Abstract

Alzheimer's Disease (AD) conversion prediction from the mild cognitive impairment (MCI) stage has been a difficult challenge. This study focuses on providing an individualized MCI to AD conversion prediction using a balanced random forest model that leverages clinical data. In order to do this, 383 Early Mild Cognitive Impairment (EMCI) patients were gathered from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Of these patients, 49 would eventually convert to AD (EMCI_C), whereas the remaining 334 did not convert (EMCI_NC). All of these patients were split randomly into training and testing data sets with 95 patients reserved for testing. Nine clinical features were selected, comprised of a mix of demographic, brain volume, and cognitive testing variables. Oversampling was then performed in order to balance the initially imbalanced classes prior to training the model with 1000 estimators. Our results showed that a random forest model was effective (93.6% accuracy) at predicting the conversion of EMCI patients to AD based on these clinical features. Additionally, we focus on explainability by assessing the importance of each clinical feature. Our model could impact the clinical environment as a tool to predict the conversion to AD from a prodromal stage or to identify ideal candidates for clinical trials.

Highlights

  • Alzheimer’s Disease (AD) is a progressive, degenerative brain disorder that leads to nerve cell death and tissue loss in the brain

  • Mild Cognitive Impairment (MCI) is an intermediary stage between being cognitively normal and having AD where 32% of mild cognitive impairment (MCI) patients will go on to develop Alzheimer’s Disease [1]. This makes the MCI stage an ideal target for early prediction as studies point to early diagnosis as being key to potentially delaying the overall progression of AD [1]

  • We have demonstrated that a random forest model can take clinical features and accurately predict MCI-to-AD conversion probability

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Summary

Introduction

Alzheimer’s Disease (AD) is a progressive, degenerative brain disorder that leads to nerve cell death and tissue loss in the brain. There are no treatment plans that prevent the progression of AD, and this has led to increased emphasis on being able to predict AD at an earlier stage. Mild Cognitive Impairment (MCI) is an intermediary stage between being cognitively normal and having AD where 32% of MCI patients will go on to develop Alzheimer’s Disease [1]. This makes the MCI stage an ideal target for early prediction as studies point to early diagnosis as being key to potentially delaying the overall progression of AD [1]. Our focus in this study was to target the earliest

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