Multimodal deep learning for Alzheimer's disease dementia assessment.

Journal: Nature communications
Published Date: Jun 20, 2022

Abstract

Worldwide, there are nearly 10 million new cases of dementia annually, of which Alzheimer's disease (AD) is the most common. New measures are needed to improve the diagnosis of individuals with cognitive impairment due to various etiologies. Here, we report a deep learning framework that accomplishes multiple diagnostic steps in successive fashion to identify persons with normal cognition (NC), mild cognitive impairment (MCI), AD, and non-AD dementias (nADD). We demonstrate a range of models capable of accepting flexible combinations of routinely collected clinical information, including demographics, medical history, neuropsychological testing, neuroimaging, and functional assessments. We then show that these frameworks compare favorably with the diagnostic accuracy of practicing neurologists and neuroradiologists. Lastly, we apply interpretability methods in computer vision to show that disease-specific patterns detected by our models track distinct patterns of degenerative changes throughout the brain and correspond closely with the presence of neuropathological lesions on autopsy. Our work demonstrates methodologies for validating computational predictions with established standards of medical diagnosis.

Authors

  • Shangran Qiu
    Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, 72 E. Concord Street, Evans 636, Boston, MA, 02118, USA.
  • Matthew I Miller
    Boston University School of Medicine, Boston, Massachusetts, United States of America.
  • Prajakta S Joshi
    Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.
  • Joyce C Lee
    Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
  • Chonghua Xue
    Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, 72 E. Concord Street, Evans 636, Boston, MA, 02118, USA.
  • Yunruo Ni
    Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
  • Yuwei Wang
    College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang, 712000, PR China.
  • Ileana De Anda-Duran
    School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
  • Phillip H Hwang
    Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.
  • Justin A Cramer
    University of Nebraska Medical Center, Omaha, NE, USA.
  • Brigid C Dwyer
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Honglin Hao
    Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
  • Michelle C Kaku
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Sachin Kedar
    Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  • Peter H Lee
    Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA.
  • Asim Z Mian
    Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
  • Daniel L Murman
    Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  • Sarah O'Shea
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Aaron B Paul
    Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA.
  • Marie-Helene Saint-Hilaire
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • E Alton Sartor
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Aneeta R Saxena
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Ludy C Shih
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Juan E Small
    Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA.
  • Maximilian J Smith
    Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA.
  • Arun Swaminathan
    Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  • Courtney E Takahashi
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Olga Taraschenko
    Department of Neurological Sciences, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
  • Hui You
    Endocrinology and Metabolism Center, National Metabolic Management Center, Division of Metabolic Surgery for Obesity and Diabetes, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
  • Jing Yuan
    School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
  • Yan Zhou
    Department of Computer Science, University of Texas at Dallas, Richardson, Texas 75080, United States.
  • Shuhan Zhu
    Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Michael L Alosco
    Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
  • Jesse Mez
    The Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA.
  • Thor D Stein
    Department of Pathology, Boston University School of Medicine, Boston, MA, 02118, USA.
  • Kathleen L Poston
    From the Departments of Radiology (K.T.C., F.B.d.C.M., S.S., G.Z.), Electrical Engineering (E.G., J.M.P.), and Neurology and Neurological Sciences (A.B., K.L.P., S.J.S., M.D.G., E.M.), Stanford University, 1201 Welch Rd, Stanford, CA 94305; Department of Engineering Physics, Tsinghua University, Beijing, PR China (J.X.); GE Healthcare, Menlo Park, Calif (M.K.); and Subtle Medical, Menlo Park, CA (E.G.).
  • Rhoda Au
    Boston University School of Medicine, rhodaau@bu.edu.
  • Vijaya B Kolachalama
    1Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA 02118 USA.

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