Longitudinal Analysis for Disease Progression via Simultaneous Multi-Relational Temporal-Fused Learning

AI for the prediction of early stages of Alzheimer's disease from neuroimaging biomarkers - A narrative review of a growing field

OBJECTIVES

The objectives of this narrative review are to summarize the current state of AI applications in neuroimaging for early Alzheimer's disease (AD) prediction and to highlight the potential of AI techniques in improving early AD diagnosis, prognosis, and management.

METHODS

We conducted a narrative review of studies using AI techniques applied to neuroimaging data for early AD prediction. We examined single-modality studies using structural MRI and PET imaging, as well as multi-modality studies integrating multiple neuroimaging techniques and biomarkers. Furthermore, they reviewed longitudinal studies that model AD progression and identify individuals at risk of rapid decline.

RESULTS

Single-modality studies using structural MRI and PET imaging have demonstrated high accuracy in classifying AD and predicting progression from mild cognitive impairment (MCI) to AD. Multi-modality studies, integrating multiple neuroimaging techniques and biomarkers, have shown improved performance and robustness compared to single-modality approaches. Longitudinal studies have highlighted the value of AI in modeling AD progression and identifying individuals at risk of rapid decline. However, challenges remain in data standardization, model interpretability, generalizability, clinical integration, and ethical considerations.

CONCLUSION

AI techniques applied to neuroimaging data have the potential to improve early AD diagnosis, prognosis, and management. Addressing challenges related to data standardization, model interpretability, generalizability, clinical integration, and ethical considerations is crucial for realizing the full potential of AI in AD research and clinical practice. Collaborative efforts among researchers, clinicians, and regulatory agencies are needed to develop reliable, robust, and ethical AI tools that can benefit AD patients and society.

Automated Video Analysis of Audio-Visual Approaches to Predict and Detect Mild Cognitive Impairment and Dementia in Older Adults

BACKGROUND

Early identification of different stages of cognitive impairment is important to provide available intervention and timely care for the elderly.

OBJECTIVE

This study aimed to examine the ability of the artificial intelligence (AI) technology to distinguish participants with mild cognitive impairment (MCI) from those with mild to moderate dementia based on automated video analysis.

METHODS

A total of 95 participants were recruited (MCI, 41; mild to moderate dementia, 54). The videos were captured during the Short Portable Mental Status Questionnaire process; the visual and aural features were extracted using these videos. Deep learning models were subsequently constructed for the binary differentiation of MCI and mild to moderate dementia. Correlation analysis of the predicted Mini-Mental State Examination, Cognitive Abilities Screening Instrument scores, and ground truth was also performed.

RESULTS

Deep learning models combining both the visual and aural features discriminated MCI from mild to moderate dementia with an area under the curve (AUC) of 77.0% and accuracy of 76.0% . The AUC and accuracy increased to 93.0% and 88.0%, respectively, when depression and anxiety were excluded. Significant moderate correlations were observed between the predicted cognitive function and ground truth, and the correlation was strong excluding depression and anxiety. Interestingly, female, but not male, exhibited a correlation.

CONCLUSION

The study showed that video-based deep learning models can differentiate participants with MCI from those with mild to moderate dementia and can predict cognitive function. This approach may offer a cost-effective and easily applicable method for early detection of cognitive impairment.

A Tensorized Multitask Deep Learning Network for Progression Prediction of Alzheimer's Disease

With the advances in machine learning for the diagnosis of Alzheimer's disease (AD), most studies have focused on either identifying the subject's status through classification algorithms or on predicting their cognitive scores through regression methods, neglecting the potential association between these two tasks. Motivated by the need to enhance the prospects for early diagnosis along with the ability to predict future disease states, this study proposes a deep neural network based on modality fusion, kernelization, and tensorization that perform multiclass classification and longitudinal regression simultaneously within a unified multitask framework. This relationship between multiclass classification and longitudinal regression is found to boost the efficacy of the final model in dealing with both tasks. Different multimodality scenarios are investigated, and complementary aspects of the multimodal features are exploited to simultaneously delineate the subject's label and predict related cognitive scores at future timepoints using baseline data. The main intent in this multitask framework is to consolidate the highest accuracy possible in terms of precision, sensitivity, F1 score, and area under the curve (AUC) in the multiclass classification task while maintaining the highest similarity in the MMSE score as measured through the correlation coefficient and the RMSE for all time points under the prediction task, with both tasks, run simultaneously under the same set of hyperparameters. The overall accuracy for multiclass classification of the proposed KTMnet method is 66.85 ± 3.77. The prediction results show an average RMSE of 2.32 ± 0.52 and a correlation of 0.71 ± 5.98 for predicting MMSE throughout the time points. These results are compared to state-of-the-art techniques reported in the literature. A discovery from the multitasking of this consolidated machine learning framework is that a set of hyperparameters that optimize the prediction results may not necessarily be the same as those that would optimize the multiclass classification. In other words, there is a breakpoint beyond which enhancing further the results of one process could lead to the downgrading in accuracy for the other.

A predictive framework based on brain volume trajectories enabling early detection of Alzheimer's disease

We present a framework for constructing predictive models of cognitive decline from longitudinal MRI examinations, based on mixed effects models and machine learning. We apply the framework to detect conversion from cognitively normal (CN) to mild cognitive impairment (MCI) and from MCI to Alzheimer's disease (AD), using a large collection of subjects sourced from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging (AIBL). We extract subcortical segmentation and cortical parcellation from corresponding T1-weighted images using FreeSurfer v.6.0, select bilateral 3D regions of interest relevant to neurodegeneration/dementia, and fit their longitudinal volume trajectories using linear mixed effects models. Features describing these model-based trajectories are then used to train an ensemble of machine learning classifiers to distinguish stable CN from converters to MCI, and stable MCI from converters to AD. On separate test sets the models achieved an average of accuracy/precision/recall score of 69/73/60% for converted to MCI and 75/74/77% for converted to AD, illustrating the framework's ability to extract predictive imaging-based biomarkers from routine T1-weighted MRI acquisitions.

Predicting Cognitive Declines Using Longitudinally Enriched Representations for Imaging Biomarkers

A critical challenge in using longitudinal neuroimaging data to study the progressions of Alzheimer's Disease (AD) is the varied number of missing records of the patients during the course when AD develops. To tackle this problem, in this paper we propose a novel formulation to learn an enriched representation with fixed length for imaging biomarkers, which aims to simultaneously capture the information conveyed by both baseline neuroimaging record and progressive variations characterized by varied counts of available follow-up records over time. Because the learned biomarker representations are a set of fixed-length vectors, they can be readily used by traditional machine learning models to study AD developments. Take into account that the missing brain scans are not aligned in terms of time in a studied cohort, we develop a new objective that maximizes the ratio of the summations of a number of l₁ -norm distances for improved robustness, which, though, is difficult to efficiently solve in general. Thus, we derive a new efficient and non-greedy iterative solution algorithm and rigorously prove its convergence. We have performed extensive experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. A clear performance gain has been achieved in predicting ten different cognitive scores when we compare the original baseline biomarker representations against the learned representations with longitudinal enrichments. We further observe that the top selected biomarkers by our new method are in accordance with known knowledge in AD studies. These promising results have demonstrated improved performances of our new method that validate its effectiveness.

Fused Sparse Network Learning for Longitudinal Analysis of Mild Cognitive Impairment

Alzheimer's disease (AD) is a neurodegenerative disease with an irreversible and progressive process. To understand the brain functions and identify the biomarkers of AD and early stages of the disease [also known as, mild cognitive impairment (MCI)], it is crucial to build the brain functional connectivity network (BFCN) using resting-state functional magnetic resonance imaging (rs-fMRI). Existing methods have been mainly developed using only a single time-point rs-fMRI data for classification. In fact, multiple time-point data is more effective than a single time-point data in diagnosing brain diseases by monitoring the disease progression patterns using longitudinal analysis. In this article, we utilize multiple rs-fMRI time-point to identify early MCI (EMCI) and late MCI (LMCI), by integrating the fused sparse network (FSN) model with parameter-free centralized (PFC) learning. Specifically, we first construct the FSN framework by building multiple time-point BFCNs. The multitask learning via PFC is then leveraged for longitudinal analysis of EMCI and LMCI. Accordingly, we can jointly learn the multiple time-point features constructed from the BFCN model. The proposed PFC method can automatically balance the contributions of different time-point information via learned specific and common features. Finally, the selected multiple time-point features are fused by a similarity network fusion (SNF) method. Our proposed method is evaluated on the public AD neuroimaging initiative phase-2 (ADNI-2) database. The experimental results demonstrate that our method can achieve quite promising performance and outperform the state-of-the-art methods.

Multi-task exclusive relationship learning for alzheimer's disease progression prediction with longitudinal data

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive impairment of memory and other cognitive functions. Currently, many multi-task learning approaches have been proposed to predict the disease progression at the early stage using longitudinal data, with each task corresponding to a particular time point. However, the underlying association among different time points in disease progression is still under-explored in previous studies. To this end, we propose a multi-task exclusive relationship learning model to automatically capture the intrinsic relationship among tasks at different time points for estimating clinical measures based on longitudinal imaging data. The proposed method can select the most discriminative features for different tasks and also model the intrinsic relatedness among different time points, by utilizing an exclusive lasso regularization and a relationship induced regularization. Specifically, the exclusive lasso regularization enables partial group structure feature selection among the longitudinal data, while the relationship induced regularization efficiently introduces the relationship information from data to guide knowledge transfer. We further develop an efficient optimization algorithm to solve the proposed objective function. Extensive experiments on both synthetic and real datasets demonstrate the effectiveness of our proposed method. In comparison with several state-of-the-art methods, our proposed method can achieve promising performance for cognitive status prediction and also can help discover disease-related biomarkers.

Parkinson's Disease Diagnosis via Joint Learning From Multiple Modalities and Relations

Parkinson's disease (PD) is a neurodegenerative progressive disease that mainly affects the motor systems of patients. To slow this disease deterioration, early and accurate diagnosis of PD is an effective way, which alleviates mental and physical sufferings by clinical intervention. In this paper, we propose a joint regression and classification framework for PD diagnosis via magnetic resonance and diffusion tensor imaging data. Specifically, we devise a unified multitask feature selection model to explore multiple relationships among features, samples, and clinical scores. We regress four clinical variables of depression, sleep, olfaction, cognition scores, as well as perform the classification of PD disease from the multimodal data. The multitask model explores the relationships at the level of clinical scores, image features, and subjects, to select the most informative and diseased-related features for diagnosis. The proposed method is evaluated on the public Parkinson's progression markers initiative dataset. The extensive experimental results show that the multitask framework can effectively boost the performance of regression and classification and outperforms other state-of-the-art methods. The computerized predictions of clinical scores and label for PD diagnosis may offer quantitative reference for decision support as well.

Multi-task fused sparse learning for mild cognitive impairment identification

BACKGROUND

Brain functional connectivity network (BFCN) has been widely applied to identify biomarkers for the brain function understanding and brain diseases analysis.

OBJECTIVE

Building a biologically meaningful brain network is a crucial work in these applications. For this task, sparse learning has been widely applied for the network construction. If multiple time-point data is added to the brain imaging application, the disease progression pattern in the longitudinal analysis can be better revealed.

METHODS

A novel longitudinal analysis for MCI classification is devised based on resting-state functional magnetic resonating imaging (rs-fMRI). Specifically, this paper proposes a novel multi-task learning method to integrate fused penalty by regularization. In addition, a novel objective function is developed for fused sparse learning via smoothness constraint.

RESULTS

The proposed method achieves the best classification performance with an accuracy of 95.74% for baseline and 93.64% for year 1 data.

CONCLUSIONS

The experimental results show that our proposed method achieves quite promising classification performance.

Joint regression and classification via relational regularization for Parkinson's disease diagnosis

It is known that the symptoms of Parkinson’s disease (PD) progress successively, early and accurate diagnosis of the disease is of great importance, which slows the disease deterioration further and alleviates mental and physical suffering. In this paper, we propose a joint regression and classification scheme for PD diagnosis using baseline multi-modal neuroimaging data. Specifically, we devise a new feature selection method via relational learning in a unified multi-task feature selection model. Three kinds of relationships (e.g., relationships among features, responses, and subjects) are integrated to represent the similarities among features, responses, and subjects. Our proposed method exploits five regression variables (depression, sleep, olfaction, cognition scores and a clinical label) to jointly select the most discriminative features for clinical scores prediction and class label identification. Extensive experiments are conducted to demonstrate the effectiveness of the proposed method on the Parkinson’s Progression Markers Initiative (PPMI) dataset. Our experimental results demonstrate that multi-modal data can effectively enhance the performance in class label identification compared with single modal data. Our proposed method can greatly improve the performance in clinical scores prediction and outperforms the state-of-art methods as well. The identified brain regions can be recognized for further medical analysis and diagnosis.

Sparse feature learning for multi-class Parkinson's disease classification

This paper solves the multi-class classification problem for Parkinson's disease (PD) analysis by a sparse discriminative feature selection framework. Specifically, we propose a framework to construct a least square regression model based on the Fisher's linear discriminant analysis (LDA) and locality preserving projection (LPP). This framework utilizes the global and local information to select the most relevant and discriminative features to boost classification performance. Differing in previous methods for binary classification, we perform a multi-class classification for PD diagnosis. Our proposed method is evaluated on the public available Parkinson's progression markers initiative (PPMI) datasets. Extensive experimental results indicate that our proposed method identifies highly suitable regions for further PD analysis and diagnosis and outperforms state-of-the-art methods.

Premature brain aging in humans exposed to maternal nutrient restriction during early gestation

BACKGROUND

Prenatal exposure to undernutrition is widespread in both developing and industrialized countries, causing irreversible damage to the developing brain, resulting in altered brain structure and decreased cognitive function during adulthood. The Dutch famine in 1944/45 was a humanitarian disaster, now enabling studies of the effects of prenatal undernutrition during gestation on brain aging in late adulthood.

METHODS

We hypothesized that study participants prenatally exposed to maternal nutrient restriction (MNR) would demonstrate altered brain structure resembling premature brain aging in late adulthood, expecting the effect being stronger in men. Utilizing the Dutch famine birth cohort (n = 118; mean age: 67.5 ± 0.9 years), this study implements an innovative biomarker for individual brain aging, using structural neuroimaging. BrainAGE was calculated using state-of-the-art pattern recognition methods, trained on an independent healthy reference sample, then applied to the Dutch famine MRI sample, to evaluate the effects of prenatal undernutrition during early gestation on individual brain aging in late adulthood.

RESULTS

Exposure to famine in early gestation was associated with BrainAGE scores indicative of an older-appearing brain in the male sample (mean difference to subjects born before famine: 4.3 years, p < 0.05). Furthermore, in explaining the observed variance in individual BrainAGE scores in the male sample, maternal age at birth, head circumference at birth, medical treatment of hypertension, history of cerebral incidences, actual heart rate, and current alcohol intake emerged to be the most influential variables (adjusted R² = 0.63, p < 0.01).

INTERPRETATION

The findings of our study on exposure to prenatal undernutrition being associated with a status of premature brain aging during late adulthood, as well as individual brain structure being shaped by birth- and late-life health characteristics, are strongly supporting the critical importance of sufficient nutrient supply during pregnancy. Interestingly, the status of premature brain aging in participants exposed to the Dutch famine during early gestation occurred in the absence of fetal growth restriction at birth as well as vascular pathology in late-life. Additionally, the neuroimaging brain aging biomarker presented in this study will further enable tracking effects of environmental influences or (preventive) treatments on individual brain maturation and aging in epidemiological and clinical studies.