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Machine learning-based cognitive impairment classification with optimal combination of neuropsychological tests.

ABSTRACT: Introduction:An extensive battery of neuropsychological tests is currently used to classify individuals as healthy (HV), mild cognitively impaired (MCI), and with Alzheimer's disease (AD). We used machine learning models for effective cognitive impairment classification and optimized the number of tests for expeditious and inexpensive implementation. Methods:Using random forests (RF) and support vector machine, we classified cognitive impairment in multi-class data sets from Rush Religious Orders Study Memory and Aging Project, and National Alzheimer's Coordinating Center. We applied Fischer's linear discrimination and assessed importance of each test iteratively for feature selection. Results:RF has best accuracy with increased sensitivity, specificity in this first ever multi-class classification of HV, MCI, and AD. Moreover, a subset of six to eight tests shows equivalent classification accuracy as an entire battery of tests. Discussions:Fully automated feature selection approach reveals six to eight tests comprising episodic, semantic memory, perceptual orientation, and executive functioning can accurately classify the cognitive status, ensuring minimal subject burden.

SUBMITTER: Gupta A

PROVIDER: S-EPMC7369403 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Machine learning-based cognitive impairment classification with optimal combination of neuropsychological tests.

Gupta Abhay A Kahali Bratati B

Alzheimer's & dementia (New York, N. Y.) 20200719 1

<h4>Introduction</h4>An extensive battery of neuropsychological tests is currently used to classify individuals as healthy (HV), mild cognitively impaired (MCI), and with Alzheimer's disease (AD). We used machine learning models for effective cognitive impairment classification and optimized the number of tests for expeditious and inexpensive implementation.<h4>Methods</h4>Using random forests (RF) and support vector machine, we classified cognitive impairment in multi-class data sets from Rush ...[more]

PMID: 32699817

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Project description:BackgroundDetection of mild cognitive impairment (MCI) is essential to screen high risk of Alzheimer's disease (AD). However, subtle changes during MCI make it challenging to classify in machine learning. The previous pathological analysis pointed out that the hippocampus is the critical hub for the white matter (WM) network of MCI. Damage to the white matter pathways around the hippocampus is the main cause of memory decline in MCI. Therefore, it is vital to biologically extract features from the WM network driven by hippocampus-related regions to improve classification performance.MethodsOur study proposes a method for feature extraction of the whole-brain WM network. First, 42 MCI and 54 normal control (NC) subjects were recruited using diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI), and T1-weighted (T1w) imaging. Second, mean diffusivity (MD) and fractional anisotropy (FA) were calculated from DTI, and the whole-brain WM networks were obtained. Third, regions of interest (ROIs) with significant functional connectivity to the hippocampus were selected for feature extraction, and the hippocampus (HIP)-related WM networks were obtained. Furthermore, the rank sum test with Bonferroni correction was used to retain significantly different connectivity between MCI and NC, and significant HIP-related WM networks were obtained. Finally, the classification performances of these three WM networks were compared to select the optimal feature and classifier.Results(1) For the features, the whole-brain WM network, HIP-related WM network, and significant HIP-related WM network are significantly improved in turn. Also, the accuracy of MD networks as features is better than FA. (2) For the classification algorithm, the support vector machine (SVM) classifier with radial basis function, taking the significant HIP-related WM network in MD as a feature, has the optimal classification performance (accuracy = 89.4%, AUC = 0.954). (3) For the pathologic mechanism, the hippocampus and thalamus are crucial hubs of the WM network for MCI.ConclusionFeature extraction from the WM network driven by hippocampus-related regions provides an effective method for the early diagnosis of AD.

Project description:Background: Despite the increasing availability in brain health related data, clinically translatable methods to predict the conversion from Mild Cognitive Impairment (MCI) to Alzheimer's disease (AD) are still lacking. Although MCI typically precedes AD, only a fraction of 20-40% of MCI individuals will progress to dementia within 3 years following the initial diagnosis. As currently available and emerging therapies likely have the greatest impact when provided at the earliest disease stage, the prompt identification of subjects at high risk for conversion to AD is of great importance in the fight against this disease. In this work, we propose a highly predictive machine learning algorithm, based only on non-invasively and easily in-the-clinic collectable predictors, to identify MCI subjects at risk for conversion to AD. Methods: The algorithm was developed using the open dataset from the Alzheimer's Disease Neuroimaging Initiative (ADNI), employing a sample of 550 MCI subjects whose diagnostic follow-up is available for at least 3 years after the baseline assessment. A restricted set of information regarding sociodemographic and clinical characteristics, neuropsychological test scores was used as predictors and several different supervised machine learning algorithms were developed and ensembled in final algorithm. A site-independent stratified train/test split protocol was used to provide an estimate of the generalized performance of the algorithm. Results: The final algorithm demonstrated an AUROC of 0.88, sensitivity of 77.7%, and a specificity of 79.9% on excluded test data. The specificity of the algorithm was 40.2% for 100% sensitivity. Conclusions: The algorithm we developed achieved sound and high prognostic performance to predict AD conversion using easily clinically derived information that makes the algorithm easy to be translated into practice. This indicates beneficial application to improve recruitment in clinical trials and to more selectively prescribe new and newly emerging early interventions to high AD risk patients.

Dataset Information

Machine learning-based cognitive impairment classification with optimal combination of neuropsychological tests.

Publications

Machine learning-based cognitive impairment classification with optimal combination of neuropsychological tests.

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