Early forecasting of individual cognitive decline in Alzheimer's disease (AD) is central to disease evaluation and management. Despite advances, it is as of yet challenging for existing methodological frameworks to integrate multimodal data for longitudinal personalized forecasting while maintaining interpretability. To address this gap, we present the Neural Koopman Machine (NKM), a new machine learning architecture inspired by dynamical systems and attention mechanisms, designed to forecast multiple cognitive scores simultaneously using multimodal genetic, neuroimaging, proteomic, and demographic data. NKM integrates analytical ($α$) and biological ($β$) knowledge to guide feature grouping and control the hierarchical attention mechanisms to extract relevant patterns. By implementing Fusion Group-Aware Hierarchical Attention within the Koopman operator framework, NKM transforms complex nonlinear trajectories into interpretable linear representations. To demonstrate NKM's efficacy, we applied it to study the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Our results suggest that NKM consistently outperforms both traditional machine learning methods and deep learning models in forecasting trajectories of cognitive decline. Specifically, NKM (1) forecasts changes of multiple cognitive scores simultaneously, (2) quantifies differential biomarker contributions to predicting distinctive cognitive scores, and (3) identifies brain regions most predictive of cognitive deterioration. Together, NKM advances personalized, interpretable forecasting of future cognitive decline in AD using past multimodal data through an explainable, explicit system and reveals potential multimodal biological underpinnings of AD progression.

Alzheimer's Disease (AD) is the most prevalent neurodegenerative disorder in aging populations, posing a significant and escalating burden on global healthcare systems. While Multi-Tusk Learning (MTL) has emerged as a powerful computational paradigm for modeling longitudinal AD data, existing frameworks do not account for the time-varying nature of feature correlations. To address this limitation, we propose a novel MTL framework, named Feature Similarity Laplacian graph Multi-Task Learning (MTL-FSL). Our framework introduces a novel Feature Similarity Laplacian (FSL) penalty that explicitly models the time-varying relationships between features. By simultaneously considering temporal smoothness among tasks and the dynamic correlations among features, our model enhances both predictive accuracy and biological interpretability. To solve the non-smooth optimization problem arising from our proposed penalty terms, we adopt the Alternating Direction Method of Multipliers (ADMM) algorithm. Experiments conducted on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset demonstrate that our proposed MTL-FSL framework achieves state-of-the-art performance, outperforming various baseline methods. The implementation source can be found at https://github.com/huatxxx/MTL-FSL.

Alzheimer's disease (AD) affects 50 million people worldwide and is projected to overwhelm 152 million by 2050. AD is characterized by cognitive decline due partly to disruptions in metabolic brain connectivity. Thus, early and accurate detection of metabolic brain network impairments is crucial for AD management. Chief to identifying such impairments is FDG-PET data. Despite advancements, most graph-based studies using FDG-PET data rely on group-level analysis or thresholding. Yet, group-level analysis can veil individual differences and thresholding may overlook weaker but biologically critical brain connections. Additionally, machine learning-based AD prediction largely focuses on univariate outcomes, such as disease status. Here, we introduce explainable graph-theoretical machine learning (XGML), a framework employing kernel density estimation and dynamic time warping to construct individual metabolic brain graphs that capture the distance between pair-wise brain regions and identify subgraphs most predictive of multivariate AD-related outcomes. Using FDG-PET data from the Alzheimer's Disease Neuroimaging Initiative, XGML builds metabolic brain graphs and uncovers subgraphs predictive of eight AD-related cognitive scores in new subjects. XGML shows robust performance, particularly for predicting scores measuring learning, memory, language, praxis, and orientation, such as CDRSB ($r = 0.74$), ADAS11 ($r = 0.73$), and ADAS13 ($r = 0.71$). Moreover, XGML unveils key edges jointly but differentially predictive of several AD-related outcomes; they may serve as potential network biomarkers for assessing overall cognitive decline. Together, we show the promise of graph-theoretical machine learning in biomarker discovery and disease prediction and its potential to improve our understanding of network neural mechanisms underlying AD.

Alzheimer's disease and related dementias (AD/ADRD) represent a growing healthcare crisis affecting over 6 million Americans. While genetic factors play a crucial role, emerging research reveals that social determinants of health (SDOH) significantly influence both the risk and progression of cognitive functioning, such as cognitive scores and cognitive decline. This report examines how these social, environmental, and structural factors impact cognitive health trajectories, with a particular focus on Hispanic populations, who face disproportionate risk for AD/ADRD. Using data from the Mexican Health and Aging Study (MHAS) and its cognitive assessment sub study (Mex-Cog), we employed ensemble of regression trees models to predict 4-year and 9-year cognitive scores and cognitive decline based on SDOH. This approach identified key predictive SDOH factors to inform potential multilevel interventions to address cognitive health disparities in this population. Introduction Alzheimer's disease and related dementias (AD/ADRD) pose an escalating medical and public health challenge, currently affecting over 6 million Americans.

Alzheimer's disease, a neurodegenerative disorder, is associated with neural, genetic, and proteomic factors while affecting multiple cognitive and behavioral faculties. Traditional AD prediction largely focuses on univariate disease outcomes, such as disease stages and severity. Multimodal data encode broader disease information than a single modality and may, therefore, improve disease prediction; but they often contain missing values. Recent "deeper" machine learning approaches show promise in improving prediction accuracy, yet the biological relevance of these models needs to be further charted. Integrating missing data analysis, predictive modeling, multimodal data analysis, and explainable AI, we propose OPTIMUS, a predictive, modular, and explainable machine learning framework, to unveil the many-to-many predictive pathways between multimodal input data and multivariate disease outcomes amidst missing values. OPTIMUS first applies modality-specific imputation to uncover data from each modality while optimizing overall prediction accuracy. It then maps multimodal biomarkers to multivariate outcomes using machine-learning and extracts biomarkers respectively predictive of each outcome. Finally, OPTIMUS incorporates XAI to explain the identified multimodal biomarkers. Using data from 346 cognitively normal subjects, 608 persons with mild cognitive impairment, and 251 AD patients, OPTIMUS identifies neural and transcriptomic signatures that jointly but differentially predict multivariate outcomes related to executive function, language, memory, and visuospatial function. Our work demonstrates the potential of building a predictive and biologically explainable machine-learning framework to uncover multimodal biomarkers that capture disease profiles across varying cognitive landscapes. The results improve our understanding of the complex many-to-many pathways in AD.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive impairment of memory and other cognitive functions. Regression analysis has been studied to relate neuroimaging measures to cognitive status. However, whether these measures have further predictive power to infer a trajectory of cognitive performance over time is still an under-explored but important topic in AD research. We propose a novel high-order multi-task learning model to address this issue. The proposed model explores the temporal correlations existing in imaging and cognitive data by structured sparsity-inducing norms. The sparsity of the model enables the selection of a small number of imaging measures while maintaining high prediction accuracy. The empirical studies, using the longitudinal imaging and cognitive data of the ADNI cohort, have yielded promising results.

Amyotrophic lateral sclerosis is a fatal disease that not only affects movement, speech, and breath but also cognition. Recent studies have focused on the use of language analysis techniques to detect ALS and infer scales for monitoring functional progression. In this paper, we focused on another important aspect, cognitive impairment, which affects 35-50% of the ALS population. In an effort to reach the ALS population, which frequently exhibits mobility limitations, we implemented the digital version of the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) test for the first time. This test which is designed to measure cognitive impairment was remotely performed by 56 participants from the EverythingALS Speech Study. As part of the study, participants (ALS and non-ALS) were asked to describe weekly one picture from a pool of many pictures with complex scenes displayed on their computer at home. We analyze the descriptions performed within +/- 60 days from the day the ECAS test was administered and extract different types of linguistic and acoustic features. We input those features into linear regression models to infer 5 ECAS sub-scores and the total score. Speech samples from the picture description are reliable enough to predict the ECAS subs-scores, achieving statistically significant Spearman correlation values between 0.32 and 0.51 for the model's performance using 10-fold cross-validation.

The ability to predict the future trajectory of a patient is a key step toward the development of therapeutics for complex diseases such as Alzheimer's disease (AD). However, most machine learning approaches developed for prediction of disease progression are either single-task or single-modality models, which can not be directly adopted to our setting involving multi-task learning with high dimensional images. Moreover, most of those approaches are trained on a single dataset (i.e. cohort), which can not be generalized to other cohorts. We propose a novel multimodal multi-task deep learning model to predict AD progression by analyzing longitudinal clinical and neuroimaging data from multiple cohorts. Our proposed model integrates high dimensional MRI features from a 3D convolutional neural network with other data modalities, including clinical and demographic information, to predict the future trajectory of patients. Our model employs an adversarial loss to alleviate the study-specific imaging bias, in particular the inter-study domain shifts. In addition, a Sharpness-Aware Minimization (SAM) optimization technique is applied to further improve model generalization. The proposed model is trained and tested on various datasets in order to evaluate and validate the results. Our results showed that 1) our model yields significant improvement over the baseline models, and 2) models using extracted neuroimaging features from 3D convolutional neural network outperform the same models when applied to MRI-derived volumetric features.

Despite the great promise that machine learning has offered in many fields of medicine, it has also raised concerns about potential biases and poor generalization across genders, age distributions, races and ethnicities, hospitals, and data acquisition equipment and protocols. In the current study, and in the context of three brain diseases, we provide evidence which suggests that when properly trained, machine learning models can generalize well across diverse conditions and do not necessarily suffer from bias. Specifically, by using multi-study magnetic resonance imaging consortia for diagnosing Alzheimer's disease, schizophrenia, and autism spectrum disorder, we find that well-trained models have a high area-under-the-curve (AUC) on subjects across different subgroups pertaining to attributes such as gender, age, racial groups, and different clinical studies and are unbiased under multiple fairness metrics such as demographic parity difference, equalized odds difference, equal opportunity difference etc. We find that models that incorporate multi-source data from demographic, clinical, genetic factors and cognitive scores are also unbiased. These models have better predictive AUC across subgroups than those trained only with imaging features but there are also situations when these additional features do not help.

Decrypting intelligence from the human brain construct is vital in the detection of particular neurological disorders. Recently, functional brain connectomes have been used successfully to predict behavioral scores. However, state-of-the-art methods, on one hand, neglect the topological properties of the connectomes and, on the other hand, fail to solve the high inter-subject brain heterogeneity. To address these limitations, we propose a novel regression graph neural network through meta-learning namely Meta-RegGNN for predicting behavioral scores from brain connectomes. The parameters of our proposed regression GNN are explicitly trained so that a small number of gradient steps combined with a small training data amount produces a good generalization to unseen brain connectomes. Our results on verbal and full-scale intelligence quotient (IQ) prediction outperform existing methods in both neurotypical and autism spectrum disorder cohorts. Furthermore, we show that our proposed approach ensures generalizability, particularly for autistic subjects. Our Meta-RegGNN source code is available at https://github.com/basiralab/Meta-RegGNN.