Medium-horizon Alzheimer's disease progression prediction is difficult because future clinical scores can remain tied to baseline severity, while biomarker histories are irregular and incompletely observed. We develop an anchor-based analysis of 24-month Clinical Dementia Rating Sum of Boxes (CDR-SB) change using harmonized Alzheimer's Disease Neuroimaging Initiative (ADNI) tables. Each labeled sample is anchored at a mild cognitive impairment visit, uses only clinical and biomarker history observed at or before that anchor, and defines the response as CDR-SB at the future visit closest to 24 months within an 18--30 month window minus anchor CDR-SB. The analytic cohort contains 2,600 labeled anchors from 858 participants and 7,276 longitudinal rows. We propose a residual gap-aware transformer that combines a mixed-effects statistical reference with transformer-based residual learning from pre-anchor clinical and biomarker histories. The model uses participant-level random intercepts in the mixed-effects reference, observation-level triplet tokenization for irregular histories, and a learned nonnegative time-gap penalty inside self-attention. We compare the proposed model with a Bayesian-information-criterion-selected linear mixed-effects baseline, GRU-D, and STraTS under repeated participant-level train--test splits. Across five participant-level random seeds, the proposed model achieves the best mean test performance across all reported metrics, reducing MSE by 13.1% and increasing prediction--observation correlation by 26.4% relative to the mixed-effects baseline. It also improves over both GRU-D and STraTS in mean error and correlation. These results show that statistical anchoring and gap-aware residual learning provide a useful structure for medium-horizon Alzheimer's disease progression prediction.

Acquisition differences across sites, scanners, and protocols in dMRI introduce variability that complicates structural connectome analysis. This motivates deep learning models that can represent high-dimensional connectomes in a low-dimensional space while explicitly separating acquisition-related effects from biological variation. Conventional dimensionality reduction methods model all variance as continuous, so acquisition effects often get absorbed into a continuous latent space. Recent hybrid latent-space models combine discrete and continuous components to address this, but typically require manual capacity tuning to ensure the discrete component captures the intended variability. We introduce an unsupervised framework that removes this manual tuning by architecturally annealing encoder outputs before decoding, allowing the model to adaptively balance discrete and continuous latent variables during training. To evaluate it, we curated a dataset of N=7,416 structural connectomes derived from dMRI, spanning ages 2 to 102 and 13 studies with 25 unique acquisition-parameter combinations. Of these, 5,900 are cognitively unimpaired, 877 have mild cognitive impairment (MCI), and 639 have Alzheimer's disease (AD). We compare against a standard VAE, PCA with k-means clustering, and hybrid models that anneal only through the loss function. Our architectural annealing produces stronger site learning (ARI=0.53, p<0.05) than these baselines. Results show that a hybrid continuous-discrete latent space, with architectural rather than loss-based annealing, provides a useful unsupervised mechanism for capturing acquisition variability in dMRI: by jointly modeling smooth and categorical structure, the Joint-VAE recovers clusters aligned with scanner and protocol differences.

Regularization is often used in high-dimensional regression settings to generate a sparse model, which can save tremendous computing resources and identify predictors that are most strongly associated with the response. When the predictors can be represented by a Gaussian graphical model, the structure of the predictor graph can be exploited during regularization. Our proposed model exploits this underlying predictor graph structure by decomposing the estimated coefficient vector into a sum of latent variables that correspond to the sum of each node contribution to the coefficient vector. Regularization is then performed on the latent variables rather than on the coefficient vector directly. We use a penalty function that permits a clear user-defined trade-off between the L1 and L2 penalties and propose a novel proximal projection during optimization. Further, our implementation computes the projection operator for the intersection of selected groups, which conserves more computing resources compared to predictor duplication methods, especially for high-dimensional data. Through simulation, we evaluate the performance of our approach under different graph structures and node counts, and present results on real-world data. Results suggest that our method exhibits stable performance relative to other singly or doubly sparse graphical regression models.

The Next Alzheimer's Breakthrough Will Take More Than Just Science At WIRED Health, pioneering Alzheimer's researcher John Hardy outlined the stakes--and next steps--of where treatment is headed next. Alzheimer's research is entering a new phase, as treatments that have taken decades to develop begin to reach patients . But getting those advances to people will depend on more than scientific progress alone, according to pioneering Alzheimer's researcher John Hardy . Speaking at WIRED Health in April, Hardy, chair of the Molecular Biology of Neurological Disease at University College London, said that alongside more effective drugs, better diagnosis and political will were still needed to improve treatment of Alzheimer's disease. "We've got to get better," he said.

We only observe their transformed versions h(xis) and g(xit), for some known function class h() and g(). Our goal is to perform a statistical test checking if Psource = Ptarget while removing the distortions induced by the transformations. This problem is closely related to domain adaptation, and in our case, is motivated by the need to combine clinical and imaging based biomarkers from multiple sites and/or batches - a fairly common impediment in conducting analyses with much larger sample sizes. We address this problem using ideas from hypothesis testing on the transformed measurements, wherein the distortions need to be estimated in tandem with the testing. We derive a simple algorithm and study its convergence and consistency properties in detail, and provide lower-bound strategies based on recent work in continuous optimization. On a dataset of individuals at risk for Alzheimer's disease, our framework is competitive with alternative procedures that are twice as expensive and in some cases operationally infeasible to implement.

Learning feature interactions can be the key for multivariate predictive modeling. ReLU-activated neural networks create piecewise linear prediction models. Other nonlinear activation functions lead to models with only high-order feature interactions, thus lacking of interpretability. Recent methods incorporate candidate polynomial terms of fixed orders into deep learning, which is subject to the issue of combinatorial explosion, or learn the orders that are difficult to adapt to different regions of the feature space. We propose a Polyhedron Attention Module (PAM) to create piecewise polynomial models where the input space is split into polyhedrons which define the different pieces and on each piece the hyperplanes that define the polyhedron boundary multiply to form the interactive terms, resulting in interactions of adaptive order to each piece. PAM is interpretable to identify important interactions in predicting a target. Theoretic analysis shows that PAM has stronger expression capability than ReLU-activated networks. Extensive experimental results demonstrate the superior classification performance of PAM on massive datasets of the click-through rate prediction and PAM can learn meaningful interaction effects in a medical problem.

We study high-dimensional mediation analysis in which exposures, mediators, and outcomes are all multivariate, and both exposures and mediators may be high-dimensional. We formalize this as a many (exposures)-to-many (mediators)-to-many (outcomes) (MMM) mediation analysis problem. Methodologically, MMM mediation analysis simultaneously performs variable selection for high-dimensional exposures and mediators, estimates the indirect effect matrix (i.e., the coefficient matrices linking exposure-to-mediator and mediator-to-outcome pathways), and enables prediction of multivariate outcomes. Theoretically, we show that the estimated indirect effect matrices are consistent and element-wise asymptotically normal, and we derive error bounds for the estimators. To evaluate the efficacy of the MMM mediation framework, we first investigate its finite-sample performance, including convergence properties, the behavior of the asymptotic approximations, and robustness to noise, via simulation studies. We then apply MMM mediation analysis to data from the Alzheimer's Disease Neuroimaging Initiative to study how cortical thickness of 202 brain regions may mediate the effects of 688 genome-wide significant single nucleotide polymorphisms (SNPs) (selected from approximately 1.5 million SNPs) on eleven cognitive-behavioral and diagnostic outcomes. The MMM mediation framework identifies biologically interpretable, many-to-many-to-many genetic-neural-cognitive pathways and improves downstream out-of-sample classification and prediction performance. Taken together, our results demonstrate the potential of MMM mediation analysis and highlight the value of statistical methodology for investigating complex, high-dimensional multi-layer pathways in science. The MMM package is available at https://github.com/THELabTop/MMM-Mediation.

Disease progression models infer group-level temporal trajectories of change in patients' features as a chronic degenerative condition plays out. They provide unique insight into disease biology and staging systems with individual-level clinical utility. Discrete models consider disease progression as a latent permutation of events, where each event corresponds to a feature becoming measurably abnormal. However, permutation inference using traditional maximum likelihood approaches becomes prohibitive due to combinatoric explosion, severely limiting model dimensionality and utility. Here we leverage ideas from optimal transport to model disease progression as a latent permutation matrix of events belonging to the Birkhoff polytope, facilitating fast inference via optimisation of the variational lower bound. This enables a factor of 1000 times faster inference than the current state of the art and, correspondingly, supports models with several orders of magnitude more features than the current state of the art can consider. Experiments demonstrate the increase in speed, accuracy and robustness to noise in simulation.