Purpose: Although functional brain imaging has been used for the early and objective assessment of cognitive dysfunction, there is a lack of generalized image-based biomarker which can evaluate individual's cognitive dysfunction in various disorders. To this end, we developed a deep learning-based cognitive signature of FDG brain PET adaptable for Parkinson's disease (PD) as well as Alzheimer's disease (AD).
Methods: A deep learning model for discriminating AD from normal controls (NCs) was built by a training set consisting of 636 FDG PET obtained from Alzheimer's Disease Neuroimaging Initiative database. The model was directly transferred to images of mild cognitive impairment (MCI) patients (n = 666) for identifying who would rapidly convert to AD and another independent cohort consisting of 62 PD patients to differentiate PD patients with dementia. The model accuracy was measured by area under curve (AUC) of receiver operating characteristic (ROC) analysis. The relationship between all images was visualized by two-dimensional projection of the deep learning-based features. The model was also designed to predict cognitive score of the subjects and validated in PD patients. Cognitive dysfunction-related regions were visualized by feature maps of the deep CNN model.
Results: AUC of ROC for differentiating AD from NC was 0.94 (95% CI 0.89-0.98). The transfer of the model could differentiate MCI patients who would convert to AD (AUC = 0.82) and PD with dementia (AUC = 0.81). The two-dimensional projection mapping visualized the degree of cognitive dysfunction compared with normal brains regardless of different disease cohorts. Predicted cognitive score, an output of the model, was highly correlated with the mini-mental status exam scores. Individual cognitive dysfunction-related regions included cingulate and high frontoparietal cortices, while they showed individual variability.
Conclusion: The deep learning-based cognitive function evaluation model could be successfully transferred to multiple disease domains. We suggest that this approach might be extended to an objective cognitive signature that provides quantitative biomarker for cognitive dysfunction across various neurodegenerative disorders.
Keywords: Deep learning; Dementia; FDG PET; Parkinson disease; Transfer learning.
Choi H, Kim YK, Yoon EJ, Lee JY, Lee DS