideration the influence of multi-scale brain connectivity disorders on some mental diseases. To improve this defect, a deep learning structure was proposed based on MRI images, which was designed to consider the brain's connections at different sizes and the attention of connections. In this work, a Multiscale View (MV) module was proposed, which was designed to detect multi-scale brain network disorders. On the basis of the MV module, the path attention module was also proposed to simulate the attention selection of the parallel paths in the MV module. Based on the two modules, we proposed a 3D Multiscale View Convolutional Neural Network with Attention (3D MVA-CNN) for classification of MRI images for mental disease. The proposed method outperformed the previous 3D CNN structures in the structural MRI data of ADHD-200 and the functional MRI data of schizophrenia. Finally, we also proposed a preliminary framework for clinical application using 3D CNN, and discussed its limitations on data accessing and reliability. This work promoted the assisted diagnosis of mental diseases based on deep learning and provided a novel 3D CNN method based on MRI data.

Machine learning with neuroimaging data to identify autism spectrum disorder: a systematic review and meta-analysis

PURPOSE

Autism Spectrum Disorder (ASD) is diagnosed through observation or interview assessments, which is time-consuming, subjective, and with questionable validity and reliability. Thus, we aimed to evaluate the role of machine learning (ML) with neuroimaging data to provide a reliable classification of ASD.

METHODS

A systematic search of PubMed, Scopus, and Embase was conducted to identify relevant publications. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to assess the studies' quality. A bivariate random-effects model meta-analysis was employed to evaluate the pooled sensitivity, the pooled specificity, and the diagnostic performance through the hierarchical summary receiver operating characteristic (HSROC) curve of ML with neuroimaging data in classifying ASD. Meta-regression was also performed.

RESULTS

Forty-four studies (5697 ASD and 6013 typically developing individuals [TD] in total) were included in the quantitative analysis. The pooled sensitivity for differentiating ASD from TD individuals was 86.25 95% confidence interval [CI] (81.24, 90.08), while the pooled specificity was 83.31 95% CI (78.12, 87.48) with a combined area under the HSROC (AUC) of 0.889. Higgins I² (> 90%) and Cochran's Q (p < 0.0001) suggest a high degree of heterogeneity. In the bivariate model meta-regression, a higher pooled specificity was observed in studies not using a brain atlas (90.91 95% CI [80.67, 96.00], p = 0.032). In addition, a greater pooled sensitivity was seen in studies recruiting both males and females (89.04 95% CI [83.84, 92.72], p = 0.021), and combining imaging modalities (94.12 95% [85.43, 97.76], p = 0.036).

CONCLUSION

ML with neuroimaging data is an exciting prospect in detecting individuals with ASD but further studies are required to improve its reliability for usage in clinical practice.

Neuroimaging in Attention-Deficit/Hyperactivity Disorder: Recent Advances

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition, leading to impaired attention and impulsive behaviors diagnosed in, but not limited to, children. ADHD can cause symptoms throughout life. This article summarizes structural (conventional, volumetric, and diffusion tensor imaging MRI) and functional [task-based functional MRI (fMRI), resting state fMRI, PET, and MR spectroscopy] brain findings in patients with ADHD. Consensus is lacking regarding altered anatomic or functional imaging findings of the brain in children with ADHD, likely because of the disorder's heterogeneity. Most anatomic studies report abnormalities in the frontal lobes, basal ganglia, and corpus callosum; decreased surface area in the left ventral frontal and right prefrontal cortex; thinner medial temporal lobes; and smaller caudate nuclei. Using fMRI, researchers have focused on the prefrontal and temporal regions, reflecting perception-action mapping alterations. Artificial intelligence models evaluating brain anatomy have highlighted changes in cortical thickness and shape of the inferior frontal cortex, bilateral sensorimotor cortex, left temporal lobe, and insula. Early intervention and/or normal brain maturation can alter imaging patterns and convert functional imaging studies to a normal pattern. While the imaging findings provide insight into the disease's neuropathophysiology, no definitive structural or functional pattern defines the disorder from a neuroradiologic perspective.

Identifying Autism Spectrum Disorder From Resting-State fMRI Using Deep Belief Network

With the increasing prevalence of autism spectrum disorder (ASD), it is important to identify ASD patients for effective treatment and intervention, especially in early childhood. Neuroimaging techniques have been used to characterize the complex biomarkers based on the functional connectivity anomalies in the ASD. However, the diagnosis of ASD still adopts the symptom-based criteria by clinical observation. The existing computational models tend to achieve unreliable diagnostic classification on the large-scale aggregated data sets. In this work, we propose a novel graph-based classification model using the deep belief network (DBN) and the Autism Brain Imaging Data Exchange (ABIDE) database, which is a worldwide multisite functional and structural brain imaging data aggregation. The remarkable connectivity features are selected through a graph extension of K -nearest neighbors and then refined by a restricted path-based depth-first search algorithm. Thanks to the feature reduction, lower computational complexity could contribute to the shortening of the training time. The automatic hyperparameter-tuning technique is introduced to optimize the hyperparameters of the DBN by exploring the potential parameter space. The simulation experiments demonstrate the superior performance of our model, which is 6.4% higher than the best result reported on the ABIDE database. We also propose to use the data augmentation and the oversampling technique to identify further the possible subtypes within the ASD. The interpretability of our model enables the identification of the most remarkable autistic neural correlation patterns from the data-driven outcomes.

Detection and Grading of Gliomas Using a Novel Two-Phase Machine Learning Method Based on MRI Images

The early detection and grading of gliomas is important for treatment decision and assessment of prognosis. Over the last decade numerous automated computer analysis tools have been proposed, which can potentially lead to more reliable and reproducible brain tumor diagnostic procedures. In this paper, we used the gradient-based features extracted from structural magnetic resonance imaging (sMRI) images to depict the subtle changes within brains of patients with gliomas. Based on the gradient features, we proposed a novel two-phase classification framework for detection and grading of gliomas. In the first phase, the probability of each local feature being related to different types (e.g., diseased or healthy for detection, benign or malignant for grading) was calculated. Then the high-level feature representing the whole MRI image was generated by concatenating the membership probability of each local feature. In the second phase, the supervised classification algorithm was used to train a classifier based on the high-level features and patient labels of the training subjects. We applied this framework on the brain imaging data collected from Zhongnan Hospital of Wuhan University for glioma detection, and the public TCIA datasets including glioblastomas (WHO IV) and low-grade gliomas (WHO II and III) data for glioma grading. The experimental results showed that the gradient-based classification framework could be a promising tool for automatic diagnosis of brain tumors.

Automatic classification of children with autism spectrum disorder by using a computerized visual-orienting task

Early screening and diagnosis of autism spectrum disorder (ASD) primarily rely on behavioral observations by qualified clinicians whose decision process can benefit from the combination of machine learning algorithms and sensor data. We designed a computerized visual-orienting task with gaze-related or non-gaze-related directional cues, which triggered participants' gaze-following behavior. Based on their eye-movement data registered by an eye tracker, we applied the machine learning algorithms to classify high-functioning children with ASD (HFA), low-functioning children with ASD (LFA), and typically developing children (TD). We found that TD children had higher success rates in obtaining rewards than HFA children, and HFA children had higher rates than LFA children. Based on raw eye-tracking data, our machine learning algorithm could classify the three groups with an accuracy of 81.1% and relatively high sensitivity and specificity. Classification became worse if only data from the gaze or nongaze conditions were used, suggesting that "less-social" directional cues also carry useful information for distinguishing these groups. Our findings not only provide insights about visual-orienting deficits among children with ASD but also demonstrate the promise of combining classical behavioral paradigms with machine learning algorithms for aiding the screening for individuals with ASD.

Diagnosis of Autism Spectrum Disorders in Young Children Based on Resting-State Functional Magnetic Resonance Imaging Data Using Convolutional Neural Networks

Statistics show that the risk of autism spectrum disorder (ASD) is increasing in the world. Early diagnosis is most important factor in treatment of ASD. Thus far, the childhood diagnosis of ASD has been done based on clinical interviews and behavioral observations. There is a significant need to reduce the use of traditional diagnostic techniques and to diagnose this disorder in the right time and before the manifestation of behavioral symptoms. The purpose of this study is to present the intelligent model to diagnose ASD in young children based on resting-state functional magnetic resonance imaging (rs-fMRI) data using convolutional neural networks (CNNs). CNNs, which are by far one of the most powerful deep learning algorithms, are mainly trained using datasets with large numbers of samples. However, obtaining comprehensive datasets such as ImageNet and achieving acceptable results in medical imaging domain have become challenges. In order to overcome these two challenges, the two methods of "combining classifiers," both dynamic (mixture of experts) and static (simple ‌Bayes) approaches, and "transfer learning" were used in this analysis. In addition, since diagnosis of ASD will be much more effective at an early age, samples ranging in age from 5 to 10 years from global Autism Brain Imaging Data Exchange I and II (ABIDE I and ABIDE II) datasets were used in this research. The accuracy, sensitivity, and specificity of presented model outperform the results of previous studies conducted on ABIDE I dataset (the best results obtained from Adamax optimization technique: accuracy = 0.7273, sensitivity = 0.712, specificity = 0.7348). Furthermore, acceptable classification results were obtained from ABIDE II dataset (the best results obtained from Adamax optimization technique: accuracy = 0.7, sensitivity = 0.582, specificity = 0.804) and the combination of ABIDE I and ABIDE II datasets (the best results obtained from Adam optimization technique: accuracy = 0.7045, sensitivity = 0.679, specificity = 0.7421). We can conclude that the proposed architecture can be considered as an efficient tool for diagnosis of ASD in young children. From another perspective, this proposed method can be applied to analyzing rs-fMRI data related to brain dysfunctions.

Machine Learning Methods for Diagnosing Autism Spectrum Disorder and Attention- Deficit/Hyperactivity Disorder Using Functional and Structural MRI: A Survey

Here we summarize recent progress in machine learning model for diagnosis of Autism Spectrum Disorder (ASD) and Attention-deficit/Hyperactivity Disorder (ADHD). We outline and describe the machine-learning, especially deep-learning, techniques that are suitable for addressing research questions in this domain, pitfalls of the available methods, as well as future directions for the field. We envision a future where the diagnosis of ASD, ADHD, and other mental disorders is accomplished, and quantified using imaging techniques, such as MRI, and machine-learning models.

Machine learning (ML) for the diagnosis of autism spectrum disorder (ASD) using brain imaging

Autism spectrum disorder (ASD) is a neurodevelopmental incurable disorder with a long diagnostic period encountered in the early years of life. If diagnosed early, the negative effects of this disease can be reduced by starting special education early. Machine learning (ML), an increasingly ubiquitous technology, can be applied for the early diagnosis of ASD. The aim of this study is to examine and provide a comprehensive state-of-the-art review of ML research for the diagnosis of ASD based on (a) structural magnetic resonance image (MRI), (b) functional MRI and (c) hybrid imaging techniques over the past decade. The accuracy of the studies with a large number of participants is in general lower than those with fewer participants leading to the conclusion that further large-scale studies are needed. An examination of the age of the participants shows that the accuracy of the automated diagnosis of ASD is higher at a younger age range. ML technology is expected to contribute significantly to the early and rapid diagnosis of ASD in the coming years and become available to clinicians in the near future. This review is aimed to facilitate that.

A Deep Network Model on Dynamic Functional Connectivity With Applications to Gender Classification and Intelligence Prediction

Increasing evidence has suggested that the dynamic properties of functional brain networks are related to individual behaviors and cognition traits. However, current fMRI-based approaches mostly focus on statistical characteristics of the windowed correlation time course, potentially overlooking subtle time-varying patterns in dynamic functional connectivity (dFC). Here, we proposed the use of an end-to-end deep learning model that combines the convolutional neural network (CNN) and long short-term memory (LSTM) network to capture temporal and spatial features of functional connectivity sequences simultaneously. The results on a large cohort (Human Connectome Project, n = 1,050) demonstrated that our model could achieve a high classification accuracy of about 93% in a gender classification task and prediction accuracies of 0.31 and 0.49 (Pearson's correlation coefficient) in fluid and crystallized intelligence prediction tasks, significantly outperforming previously reported models. Furthermore, we demonstrated that our model could effectively learn spatiotemporal dynamics underlying dFC with high statistical significance based on the null hypothesis estimated using surrogate data. Overall, this study suggests the advantages of a deep learning model in making full use of dynamic information in resting-state functional connectivity, and highlights the potential of time-varying connectivity patterns in improving the prediction of individualized characterization of demographics and cognition traits.

Towards a brain-based predictome of mental illness

Neuroimaging-based approaches have been extensively applied to study mental illness in recent years and have deepened our understanding of both cognitively healthy and disordered brain structure and function. Recent advancements in machine learning techniques have shown promising outcomes for individualized prediction and characterization of patients with psychiatric disorders. Studies have utilized features from a variety of neuroimaging modalities, including structural, functional, and diffusion magnetic resonance imaging data, as well as jointly estimated features from multiple modalities, to assess patients with heterogeneous mental disorders, such as schizophrenia and autism. We use the term "predictome" to describe the use of multivariate brain network features from one or more neuroimaging modalities to predict mental illness. In the predictome, multiple brain network-based features (either from the same modality or multiple modalities) are incorporated into a predictive model to jointly estimate features that are unique to a disorder and predict subjects accordingly. To date, more than 650 studies have been published on subject-level prediction focusing on psychiatric disorders. We have surveyed about 250 studies including schizophrenia, major depression, bipolar disorder, autism spectrum disorder, attention-deficit hyperactivity disorder, obsessive-compulsive disorder, social anxiety disorder, posttraumatic stress disorder, and substance dependence. In this review, we present a comprehensive review of recent neuroimaging-based predictomic approaches, current trends, and common shortcomings and share our vision for future directions.

The Development of a Practical Artificial Intelligence Tool for Diagnosing and Evaluating Autism Spectrum Disorder: Multicenter Study

Background

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with an unknown etiology. Early diagnosis and intervention are key to improving outcomes for patients with ASD. Structural magnetic resonance imaging (sMRI) has been widely used in clinics to facilitate the diagnosis of brain diseases such as brain tumors. However, sMRI is less frequently used to investigate neurological and psychiatric disorders, such as ASD, owing to the subtle, if any, anatomical changes of the brain.

Objective

This study aimed to investigate the possibility of identifying structural patterns in the brain of patients with ASD as potential biomarkers in the diagnosis and evaluation of ASD in clinics.

Methods

We developed a novel 2-level histogram-based morphometry (HBM) classification framework in which an algorithm based on a 3D version of the histogram of oriented gradients (HOG) was used to extract features from sMRI data. We applied this framework to distinguish patients with ASD from healthy controls using 4 datasets from the second edition of the Autism Brain Imaging Data Exchange, including the ETH Zürich (ETH), NYU Langone Medical Center: Sample 1, Oregon Health and Science University, and Stanford University (SU) sites. We used a stratified 10-fold cross-validation method to evaluate the model performance, and we applied the Naive Bayes approach to identify the predictive ASD-related brain regions based on classification contributions of each HOG feature.

Results

On the basis of the 3D HOG feature extraction method, our proposed HBM framework achieved an area under the curve (AUC) of >0.75 in each dataset, with the highest AUC of 0.849 in the ETH site. We compared the 3D HOG algorithm with the original 2D HOG algorithm, which showed an accuracy improvement of >4% in each dataset, with the highest improvement of 14% (6/42) in the SU site. A comparison of the 3D HOG algorithm with the scale-invariant feature transform algorithm showed an AUC improvement of >18% in each dataset. Furthermore, we identified ASD-related brain regions based on the sMRI images. Some of these regions (eg, frontal gyrus, temporal gyrus, cingulate gyrus, postcentral gyrus, precuneus, caudate, and hippocampus) are known to be implicated in ASD in prior neuroimaging literature. We also identified less well-known regions that may play unrecognized roles in ASD and be worth further investigation.

Conclusions

Our research suggested that it is possible to identify neuroimaging biomarkers that can distinguish patients with ASD from healthy controls based on the more cost-effective sMRI images of the brain. We also demonstrated the potential of applying data-driven artificial intelligence technology in the clinical setting of neurological and psychiatric disorders, which usually harbor subtle anatomical changes in the brain that are often invisible to the human eye.

Multimodal neuroimaging-based prediction of adult outcomes in childhood-onset ADHD using ensemble learning techniques

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and heterogeneous neurodevelopmental disorder, which is diagnosed using subjective symptom reports. Machine learning classifiers have been utilized to assist in the development of neuroimaging-based biomarkers for objective diagnosis of ADHD. However, existing basic model-based studies in ADHD report suboptimal classification performances and inconclusive results, mainly due to the limited flexibility for each type of basic classifier to appropriately handle multi-dimensional source features with varying properties. This study applied ensemble learning techniques (ELTs), a meta-algorithm that combine several basic machine learning models into one predictive model in order to decrease variance, bias, or improve predictions, in multimodal neuroimaging data collected from 72 young adults, including 36 probands (18 remitters and 18 persisters of childhood ADHD) and 36 group-matched controls. All currently available optimization strategies for ELTs (i.e., voting, bagging, boosting and stacking techniques) were tested in a pool of semifinal classification results generated by seven basic classifiers. The high-dimensional neuroimaging features for classification included regional cortical gray matter (GM) thickness and surface area, GM volume of subcortical structures, volume and fractional anisotropy of major white matter fiber tracts, pair-wise regional connectivity and global/nodal topological properties of the functional brain network for cue-evoked attention process. As a result, the bagging-based ELT with the base model of support vector machine achieved the best results, with significant improvement of the area under the receiver of operating characteristic curve (0.89 for ADHD vs. controls and 0.9 for ADHD persisters vs. remitters). Features of nodal efficiency in right inferior frontal gyrus, right middle frontal (MFG)-inferior parietal (IPL) functional connectivity, and right amygdala volume significantly contributed to accurate discrimination between ADHD probands and controls; higher nodal efficiency of right MFG greatly contributed to inattentive and hyperactive/impulsive symptom remission, while higher right MFG-IPL functional connectivity strongly linked to symptom persistence in adults with childhood ADHD. Considering their improved robustness than the commonly implemented basic classifiers, findings suggest that ELTs may have the potential to identify more reliable neurobiological markers for neurodevelopmental disorders.

Attentional Connectivity-based Prediction of Autism Using Heterogeneous rs-fMRI Data from CC200 Atlas

Autism spectrum disorder (ASD) is a developmental syndrome characterized by obvious drawbacks in sociality and communication. It has crucial significance to exactly discern the individuals with ASD and typical controls (TC). Previous imaging studies on ASD/TC identification have made remarkable progress in the exploration of objective as well as crucial biomarkers associated with ASD. However, glaring deficiency is manifested by the investigation on solely homogeneous and small datasets. Thus, we attempted to unveil some replicable and robust neural patterns of autism using a heterogeneous multi-site brain imaging dataset from ABIDE (Autism Brain Imaging Data Exchange). Experiments were carried out with an attention mechanism based on Extra-Trees algorithm, taking the study object of brain connectivity measured with the resting-state functional magnetic resonance imaging (fMRI) data of CC200 atlas. With cross-validation strategy, our proposed method resulted in a mean classification accuracy of 72.2% (sensitivity=68.6%, specificity=75.4%). It raised the precision of ASD prediction by about 2% and specificity by 3.2% in comparison with the most competitive reported effort. Connectivity analysis on the optimal model highlighted informative regions strongly involved in the social cognition as well as interaction, and manifested lower correlation between the anterior and posterior default mode network (DMN) in autistic individuals than controls. This observation is concordant with previous studies, which enables our proposed method to effectively identify the individuals with risk of ASD.

Event-Related Potential Analysis of ADHD and Control Adults During a Sustained Attention Task

Background. Event-related potentials (ERPs) of attention deficit hyperactivity disorder (ADHD) population have been extensively studied using the time-domain representation of signals but time-frequency domain techniques are less explored. Although, adult ADHD is a proven disorder, most of the electrophysiological studies have focused only on children with ADHD. Methods. ERP data of 35 university students with ADHD and 35 control adults were recorded during visual continuous performance task (CPT). Gray level co-occurrence matrix-based texture features were extracted from time-frequency (t-f) images of event-related EEG epochs. Different ERP components measures, that is, amplitudes and latencies corresponding to N1, N2, and P3 components were also computed relative to standard and target stimuli. Results. Texture analysis has shown that the mean value of contrast, dissimilarity, and difference entropy is significantly reduced in adults with ADHD than in control adults. The mean correlation and homogeneity in adults with ADHD were significantly increased as compared with control adults. ERP components analysis has reported that adults with ADHD have reduced N1 amplitude to target stimuli, reduced N2 and P3 amplitude to both standard and target stimuli than controls. Conclusions. The differences in texture features obtained from t-f images of ERPs point toward altered information processing in adults with ADHD during a cognitive task. Findings of reduction in N1, N2, and P3 components highlight deficits of early sensory processing, stimulus categorization, and attentional resources, respectively, in adults with ADHD.

Biomarkers for Autism Spectrum Disorders (ASD): A Meta-analysis

OBJECTIVE

To compare the reported accuracy and sensitivity of the various modalities used to diagnose autism spectrum disorders (ASD) in efforts to help focus further biomarker research on the most promising methods for early diagnosis.

METHODS

The Medline scientific literature database was searched to identify publications assessing potential clinical ASD biomarkers. Reports were categorized by the modality used to assess the putative markers, including protein, genetic, metabolic, or objective imaging methods. The reported sensitivity, specificity, area under the curve, and overall agreement were summarized and analyzed to determine weighted averages for each diagnostic modality. Heterogeneity was measured using the I² test.

RESULTS

Of the 71 papers included in this analysis, each belonging to one of five modalities, protein-based followed by metabolite-based markers provided the highest diagnostic accuracy, each with a pooled overall agreement of 83.3% and respective weighted area under the curve (AUC) of 89.5% and 88.3%. Sensitivity provided by protein markers was highest (85.5%), while metabolic (85.9%) and protein markers (84.7%) had the highest specificity. Other modalities showed degrees of sensitivity, specificity, and overall agreements in the range of 73%-80%.

CONCLUSIONS

Each modality provided for diagnostic accuracy and specificity similar or slightly higher than those reported for the gold-standard Autism Diagnostic Observation Schedule (ADOS) instrument. Further studies are required to identify the most predictive markers within each modality and to evaluate biological pathways or clustering with possible etiological relevance. Analyses will also be necessary to determine the potential of these novel biomarkers in diagnosing pediatric patients, thereby enabling early intervention.

Functional Connectivities Are More Informative Than Anatomical Variables in Diagnostic Classification of Autism

Machine learning techniques have been implemented to reveal brain features that distinguish people with autism spectrum disorders (ASDs) from typically developing (TD) peers. However, it remains unknown whether different neuroimaging modalities are equally informative for diagnostic classification. We combined anatomical magnetic resonance imaging (aMRI), diffusion weighted imaging (DWI), and functional connectivity MRI (fcMRI) using conditional random forest (CRF) for supervised learning to compare how informative each modality was in diagnostic classification. In-house data (N = 93) included 47 TD and 46 ASD participants, matched on age, motion, and nonverbal IQ. Four main analyses consistently indicated that fcMRI variables were significantly more informative than anatomical variables from aMRI and DWI. This was found (1) when the top 100 variables from CRF (run separately in each modality) were combined for multimodal CRF; (2) when only 19 top variables reaching >67% accuracy in each modality were combined in multimodal CRF; and (3) when the large number of initial variables (before dimension reduction) potentially biasing comparisons in favor of fcMRI was reduced using a less granular region of interest scheme. Consistent superiority of fcMRI was even found (4) when 100 variables per modality were randomly selected, removing any such potential bias. Greater informative value of functional than anatomical modalities may relate to the nature of fcMRI data, reflecting more closely behavioral condition, which is also the basis of diagnosis, whereas brain anatomy may be more reflective of neurodevelopmental history.

An algorithm for learning shape and appearance models without annotations

This paper presents a framework for automatically learning shape and appearance models for medical (and certain other) images. The algorithm was developed with the aim of eventually enabling distributed privacy-preserving analysis of brain image data, such that shared information (shape and appearance basis functions) may be passed across sites, whereas latent variables that encode individual images remain secure within each site. These latent variables are proposed as features for privacy-preserving data mining applications. The approach is demonstrated qualitatively on the KDEF dataset of 2D face images, showing that it can align images that traditionally require shape and appearance models trained using manually annotated data (manually defined landmarks etc.). It is applied to the MNIST dataset of handwritten digits to show its potential for machine learning applications, particularly when training data is limited. The model is able to handle "missing data", which allows it to be cross-validated according to how well it can predict left-out voxels. The suitability of the derived features for classifying individuals into patient groups was assessed by applying it to a dataset of over 1900 segmented T1-weighted MR images, which included images from the COBRE and ABIDE datasets.

Characterizing and Predicting Autism Spectrum Disorder by Performing Resting-State Functional Network Community Pattern Analysis

Growing evidence indicates that autism spectrum disorder (ASD) is a neuropsychological disconnection syndrome that can be analyzed using various complex network metrics used as pathology biomarkers. Recently, community detection and analysis rooted in the complex network and graph theories have been introduced to investigate the changes in resting-state functional network community structure under neurological pathologies. However, the potential of hidden patterns in the modular organization of networks derived from resting-state functional magnetic resonance imaging to predict brain pathology has never been investigated. In this study, we present a novel analysis technique to identify alterations in community patterns in functional networks under ASD. In addition, we design machine learning classifiers to predict the clinical class of patients with ASD and controls by using only community pattern quality metrics as features. Analyses conducted on six publicly available datasets from 235 subjects, including patients with ASD and age-matched controls revealed that the modular structure is significantly disturbed in patients with ASD. Machine learning algorithms showed that the predictive power of our five metrics is relatively high (~85.16% peak accuracy for in-site data and ~75.00% peak accuracy for multisite data). These results lend further credence to the dysconnectivity theory of this pathology.

Enhancing Diagnosis of Autism With Optimized Machine Learning Models and Personal Characteristic Data

Autism spectrum disorder (ASD) is a developmental disorder, affecting about 1% of the global population. Currently, the only clinical method for diagnosing ASD are standardized ASD tests which require prolonged diagnostic time and increased medical costs. Our objective was to explore the predictive power of personal characteristic data (PCD) from a large well-characterized dataset to improve upon prior diagnostic models of ASD. We extracted six personal characteristics (age, sex, handedness, and three individual measures of IQ) from 851 subjects in the Autism Brain Imaging Data Exchange (ABIDE) database. ABIDE is an international collaborative project that collected data from a large number of ASD patients and typical non-ASD controls from 17 research and clinical institutes. We employed this publicly available database to test nine supervised machine learning models. We implemented a cross-validation strategy to train and test those machine learning models for classification between typical non-ASD controls and ASD patients. We assessed classification performance using accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Of the nine models we tested using six personal characteristics, the neural network model performed the best with a mean AUC (SD) of 0.646 (0.005), followed by k-nearest neighbor with a mean AUC (SD) of 0.641 (0.004). This study established an optimal ASD classification performance with PCD as features. With additional discriminative features (e.g., neuroimaging), machine learning models may ultimately enable automated clinical diagnosis of autism.

Neurodevelopmental heterogeneity and computational approaches for understanding autism

In recent years, the emerging field of computational psychiatry has impelled the use of machine learning models as a means to further understand the pathogenesis of multiple clinical disorders. In this paper, we discuss how autism spectrum disorder (ASD) was and continues to be diagnosed in the context of its complex neurodevelopmental heterogeneity. We review machine learning approaches to streamline ASD's diagnostic methods, to discern similarities and differences from comorbid diagnoses, and to follow developmentally variable outcomes. Both supervised machine learning models for classification outcome and unsupervised approaches to identify new dimensions and subgroups are discussed. We provide an illustrative example of how computational analytic methods and a longitudinal design can improve our inferential ability to detect early dysfunctional behaviors that may or may not reach threshold levels for formal diagnoses. Specifically, an unsupervised machine learning approach of anomaly detection is used to illustrate how community samples may be utilized to investigate early autism risk, multidimensional features, and outcome variables. Because ASD symptoms and challenges are not static within individuals across development, computational approaches present a promising method to elucidate subgroups of etiological contributions to phenotype, alternative developmental courses, interactions with biomedical comorbidities, and to predict potential responses to therapeutic interventions.

Classification Accuracy of Neuroimaging Biomarkers in Attention-Deficit/Hyperactivity Disorder: Effects of Sample Size and Circular Analysis

BACKGROUND

Motivated by an inconsistency between reports of high diagnosis-classification accuracies and known heterogeneity in attention-deficit/hyperactivity disorder (ADHD), this study assessed classification accuracy in studies of ADHD as a function of methodological factors that can bias results. We hypothesized that high classification results in ADHD diagnosis are inflated by methodological factors.

METHODS

We reviewed 69 studies (of 95 studies identified) that used neuroimaging features to predict ADHD diagnosis. Based on reported methods, we assessed the prevalence of circular analysis, which inflates classification accuracy, and evaluated the relationship between sample size and accuracy to test if small-sample models tend to report higher classification accuracy, also an indicator of bias.

RESULTS

Circular analysis was detected in 15.9% of ADHD classification studies, lack of independent test set was noted in 13%, and insufficient methodological detail to establish its presence was noted in another 11.6%. Accuracy of classification ranged from 60% to 80% in the 59.4% of reviewed studies that met criteria for independence of feature selection, model construction, and test datasets. Moreover, there was a negative relationship between accuracy and sample size, implying additional bias contributing to reported accuracies at lower sample sizes.

CONCLUSIONS

High classification accuracies in neuroimaging studies of ADHD appear to be inflated by circular analysis and small sample size. Accuracies on independent datasets were consistent with known heterogeneity of the disorder. Steps to resolve these issues, and a shift toward accounting for sample heterogeneity and prediction of future outcomes, will be crucial in future classification studies in ADHD.

Combination of rs-fMRI and sMRI Data to Discriminate Autism Spectrum Disorders in Young Children Using Deep Belief Network

In recent years, the use of advanced magnetic resonance (MR) imaging methods such as functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (sMRI) has recorded a great increase in neuropsychiatric disorders. Deep learning is a branch of machine learning that is increasingly being used for applications of medical image analysis such as computer-aided diagnosis. In a bid to classify and represent learning tasks, this study utilized one of the most powerful deep learning algorithms (deep belief network (DBN)) for the combination of data from Autism Brain Imaging Data Exchange I and II (ABIDE I and ABIDE II) datasets. The DBN was employed so as to focus on the combination of resting-state fMRI (rs-fMRI), gray matter (GM), and white matter (WM) data. This was done based on the brain regions that were defined using the automated anatomical labeling (AAL), in order to classify autism spectrum disorders (ASDs) from typical controls (TCs). Since the diagnosis of ASD is much more effective at an early age, only 185 individuals (116 ASD and 69 TC) ranging in age from 5 to 10 years were included in this analysis. In contrast, the proposed method is used to exploit the latent or abstract high-level features inside rs-fMRI and sMRI data while the old methods consider only the simple low-level features extracted from neuroimages. Moreover, combining multiple data types and increasing the depth of DBN can improve classification accuracy. In this study, the best combination comprised rs-fMRI, GM, and WM for DBN of depth 3 with 65.56% accuracy (sensitivity = 84%, specificity = 32.96%, F1 score = 74.76%) obtained via 10-fold cross-validation. This result outperforms previously presented methods on ABIDE I dataset.