Biological Brain Age Prediction Using Cortical Thickness Data: A Large Scale Cohort Study

Deep learning of brain magnetic resonance images: A brief review

Magnetic resonance imaging (MRI) is one of the most popular techniques in brain science and is important for understanding brain function and neuropsychiatric disorders. However, the processing and analysis of MRI is not a trivial task with lots of challenges. Recently, deep learning has shown superior performance over traditional machine learning approaches in image analysis. In this survey, we give a brief review of the recent popular deep learning approaches and their applications in brain MRI analysis. Furthermore, popular brain MRI databases and deep learning tools are also introduced. The strength and weaknesses of different approaches are addressed, and challenges as well as future directions are also discussed.

Association of Sleep Electroencephalography-Based Brain Age Index With Dementia

IMPORTANCE

Dementia is an increasing cause of disability and loss of independence in the elderly population yet remains largely underdiagnosed. A biomarker for dementia that can identify individuals with or at risk for developing dementia may help close this diagnostic gap.

OBJECTIVE

To investigate the association between a sleep electroencephalography-based brain age index (BAI), the difference between chronological age and brain age estimated using the sleep electroencephalogram, and dementia.

DESIGN, SETTING, AND PARTICIPANTS

In this retrospective cross-sectional study of 9834 polysomnograms, BAI was computed among individuals with previously determined dementia, mild cognitive impairment (MCI), or cognitive symptoms but no diagnosis of MCI or dementia, and among healthy individuals without dementia from August 22, 2008, to June 4, 2018. Data were analyzed from November 15, 2018, to June 24, 2020.

EXPOSURE

Dementia, MCI, and dementia-related symptoms, such as cognitive change and memory impairment.

MAIN OUTCOMES AND MEASURES

The outcome measures were the trend in BAI when moving from groups ranging from healthy, to symptomatic, to MCI, to dementia and pairwise comparisons of BAI among these groups.

FINDINGS

A total of 5144 sleep studies were included in BAI examinations. Patients in these studies had a median (interquartile range) age of 54 (43-65) years, and 3026 (59%) were men. The patients included 88 with dementia, 44 with MCI, 1075 who were symptomatic, and 2336 without dementia. There was a monotonic increase in mean (SE) BAI from the nondementia group to the dementia group (nondementia: 0.20 [0.42]; symptomatic: 0.58 [0.41]; MCI: 1.65 [1.20]; dementia: 4.18 [1.02]; P < .001).

CONCLUSIONS AND RELEVANCE

These findings suggest that a sleep-state electroencephalography-based BAI shows promise as a biomarker associated with progressive brain processes that ultimately result in dementia.

An automated machine learning approach to predict brain age from cortical anatomical measures

The use of machine learning (ML) algorithms has significantly increased in neuroscience. However, from the vast extent of possible ML algorithms, which one is the optimal model to predict the target variable? What are the hyperparameters for such a model? Given the plethora of possible answers to these questions, in the last years, automated ML (autoML) has been gaining attention. Here, we apply an autoML library called Tree-based Pipeline Optimisation Tool (TPOT) which uses a tree-based representation of ML pipelines and conducts a genetic programming-based approach to find the model and its hyperparameters that more closely predicts the subject's true age. To explore autoML and evaluate its efficacy within neuroimaging data sets, we chose a problem that has been the focus of previous extensive study: brain age prediction. Without any prior knowledge, TPOT was able to scan through the model space and create pipelines that outperformed the state-of-the-art accuracy for Freesurfer-based models using only thickness and volume information for anatomical structure. In particular, we compared the performance of TPOT (mean absolute error [MAE]: 4.612 ± .124 years) and a relevance vector regression (MAE 5.474 ± .140 years). TPOT also suggested interesting combinations of models that do not match the current most used models for brain prediction but generalise well to unseen data. AutoML showed promising results as a data-driven approach to find optimal models for neuroimaging applications.

Gray matter volume and estimated brain age gap are not linked with sleep-disordered breathing

Alzheimer's disease (AD) and sleep-disordered breathing (SDB) are prevalent conditions with a rising burden. It is suggested that SDB may contribute to cognitive decline and advanced aging. Here, we assessed the link between self-reported SDB and gray matter volume in patients with AD, mild cognitive impairment (MCI) and healthy controls (HCs). We further investigated whether SDB was associated with advanced brain aging. We included a total of 330 participants, divided based on self-reported history of SDB, and matched across diagnoses for age, sex and presence of the Apolipoprotein E4 allele, from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Gray-matter volume was measured using voxel-wise morphometry and group differences in terms of SDB, cognitive status, and their interaction were assessed. Further, using an age-prediction model fitted on gray-matter data of external datasets, we predicted study participants' age from their structural images. Cognitive decline and advanced age were associated with lower gray matter volume in various regions, particularly in the bilateral temporal lobes. Brains age was well predicted from the morphological data in HCs and, as expected, elevated in MCI and particularly in AD subjects. However, there was neither a significant difference between regional gray matter volume in any diagnostic group related to the SDB status, nor in SDB-by-cognitive status interaction. Moreover, we found no difference in estimated chronological age gap related to SDB, or by-cognitive status interaction. Contrary to our hypothesis, we were not able to find a general or a diagnostic-dependent association of SDB with either gray-matter volumetric or brain aging.

Large-Scale Structural Covariance Networks Predict Age in Middle-to-Late Adulthood: A Novel Brain Aging Biomarker

The aging process is accompanied by changes in the brain's cortex at many levels. There is growing interest in summarizing these complex brain-aging profiles into a single, quantitative index that could serve as a biomarker both for characterizing individual brain health and for identifying neurodegenerative and neuropsychiatric diseases. Using a large-scale structural covariance network (SCN)-based framework with machine learning algorithms, we demonstrate this framework's ability to predict individual brain age in a large sample of middle-to-late age adults, and highlight its clinical specificity for several disease populations from a network perspective. A proposed estimator with 40 SCNs could predict individual brain age, balancing between model complexity and prediction accuracy. Notably, we found that the most significant SCN for predicting brain age included the caudate nucleus, putamen, hippocampus, amygdala, and cerebellar regions. Furthermore, our data indicate a larger brain age disparity in patients with schizophrenia and Alzheimer's disease than in healthy controls, while this metric did not differ significantly in patients with major depressive disorder. These findings provide empirical evidence supporting the estimation of brain age from a brain network perspective, and demonstrate the clinical feasibility of evaluating neurological diseases hypothesized to be associated with accelerated brain aging.

Extensive Evaluation of Morphological Statistical Harmonization for Brain Age Prediction

Characterizing both neurodevelopmental and aging brain structural trajectories is important for understanding normal biological processes and atypical patterns that are related to pathological phenomena. Initiatives to share open access morphological data contributed significantly to the advance in brain structure characterization. Indeed, such initiatives allow large brain morphology multi-site datasets to be shared, which increases the statistical sensitivity of the outcomes. However, using neuroimaging data from multi-site studies requires harmonizing data across the site to avoid bias. In this work we evaluated three different harmonization techniques on the Autism Brain Imaging Data Exchange (ABIDE) dataset for age prediction analysis in two groups of subjects (i.e., controls and autism spectrum disorder). We extracted the morphological features from T1-weighted images of a mixed cohort of 654 subjects acquired from 17 sites to predict the biological age of the subjects using three machine learning regression models. A machine learning framework was developed to quantify the effects of the different harmonization strategies on the final performance of the models and on the set of morphological features that are relevant to the age prediction problem in both the presence and absence of pathology. The results show that, even if two harmonization strategies exhibit similar accuracy of predictive models, a greater mismatch occurs between the sets of most age-related predictive regions for the Autism Spectrum Disorder (ASD) subjects. Thus, we propose to use a stability index to extract meaningful features for a robust clinical validation of the outcomes of multiple harmonization strategies.

BRAIN AGE ESTIMATION USING LSTM ON CHILDREN'S BRAIN MRI

Brain age prediction based on children's brain MRI is an important biomarker for brain health and brain development analysis. In this paper, we consider the 3D brain MRI volume as a sequence of 2D images and propose a new framework using the recurrent neural network for brain age estimation. The proposed method is named as 2D-ResNet18+Long short-term memory (LSTM), which consists of four parts: 2D ResNet18 for feature extraction on 2D images, a pooling layer for feature reduction over the sequences, an LSTM layer, and a final regression layer. We apply the proposed method on a public multisite NIH-PD dataset and evaluate generalization on a second multisite dataset, which shows that the proposed 2D-ResNet18+LSTM method provides better results than traditional 3D based neural network for brain age estimation.

Brain Age Prediction With Morphological Features Using Deep Neural Networks: Results From Predictive Analytic Competition 2019

Morphological changes in the brain over the lifespan have been successfully described by using structural magnetic resonance imaging (MRI) in conjunction with machine learning (ML) algorithms. International challenges and scientific initiatives to share open access imaging datasets also contributed significantly to the advance in brain structure characterization and brain age prediction methods. In this work, we present the results of the predictive model based on deep neural networks (DNN) proposed during the Predictive Analytic Competition 2019 for brain age prediction of 2638 healthy individuals. We used FreeSurfer software to extract some morphological descriptors from the raw MRI scans of the subjects collected from 17 sites. We compared the proposed DNN architecture with other ML algorithms commonly used in the literature (RF, SVR, Lasso). Our results highlight that the DNN models achieved the best performance with MAE = 4.6 on the hold-out test, outperforming the other ML strategies. We also propose a complete ML framework to perform a robust statistical evaluation of feature importance for the clinical interpretability of the results.

Improved prediction of brain age using multimodal neuroimaging data

Brain age prediction based on imaging data and machine learning (ML) methods has great potential to provide insights into the development of cognition and mental disorders. Though different ML models have been proposed, a systematic comparison of ML models in combination with imaging features derived from different modalities is still needed. In this study, we evaluate the prediction performance of 36 combinations of imaging features and ML models including deep learning. We utilize single and multimodal brain imaging data including MRI, DTI, and rs‐fMRI from a large data set with 839 subjects. Our study is a follow‐up to the initial work (Liang et al., 2019. Human Brain Mapping) to investigate different analytic strategies to combine data from MRI, DTI, and rs‐fMRI with the goal to improve brain age prediction accuracy. Additionally, the traditional approach to predicting the brain age gap has been shown to have a systematic bias. The potential nonlinear relationship between the brain age gap and chronological age has not been thoroughly tested. Here we propose a new method to correct the systematic bias of brain age gap by taking gender, chronological age, and their interactions into consideration. As the true brain age is unknown and may deviate from chronological age, we further examine whether various levels of behavioral performance across subjects predict their brain age estimated from neuroimaging data. This is an important step to quantify the practical implication of brain age prediction. Our findings are helpful to advance the practice of optimizing different analytic methodologies in brain age prediction.

Accelerating research on biological aging and mental health: Current challenges and future directions

Aging is associated with complex biological changes that can be accelerated, slowed, or even temporarily reversed by biological and non-biological factors. This article focuses on the link between biological aging, psychological stressors, and mental illness. Rather than comprehensively reviewing this rapidly expanding field, we highlight challenges in this area of research and propose potential strategies to accelerate progress in this field. This effort requires the interaction of scientists across disciplines - including biology, psychiatry, psychology, and epidemiology; and across levels of analysis that emphasize different outcome measures - functional capacity, physiological, cellular, and molecular. Dialogues across disciplines and levels of analysis naturally lead to new opportunities for discovery but also to stimulating challenges. Some important challenges consist of 1) establishing the best objective and predictive biological age indicators or combinations of indicators, 2) identifying the basis for inter-individual differences in the rate of biological aging, and 3) examining to what extent interventions can delay, halt or temporarily reverse aging trajectories. Discovering how psychological states influence biological aging, and vice versa, has the potential to create novel and exciting opportunities for healthcare and possibly yield insights into the fundamental mechanisms that drive human aging.

Age Prediction Based on Brain MRI Image: A Survey

Human age prediction is an interesting and applicable issue in different fields. It can be based on various criteria such as face image, DNA methylation, chest plate radiographs, knee radiographs, dental images and etc. Most of the age prediction researches have mainly been based on images. Since the image processing and Machine Learning (ML) techniques have grown up, the investigations were led to use them in age prediction problem. The implementations would be used in different fields, especially in medical applications. Brain Age Estimation (BAE) has attracted more attention in recent years and it would be so helpful in early diagnosis of some neurodegenerative diseases such as Alzheimer, Parkinson, Huntington, etc. BAE is performed on Magnetic Resonance Imaging (MRI) images to compute the brain ages. Studies based on brain MRI shows that there is a relation between accelerated aging and accelerated brain atrophy. This refers to the effects of neurodegenerative diseases on brain structure while making the whole of it older. This paper reviews and summarizes the main approaches for age prediction based on brain MRI images including preprocessing methods, useful tools used in different research works and the estimation algorithms. We categorize the BAE methods based on two factors, first the way of processing MRI images, which includes pixel-based, surface-based, or voxel-based methods and second, the generation of ML algorithms that includes traditional or Deep Learning (DL) methods. The modern techniques as DL methods help MRI based age prediction to get results that are more accurate. In recent years, more precise and statistical ML approaches have been utilized with the help of related tools for simplifying computations and getting accurate results. Pros and cons of each research and the challenges in each work are expressed and some guidelines and deliberations for future research are suggested.

Investigating systematic bias in brain age estimation with application to post-traumatic stress disorders

Brain age prediction using machine-learning techniques has recently attracted growing attention, as it has the potential to serve as a biomarker for characterizing the typical brain development and neuropsychiatric disorders. Yet one long-standing problem is that the predicted brain age is overestimated in younger subjects and underestimated in older. There is a plethora of claims as to the bias origins, both methodologically and in data itself. With a large neuroanatomical dataset (N = 2,026; 6-89 years of age) from multiple shared datasets, we show this bias is neither data-dependent nor specific to particular method including deep neural network. We present an alternative account that offers a statistical explanation for the bias and describe a simple, yet efficient, method using general linear model to adjust the bias. We demonstrate the effectiveness of bias adjustment with a large multi-modal neuroimaging data (N = 804; 8-21 years of age) for both healthy controls and post-traumatic stress disorders patients obtained from the Philadelphia Neurodevelopmental Cohort.

The many ages of man: diverse approaches to assessing ageing-related biological and psychological measures and their relationship to chronological age

PURPOSE OF REVIEW

Chronological age is a crude measure and may not be the best indicator of the ageing process. Establishing valid and reliable biomarkers to understand the true effect of ageing is of great interest. We provide an overview of biological and psychological characteristics that change with age and can potentially serve as markers of the ageing process, and discuss if an integration of these characteristics may more accurately measure the true age of a person. We also describe the clinicopathological continuum of these ageing-related changes.

RECENT FINDINGS

Ageing-related changes in the biological and psychological systems of the body have been studied to varying degrees and with differing emphases. Despite the development of ageing indices, there is no single indicator that can holistically estimate the ageing process. Differential ageing of bodily systems remains poorly understood, and valid methods have not been developed for composite markers of biological and psychological processes.

SUMMARY

The ageing process is complex and heterogeneous. Incorporating biological and psychological measures may improve accuracy in reflecting an individual's 'true age,' and elucidate why some people age successfully, whereas others show ageing-related decline and disease.