An ensemble learning system for a 4-way classification of Alzheimer's disease and mild cognitive impairment

dcSBM: A federated constrained source-based morphometry approach for multivariate brain structure mapping

The examination of multivariate brain morphometry patterns has gained attention in recent years, especially for their powerful exploratory capabilities in the study of differences between patients and controls. Among the many existing methods and tools for the analysis of brain anatomy based on structural magnetic resonance imaging data, data-driven source-based morphometry (SBM) focuses on the exploratory detection of such patterns. Here, we implement a semi-blind extension of SBM, called constrained source-based morphometry (constrained SBM), which enables the extraction of maximally independent reference-alike sources using the constrained independent component analysis (ICA) approach. To do this, we combine SBM with a set of reference components covering the full brain, derived from a large independent data set (UKBiobank), to provide a fully automated SBM framework. This also allows us to implement a federated version of constrained SBM (cSBM) to allow analysis of data that is not locally accessible. In our proposed decentralized constrained source-based morphometry (dcSBM), the original data never leaves the local site. Each site operates constrained ICA on its private local data using a common distributed computation platform. Next, an aggregator/master node aggregates the results estimated from each local site and applies statistical analysis to estimate the significance of the sources. Finally, we utilize two additional multisite patient data sets to validate our model by comparing the resulting group difference estimates from both cSBM and dcSBM.

Computer aided progression detection model based on optimized deep LSTM ensemble model and the fusion of multivariate time series data

Alzheimer's disease (AD) is the most common form of dementia. Early and accurate detection of AD is crucial to plan for disease modifying therapies that could prevent or delay the conversion to sever stages of the disease. As a chronic disease, patient's multivariate time series data including neuroimaging, genetics, cognitive scores, and neuropsychological battery provides a complete profile about patient's status. This data has been used to build machine learning and deep learning (DL) models for the early detection of the disease. However, these models still have limited performance and are not stable enough to be trusted in real medical settings. Literature shows that DL models outperform classical machine learning models, but ensemble learning has proven to achieve better results than standalone models. This study proposes a novel deep stacking framework which combines multiple DL models to accurately predict AD at an early stage. The study uses long short-term memory (LSTM) models as base models over patient's multivariate time series data to learn the deep longitudinal features. Each base LSTM classifier has been optimized using the Bayesian optimizer using different feature sets. As a result, the final optimized ensembled model employed heterogeneous base models that are trained on heterogeneous data. The performance of the resulting ensemble model has been explored using a cohort of 685 patients from the University of Washington's National Alzheimer's Coordinating Center dataset. Compared to the classical machine learning models and base LSTM classifiers, the proposed ensemble model achieves the highest testing results (i.e., 82.02, 82.25, 82.02, and 82.12 for accuracy, precision, recall, and F1-score, respectively). The resulting model enhances the performance of the state-of-the-art literature, and it could be used to build an accurate clinical decision support tool that can assist domain experts for AD progression detection.

A novel Ontology-guided Attribute Partitioning ensemble learning model for early prediction of cognitive deficits using quantitative Structural MRI in very preterm infants

Structural magnetic resonance imaging studies have shown that brain anatomical abnormalities are associated with cognitive deficits in preterm infants. Brain maturation and geometric features can be used with machine learning models for predicting later neurodevelopmental deficits. However, traditional machine learning models would suffer from a large feature-to-instance ratio (i.e., a large number of features but a small number of instances/samples). Ensemble learning is a paradigm that strategically generates and integrates a library of machine learning classifiers and has been successfully used on a wide variety of predictive modeling problems to boost model performance. Attribute (i.e., feature) bagging method is the most commonly used feature partitioning scheme, which randomly and repeatedly draws feature subsets from the entire feature set. Although attribute bagging method can effectively reduce feature dimensionality to handle the large feature-to-instance ratio, it lacks consideration of domain knowledge and latent relationship among features. In this study, we proposed a novel Ontology-guided Attribute Partitioning (OAP) method to better draw feature subsets by considering the domain-specific relationship among features. With the better-partitioned feature subsets, we developed an ensemble learning framework, which is referred to as OAP-Ensemble Learning (OAP-EL). We applied the OAP-EL to predict cognitive deficits at 2 years of age using quantitative brain maturation and geometric features obtained at term equivalent age in very preterm infants. We demonstrated that the proposed OAP-EL approach significantly outperformed the peer ensemble learning and traditional machine learning approaches.

Large Margin and Local Structure Preservation Sparse Representation Classifier for Alzheimer’s Magnetic Resonance Imaging Classification

Alzheimer’s disease (AD) is a progressive dementia in which the brain shrinks as the disease progresses. The use of machine learning and brain magnetic resonance imaging (MRI) for the early diagnosis of AD has a high probability of clinical value and social significance. Sparse representation classifier (SRC) is widely used in MRI image classification. However, the traditional SRC only considers the reconstruction error and classification error of the dictionary, and does not consider the global and local structural information between images, which results in unsatisfactory classification performance. Therefore, a large margin and local structure preservation sparse representation classifier (LMLS-SRC) is developed in this manuscript. The LMLS-SRC algorithm uses the classification large margin term based on the representation coefficient, which results in compactness between representation coefficients of the same class and a large margin between representation coefficients of different classes. The LMLS-SRC algorithm uses local structure preservation term to inherit the manifold structure of the original data. In addition, the LMLS-SRC algorithm imposes the ℓ_2,1-norm on the representation coefficients to enhance the sparsity and robustness of the model. Experiments on the KAGGLE Alzheimer’s dataset show that the LMLS-SRC algorithm can effectively diagnose non AD, moderate AD, mild AD, and very mild AD.

Whole-Brain Functional Connectivity Dynamics Associated With Electroconvulsive Therapy Treatment Response

BACKGROUND

Depressive episodes (DEPs), characterized by abnormalities in cognitive functions and mood, are a leading cause of disability. Electroconvulsive therapy (ECT), which involves a brief electrical stimulation of the anesthetized brain, is one of the most effective treatments used in patients with DEP due to its rapid efficacy.

METHODS

In this work, we investigated how dynamic brain functional connectivity responds to ECT and whether the dynamic responses are associated with treatment outcomes and side effects in patients. We applied a fully automated independent component analysis-based pipeline to 110 patients with DEP (including diagnosis of unipolar depression or bipolar depression) and 60 healthy control subjects. The dynamic functional connectivity was analyzed by a combination of the sliding window approach and clustering analysis.

RESULTS

Five recurring connectivity states were identified, and patients with DEPs had fewer occurrences in one brain state (state 1) with strong positive and negative connectivity. Patients with DEP changed the occupancy of two states (states 3 and 4) after ECT, resulting in significantly different occurrences of one additional state (state 3) compared with healthy control subjects. We further found that patients with DEP had diminished global metastate dynamism, two of which recovered to normal after ECT. The changes in dynamic connectivity characteristics were associated with the changes in memory recall and Hamilton Depression Rating Scale of DEP after ECT.

CONCLUSIONS

These converging results extend current findings on subcortical-cortical dysfunction and dysrhythmia in DEP and demonstrate that ECT might cause remodeling of brain functional dynamics that enhance the neuroplasticity of the diseased brain.

The Road to Personalized Medicine in Alzheimer’s Disease: The Use of Artificial Intelligence

Dementia remains an extremely prevalent syndrome among older people and represents a major cause of disability and dependency. Alzheimer’s disease (AD) accounts for the majority of dementia cases and stands as the most common neurodegenerative disease. Since age is the major risk factor for AD, the increase in lifespan not only represents a rise in the prevalence but also adds complexity to the diagnosis. Moreover, the lack of disease-modifying therapies highlights another constraint. A shift from a curative to a preventive approach is imminent and we are moving towards the application of personalized medicine where we can shape the best clinical intervention for an individual patient at a given point. This new step in medicine requires the most recent tools and analysis of enormous amounts of data where the application of artificial intelligence (AI) plays a critical role on the depiction of disease–patient dynamics, crucial in reaching early/optimal diagnosis, monitoring and intervention. Predictive models and algorithms are the key elements in this innovative field. In this review, we present an overview of relevant topics regarding the application of AI in AD, detailing the algorithms and their applications in the fields of drug discovery, and biomarkers.

An Ensemble Feature Selection Approach to Identify Relevant Features from EEG Signals

Identifying relevant data to support the automatic analysis of electroencephalograms (EEG) has become a challenge. Although there are many proposals to support the diagnosis of neurological pathologies, the current challenge is to improve the reliability of the tools to classify or detect abnormalities. In this study, we used an ensemble feature selection approach to integrate the advantages of several feature selection algorithms to improve the identification of the characteristics with high power of differentiation in the classification of normal and abnormal EEG signals. Discrimination was evaluated using several classifiers, i.e., decision tree, logistic regression, random forest, and Support Vecctor Machine (SVM); furthermore, performance was assessed by accuracy, specificity, and sensitivity metrics. The evaluation results showed that Ensemble Feature Selection (EFS) is a helpful tool to select relevant features from the EEGs. Thus, the stability calculated for the EFS method proposed was almost perfect in most of the cases evaluated. Moreover, the assessed classifiers evidenced that the models improved in performance when trained with the EFS approach’s features. In addition, the classifier of epileptiform events built using the features selected by the EFS method achieved an accuracy, sensitivity, and specificity of 97.64%, 96.78%, and 97.95%, respectively; finally, the stability of the EFS method evidenced a reliable subset of relevant features. Moreover, the accuracy, sensitivity, and specificity of the EEG detector are equal to or greater than the values reported in the literature.

Machine learning for modeling the progression of Alzheimer disease dementia using clinical data: a systematic literature review

OBJECTIVE

Alzheimer disease (AD) is the most common cause of dementia, a syndrome characterized by cognitive impairment severe enough to interfere with activities of daily life. We aimed to conduct a systematic literature review (SLR) of studies that applied machine learning (ML) methods to clinical data derived from electronic health records in order to model risk for progression of AD dementia.

MATERIALS AND METHODS

We searched for articles published between January 1, 2010, and May 31, 2020, in PubMed, Scopus, ScienceDirect, IEEE Explore Digital Library, Association for Computing Machinery Digital Library, and arXiv. We used predefined criteria to select relevant articles and summarized them according to key components of ML analysis such as data characteristics, computational algorithms, and research focus.

RESULTS

There has been a considerable rise over the past 5 years in the number of research papers using ML-based analysis for AD dementia modeling. We reviewed 64 relevant articles in our SLR. The results suggest that majority of existing research has focused on predicting progression of AD dementia using publicly available datasets containing both neuroimaging and clinical data (neurobehavioral status exam scores, patient demographics, neuroimaging data, and laboratory test values).

DISCUSSION

Identifying individuals at risk for progression of AD dementia could potentially help to personalize disease management to plan future care. Clinical data consisting of both structured data tables and clinical notes can be effectively used in ML-based approaches to model risk for AD dementia progression. Data sharing and reproducibility of results can enhance the impact, adaptation, and generalizability of this research.

Multiclass diagnosis of stages of Alzheimer's disease using linear discriminant analysis scoring for multimodal data

Alzheimer's disease (AD) is a progressive neurodegenerative disease, and mild cognitive impairment (MCI) is a transitional stage between normal control (NC) and AD. A multiclass classification of AD is a difficult task because there are multiple similarities between neighboring groups. The performance of classification can be improved by using multimodal data, but the improvement could be limited with inefficient fusion of multimodal data. This study aims to develop a framework for AD multiclass diagnosis with a linear discriminant analysis (LDA) scoring method to fuse multimodal data more efficiently. Magnetic resonance imaging, positron emission tomography, cerebrospinal fluid biomarkers, and genetic features were first preprocessed by performing age correction, feature selection, and feature reduction. Then, they were individually scored using LDA, and the scores that represent the AD pathological progress in different modalities were obtained. Finally, an extreme learning machine-based decision tree was established to perform multiclass diagnosis using these scores. The experiments were conducted on the AD Neuroimaging Initiative dataset, and accuracies of 66.7% and 57.3% and F1-scores of 64.9% and 55.7% were achieved in three- and four-way classifications, respectively. The results also showed that the proposed framework achieved a better performance than the method that did not score multimodal data and the methods in previous studies, thereby indicating that the LDA scoring strategy is an efficient way for multimodalities fusion in AD multiclass classification.

A Gaussian-based model for early detection of mild cognitive impairment using multimodal neuroimaging

BACKGROUND

Diagnosis of early mild cognitive impairment (EMCI) as a prodromal stage of Alzheimer's disease (AD) with its delineation from the cognitively normal (CN) group remains a challenging but essential step for the planning of early treatment. Although several studies have focused on the MCI diagnosis, this study introduces the early stage of MCI to assess more thoroughly the earliest signs of disease manifestation and progression.

NEW METHOD

We used random forest feature selection model with a Gaussian-based algorithm to perform method evaluation. This integrated method serves to define multivariate normal distributions in order to classify different stages of AD, with the focus placed on detecting EMCI subjects in the most challenging classification of CN vs. EMCI.

RESULTS

Using 896 participants classified into the four categories of CN, EMCI, late mild cognitive impairment (LMCI) and AD, the results show that the EMCI group can be delineated from the CN group with a relatively high accuracy of 78.8% and sensitivity of 81.3%.

COMPARISON WITH EXISTING METHOD(S)

The feature selection model and classifier are compared with some other prominent algorithms. Although higher accuracy has been achieved using the Gaussian process (GP) model (78.8%) over the SVM classifier (75.6%) for CN vs. EMCI classification, with 0.05 being the cutoff for significance, and based on student's t-test, it was determined that the differences for accuracy, sensitivity, specificity between the GP method and support vector machine (SVM) are not statistically significant.

CONCLUSION

Addressing the challenging classification of CN vs. EMCI provides useful information to help clinicians and researchers determine essential measures that can help in the early detection of AD.

Combining heterogeneous data sources for neuroimaging based diagnosis: re-weighting and selecting what is important

Combining neuroimaging and clinical information for diagnosis, as for example behavioral tasks and genetics characteristics, is potentially beneficial but presents challenges in terms of finding the best data representation for the different sources of information. Their simple combination usually does not provide an improvement if compared with using the best source alone. In this paper, we proposed a framework based on a recent multiple kernel learning algorithm called EasyMKL and we investigated the benefits of this approach for diagnosing two different mental health diseases. The well known Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset tackling the Alzheimer Disease (AD) patients versus healthy controls classification task, and a second dataset tackling the task of classifying an heterogeneous group of depressed patients versus healthy controls. We used EasyMKL to combine a huge amount of basic kernels alongside a feature selection methodology, pursuing an optimal and sparse solution to facilitate interpretability. Our results show that the proposed approach, called EasyMKLFS, outperforms baselines (e.g. SVM and SimpleMKL), state-of-the-art random forests (RF) and feature selection (FS) methods.

Development of Prediction Models Using Machine Learning Algorithms for Girls with Suspected Central Precocious Puberty: Retrospective Study

Background

Central precocious puberty (CPP) in girls seriously affects their physical and mental development in childhood. The method of diagnosis—gonadotropin-releasing hormone (GnRH)–stimulation test or GnRH analogue (GnRHa)–stimulation test—is expensive and makes patients uncomfortable due to the need for repeated blood sampling.

Objective

We aimed to combine multiple CPP–related features and construct machine learning models to predict response to the GnRHa-stimulation test.

Methods

In this retrospective study, we analyzed clinical and laboratory data of 1757 girls who underwent a GnRHa test in order to develop XGBoost and random forest classifiers for prediction of response to the GnRHa test. The local interpretable model-agnostic explanations (LIME) algorithm was used with the black-box classifiers to increase their interpretability. We measured sensitivity, specificity, and area under receiver operating characteristic (AUC) of the models.

Results

Both the XGBoost and random forest models achieved good performance in distinguishing between positive and negative responses, with the AUC ranging from 0.88 to 0.90, sensitivity ranging from 77.91% to 77.94%, and specificity ranging from 84.32% to 87.66%. Basal serum luteinizing hormone, follicle-stimulating hormone, and insulin-like growth factor-I levels were found to be the three most important factors. In the interpretable models of LIME, the abovementioned variables made high contributions to the prediction probability.

Conclusions

The prediction models we developed can help diagnose CPP and may be used as a prescreening tool before the GnRHa-stimulation test.