Automatic Prognostic Determination and Evolution of Cognitive Decline using Artificial Neural Networks

Abstract. This work tries to go a step further in the development of methods based on automatic learning techniques to parse and interpret data relating to cognitive decline (CD). There have been studied the neuropsychological tests of 267 consultations made over 30 patients by the Alzheimer's Patient Association of Gran Canaria in 2005. The Sanger neural network adaptation for missing values treatment has allowed making a Principal Components Analysis (PCA) on the successfully obtained data. The results show that the first three obtained principal components are able to extract information relating to functional, cognitive and instrumental sintomatology, respectively, from the test. By means of these techniques, it is possible to develop tools that allow physicians to quantify, view and make a better pursuit of the sintomatology associated to the cognitive decline processes, contributing to a better knowledge of these ones

Artificial intelligence applied to neuroimaging data in Parkinsonian syndromes: Actuality and expectations

Idiopathic Parkinson's Disease (iPD) is a common motor neurodegenerative disorder. It affects more frequently the elderly population, causing a significant emotional burden both for the patient and caregivers, due to the disease-related onset of motor and cognitive disabilities. iPD's clinical hallmark is the onset of cardinal motor symptoms such as bradykinesia, rest tremor, rigidity, and postural instability. However, these symptoms appear when the neurodegenerative process is already in an advanced stage. Furthermore, the greatest challenge is to distinguish iPD from other similar neurodegenerative disorders, "atypical parkinsonisms", such as Multisystem Atrophy, Progressive Supranuclear Palsy and Cortical Basal Degeneration, since they share many phenotypic manifestations, especially in the early stages. The diagnosis of these neurodegenerative motor disorders is essentially clinical. Consequently, the diagnostic accuracy mainly depends on the professional knowledge and experience of the physician. Recent advances in artificial intelligence have made it possible to analyze the large amount of clinical and instrumental information in the medical field. The application machine learning algorithms to the analysis of neuroimaging data appear to be a promising tool for identifying microstructural alterations related to the pathological process in order to explain the onset of symptoms and the spread of the neurodegenerative process. In this context, the search for quantitative biomarkers capable of identifying parkinsonian patients in the prodromal phases of the disease, of correctly distinguishing them from atypical parkinsonisms and of predicting clinical evolution and response to therapy represent the main goal of most current clinical research studies. Our aim was to review the recent literature and describe the current knowledge about the contribution given by machine learning applications to research and clinical management of parkinsonian syndromes

Classification of dementias based on brain radiomics features

Dissertação de mestrado integrado em Engenharia InformáticaNeurodegenerative diseases impair the functioning of the brain and are characterized by alterations in the morphology of specific brain regions. Some of the main disorders include Alzheimer's, Parkinson's, and Huntington's diseases, and the number of cases increases exponentially since ageing is one of the main risk factors. Trying to identify the areas in which this type of disease appears is something that can have a very positive impact in this area of Medicine and can guarantee a more appropriate treatment or allow the improvement of the quality of life of patients. With the current technological advances, computer tools are capable of performing a structural or functional analysis of neuroimaging data from Magnetic Resonance Images(MRI). Therefore, Medical Informatics uses these techniques to create and manage medical neuroimaging data to improve the diagnosis and management of these patients. MRI is the image type used in the analysis of the brain area and points to a promising and reliable diagnostic tool since it allows high-quality images in various planes or strategies and MRI methods are fundamental diagnostic tools in clinical practice, allowing the diagnosis of pathologic processes such as stroke or brain tumours. However, structural MRI has limitations for the diagnosis of neurodegenerative disorders since it mainly identifies atrophy of brain regions. Currently, there is increased interest in informatics applications capable of monitoring and quantifying human brain imaging alterations, with potential for neurodegenerative disorders diagnosis and monitoring. One of these applications is Radiomics, which corresponds to a methodolog ythat allows the extraction of features from images of a given region of the brain. Specific quantitative metrics from MRI are acquired by this tool, and they correspond to a set of features, including texture, shape, among others. To standardize Radiomics application, specific libraries have been proposed to be used by the bioinformatics and biomedical communities, such as PyRadiomics, which corresponds to an open source Python package for extracting Radiomics of MRIs. Therefore, this dissertation was developed based on magnetic resonance images and the study of Deep Learning (DL) techniques to assist researchers and neuroradiologists in the diagnosis and prediction of neurodegenerative disease development. Two different main tasks were made: first, a segmentation, using FreeSurfer, of different regions of the brain and then, a model was build from radiomic features extracted from each part of the brain and interpreted for knowledge extraction.As doenças neurodegenerativas estão associadas ao funcionamento do cérebro e caracterizam-se pelo facto de serem altamente incapacitantes. São exemplos destas, as doenças de Alzheimer, Parkinson e Huntington, e o seu número de casos tem vindo a aumentar exponencialmente, uma vez que o envelhecimento é um dos principais factores de risco. Tentar identificar quais são as regiões cerebrais que permitem predizer o seu aparecimento e desenvolvimento é algo que, sendo possível, terá um impacto muito positivo nesta área da Medicina e poderá garantir um tratamento mais adequado, ou simplesmente melhorar a qualidade de vida dos pacientes. Com os avanços tecnológicos atuais, foram desenvolvidas ferramentas informáticas que são capazes de efetuar uma análise estrutural ou funcional de Ressonâncias Magnéticas (MRI), sendo essas ferramentas usadas para promover a melhoria e o conhecimento clínico. Deste modo, as constantes evoluções científicas têm realçado o papel da Informática Médica na neuroimagem para criar e gerenciar dados médicos, melhorando o diagnóstico destes pacientes. A MRI é o tipo de imagem utilizada na análise de regiões cerebrais e aponta para uma ferramenta de diagnóstico promissora e fiável, uma vez que permite obter imagens de alta qualidade em vários planos, permitindo assim, o diagnóstico de processos patológicos, tais como acidentes vasculares ou tumores cerebrais. Atualmente, existem inúmeras aplicações informáticas capazes de efetuar análises estruturais e funcionais do cérebro humano, pois é este o principal órgão afetado pelas doenças neurodegenerativas. Uma dessas aplicações é o Radiomics, que permite fazer a extração de features de imagens do cérebro. A biblioteca a utilizar será PyRadiomics, que corresponde a um package open source em Python para a extração de features Radiomics de imagens médicas. As features correspondem a características da imagem. Assim sendo, a presente dissertação foi desenvolvida com base em imagens de ressonância magnética e no estudo das técnicas de Deep Learning para investigar e auxiliar os médicos neurorradiologistas a diagnosticar e a prever o desenvolvimento de doenças neurodegenerativas. Foram feitas duas principais tarefas: primeiro, uma segmentação, utilizando o software FreeSurfer, de diferentes regiões do cérebro e, de seguida, foi construído um modelo a partir das features radiómicas extraídas de cada parte do cérebro que foi interpretado

Advancing mental health care with AI-enabled precision psychiatry tools: A patent review

The review provides an overview of patents on AI-enabled precision psychiatry tools published between 2015 and mid-October 2022. Multiple analytic approaches, such as graphic network analysis and topic modeling, are used to analyze the scope, content, and trends of the retained patents. The included tools aim to provide accurate diagnoses according to established psychometric criteria, predict the response to specific treatment approaches, suggest optimal treatments, and make prognoses regarding disorder courses without intervention. About one-third of the tools recommend treatment options or include treatment administration related to digital therapeutics, pharmacotherapy, and electrotherapy. Data sources used to make predictions include behavioral data collected through mobile devices, neuroimaging, and electronic health records. The complexity of technology combinations used in the included devices has increased until 2021. The topics extracted from the patent data illuminate current trends and potential future developments in AI-enabled precision psychiatry. The most impactful patents and associated available products reveal relevant commercialization possibilities and likely future developments. Overall, the review highlights the potential of adopting AI-enabled precision psychiatry tools in practice

A precision medicine initiative for Alzheimer's disease: the road ahead to biomarker-guided integrative disease modeling

After intense scientific exploration and more than a decade of failed trials, Alzheimer’s disease (AD) remains a fatal global epidemic. A traditional research and drug development paradigm continues to target heterogeneous late-stage clinically phenotyped patients with single 'magic bullet' drugs. Here, we propose that it is time for a paradigm shift towards the implementation of precision medicine (PM) for enhanced risk screening, detection, treatment, and prevention of AD. The overarching structure of how PM for AD can be achieved will be provided through the convergence of breakthrough technological advances, including big data science, systems biology, genomic sequencing, blood-based biomarkers, integrated disease modeling and P4 medicine. It is hypothesized that deconstructing AD into multiple genetic and biological subsets existing within this heterogeneous target population will provide an effective PM strategy for treating individual patients with the specific agent(s) that are likely to work best based on the specific individual biological make-up. The Alzheimer’s Precision Medicine Initiative (APMI) is an international collaboration of leading interdisciplinary clinicians and scientists devoted towards the implementation of PM in Neurology, Psychiatry and Neuroscience. It is hypothesized that successful realization of PM in AD and other neurodegenerative diseases will result in breakthrough therapies, such as in oncology, with optimized safety profiles, better responder rates and treatment responses, particularly through biomarker-guided early preclinical disease-stage clinical trials

Non-communicable Diseases, Big Data and Artificial Intelligence

This reprint includes 15 articles in the field of non-communicable Diseases, big data, and artificial intelligence, overviewing the most recent advances in the field of AI and their application potential in 3P medicine

Advances in Clinical Neurophysiology

Including some of the newest advances in the field of neurophysiology, this book can be considered as one of the treasures that interested scientists would like to collect. It discusses many disciplines of clinical neurophysiology that are, currently, crucial in the practice as they explain methods and findings of techniques that help to improve diagnosis and to ensure better treatment. While trying to rely on evidence-based facts, this book presents some new ideas to be applied and tested in the clinical practice. Advances in Clinical Neurophysiology is important not only for the neurophysiologists but also for clinicians interested or working in wide range of specialties such as neurology, neurosurgery, intensive care units, pediatrics and so on. Generally, this book is written and designed to all those involved in, interpreting or requesting neurophysiologic tests

Location Detection of Dementia Using GPS Coordinate Finder

Gerontology problems affect many old citizens at the age of 67 years old and above. Many people become forgetful as they become older and one of the problems is dementia. Memory impairments are the most common among people with dementia. Dementia can happen to anybody, but it is more common after the age of 65 years. It causes a loss of mental ability, and other symptoms. Dementia can be caused by various disorders which affect parts of the brain involved with thought processes. People with dementia do not remember how to get back home and there is no specialized device to assist family members to take care of their elders in Malaysia. Thus, this project aims to identify tracking system that is suitable for dementia and to develop an application to help relatives to track dementia’s location. This scope is to find the location of dementia and to help relatives to track dementia’s location using GPS tracker and coordinate finder application. This paper discussed about the location detection of the GPS in order to track for dementia’s location for the wide range of network with the accessibility of the Internet network. This system will help relatives to track the location of the people with dementia and to reduce the burden of family member to take care of dementia people. Additionally, the GPS will detect the location and send the message to receiver to inform the current coordinate location. MIT AppInventor is used in developing the Android Application and tested with a smart phone. This paper describes the system designed of GPS and application, and discussed the implementation of the system to the dementia people. Positive results are received from the conducted user perception study and shows that users (family members) are satisfied with the application in identifying dementia’s location effectivel

Recent publications from the Alzheimer's Disease Neuroimaging Initiative: Reviewing progress toward improved AD clinical trials

INTRODUCTION: The Alzheimer's Disease Neuroimaging Initiative (ADNI) has continued development and standardization of methodologies for biomarkers and has provided an increased depth and breadth of data available to qualified researchers. This review summarizes the over 400 publications using ADNI data during 2014 and 2015. METHODS: We used standard searches to find publications using ADNI data. RESULTS: (1) Structural and functional changes, including subtle changes to hippocampal shape and texture, atrophy in areas outside of hippocampus, and disruption to functional networks, are detectable in presymptomatic subjects before hippocampal atrophy; (2) In subjects with abnormal β-amyloid deposition (Aβ+), biomarkers become abnormal in the order predicted by the amyloid cascade hypothesis; (3) Cognitive decline is more closely linked to tau than Aβ deposition; (4) Cerebrovascular risk factors may interact with Aβ to increase white-matter (WM) abnormalities which may accelerate Alzheimer's disease (AD) progression in conjunction with tau abnormalities; (5) Different patterns of atrophy are associated with impairment of memory and executive function and may underlie psychiatric symptoms; (6) Structural, functional, and metabolic network connectivities are disrupted as AD progresses. Models of prion-like spreading of Aβ pathology along WM tracts predict known patterns of cortical Aβ deposition and declines in glucose metabolism; (7) New AD risk and protective gene loci have been identified using biologically informed approaches; (8) Cognitively normal and mild cognitive impairment (MCI) subjects are heterogeneous and include groups typified not only by "classic" AD pathology but also by normal biomarkers, accelerated decline, and suspected non-Alzheimer's pathology; (9) Selection of subjects at risk of imminent decline on the basis of one or more pathologies improves the power of clinical trials; (10) Sensitivity of cognitive outcome measures to early changes in cognition has been improved and surrogate outcome measures using longitudinal structural magnetic resonance imaging may further reduce clinical trial cost and duration; (11) Advances in machine learning techniques such as neural networks have improved diagnostic and prognostic accuracy especially in challenges involving MCI subjects; and (12) Network connectivity measures and genetic variants show promise in multimodal classification and some classifiers using single modalities are rivaling multimodal classifiers. DISCUSSION: Taken together, these studies fundamentally deepen our understanding of AD progression and its underlying genetic basis, which in turn informs and improves clinical trial desig