An artificial neural network model for clinical score prediction in Alzheimer disease using structural neuroimaging measures

• Published in: Journal of psychiatry & neuroscience Vol. 44; no. 4; pp. 246 - 260
• Main Authors: Bhagwat, Nikhil, Pipitone, Jon, Voineskos, Aristotle N., Chakravarty, M. Mallar
• Format: Journal Article
• Language: English
• Published: Canada Joule Inc 01.07.2019; CMA Impact, Inc
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - pathology; Alzheimer Disease - physiopathology; Alzheimer's disease; Artificial neural networks; Atrophy; Automation; Biomarkers; Brain; Cerebral Cortex - diagnostic imaging; Cerebral Cortex - pathology; Cognitive ability; Cross-Sectional Studies; Datasets; Diagnostic imaging; Epidemiology; Female; Hippocampus; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Medical imaging; Medical research; Natural language processing; Neural networks; Neural Networks, Computer; Neurodegeneration; Neurodegenerative diseases; Neuroimaging; Neuroimaging - methods; Neuroimaging - standards; NMR; Novels; Nuclear magnetic resonance; Pharmaceutical industry; Prognosis; Proof of Concept Study; Reproducibility of Results; Research Paper; Severity of Illness Index; United States
• ISSN: 1180-4882; 1488-2434
• DOI: 10.1503/jpn.180016

The development of diagnostic and prognostic tools for Alzheimer disease is complicated by substantial clinical heterogeneity in prodromal stages. Many neuroimaging studies have focused on case–control classification and predicting conversion from mild cognitive impairment to Alzheimer disease, but predicting scores from clinical assessments (such as the Alzheimer’s Disease Assessment Scale or the Mini Mental State Examination) using MRI data has received less attention. Predicting clinical scores can be crucial in providing a nuanced prognosis and inferring symptomatic severity. We predicted clinical scores at the individual level using a novel anatomically partitioned artificial neural network (APANN) model. The model combined input from 2 structural MRI measures relevant to the neurodegenerative patterns observed in Alzheimer disease: hippocampal segmentations and cortical thickness. We evaluated the performance of the APANN model with 10 rounds of 10-fold cross-validation in 3 experiments, using cohorts from the Alzheimer’s Disease Neuroimaging Initiative (ADNI): ADNI1, ADNI2 and ADNI1 + 2. Pearson correlation and root mean square error between the actual and predicted scores on the Alzheimer’s Disease Assessment Scale (ADNI1: r = 0.60; ADNI2: r = 0.68; ADNI1 + 2: r = 0.63) and Mini Mental State Examination (ADNI1: r = 0.52; ADNI2: r = 0.55; ADNI1 + 2: r = 0.55) showed that APANN can accurately infer clinical severity from MRI data. To rigorously validate the model, we focused primarily on large cross-sectional baseline data sets with only proof-of-concept longitudinal results. The APANN provides a highly robust and scalable framework for predicting clinical severity at the individual level using high-dimensional, multimodal neuroimaging data.