A Deep Longitudinal Model for Mild Cognitive Impairment to Alzheimer’s Disease Conversion Prediction in Low-Income Countries

Abstract

Alzheimer’s disease (AD) is a progressive and fatal disease, due to the nonavailability of any permanent cure. Some treatments are under experimentation that can slow down and possibly pause the progression of the disease only if the disease is diagnosed earlier. The onset of AD can only be detected at the mild cognitive impairment (MCI) stage in which slight memory loss is observed but daily routine functions are intact. A small fraction of the patient progresses from MCI to AD. In this research, we have designed a cascaded deep neural network model to identify those MCI subjects who will progress to AD in the following year. The analysis and experimentation have been performed using twenty longitudinal neuropsychological measures (NMs) provided by Alzheimer’s Disease Neuroimaging Initiative (ADNI). After normalization and ranking of longitudinal data, the deep neural network regression model is trained and tuned to forecast the next in-sequence biomarker value using two previous follow-up readings for each marker. Then, the three time-domain window samples are fed into another deep neural network classifier model for the classification of MCI progressor (MCIp) and MCI stables (MCIs). Our model presented regression forecasting MAE of 0.13 and classification accuracy of 86.9% with AUC of 92.1% (Sensitivity: 67.7%, specificity: 92.3%) over 5-fold cross-validation. We conclude that time-domain measures of NM alone can deliver comparable MCI to AD conversion prediction performance without leveraging more expensive and invasive counterparts such as MR imaging, PET scans, and CSF measures. Middle and low-income countries will benefit from such cheap and effective solutions greatly.