9,296 research outputs found
A model of brain morphological changes related to aging and Alzheimer's disease from cross-sectional assessments
In this study we propose a deformation-based framework to jointly model the
influence of aging and Alzheimer's disease (AD) on the brain morphological
evolution. Our approach combines a spatio-temporal description of both
processes into a generative model. A reference morphology is deformed along
specific trajectories to match subject specific morphologies. It is used to
define two imaging progression markers: 1) a morphological age and 2) a disease
score. These markers can be computed locally in any brain region. The approach
is evaluated on brain structural magnetic resonance images (MRI) from the ADNI
database. The generative model is first estimated on a control population,
then, for each subject, the markers are computed for each acquisition. The
longitudinal evolution of these markers is then studied in relation with the
clinical diagnosis of the subjects and used to generate possible morphological
evolution. In the model, the morphological changes associated with normal aging
are mainly found around the ventricles, while the Alzheimer's disease specific
changes are more located in the temporal lobe and the hippocampal area. The
statistical analysis of these markers highlights differences between clinical
conditions even though the inter-subject variability is quiet high. In this
context, the model can be used to generate plausible morphological trajectories
associated with the disease. Our method gives two interpretable scalar imaging
biomarkers assessing the effects of aging and disease on brain morphology at
the individual and population level. These markers confirm an acceleration of
apparent aging for Alzheimer's subjects and can help discriminate clinical
conditions even in prodromal stages. More generally, the joint modeling of
normal and pathological evolutions shows promising results to describe
age-related brain diseases over long time scales.Comment: NeuroImage, Elsevier, In pres
A Survey of Multimodal Information Fusion for Smart Healthcare: Mapping the Journey from Data to Wisdom
Multimodal medical data fusion has emerged as a transformative approach in
smart healthcare, enabling a comprehensive understanding of patient health and
personalized treatment plans. In this paper, a journey from data to information
to knowledge to wisdom (DIKW) is explored through multimodal fusion for smart
healthcare. We present a comprehensive review of multimodal medical data fusion
focused on the integration of various data modalities. The review explores
different approaches such as feature selection, rule-based systems, machine
learning, deep learning, and natural language processing, for fusing and
analyzing multimodal data. This paper also highlights the challenges associated
with multimodal fusion in healthcare. By synthesizing the reviewed frameworks
and theories, it proposes a generic framework for multimodal medical data
fusion that aligns with the DIKW model. Moreover, it discusses future
directions related to the four pillars of healthcare: Predictive, Preventive,
Personalized, and Participatory approaches. The components of the comprehensive
survey presented in this paper form the foundation for more successful
implementation of multimodal fusion in smart healthcare. Our findings can guide
researchers and practitioners in leveraging the power of multimodal fusion with
the state-of-the-art approaches to revolutionize healthcare and improve patient
outcomes.Comment: This work has been submitted to the ELSEVIER for possible
publication. Copyright may be transferred without notice, after which this
version may no longer be accessibl
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
From tumour perfusion to drug delivery and clinical translation of in silico cancer models
In silico cancer models have demonstrated great potential as a tool to improve drug design, optimise the delivery of drugs to target sites in the host tissue and, hence, improve therapeutic efficacy and patient outcome. However, there are significant barriers to the successful translation of in silico technology from bench to bedside. More precisely, the specification of unknown model parameters, the necessity for models to adequately reflect in vivo conditions, and the limited amount of pertinent validation data to evaluate models' accuracy and assess their reliability, pose major obstacles in the path towards their clinical translation. This review aims to capture the state-of-the-art in in silico cancer modelling of vascularised solid tumour growth, and identify the important advances and barriers to success of these models in clinical oncology. Particular emphasis has been put on continuum-based models of cancer since they - amongst the class of mechanistic spatio-temporal modelling approaches - are well-established in simulating transport phenomena and the biomechanics of tissues, and have demonstrated potential for clinical translation. Three important avenues in in silico modelling are considered in this contribution: first, since systemic therapy is a major cancer treatment approach, we start with an overview of the tumour perfusion and angiogenesis in silico models. Next, we present the state-of-the-art in silico work encompassing the delivery of chemotherapeutic agents to cancer nanomedicines through the bloodstream, and then review continuum-based modelling approaches that demonstrate great promise for successful clinical translation. We conclude with a discussion of what we view to be the key challenges and opportunities for in silico modelling in personalised and precision medicine
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