Pre-trained MRI-based Alzheimer's disease classification models to classify memory clinic patients

NeuroImage Clinical, vol. 27, pp. 102303

Abstract

Anatomical magnetic resonance imaging (MRI), diffusion MRI and resting state functional MRI (rs-fMRI) have been used for Alzheimer's disease (AD) classification. These scans are typically used to build models for discriminating AD patients from control subjects, but it is not clear if these models can also discriminate AD in diverse clinical populations as found in memory clinics. To study this, we trained MRI-based AD classification models on a single centre data set consisting of AD patients (N = 76) and controls (N = 173), and used these models to assign AD scores to subjective memory complainers (N = 67), mild cognitive impairment (MCI) patients (N = 61), and AD patients (N = 61) from a multi-centre memory clinic data set. The anatomical MRI scans were used to calculate grey matter density, subcortical volumes and cortical thickness, the diffusion MRI scans were used to calculate fractional anisotropy, mean, axial and radial diffusivity, and the rs-fMRI scans were used to calculate functional connectivity between resting state networks and amplitude of low frequency fluctuations. Within the multi-centre memory clinic data set we removed scan site differences prior to applying the models. For all models, on average, the AD patients were assigned the highest AD scores, followed by MCI patients, and later followed by SMC subjects. The anatomical MRI models performed best, and the best performing anatomical MRI measure was grey matter density, separating SMC subjects from MCI patients with an AUC of 0.69, MCI patients from AD patients with an AUC of 0.70, and SMC patients from AD patients with an AUC of 0.86. The diffusion MRI models did not generalise well to the memory clinic data, possibly because of large scan site differences. The functional connectivity model separated SMC subjects and MCI patients relatively good (AUC = 0.66). The multimodal MRI model did not improve upon the anatomical MRI model. In conclusion, we showed that the grey matter density model generalises best to memory clinic subjects. When also considering the fact that grey matter density generally performs well in AD classification studies, this feature is probably the best MRI-based feature for AD diagnosis in clinical practice.

Authors 14

1. Frank de Vos corresponding Aachen Department of Radiology, Leiden University Medical Center Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Institute of Psychology, Leiden University, the Netherlands; Department of Radiology, Leiden University Medical Center, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands. Electronic address: f.de.vos@fsw.leidenuniv.nl

   Department of Radiology, Leiden University Medical Center, the Netherlands

   Institute of Psychology, Leiden University, the Netherlands

   Leiden Institute for Brain and Cognition, the Netherlands

2. Tijn M. Schouten Aachen Department of Radiology, Leiden University Medical Center Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Institute of Psychology, Leiden University, the Netherlands; Department of Radiology, Leiden University Medical Center, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands

   Department of Radiology, Leiden University Medical Center, the Netherlands

   Institute of Psychology, Leiden University, the Netherlands

   Leiden Institute for Brain and Cognition, the Netherlands

3. Marisa Koini

   Medical University of Graz

   Affiliation as printed

   Department of Neurology, Medical University of Graz, Austria

4. Mark J.R.J. Bouts Aachen Department of Radiology, Leiden University Medical Center Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Institute of Psychology, Leiden University, the Netherlands; Department of Radiology, Leiden University Medical Center, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands

   Department of Radiology, Leiden University Medical Center, the Netherlands

   Institute of Psychology, Leiden University, the Netherlands

   Leiden Institute for Brain and Cognition, the Netherlands

5. Rogier A. Feis Aachen Department of Radiology, Leiden University Medical Center Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Institute of Psychology, Leiden University, the Netherlands; Department of Radiology, Leiden University Medical Center, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands

   Department of Radiology, Leiden University Medical Center, the Netherlands

   Institute of Psychology, Leiden University, the Netherlands

   Leiden Institute for Brain and Cognition, the Netherlands

6. Anita Lechner

   Medical University of Graz

   Affiliation as printed

   Department of Neurology, Medical University of Graz, Austria

7. Reinhold Ernst Schmidt

   Medical University of Graz

   Affiliation as printed

   Department of Neurology, Medical University of Graz, Austria

8. Mark A. van Buchem Aachen Department of Radiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Radiology, Leiden University Medical Center, the Netherlands

9. Frans R.J. Verhey

   Maastricht University

   Affiliation as printed

   Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Alzheimer Centrum Limburg, Maastricht University, the Netherlands

10. Marcel G. M. Olde Rikkert

    Radboud University Nijmegen · Radboud University Medical Center · Donders Institute for Brain, Cognition and Behaviour

    Affiliation as printed

    Department of Geriatric Medicine, Radboudumc Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Geriatric Medicine, Radboudumc Alzheimer Centre, Donders Institute for Medical Neurosciences, Radboud University Medical Center, Nijmegen, the Netherlands

    Department of Geriatric Medicine, Radboudumc Alzheimer Centre, Donders Institute for Medical Neurosciences, Radboud University Medical Center, Nijmegen, the Netherlands

    Department of Geriatric Medicine, Radboudumc Alzheimer Centre, Radboud University Medical Center, Nijmegen, the Netherlands

11. Philip Scheltens

    Amsterdam Neuroscience · Amsterdam University Medical Centers · Vrije Universiteit Amsterdam

    Affiliation as printed

    Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

12. Mark de Rooij Aachen Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

    Leiden University

    Affiliation as printed

    Institute of Psychology, Leiden University, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands

    Institute of Psychology, Leiden University, the Netherlands

    Leiden Institute for Brain and Cognition, the Netherlands

13. Jeroen van der Grond Aachen Department of Radiology, Leiden University Medical Center

    Leiden University Medical Center

    Affiliation as printed

    Department of Radiology, Leiden University Medical Center, the Netherlands

14. Serge A.R.B. Rombouts Aachen Department of Radiology, Leiden University Medical Center Institute of Psychology, Leiden University Leiden Institute for Brain and Cognition

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Institute of Psychology, Leiden University, the Netherlands; Department of Radiology, Leiden University Medical Center, the Netherlands; Leiden Institute for Brain and Cognition, the Netherlands

    Department of Radiology, Leiden University Medical Center, the Netherlands

    Institute of Psychology, Leiden University, the Netherlands

    Leiden Institute for Brain and Cognition, the Netherlands