Modelling prognostic trajectories in Alzheimer’s disease

Progression to dementia due to Alzheimer’s Disease (AD) is a long and protracted process that involves multiple pathways of disease pathophysiology. Predicting these dynamic changes has major implications for timely and effective clinical management in AD. There are two reasons why at present we lack appropriate tools to make such predictions. First, a key feature of AD is the interactive nature of the relationships between biomarkers, such as accumulation of β-amyloid -a peptide that builds plaques between nerve cells-, tau -a protein found in the axons of nerve cells- and widespread neurodegeneration. Current models fail to capture these relationships because they are unable to successfully reduce the high dimensionality of biomarkers while exploiting informative multivariate relationships. Second, current models focus on simply predicting in a binary manner whether an individual will develop dementia due to AD or not, without informing clinicians about their predicted disease trajectory. This can result in administering inefficient treatment plans and hindering appropriate stratification for clinical trials. In this thesis, we overcome these challenges by using applied machine learning to build predictive models of patient disease trajectories in the earliest stages of AD. Specifically, to exploit the multi-dimensionality of biomarker data, we used a novel feature generation methodology Partial Least Squares regression with recursive feature elimination (PLSr-RFE). This method applies a hybrid-feature selection and feature construction method that captures co-morbidities in cognition and pathophysiology, resulting in an index of Alzheimer’s disease atrophy from structural MRI. We validated our choice of biomarker and the efficacy of our methodology by showing that the learnt pattern of grey matter atrophy is highly predictive of tau accumulation in an independent sample. Next, to go beyond predicting binary outcomes to deriving individualised prognostic scores of cognitive decline due to AD, we used a novel trajectory modelling approach (Generalised Metric Learning Vector Quantization – Scalar projection) that mines multimodal data from large AD research cohorts. Using this approach, we derive individualised prognostic scores of cognitive decline due to AD, revealing interactive cognitive, and biological factors that improve prediction accuracy. Next, we extended our machine learning framework to classify and stage early AD individuals based on future pathological tau accumulation. Our results show that the characteristic spreading pattern of tau in early AD can be predicted by baseline biomarkers, particularly when stratifying groups using multimodal data. Further, we showed that our prognostic index predicts individualised rates of future tau accumulation with high accuracy and regional specificity in an independent sample of cognitively unimpaired individuals. Overall, our work used machine learning to combine continuous information from AD biomarkers predicting pathophysiological changes at different stages in the AD cascade. The approaches presented in this thesis provide an excellent framework to support personalised clinical interventions and guide effective drug discovery trials

Nonverbal Semantics Test (NVST)—A Novel Diagnostic Tool to Assess Semantic Processing Deficits: Application to Persons with Aphasia after Cerebrovascular Accident

Assessment of semantic processing capacities often relies on verbal tasks which are, however, sensitive to impairments at several language processing levels. Especially for persons with aphasia there is a strong need for a tool that measures semantic processing skills independent of verbal abilities. Furthermore, in order to assess a patient’s potential for using alternative means of communication in cases of severe aphasia, semantic processing should be assessed in different nonverbal conditions. The Nonverbal Semantics Test (NVST) is a tool that captures semantic processing capacities through three tasks—Semantic Sorting, Drawing, and Pantomime. The main aim of the current study was to investigate the relationship between the NVST and measures of standard neurolinguistic assessment. Fifty-one persons with aphasia caused by left hemisphere brain damage were administered the NVST as well as the Aachen Aphasia Test (AAT). A principal component analysis (PCA) was conducted across all AAT and NVST subtests. The analysis resulted in a two-factor model that captured 69% of the variance of the original data, with all linguistic tasks loading high on one factor and the NVST subtests loading high on the other. These findings suggest that nonverbal tasks assessing semantic processing capacities should be administered alongside standard neurolinguistic aphasia tests. View Full-Tex

Systems Analytics and Integration of Big Omics Data

A “genotype"" is essentially an organism's full hereditary information which is obtained from its parents. A ""phenotype"" is an organism's actual observed physical and behavioral properties. These may include traits such as morphology, size, height, eye color, metabolism, etc. One of the pressing challenges in computational and systems biology is genotype-to-phenotype prediction. This is challenging given the amount of data generated by modern Omics technologies. This “Big Data” is so large and complex that traditional data processing applications are not up to the task. Challenges arise in collection, analysis, mining, sharing, transfer, visualization, archiving, and integration of these data. In this Special Issue, there is a focus on the systems-level analysis of Omics data, recent developments in gene ontology annotation, and advances in biological pathways and network biology. The integration of Omics data with clinical and biomedical data using machine learning is explored. This Special Issue covers new methodologies in the context of gene–environment interactions, tissue-specific gene expression, and how external factors or host genetics impact the microbiome

Alzheimer’s Disease Diagnosis Using Machine Learning: A Survey

Alzheimer’s is a neurodegenerative disorder affecting the central nervous system and cognitive processes, explicitly impairing detailed mental analysis. Throughout this condition, the affected individual’s cognitive abilities to process and analyze information gradually deteriorate, resulting in mental decline. In recent years, there has been a notable increase in endeavors aimed at identifying Alzheimer’s disease and addressing its progression. Research studies have demonstrated the significant involvement of genetic factors, stress, and nutrition in developing this condition. The utilization of computer-aided analysis models based on machine learning and artificial intelligence has the potential to significantly enhance the exploration of various neuroimaging methods and non-image biomarkers. This study conducts a comparative assessment of more than 80 publications that have been published since 2017. Alzheimer’s disease detection is facilitated by utilizing fundamental machine learning architectures such as support vector machines, decision trees, and ensemble models. Furthermore, around 50 papers that utilized a specific architectural or design approach concerning Alzheimer’s disease were examined. The body of literature under consideration has been categorized and elucidated through the utilization of data-related, methodology-related, and medical-fostering components to illustrate the underlying challenges. The conclusion section of our study encompasses a discussion of prospective avenues for further investigation and furnishes recommendations for future research activities on the diagnosis of Alzheimer’s disease

EXplainable Artificial Intelligence: enabling AI in neurosciences and beyond

The adoption of AI models in medicine and neurosciences has the potential to play a significant role not only in bringing scientific advancements but also in clinical decision-making. However, concerns mounts due to the eventual biases AI could have which could result in far-reaching consequences particularly in a critical field like biomedicine. It is challenging to achieve usable intelligence because not only it is fundamental to learn from prior data, extract knowledge and guarantee generalization capabilities, but also to disentangle the underlying explanatory factors in order to deeply understand the variables leading to the final decisions. There hence has been a call for approaches to open the AI `black box' to increase trust and reliability on the decision-making capabilities of AI algorithms. Such approaches are commonly referred to as XAI and are starting to be applied in medical fields even if not yet fully exploited. With this thesis we aim at contributing to enabling the use of AI in medicine and neurosciences by taking two fundamental steps: (i) practically pervade AI models with XAI (ii) Strongly validate XAI models. The first step was achieved on one hand by focusing on XAI taxonomy and proposing some guidelines specific for the AI and XAI applications in the neuroscience domain. On the other hand, we faced concrete issues proposing XAI solutions to decode the brain modulations in neurodegeneration relying on the morphological, microstructural and functional changes occurring at different disease stages as well as their connections with the genotype substrate. The second step was as well achieved by firstly defining four attributes related to XAI validation, namely stability, consistency, understandability and plausibility. Each attribute refers to a different aspect of XAI ranging from the assessment of explanations stability across different XAI methods, or highly collinear inputs, to the alignment of the obtained explanations with the state-of-the-art literature. We then proposed different validation techniques aiming at practically fulfilling such requirements. With this thesis, we contributed to the advancement of the research into XAI aiming at increasing awareness and critical use of AI methods opening the way to real-life applications enabling the development of personalized medicine and treatment by taking a data-driven and objective approach to healthcare