Abstract

Quantitatively predicting the progression of Alzheimer's disease (AD) in an individual on a continuous scale, such as the Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog) scores, is informative for a personalized approach as opposed to qualitatively classifying the individual into a broad disease category. To evaluate the hypothesis that the multi-modal data and predictive learning models can be employed for future predicting ADAS-cog scores. Unimodal and multi-modal regression models were trained on baseline data comprised of demographics, neuroimaging, and cerebrospinal fluid based markers, and genetic factors to predict future ADAS-cog scores for 12, 24, and 36 months. We subjected the prediction models to repeated cross-validation and assessed the resulting mean absolute error (MAE) and cross-validated correlation (ρ) of the model. Prediction models trained on multi-modal data outperformed the models trained on single modal data in predicting future ADAS-cog scores (MAE12, 24 & 36 months= 4.1, 4.5, and 5.0, ρ12, 24 & 36 months= 0.88, 0.82, and 0.75). Including baseline ADAS-cog scores to prediction models improved predictive performance (MAE12, 24 & 36 months= 3.5, 3.7, and 4.6, ρ12, 24 & 36 months= 0.89, 0.87, and 0.80). Future ADAS-cog scores were predicted which could aid clinicians in identifying those at greater risk of decline and apply interventions at an earlier disease stage and inform likely future disease progression in individuals enrolled in AD clinical trials.

Highlights

  • Predicting the progression of Alzheimer’s disease (AD) in an individual on a continuous scale, such as AD assessment scale-cognitive (ADAS-cog) scores, is informative for a personalized approach as opposed to qualitatively classifying the individual into a broad disease category

  • Future ADAS-cog scores were successfully estimated via predictive learning aiding clinicians in identifying those at greater risk of decline and apply interventions at an earlier disease stage and inform likely future disease progression in individuals enrolled in AD clinical trials

  • The main objective of Alzheimer’s Disease Neuroimaging Initiative (ADNI) is to evaluate the application of serial magnetic resonance imaging (MRI), positron emission tomography (PET), other biological markers, and clinical and neuropsychological assessment in a multi-modal approach to determine the longitudinal progression of mild cognitive impairment (MCI) and early Alzheimer’s disease (AD)

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Summary

Introduction

Predicting the progression of Alzheimer’s disease (AD) in an individual on a continuous scale, such as AD assessment scale-cognitive (ADAS-cog) scores, is informative for a personalized approach as opposed to qualitatively classifying the individual into a broad disease category. Alzheimer’s disease (AD) is an irreversible and multi-factorial neurodegenerative disease with a progressive decline in cognitive abilities [1]. Brain volumetry from magnetic resonance imaging (MRI), amyloid load and glucose consumption levels from positron emission tomography (PET), and protein analysis of cerebrospinal fluid (CSF) provide valuable and complementary disease markers to chart the disease progression [3]. Qualitative manual analysis of these markers to diagnose patients could be potentially aided by automated algorithms. Declining cognitive skills is common and can potentially lead to dementia [6]. At post-mortem, AD is characterized by the presence of amyloid β-peptide plaques and accumulations of τ proteins in the brain histology samples [9]

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