DenseNet and Support Vector Machine classifications of major depressive disorder using vertex-wise cortical features

Major depressive disorder (MDD) is a complex psychiatric disorder that affects the lives of hundreds of millions of individuals around the globe. Even today, researchers debate if morphological alterations in the brain are linked to MDD, likely due to the heterogeneity of this disorder. The application of deep learning tools to neuroimaging data, capable of capturing complex non-linear patterns, has the potential to provide diagnostic and predictive biomarkers for MDD. However, previous attempts to demarcate MDD patients and healthy controls (HC) based on segmented cortical features via linear machine learning approaches have reported low accuracies. In this study, we used globally representative data from the ENIGMA-MDD working group containing an extensive sample of people with MDD (N=2,772) and HC (N=4,240), which allows a comprehensive analysis with generalizable results. Based on the hypothesis that integration of vertex-wise cortical features can improve classification performance, we evaluated the classification of a DenseNet and a Support Vector Machine (SVM), with the expectation that the former would outperform the latter. As we analyzed a multi-site sample, we additionally applied the ComBat harmonization tool to remove potential nuisance effects of site. We found that both classifiers exhibited close to chance performance (balanced accuracy DenseNet: 51%; SVM: 53%), when estimated on unseen sites. Slightly higher classification performance (balanced accuracy DenseNet: 58%; SVM: 55%) was found when the cross-validation folds contained subjects from all sites, indicating site effect. In conclusion, the integration of vertex-wise morphometric features and the use of the non-linear classifier did not lead to the differentiability between MDD and HC. Our results support the notion that MDD classification on this combination of features and classifiers is unfeasible.

Video and Synthetic MRI Pre-training of 3D Vision Architectures for Neuroimage Analysis

Transfer learning represents a recent paradigm shift in the way we build artificial intelligence (AI) systems. In contrast to training task-specific models, transfer learning involves pre-training deep learning models on a large corpus of data and minimally fine-tuning them for adaptation to specific tasks. Even so, for 3D medical imaging tasks, we do not know if it is best to pre-train models on natural images, medical images, or even synthetically generated MRI scans or video data. To evaluate these alternatives, here we benchmarked vision transformers (ViTs) and convolutional neural networks (CNNs), initialized with varied upstream pre-training approaches. These methods were then adapted to three unique downstream neuroimaging tasks with a range of difficulty: Alzheimer's disease (AD) and Parkinson's disease (PD) classification, "brain age" prediction. Experimental tests led to the following key observations: 1. Pre-training improved performance across all tasks including a boost of 7.4% for AD classification and 4.6% for PD classification for the ViT and 19.1% for PD classification and reduction in brain age prediction error by 1.26 years for CNNs, 2. Pre-training on large-scale video or synthetic MRI data boosted performance of ViTs, 3. CNNs were robust in limited-data settings, and in-domain pretraining enhanced their performances, 4. Pre-training improved generalization to out-of-distribution datasets and sites. Overall, we benchmarked different vision architectures, revealing the value of pre-training them with emerging datasets for model initialization. The resulting pre-trained models can be adapted to a range of downstream neuroimaging tasks, even when training data for the target task is limited.

Incomplete Multimodal Learning for Complex Brain Disorders Prediction

Recent advancements in the acquisition of various brain data sources have created new opportunities for integrating multimodal brain data to assist in early detection of complex brain disorders. However, current data integration approaches typically need a complete set of biomedical data modalities, which may not always be feasible, as some modalities are only available in large-scale research cohorts and are prohibitive to collect in routine clinical practice. Especially in studies of brain diseases, research cohorts may include both neuroimaging data and genetic data, but for practical clinical diagnosis, we often need to make disease predictions only based on neuroimages. As a result, it is desired to design machine learning models which can use all available data (different data could provide complementary information) during training but conduct inference using only the most common data modality. We propose a new incomplete multimodal data integration approach that employs transformers and generative adversarial networks to effectively exploit auxiliary modalities available during training in order to improve the performance of a unimodal model at inference. We apply our new method to predict cognitive degeneration and disease outcomes using the multimodal imaging genetic data from Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Experimental results demonstrate that our approach outperforms the related machine learning and deep learning methods by a significant margin.

A Surface-Based Federated Chow Test Model for Integrating APOE Status, Tau Deposition Measure, and Hippocampal Surface Morphometry

Background: Alzheimer's Disease (AD) is the most common type of age-related dementia, affecting 6.2 million people aged 65 or older according to CDC data. It is commonly agreed that discovering an effective AD diagnosis biomarker could have enormous public health benefits, potentially preventing or delaying up to 40% of dementia cases. Tau neurofibrillary tangles are the primary driver of downstream neurodegeneration and subsequent cognitive impairment in AD, resulting in structural deformations such as hippocampal atrophy that can be observed in magnetic resonance imaging (MRI) scans. Objective: To build a surface-based model to 1) detect differences between APOE subgroups in patterns of tau deposition and hippocampal atrophy, and 2) use the extracted surface-based features to predict cognitive decline. Methods: Using data obtained from different institutions, we develop a surface-based federated Chow test model to study the synergistic effects of APOE, a previously reported significant risk factor of AD, and tau on hippocampal surface morphometry. Results: We illustrate that the APOE-specific morphometry features correlate with AD progression and better predict future AD conversion than other MRI biomarkers. For example, a strong association between atrophy and abnormal tau was identified in hippocampal subregion cornu ammonis 1 (CA1 subfield) and subiculum in e4 homozygote cohort. Conclusion: Our model allows for identifying MRI biomarkers for AD and cognitive decline prediction and may uncover a corner of the neural mechanism of the influence of APOE and tau deposition on hippocampal morphology.

Few-Shot Classification of Autism Spectrum Disorder using Site-Agnostic Meta-Learning and Brain MRI

For machine learning applications in medical imaging, the availability of training data is often limited, which hampers the design of radiological classifiers for subtle conditions such as autism spectrum disorder (ASD). Transfer learning is one method to counter this problem of low training data regimes. Here we explore the use of meta-learning for very low data regimes in the context of having prior data from multiple sites - an approach we term site-agnostic meta-learning. Inspired by the effectiveness of meta-learning for optimizing a model across multiple tasks, here we propose a framework to adapt it to learn across multiple sites. We tested our meta-learning model for classifying ASD versus typically developing controls in 2,201 T1-weighted (T1-w) MRI scans collected from 38 imaging sites as part of Autism Brain Imaging Data Exchange (ABIDE) [age: 5.2-64.0 years]. The method was trained to find a good initialization state for our model that can quickly adapt to data from new unseen sites by fine-tuning on the limited data that is available. The proposed method achieved an ROC-AUC=0.857 on 370 scans from 7 unseen sites in ABIDE using a few-shot setting of 2-way 20-shot i.e., 20 training samples per site. Our results outperformed a transfer learning baseline by generalizing across a wider range of sites as well as other related prior work. We also tested our model in a zero-shot setting on an independent test site without any additional fine-tuning. Our experiments show the promise of the proposed site-agnostic meta-learning framework for challenging neuroimaging tasks involving multi-site heterogeneity with limited availability of training data.

Efficiently Training Vision Transformers on Structural MRI Scans for Alzheimer's Disease Detection

Neuroimaging of large populations is valuable to identify factors that promote or resist brain disease, and to assist diagnosis, subtyping, and prognosis. Data-driven models such as convolutional neural networks (CNNs) have increasingly been applied to brain images to perform diagnostic and prognostic tasks by learning robust features. Vision transformers (ViT) - a new class of deep learning architectures - have emerged in recent years as an alternative to CNNs for several computer vision applications. Here we tested variants of the ViT architecture for a range of desired neuroimaging downstream tasks based on difficulty, in this case for sex and Alzheimer's disease (AD) classification based on 3D brain MRI. In our experiments, two vision transformer architecture variants achieved an AUC of 0.987 for sex and 0.892 for AD classification, respectively. We independently evaluated our models on data from two benchmark AD datasets. We achieved a performance boost of 5% and 9-10% upon fine-tuning vision transformer models pre-trained on synthetic (generated by a latent diffusion model) and real MRI scans, respectively. Our main contributions include testing the effects of different ViT training strategies including pre-training, data augmentation and learning rate warm-ups followed by annealing, as pertaining to the neuroimaging domain. These techniques are essential for training ViT-like models for neuroimaging applications where training data is usually limited. We also analyzed the effect of the amount of training data utilized on the test-time performance of the ViT via data-model scaling curves.

Transferring Models Trained on Natural Images to 3D MRI via Position Encoded Slice Models

Transfer learning has remarkably improved computer vision. These advances also promise improvements in neuroimaging, where training set sizes are often small. However, various difficulties arise in directly applying models pretrained on natural images to radiologic images, such as MRIs. In particular, a mismatch in the input space (2D images vs. 3D MRIs) restricts the direct transfer of models, often forcing us to consider only a few MRI slices as input. To this end, we leverage the 2D-Slice-CNN architecture of Gupta et al. (2021), which embeds all the MRI slices with 2D encoders (neural networks that take 2D image input) and combines them via permutation-invariant layers. With the insight that the pretrained model can serve as the 2D encoder, we initialize the 2D encoder with ImageNet pretrained weights that outperform those initialized and trained from scratch on two neuroimaging tasks -- brain age prediction on the UK Biobank dataset and Alzheimer's disease detection on the ADNI dataset. Further, we improve the modeling capabilities of 2D-Slice models by incorporating spatial information through position embeddings, which can improve the performance in some cases.

Curriculum Based Multi-Task Learning for Parkinson's Disease Detection

There is great interest in developing radiological classifiers for diagnosis, staging, and predictive modeling in progressive diseases such as Parkinson's disease (PD), a neurodegenerative disease that is difficult to detect in its early stages. Here we leverage severity-based meta-data on the stages of disease to define a curriculum for training a deep convolutional neural network (CNN). Typically, deep learning networks are trained by randomly selecting samples in each mini-batch. By contrast, curriculum learning is a training strategy that aims to boost classifier performance by starting with examples that are easier to classify. Here we define a curriculum to progressively increase the difficulty of the training data corresponding to the Hoehn and Yahr (H&Y) staging system for PD (total N=1,012; 653 PD patients, 359 controls; age range: 20.0-84.9 years). Even with our multi-task setting using pre-trained CNNs and transfer learning, PD classification based on T1-weighted (T1-w) MRI was challenging (ROC AUC: 0.59-0.65), but curriculum training boosted performance (by 3.9%) compared to our baseline model. Future work with multimodal imaging may further boost performance.

Improved Prediction of Beta-Amyloid and Tau Burden Using Hippocampal Surface Multivariate Morphometry Statistics and Sparse Coding

Background: Beta-amyloid (A$\beta$) plaques and tau protein tangles in the brain are the defining 'A' and 'T' hallmarks of Alzheimer's disease (AD), and together with structural atrophy detectable on brain magnetic resonance imaging (MRI) scans as one of the neurodegenerative ('N') biomarkers comprise the ''ATN framework'' of AD. Current methods to detect A$\beta$/tau pathology include cerebrospinal fluid (CSF; invasive), positron emission tomography (PET; costly and not widely available), and blood-based biomarkers (BBBM; promising but mainly still in development). Objective: To develop a non-invasive and widely available structural MRI-based framework to quantitatively predict the amyloid and tau measurements. Methods: With MRI-based hippocampal multivariate morphometry statistics (MMS) features, we apply our Patch Analysis-based Surface Correntropy-induced Sparse coding and max-pooling (PASCS-MP) method combined with the ridge regression model to individual amyloid/tau measure prediction. Results: We evaluate our framework on amyloid PET/MRI and tau PET/MRI datasets from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Each subject has one pair consisting of a PET image and MRI scan, collected at about the same time. Experimental results suggest that amyloid/tau measurements predicted with our PASCP-MP representations are closer to the real values than the measures derived from other approaches, such as hippocampal surface area, volume, and shape morphometry features based on spherical harmonics (SPHARM). Conclusion: The MMS-based PASCP-MP is an efficient tool that can bridge hippocampal atrophy with amyloid and tau pathology and thus help assess disease burden, progression, and treatment effects.

Secure Federated Learning for Neuroimaging

The amount of biomedical data continues to grow rapidly. However, the ability to collect data from multiple sites for joint analysis remains challenging due to security, privacy, and regulatory concerns. We present a Secure Federated Learning architecture, MetisFL, which enables distributed training of neural networks over multiple data sources without sharing data. Each site trains the neural network over its private data for some time, then shares the neural network parameters (i.e., weights, gradients) with a Federation Controller, which in turn aggregates the local models, sends the resulting community model back to each site, and the process repeats. Our architecture provides strong security and privacy. First, sample data never leaves a site. Second, neural parameters are encrypted before transmission and the community model is computed under fully-homomorphic encryption. Finally, we use information-theoretic methods to limit information leakage from the neural model to prevent a curious site from performing membership attacks. We demonstrate this architecture in neuroimaging. Specifically, we investigate training neural models to classify Alzheimer's disease, and estimate Brain Age, from magnetic resonance imaging datasets distributed across multiple sites, including heterogeneous environments where sites have different amounts of data, statistical distributions, and computational capabilities.