Deep Learning of Brain Lesion Patterns for Predicting Future Disease Activity in Patients with Early Symptoms of Multiple Sclerosis

Revolutionising Neurological Therapeutics: Investigating Drug Repurposing Strategies

Repurposing drugs (DR) has become a viable approach to hasten the search for cures for neurodegenerative diseases (NDs). This review examines different off-target and on-target drug discovery techniques and how they might be used to find possible treatments for non-diagnostic depressions. Off-target strategies look at the known or unknown side effects of currently approved drugs for repositioning, whereas on-target strategies connect disease pathways to targets that can be treated with drugs. The review highlights the potential of experimental and computational methodologies, such as machine learning, proteomic techniques, network and genomics-based approaches, and in silico screening, in uncovering new drug-disease correlations. It also looks at difficulties and failed attempts at drug repurposing for NDs, highlighting the necessity of exact and standardised procedures to increase success rates. This review's objectives are to address the purpose of drug repurposing in human disorders, particularly neurological diseases, and to provide an overview of repurposing candidates that are presently undergoing clinical trials for neurological conditions, along with any possible causes and early findings. We then include a list of drug repurposing strategies, restrictions, and difficulties for upcoming research.

Predicting multiple sclerosis disease progression and outcomes with machine learning and MRI-based biomarkers: a review

Multiple sclerosis (MS) is a demyelinating neurological disorder with a highly heterogeneous clinical presentation and course of progression. Disease-modifying therapies are the only available treatment, as there is no known cure for the disease. Careful selection of suitable therapies is necessary, as they can be accompanied by serious risks and adverse effects such as infection. Magnetic resonance imaging (MRI) plays a central role in the diagnosis and management of MS, though MRI lesions have displayed only moderate associations with MS clinical outcomes, known as the clinico-radiological paradox. With the advent of machine learning (ML) in healthcare, the predictive power of MRI can be improved by leveraging both traditional and advanced ML algorithms capable of analyzing increasingly complex patterns within neuroimaging data. The purpose of this review was to examine the application of MRI-based ML for prediction of MS disease progression. Studies were divided into five main categories: predicting the conversion of clinically isolated syndrome to MS, cognitive outcome, EDSS-related disability, motor disability and disease activity. The performance of ML models is discussed along with highlighting the influential MRI-derived biomarkers. Overall, MRI-based ML presents a promising avenue for MS prognosis. However, integration of imaging biomarkers with other multimodal patient data shows great potential for advancing personalized healthcare approaches in MS.

A pilot evaluation of the diagnostic accuracy of ChatGPT-3.5 for multiple sclerosis from case reports

The limitation of artificial intelligence (AI) large language models to diagnose diseases from the perspective of patient safety remains underexplored and potential challenges, such as diagnostic errors and legal challenges, need to be addressed. To demonstrate the limitations of AI, we used ChatGPT-3.5 developed by OpenAI, as a tool for medical diagnosis using text-based case reports of multiple sclerosis (MS), which was selected as a prototypic disease. We analyzed 98 peer-reviewed case reports selected based on free-full text availability and published within the past decade (2014-2024), excluding any mention of an MS diagnosis to avoid bias. ChatGPT-3.5 was used to interpret clinical presentations and laboratory data from these reports. The model correctly diagnosed MS in 77 cases, achieving an accuracy rate of 78.6%. However, the remaining 21 cases were misdiagnosed, highlighting the model's limitations. Factors contributing to the errors include variability in data presentation and the inherent complexity of MS diagnosis, which requires imaging modalities in addition to clinical presentations and laboratory data. While these findings suggest that AI can support disease diagnosis and healthcare providers in decision-making, inadequate training with large datasets may lead to significant inaccuracies. Integrating AI into clinical practice necessitates rigorous validation and robust regulatory frameworks to ensure responsible use.

Multiple Sclerosis Diagnosis Using Machine Learning and Deep Learning: Challenges and Opportunities

Multiple Sclerosis (MS) is a disease that impacts the central nervous system (CNS), which can lead to brain, spinal cord, and optic nerve problems. A total of 2.8 million are estimated to suffer from MS. Globally, a new case of MS is reported every five minutes. In this review, we discuss the proposed approaches to diagnosing MS using machine learning (ML) published between 2011 and 2022. Numerous models have been developed using different types of data, including magnetic resonance imaging (MRI) and clinical data. We identified the methods that achieved the best results in diagnosing MS. The most implemented approaches are SVM, RF, and CNN. Moreover, we discussed the challenges and opportunities in MS diagnosis to improve AI systems to enable researchers and practitioners to enhance their approaches and improve the automated diagnosis of MS. The challenges faced by automated MS diagnosis include difficulty distinguishing the disease from other diseases showing similar symptoms, protecting the confidentiality of the patients' data, achieving reliable ML models that are also easily understood by non-experts, and the difficulty of collecting a large reliable dataset. Moreover, we discussed several opportunities in the field such as the implementation of secure platforms, employing better AI solutions, developing better disease prognosis systems, combining more than one data type for better MS prediction and using OCT data for diagnosis, utilizing larger, multi-center datasets to improve the reliability of the developed models, and commercialization.

Region Convolutional Neural Network for Brain Tumor Segmentation

Gliomas are often difficult to find and distinguish using typical manual segmentation approaches because of their vast range of changes in size, shape, and appearance. Furthermore, the manual annotation of cancer tissue segmentation under the close supervision of a human professional is both time-consuming and exhausting to perform. It will be easier and faster in the future to get accurate and quick diagnoses and treatments thanks to automated segmentation and survival rate prediction models that can be used now. In this article, a segmentation model is designed using RCNN that enables automatic prognosis on brain tumors using MRI. The study adopts a U-Net encoder for capturing the features during the training of the model. The feature extraction extracts geometric features for the estimation of tumor size. It is seen that the shape, location, and size of a tumor are significant factors in the estimation of prognosis. The experimental methods are conducted to test the efficacy of the model, and the results of the simulation show that the proposed method achieves a reduced error rate with increased accuracy than other methods.

Deep learning based brain tumor segmentation: a survey

Brain tumor segmentation is one of the most challenging problems in medical image analysis. The goal of brain tumor segmentation is to generate accurate delineation of brain tumor regions. In recent years, deep learning methods have shown promising performance in solving various computer vision problems, such as image classification, object detection and semantic segmentation. A number of deep learning based methods have been applied to brain tumor segmentation and achieved promising results. Considering the remarkable breakthroughs made by state-of-the-art technologies, we provide this survey with a comprehensive study of recently developed deep learning based brain tumor segmentation techniques. More than 150 scientific papers are selected and discussed in this survey, extensively covering technical aspects such as network architecture design, segmentation under imbalanced conditions, and multi-modality processes. We also provide insightful discussions for future development directions.

Predicting future amyloid biomarkers in dementia patients with machine learning to improve clinical trial patient selection

INTRODUCTION

In Alzheimer's disease, asymptomatic patients may have amyloid deposition, but predicting their progression rate remains a substantial challenge with implications for clinical trial enrollment. Here, we demonstrate an artificial intelligence approach to use baseline clinical information and images to predict changes in quantitative biomarkers of brain pathology on future images.

METHODS

Patients from the Alzheimer's Disease Neuroimaging Initiative (ADNI) who underwent positron emission tomography (PET) with the amyloid radiotracer 18F-AV45 (florbetapir) were included. We identified important baseline PET image features using a deep convolutional neural network based on ResNet. These were combined with eight clinical, demographic, and genetic markers using a gradient-boosted decision tree (GBDT) algorithm to predict future quantitative standardized uptake value ratio (SUVR), an established biomarker of brain amyloid deposition. We used this model to better identify individuals with the highest positive change in amyloid deposition on future images and compared this to typical inclusion criteria for clinical trials. We also compared the model's performance to other methods such as multivariate linear regression and GBDT without imaging features.

FINDINGS

Using 2577 PET scans from 1224 unique individuals, we showed that the GBDT with deep image features was significantly more accurate than the other approaches, reaching a root mean squared error of 0.0339 ± 0.0027 for future SUVR prediction. Using this approach, we could identify individuals with the highest 10% SUVR accumulation at rates 2- to 4-fold higher than by random pick or existing inclusion criteria.

DISCUSSION

Predicting quantitative biomarkers on future images using machine learning methods consisting of deep image features combined with clinical data may allow better targeting of treatments or enrollment in clinical trials.

Automatic brain lesion segmentation on standard magnetic resonance images: a scoping review

OBJECTIVES

Medical image analysis practices face challenges that can potentially be addressed with algorithm-based segmentation tools. In this study, we map the field of automatic MR brain lesion segmentation to understand the clinical applicability of prevalent methods and study designs, as well as challenges and limitations in the field.

DESIGN

Scoping review.

SETTING

Three databases (PubMed, IEEE Xplore and Scopus) were searched with tailored queries. Studies were included based on predefined criteria. Emerging themes during consecutive title, abstract, methods and whole-text screening were identified. The full-text analysis focused on materials, preprocessing, performance evaluation and comparison.

RESULTS

Out of 2990 unique articles identified through the search, 441 articles met the eligibility criteria, with an estimated growth rate of 10% per year. We present a general overview and trends in the field with regard to publication sources, segmentation principles used and types of lesions. Algorithms are predominantly evaluated by measuring the agreement of segmentation results with a trusted reference. Few articles describe measures of clinical validity.

CONCLUSIONS

The observed reporting practices leave room for improvement with a view to studying replication, method comparison and clinical applicability. To promote this improvement, we propose a list of recommendations for future studies in the field.

Deep learning for brain disorders: from data processing to disease treatment

In order to reach precision medicine and improve patients' quality of life, machine learning is increasingly used in medicine. Brain disorders are often complex and heterogeneous, and several modalities such as demographic, clinical, imaging, genetics and environmental data have been studied to improve their understanding. Deep learning, a subpart of machine learning, provides complex algorithms that can learn from such various data. It has become state of the art in numerous fields, including computer vision and natural language processing, and is also growingly applied in medicine. In this article, we review the use of deep learning for brain disorders. More specifically, we identify the main applications, the concerned disorders and the types of architectures and data used. Finally, we provide guidelines to bridge the gap between research studies and clinical routine.

Considering patient clinical history impacts performance of machine learning models in predicting course of multiple sclerosis

Multiple Sclerosis (MS) progresses at an unpredictable rate, but predictions on the disease course in each patient would be extremely useful to tailor therapy to the individual needs. We explore different machine learning (ML) approaches to predict whether a patient will shift from the initial Relapsing-Remitting (RR) to the Secondary Progressive (SP) form of the disease, using only "real world" data available in clinical routine. The clinical records of 1624 outpatients (207 in the SP phase) attending the MS service of Sant'Andrea hospital, Rome, Italy, were used. Predictions at 180, 360 or 720 days from the last visit were obtained considering either the data of the last available visit (Visit-Oriented setting), comparing four classical ML methods (Random Forest, Support Vector Machine, K-Nearest Neighbours and AdaBoost) or the whole clinical history of each patient (History-Oriented setting), using a Recurrent Neural Network model, specifically designed for historical data. Missing values were handled by removing either all clinical records presenting at least one missing parameter (Feature-saving approach) or the 3 clinical parameters which contained missing values (Record-saving approach). The performances of the classifiers were rated using common indicators, such as Recall (or Sensitivity) and Precision (or Positive predictive value). In the visit-oriented setting, the Record-saving approach yielded Recall values from 70% to 100%, but low Precision (5% to 10%), which however increased to 50% when considering only predictions for which the model returned a probability above a given "confidence threshold". For the History-oriented setting, both indicators increased as prediction time lengthened, reaching values of 67% (Recall) and 42% (Precision) at 720 days. We show how "real world" data can be effectively used to forecast the evolution of MS, leading to high Recall values and propose innovative approaches to improve Precision towards clinically useful values.

An Advanced MRI Multi-Modalities Segmentation Methodology Dedicated to Multiple Sclerosis Lesions Exploration and Differentiation

Multiple sclerosis (MS) is one of the most common neurological diseases in young people. This paper dealt with an automatic biomedical aided tool involving volumetric segmentation of multiple sclerosis lesions. To meet this challenge, our proposed methodology requires one preliminary cerebral zones segmentation performed using a new Gaussian mixture model based on various databases atlases. Afterward, lesion segmentation begins with the estimation of a lesion map, which is then subjected to threshold constraints and refined by a new lesion expansion algorithm. The evaluation was carried out on four clinical databases integrating various clinical cases which had different lesion loads and were presented by a set of MRI modalities at several noise levels. The results compared with those of the existing methods proved excellent cerebral segmentation with dice averages close to 0.8 and sensitivity and specificity averages greater than 0.9. In addition, depending on the used database, the lesion segmentation recorded mean values were close to or greater than 0.8 for the different metrics. The detection error and outline error averages were about 0.3. Besides the ability to identify the lesions affecting the different parts of the brain, even those spreading in the gray matter, the proposed methodology identified the lesions cores and their surrounding vasogenic edema. This has been thoroughly tested and validated by highly qualified radiologists and neurologists. The evaluation of the resulting discriminations recorded values close to or greater than 0.9 for dice, sensitivity, and specificity. As a valuable benefit, a computer aided diagnosis tool could be offered to clinicians. It would help efficiently during the MS diagnosis and avoid several confusions. Besides, it could be used for longitudinal survey and henceforth extends to other pathologies that could be explored by MRI modalities, such as glioblastoma or alzheimer's disease.