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Modeling and prediction of clinical symptom trajectories in Alzheimer's disease using longitudinal data.

ABSTRACT: Computational models predicting symptomatic progression at the individual level can be highly beneficial for early intervention and treatment planning for Alzheimer's disease (AD). Individual prognosis is complicated by many factors including the definition of the prediction objective itself. In this work, we present a computational framework comprising machine-learning techniques for 1) modeling symptom trajectories and 2) prediction of symptom trajectories using multimodal and longitudinal data. We perform primary analyses on three cohorts from Alzheimer's Disease Neuroimaging Initiative (ADNI), and a replication analysis using subjects from Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL). We model the prototypical symptom trajectory classes using clinical assessment scores from mini-mental state exam (MMSE) and Alzheimer's Disease Assessment Scale (ADAS-13) at nine timepoints spanned over six years based on a hierarchical clustering approach. Subsequently we predict these trajectory classes for a given subject using magnetic resonance (MR) imaging, genetic, and clinical variables from two timepoints (baseline + follow-up). For prediction, we present a longitudinal Siamese neural-network (LSN) with novel architectural modules for combining multimodal data from two timepoints. The trajectory modeling yields two (stable and decline) and three (stable, slow-decline, fast-decline) trajectory classes for MMSE and ADAS-13 assessments, respectively. For the predictive tasks, LSN offers highly accurate performance with 0.900 accuracy and 0.968 AUC for binary MMSE task and 0.760 accuracy for 3-way ADAS-13 task on ADNI datasets, as well as, 0.724 accuracy and 0.883 AUC for binary MMSE task on replication AIBL dataset.

SUBMITTER: Bhagwat N

PROVIDER: S-EPMC6157905 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Modeling and prediction of clinical symptom trajectories in Alzheimer's disease using longitudinal data.

Bhagwat Nikhil N Viviano Joseph D JD Voineskos Aristotle N AN Chakravarty M Mallar MM

PLoS computational biology 20180914 9

Computational models predicting symptomatic progression at the individual level can be highly beneficial for early intervention and treatment planning for Alzheimer's disease (AD). Individual prognosis is complicated by many factors including the definition of the prediction objective itself. In this work, we present a computational framework comprising machine-learning techniques for 1) modeling symptom trajectories and 2) prediction of symptom trajectories using multimodal and longitudinal dat ...[more]

PMID: 30216352

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Project description:Incipient Alzheimer's Disease (AD) is characterized by a slow onset of clinical symptoms, with pathological brain changes starting several years earlier. Consequently, it is necessary to first understand and differentiate age-related changes in brain regions in the absence of disease, and then to support early and accurate AD diagnosis. However, there is poor understanding of the initial stage of AD; seemingly healthy elderly brains lose matter in regions related to AD, but similar changes can also be found in non-demented subjects having mild cognitive impairment (MCI). By using a Linear Mixed Effects approach, we modelled the change of 166 Magnetic Resonance Imaging (MRI)-based biomarkers available at a 5-year follow up on healthy elderly control (HC, n = 46) subjects. We hypothesized that, by identifying their significant variant (vr) and quasi-variant (qvr) brain regions over time, it would be possible to obtain an age-based null model, which would characterize their normal atrophy and growth patterns as well as the correlation between these two regions. By using the null model on those subjects who had been clinically diagnosed as HC (n = 161), MCI (n = 209) and AD (n = 331), normal age-related changes were estimated and deviation scores (residuals) from the observed MRI-based biomarkers were computed. Subject classification, as well as the early prediction of conversion to MCI and AD, were addressed through residual-based Support Vector Machines (SVM) modelling. We found reductions in most cortical volumes and thicknesses (with evident gender differences) as well as in sub-cortical regions, including greater atrophy in the hippocampus. The average accuracies (ACC) recorded for men and women were: AD-HC: 94.11%, MCI-HC: 83.77% and MCI converted to AD (cAD)-MCI non-converter (sMCI): 76.72%. Likewise, as compared to standard clinical diagnosis methods, SVM classifiers predicted the conversion of cAD to be 1.9 years earlier for females (ACC:72.5%) and 1.4 years earlier for males (ACC:69.0%).

Dataset Information

Modeling and prediction of clinical symptom trajectories in Alzheimer's disease using longitudinal data.

Publications

Modeling and prediction of clinical symptom trajectories in Alzheimer's disease using longitudinal data.

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