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Maheux E, Koval I, Ortholand J, Birkenbihl C, Archetti D, Bouteloup V, Epelbaum S, Dufouil C, Hofmann-Apitius M, Durrleman S. Forecasting individual progression trajectories in Alzheimer's disease. Nat Commun 2023; 14:761. [PMID: 36765056 PMCID: PMC9918533 DOI: 10.1038/s41467-022-35712-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 12/19/2022] [Indexed: 02/12/2023] Open
Abstract
The anticipation of progression of Alzheimer's disease (AD) is crucial for evaluations of secondary prevention measures thought to modify the disease trajectory. However, it is difficult to forecast the natural progression of AD, notably because several functions decline at different ages and different rates in different patients. We evaluate here AD Course Map, a statistical model predicting the progression of neuropsychological assessments and imaging biomarkers for a patient from current medical and radiological data at early disease stages. We tested the method on more than 96,000 cases, with a pool of more than 4,600 patients from four continents. We measured the accuracy of the method for selecting participants displaying a progression of clinical endpoints during a hypothetical trial. We show that enriching the population with the predicted progressors decreases the required sample size by 38% to 50%, depending on trial duration, outcome, and targeted disease stage, from asymptomatic individuals at risk of AD to subjects with early and mild AD. We show that the method introduces no biases regarding sex or geographic locations and is robust to missing data. It performs best at the earliest stages of disease and is therefore highly suitable for use in prevention trials.
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Affiliation(s)
- Etienne Maheux
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Igor Koval
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Juliette Ortholand
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Colin Birkenbihl
- Department of bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, 53115, Germany
| | - Damiano Archetti
- IRCCS Instituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Vincent Bouteloup
- Université de Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre Hospitalier Universitaire (CHU) de Bordeaux, pôle de neurosciences cliniques, centre mémoire de ressources et de recherche, Bordeaux, France
| | - Stéphane Epelbaum
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Institut de la mémoire et de la maladie d'Alzheimer (IM2A), center of excellence of neurodegenerative diseases (CoEN), department of Neurology, DMU Neurosciences, Paris, France
| | - Carole Dufouil
- Université de Bordeaux, CNRS UMR 5293, Institut des Maladies Neurodégénératives, Bordeaux, France
- Centre Hospitalier Universitaire (CHU) de Bordeaux, pôle de neurosciences cliniques, centre mémoire de ressources et de recherche, Bordeaux, France
| | - Martin Hofmann-Apitius
- Department of bioinformatics, Fraunhofer Institute for Algorithms and Scientific Computing (SCAI), Sankt Augustin, Germany
- Bonn-Aachen International Center for IT, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, 53115, Germany
| | - Stanley Durrleman
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
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Koval I, Dighiero-Brecht T, Tobin AJ, Tabrizi SJ, Scahill RI, Tezenas du Montcel S, Durrleman S, Durr A. Forecasting individual progression trajectories in Huntington disease enables more powered clinical trials. Sci Rep 2022; 12:18928. [PMID: 36344508 PMCID: PMC9640581 DOI: 10.1038/s41598-022-18848-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/22/2022] [Indexed: 11/09/2022] Open
Abstract
Variability in neurodegenerative disease progression poses great challenges for the evaluation of potential treatments. Identifying the persons who will experience significant progression in the short term is key for the implementation of trials with smaller sample sizes. We apply here disease course mapping to forecast biomarker progression for individual carriers of the pathological CAG repeat expansions responsible for Huntington disease. We used data from two longitudinal studies (TRACK-HD and TRACK-ON) to synchronize temporal progression of 15 clinical and imaging biomarkers from 290 participants with Huntington disease. We used then the resulting HD COURSE MAP to forecast clinical endpoints from the baseline data of 11,510 participants from ENROLL-HD, an external validation cohort. We used such forecasts to select participants at risk for progression and compute the power of trials for such an enriched population. HD COURSE MAP forecasts biomarkers 5 years after the baseline measures with a maximum mean absolute error of 10 points for the total motor score and 2.15 for the total functional capacity. This allowed reducing sample sizes in trial up to 50% including participants with a higher risk for progression ensuring a more homogeneous group of participants.
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Affiliation(s)
- Igor Koval
- Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013, Paris, France
| | - Thomas Dighiero-Brecht
- Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013, Paris, France
| | - Allan J Tobin
- Biological Adaptation and Ageing, Sorbonne Université, Paris, France
- Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Sarah J Tabrizi
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, UK
| | - Rachael I Scahill
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, UK
| | - Sophie Tezenas du Montcel
- Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013, Paris, France
| | - Stanley Durrleman
- Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013, Paris, France.
| | - Alexandra Durr
- Department of Neurology, DMU Neurosciences, Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, 75013, Paris, France.
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Cacciamani F, Valladier A, Maheux E, Koval I, Durrleman S, Epelbaum S. Changes in the awareness of cognitive decline across the course of Alzheimer’s disease: Comparison of two assessment methods. Alzheimers Dement 2021. [DOI: 10.1002/alz.053074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Federica Cacciamani
- ARAMIS Lab, Brain & Spine Institute (ICM), Pitié‐Salpêtrière Hospital Paris France
| | - Arnaud Valladier
- ARAMIS Lab, Brain & Spine Institute (ICM), Pitié‐Salpêtrière Hospital Paris France
| | - Etienne Maheux
- Inria, Aramis project‐team, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université Paris France
| | - Igor Koval
- Inria, Aramis‐project team, Sorbonne Universités, UPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐Salpêtrière Paris France
| | - Stanley Durrleman
- Sorbonne Universités, Inserm, CNRS, Institut du cerveau et la moelle (ICM), Aramis‐project team, AP‐HP ‐ Hôpital Pitié‐Salpêtrière Paris France
| | - Stéphane Epelbaum
- APHP, Sorbonne Universités, Inserm, CNRS, Institut du cerveau et de la Moelle Epinière (ICM), Aramis project‐team, Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié‐Salpêtrière Paris France
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Koval I, Bône A, Louis M, Lartigue T, Bottani S, Marcoux A, Samper-González J, Burgos N, Charlier B, Bertrand A, Epelbaum S, Colliot O, Allassonnière S, Durrleman S. AD Course Map charts Alzheimer's disease progression. Sci Rep 2021; 11:8020. [PMID: 33850174 PMCID: PMC8044144 DOI: 10.1038/s41598-021-87434-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by the progressive alterations seen in brain images which give rise to the onset of various sets of symptoms. The variability in the dynamics of changes in both brain images and cognitive impairments remains poorly understood. This paper introduces AD Course Map a spatiotemporal atlas of Alzheimer's disease progression. It summarizes the variability in the progression of a series of neuropsychological assessments, the propagation of hypometabolism and cortical thinning across brain regions and the deformation of the shape of the hippocampus. The analysis of these variations highlights strong genetic determinants for the progression, like possible compensatory mechanisms at play during disease progression. AD Course Map also predicts the patient's cognitive decline with a better accuracy than the 56 methods benchmarked in the open challenge TADPOLE. Finally, AD Course Map is used to simulate cohorts of virtual patients developing Alzheimer's disease. AD Course Map offers therefore new tools for exploring the progression of AD and personalizing patients care.
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Affiliation(s)
- Igor Koval
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- Centre de Mathématiques Appliquées, Ecole Polytechnique, Palaiseau, France
| | - Alexandre Bône
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Maxime Louis
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Thomas Lartigue
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- Centre de Mathématiques Appliquées, Ecole Polytechnique, Palaiseau, France
| | - Simona Bottani
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Arnaud Marcoux
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Jorge Samper-González
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Ninon Burgos
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
| | - Benjamin Charlier
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- Laboratoire Alexandre Grotendieck, Université de Montpellier, Montpellier, France
| | - Anne Bertrand
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stéphane Epelbaum
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Olivier Colliot
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France
- Inria, Aramis project-team, Paris, France
- AP-HP, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Stéphanie Allassonnière
- Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, France
- Centre de Mathématiques Appliquées, Ecole Polytechnique, Palaiseau, France
| | - Stanley Durrleman
- Institut du Cerveau et de la Moelle épinière (ICM) & Inserm, U 1127 & CNRS, UMR 7225, Sorbonne Université, 75013, Paris, France.
- Inria, Aramis project-team, Paris, France.
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Koval I, Khaustova O, Skurat K. Peculiarities of the psychological state of patients with chronic non-infectious liver diseases. Eur Psychiatry 2021. [PMCID: PMC9528508 DOI: 10.1192/j.eurpsy.2021.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The prevalence of chronic liver diseases (CLD) is over 30 million people worldwide, they are associated with significant health care costs, loss of productivity of patients, and has a significant impact on the quality of life associated with health. Objectives The research objective was to determine current views on the psychological state of patients with CLD. Methods A qualitative and quantitative analysis of the content of scientific Ukrainian and English literature published from 2014 to 2020, which sets out different views on the psychological state of patients with chronic liver diseases using the PubMed and Google Scholar databases. Only concept analysis, meta-analysis, and systematic reviews published in English, presented in the scientific literature were included. Results The information on the peculiarities of the psychological state of patients with CLD was generalized. Based on the research, we can conclude that this group of patients is characterized by low mood, chronic fatigue, low level of social adaptation, increased anxiety, and reduced efficiency. Conclusions Studies by different scientists from different countries agree that patients with chronic liver disease are characterized by the above symptoms. Some emphasize psychoneurophysiology and associate these symptoms with chronic inflammation, which occurs as liver damage progresses. Other researchers suggest that it is due to the quality of life of these patients and the severity of the disease. However, the scientific community has yet to find out what exactly caused this.
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Cacciamani F, Valladier A, Maheux E, Koval I, Durrleman S, Epelbaum S. Awareness of cognitive decline through the continuum of Alzheimer’s disease and its association to APOE‐ε4 and amyloid load. Alzheimers Dement 2020. [DOI: 10.1002/alz.042730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Federica Cacciamani
- ARAMIS Lab, Brain & Spine Institute (ICM) Pitié‐Salpêtrière Hospital Paris France
| | - Arnaud Valladier
- ARAMIS Lab, Brain & Spine Institute (ICM) Pitié‐Salpêtrière Hospital Paris France
| | - Etienne Maheux
- Inria, Aramis Project‐Team, Institut du Cerveau et de la Moelle épinière, ICM, Inserm U 1127, CNRS UMR 7225 Sorbonne Université F‐75013 Paris France
| | - Igor Koval
- Inria, Aramis‐Project Team Sorbonne Universités UPMC Univ Paris 06, INSERM, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐Salpêtrière Paris France
| | - Stanley Durrleman
- Sorbonne Universités Inserm, CNRS, Institut du Cerveau et la Moelle (ICM), Aramis‐Project Team, AP‐HP ‐ Hôpital Pitié‐Salpêtrière Paris France
| | - Stéphane Epelbaum
- APHP, Sorbonne Universités INSERM, CNRS, Institut du Cerveau et de la Moelle Epinière (ICM), Aramis Project‐Team, Département de Neurologie, Institut de la Mémoire et de la Maladie d’Alzheimer (IM2A), Hôpital Pitié‐Salpêtrière Paris France
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Maheux E, Koval I, Archetti D, Redolfi A, Durrleman S. Towards cross‐cohort estimation of cognitive decline in neurodegenerative diseases. Alzheimers Dement 2020. [DOI: 10.1002/alz.041498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Etienne Maheux
- Inria, Aramis Project Team, Institut du Cerveau et de la Moelle Épinière, ICM, Inserm U 1127, CNRS UMR 7225 Sorbonne Université F‐75013 Paris France
| | - Igor Koval
- Inria, Aramis‐project team, Sorbonne Universités, UPMC University Paris 06, Inserm, CNRS Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐Salpêtrière Paris France
| | | | - Alberto Redolfi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology ‐ LANE IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Brescia Italy
| | - Stanley Durrleman
- Sorbonne Universités, Inserm, CNRS Institut du Cerveau et la Moelle (ICM), Aramis‐project team AP‐HP ‐ Hôpital Pitié‐Salpêtrière Paris France
- Inria, Aramis Project Team Centre de Recherche Paris‐Rocquencourt Paris France
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Maheux E, Koval I, Archetti D, Redolfi A, Durrleman S. Prediction of the MMSE up to 6 years ahead with cross‐cohort replications. Alzheimers Dement 2020. [DOI: 10.1002/alz.043541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Etienne Maheux
- Inria, Aramis Project Team, Institut du Cerveau et de la Moelle Épinière, ICM, Inserm U 1127, CNRS UMR 7225 Sorbonne Université F‐75013 Paris France
| | - Igor Koval
- Inria, Aramis‐Project Team Sorbonne Universités UPMC University Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐Salpêtrière Paris France
| | | | - Alberto Redolfi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology ‐ LANE IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli Brescia Italy
| | - Stanley Durrleman
- Sorbonne Universités Inserm, CNRS, Institut du Cerveau et la Moelle (ICM), Aramis‐Project Team, AP‐HP ‐ Hôpital Pitié‐Salpêtrière Paris France
- Inria Paris, Aramis Project Team Paris France
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Ansart M, Epelbaum S, Bassignana G, Bône A, Bottani S, Cattai T, Couronné R, Faouzi J, Koval I, Louis M, Thibeau-Sutre E, Wen J, Wild A, Burgos N, Dormont D, Colliot O, Durrleman S. Predicting the progression of mild cognitive impairment using machine learning: A systematic, quantitative and critical review. Med Image Anal 2020; 67:101848. [PMID: 33091740 DOI: 10.1016/j.media.2020.101848] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 08/17/2020] [Accepted: 08/31/2020] [Indexed: 11/25/2022]
Abstract
We performed a systematic review of studies focusing on the automatic prediction of the progression of mild cognitive impairment to Alzheimer's disease (AD) dementia, and a quantitative analysis of the methodological choices impacting performance. This review included 172 articles, from which 234 experiments were extracted. For each of them, we reported the used data set, the feature types, the algorithm type, performance and potential methodological issues. The impact of these characteristics on the performance was evaluated using a multivariate mixed effect linear regressions. We found that using cognitive, fluorodeoxyglucose-positron emission tomography or potentially electroencephalography and magnetoencephalography variables significantly improved predictive performance compared to not including them, whereas including other modalities, in particular T1 magnetic resonance imaging, did not show a significant effect. The good performance of cognitive assessments questions the wide use of imaging for predicting the progression to AD and advocates for exploring further fine domain-specific cognitive assessments. We also identified several methodological issues, including the absence of a test set, or its use for feature selection or parameter tuning in nearly a fourth of the papers. Other issues, found in 15% of the studies, cast doubts on the relevance of the method to clinical practice. We also highlight that short-term predictions are likely not to be better than predicting that subjects stay stable over time. These issues highlight the importance of adhering to good practices for the use of machine learning as a decision support system for the clinical practice.
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Affiliation(s)
- Manon Ansart
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France.
| | - Stéphane Epelbaum
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France; Institute of Memory and Alzheimer's Disease (IM2A), Centre of excellence of neurodegenerative disease (CoEN), National Reference Center for Rare or Early Dementias, Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris, F-75013, France
| | - Giulia Bassignana
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Alexandre Bône
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Simona Bottani
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Tiziana Cattai
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France; Dept. of Information Engineering, Electronics and Telecommunication, Sapienza University of Rome, Italy
| | - Raphaël Couronné
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Johann Faouzi
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Igor Koval
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Maxime Louis
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Elina Thibeau-Sutre
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Junhao Wen
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Adam Wild
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Ninon Burgos
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France
| | - Didier Dormont
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France; AP-HP, Pitié-Salpêtrière hospital, Department of Neuroradiology, Paris, France
| | - Olivier Colliot
- Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France; Inria, Aramis project-team, Paris, F-75013, France; Institute of Memory and Alzheimer's Disease (IM2A), Centre of excellence of neurodegenerative disease (CoEN), National Reference Center for Rare or Early Dementias, Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris, F-75013, France; AP-HP, Pitié-Salpêtrière hospital, Department of Neuroradiology, Paris, France
| | - Stanley Durrleman
- Inria, Aramis project-team, Paris, F-75013, France; Institut du Cerveau et de la Moelle épinière, ICM, Paris, F-75013, France; Inserm, U 1127, Paris, F-75013, France; CNRS, UMR 7225, Paris, F-75013, France; Sorbonne Université, Paris, F-75013, France
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Deshko L, Kostenko Y, Koval I, Mikhailina T, Oliinyk O. ; THE RIGHT TO HEALTH: UKRAINE'S INTERNATIONAL OBLIGATIONS AND FINANCIAL ACTIVITY OF PUBLIC AUTHORITIES IN THE CONTEXT OF REFORMING THE NATIONAL HEALTHCARE SYSTEM. Georgian Med News 2020:177-182. [PMID: 32965271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The article explores the issue of the human right to health as a fundamental one in a democratic society, international norms and standards, international obligations of Ukraine, as well as the financial activities of public authorities in the context of radical reform of the health care system in Ukraine. It is being focused onto the WHO's "Health for All" policy, as well as "Health 2020", which became the basis for a new European Health Strategy, the nationwide Health 2020: Ukrainian Dimension. It is emphasized that the financing function of the WHO and other international organizations is considered to be the key function of the health system. The purpose of this article is of this article is to identify the peculiarities of the financial activities of public authorities in the context of a thorough reform of the healthcare system in Ukraine and to evaluate the compliance of national legislation with international norms and standards. The methodological basis of the conducted research is the general methods of scientific cognitivism as well as concerning those used in legal science: methods of analysis and synthesis, formal logic, comparative law etc.; The norms of international documents of universal and regional status, adopted by the new legislation of Ukraine in the light of radical reform of the health care system, are analyzed. The object of the study is the public relations that arise during implementation of financial activities by public authorities.; The research revealed measures taken by the state to fulfill its obligations under international treaties in the field of healthcare: amending the current legislation and practice of its implementation; making changes to administrative practice; providing legal expertise of bills; provision of training in the study of international treaties and the practice of international judicial institutions to categories of the employees whose professional activity is related to law enforcement, as well as to the detention of people (imprisoned); measures taken to ensure the elimination of systemic deficiencies and the cessation of breaches within international treaties caused by these deficiencies. Attention is drawn to the relation between the concepts of "public finances" and "public financial activities". The peculiarities of the legal organization of financial activity of the state and bodies of local self-government, the content of financial activity in the sphere of healthcare are revealed. The role of the state and local self-government bodies in financial activity as subjects of financial function is revealed. The principles, methods, forms of financial activity are described. It is emphasized that the new model of financing healthcare in Ukraine is based on the following principles: financial protection; universality of coverage and equity of access to care; transparency and accountability; efficiency; free choice; competition among suppliers; predictability of the volume of funds for medical services in the state budget; subsidiarity.
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Affiliation(s)
- L Deshko
- 1Taras Shevchenko National University of Kyiv; Ukraine
| | - Y Kostenko
- 2Vasyl' Stus Donetsk National University; Ukraine
| | - I Koval
- 2Vasyl' Stus Donetsk National University; Ukraine
| | - T Mikhailina
- 2Vasyl' Stus Donetsk National University; Ukraine
| | - O Oliinyk
- 3Kyiv National University of Trade and Economics, Ukraine
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Ansart M, Koval I, Bertrand A, Dormont D, Durrleman S. P1‐363: DESIGN OF A DECISION SUPPORT SYSTEM FOR PREDICTING THE PROGRESSION OF ALZHEIMER'S DISEASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Manon Ansart
- Sorbonne UniversitésUPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐SalpêtrièreParisFrance
- Inria Paris, Aramis Project-teamParisFrance
| | - Igor Koval
- Sorbonne UniversitésUPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐SalpêtrièreParisFrance
- Inria Paris, Aramis Project-teamParisFrance
| | - Anne Bertrand
- Inria Paris, Aramis Project-teamParisFrance
- Sorbonne UniversitésUPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM), AP‐HP ‐ Hôpital Pitié‐SalpêtrièreParisFrance
| | - Didier Dormont
- Inria Paris, Aramis Project-teamParisFrance
- Sorbonne UniversitésUPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM), AP‐HP ‐ Hôpital Pitié‐SalpêtrièreParisFrance
| | - Stanley Durrleman
- Sorbonne UniversitésUPMC Univ Paris 06, Inserm, CNRS, Institut du Cerveau et la Moelle (ICM) ‐ Hôpital de la Pitié‐SalpêtrièreParisFrance
- Inria Paris, Aramis Project-teamParisFrance
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Koval I, Schiratti JB, Routier A, Bacci M, Colliot O, Allassonnière S, Durrleman S. Spatiotemporal Propagation of the Cortical Atrophy: Population and Individual Patterns. Front Neurol 2018; 9:235. [PMID: 29780348 PMCID: PMC5945895 DOI: 10.3389/fneur.2018.00235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 03/26/2018] [Indexed: 01/19/2023] Open
Abstract
Repeated failures in clinical trials for Alzheimer’s disease (AD) have raised a strong interest for the prodromal phase of the disease. A better understanding of the brain alterations during this early phase is crucial to diagnose patients sooner, to estimate an accurate disease stage, and to give a reliable prognosis. According to recent evidence, structural alterations in the brain are likely to be sensitive markers of the disease progression. Neuronal loss translates in specific spatiotemporal patterns of cortical atrophy, starting in the enthorinal cortex and spreading over other cortical regions according to specific propagation pathways. We developed a digital model of the cortical atrophy in the left hemisphere from prodromal to diseased phases, which is built on the temporal alignment and combination of several short-term observation data to reconstruct the long-term history of the disease. The model not only provides a description of the spatiotemporal patterns of cortical atrophy at the group level but also shows the variability of these patterns at the individual level in terms of difference in propagation pathways, speed of propagation, and age at propagation onset. Longitudinal MRI datasets of patients with mild cognitive impairments who converted to AD are used to reconstruct the cortical atrophy propagation across all disease stages. Each observation is considered as a signal spatially distributed on a network, such as the cortical mesh, each cortex location being associated to a node. We consider how the temporal profile of the signal varies across the network nodes. We introduce a statistical mixed-effect model to describe the evolution of the cortex alterations. To ensure a spatiotemporal smooth propagation of the alterations, we introduce a constrain on the propagation signal in the model such that neighboring nodes have similar profiles of the signal changes. Our generative model enables the reconstruction of personalized patterns of the neurodegenerative spread, providing a way to estimate disease progression stages and predict the age at which the disease will be diagnosed. The model shows that, for instance, APOE carriers have a significantly higher pace of cortical atrophy but not earlier atrophy onset.
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Affiliation(s)
- Igor Koval
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,INSERM UMRS 1138, Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, France
| | - Jean-Baptiste Schiratti
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,INSERM UMRS 1138, Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, France
| | - Alexandre Routier
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Michael Bacci
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Olivier Colliot
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.,AP-HP, Pitié-Salpétriere Hospital, Department of Neurology, Paris, France.,AP-HP, Pitié-Salpétriere Hospital, Department of Neuroradiology, Paris, France
| | - Stéphanie Allassonnière
- INSERM UMRS 1138, Centre de Recherche des Cordeliers, Université Paris Descartes, Paris, France
| | - Stanley Durrleman
- Inria Paris-Rocquencourt, INSERM U1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMRS 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
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