Abstract Alzheimer’s disease (AD) is a neurogenerative condition characterized by sharp cognitive decline with no confirmed effective treatment or cure. This makes it critically important to identify the symptoms of Alzheimer’s disease in its early stages before significant cognitive deterioration has taken hold and even before any brain morphology and neuropathology are noticeable. In this study, five different multimodal deep neural networks (MDNN), with different architectures, in search of an optimal model for predicting the cognitive test scores for the Mini-Mental State Examination (MMSE) and the modified Alzheimer’s Disease Assessment Scale (ADAS-CoG13) over a span of 60 months (5 years). The multimodal data utilized to train and test the proposed models were obtained from the Alzheimer’s Disease Neuroimaging Initiative study and includes cerebrospinal fluid (CSF) levels of tau and beta-amyloid, structural measures from magnetic resonance imaging (MRI), functional and metabolic measures from positron emission tomography (PET), and cognitive scores from the neuropsychological tests (Cog). The models developed herein delve into two main issues: (1) application merits of single-task vs. multitask for predicting future cognitive scores and (2) whether time-varying input data are better suited than specific timepoints for optimizing prediction results. This model yields a high of 90.27% (SD = 1.36) prediction accuracy (correlation) at 6 months after the initial visit to a lower 79.91% (SD = 8.84) prediction accuracy at 60 months. The analysis provided is comprehensive as it determines the predictions at all other timepoints and all MDNN models include converters in the CN and MCI groups (CNc, MCIc) and all the unstable groups in the CN and MCI groups (CNun and MCIun) that reverted to CN from MCI and to MCI from AD, so as not to bias the results. The results show that the best performance is achieved by a multimodal combined single-task long short-term memory (LSTM) regressor with an input sequence length of 2 data points (2 visits, 6 months apart) augmented with a pretrained Neural Network Estimator to fill in for the missing values.
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A Deep-Learning Approach for the Prediction of Mini-Mental State Examination Scores in a Multimodal Longitudinal Study
This study introduces a new multimodal deep regression method to predict cognitive test score in a 5-year longitudinal study on Alzheimer’s disease (AD). The proposed model takes advantage of multimodal data that includes cerebrospinal fluid (CSF) levels of tau and beta-amyloid, structural measures from magnetic resonance imaging (MRI), functional and metabolic measures from positron emission tomography (PET), and cognitive scores from neuropsychological tests (Cog), all with the aim of achieving highly accurate predictions of future Mini-Mental State Examination (MMSE) test scores up to five years after baseline biomarker collection. A novel data augmentation technique is leveraged to increase the numbers of training samples without relying on synthetic data. With the proposed method, the best and most encompassing regressor is shown to achieve better than state-of-the-art correlations of 85.07%(SD=1.59) for 6 months in the future, 87.39% (SD =1.48) for 12 months, 84.78% (SD=2.66) for 18 months, 85.13% (SD=2.19) for 24 months, 81.15% (SD=5.48) for 30 months, 81.17% (SD=4.44) for 36 months, 79.25% (SD=5.85) for 42 months, 78.98% (SD=5.79) for 48 months, 78.93%(SD=5.76) for 54 months, and 74.96% (SD=7.54) for 60 months.
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- NSF-PAR ID:
- 10275892
- Date Published:
- Journal Name:
- 2020 International Conference on Computational Science and Computational Intelligence (CSCI)
- Page Range / eLocation ID:
- 761 to 766
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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With the advances in machine learning for the diagnosis of Alzheimer’s disease (AD), most studies have focused on either identifying the subject’s status through classification algorithms or on predicting their cognitive scores through regression methods, neglecting the potential association between these two tasks. Motivated by the need to enhance the prospects for early diagnosis along with the ability to predict future disease states, this study proposes a deep neural network based on modality fusion, kernelization, and tensorization that perform multiclass classification and longitudinal regression simultaneously within a unified multitask framework. This relationship between multiclass classification and longitudinal regression is found to boost the efficacy of the final model in dealing with both tasks. Different multimodality scenarios are investigated, and complementary aspects of the multimodal features are exploited to simultaneously delineate the subject’s label and predict related cognitive scores at future timepoints using baseline data. The main intent in this multitask framework is to consolidate the highest accuracy possible in terms of precision, sensitivity, F1 score, and area under the curve (AUC) in the multiclass classification task while maintaining the highest similarity in the MMSE score as measured through the correlation coefficient and the RMSE for all time points under the prediction task, with both tasks, run simultaneously under the same set of hyperparameters. The overall accuracy for multiclass classification of the proposed KTMnet method is 66.85 ± 3.77. The prediction results show an average RMSE of 2.32 ± 0.52 and a correlation of 0.71 ± 5.98 for predicting MMSE throughout the time points. These results are compared to state-of-the-art techniques reported in the literature. A discovery from the multitasking of this consolidated machine learning framework is that a set of hyperparameters that optimize the prediction results may not necessarily be the same as those that would optimize the multiclass classification. In other words, there is a breakpoint beyond which enhancing further the results of one process could lead to the downgrading in accuracy for the other.more » « less
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Importance Little is known about the functional correlates of post–COVID-19 condition (PCC), also known as long COVID, particularly the relevance of neurocognitive symptoms.
Objective To characterize prevalence of unemployment among individuals who did, or did not, develop PCC after acute infection.
Design, Setting, and Participants This survey study used data from 8 waves of a 50-state US nonprobability internet population-based survey of respondents aged 18 to 69 years conducted between February 2021 and July 2022.
Main Outcomes and Measures The primary outcomes were self-reported current employment status and the presence of PCC, defined as report of continued symptoms at least 2 months beyond initial month of symptoms confirmed by a positive COVID-19 test.
Results The cohort included 15 308 survey respondents with test-confirmed COVID-19 at least 2 months prior, of whom 2236 (14.6%) reported PCC symptoms, including 1027 of 2236 (45.9%) reporting either brain fog or impaired memory. The mean (SD) age was 38.8 (13.5) years; 9679 respondents (63.2%) identified as women and 10 720 (70.0%) were White. Overall, 1418 of 15 308 respondents (9.3%) reported being unemployed, including 276 of 2236 (12.3%) of those with PCC and 1142 of 13 071 (8.7%) of those without PCC; 8229 respondents (53.8%) worked full-time, including 1017 (45.5%) of those with PCC and 7212 (55.2%) without PCC. In survey-weighted regression models excluding retired respondents, the presence of PCC was associated with a lower likelihood of working full-time (odds ratio [OR], 0.71 [95% CI, 0.63-0.80]; adjusted OR, 0.84 [95% CI, 0.74-0.96]) and with a higher likelihood of being unemployed (OR, 1.45 [95% CI, 1.22-1.73]; adjusted OR, 1.23 [95% CI, 1.02-1.48]). The presence of any cognitive symptom was associated with lower likelihood of working full time (OR, 0.70 [95% CI, 0.56-0.88]; adjusted OR, 0.75 [95% CI, 0.59-0.84]).
Conclusions and Relevance PCC was associated with a greater likelihood of unemployment and lesser likelihood of working full time in adjusted models. The presence of cognitive symptoms was associated with diminished likelihood of working full time. These results underscore the importance of developing strategies to treat and manage PCC symptoms.
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Importance The frequent occurrence of cognitive symptoms in post–COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations.
Objective To investigate the prevalence of self-reported cognitive symptoms in post–COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post–COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status.
Design, Setting, and Participants Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older.
Exposure Post–COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness.
Main Outcomes and Measures Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9.
Results The 14 767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10 811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post–COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post–COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]).
Conclusions and Relevance The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post–COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post–COVID-19 condition.
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Abstract Expert testimony varies in scientific quality and jurors have a difficult time evaluating evidence quality (McAuliff et al., 2009). In the current study, we apply Fuzzy Trace Theory principles, examining whether visual and gist aids help jurors calibrate to the strength of scientific evidence. Additionally we were interested in the role of jurors’ individual differences in scientific reasoning skills in their understanding of case evidence. Contrary to our preregistered hypotheses, there was no effect of evidence condition or gist aid on evidence understanding. However, individual differences between jurors’ numeracy skills predicted evidence understanding. Summary Poor-quality expert evidence is sometimes admitted into court (Smithburn, 2004). Jurors’ calibration to evidence strength varies widely and is not robustly understood. For instance, previous research has established jurors lack understanding of the role of control groups, confounds, and sample sizes in scientific research (McAuliff, Kovera, & Nunez, 2009; Mill, Gray, & Mandel, 1994). Still others have found that jurors can distinguish weak from strong evidence when the evidence is presented alone, yet not when simultaneously presented with case details (Smith, Bull, & Holliday, 2011). This research highlights the need to present evidence to jurors in a way they can understand. Fuzzy Trace Theory purports that people encode information in exact, verbatim representations and through “gist” representations, which represent summary of meaning (Reyna & Brainerd, 1995). It is possible that the presenting complex scientific evidence to people with verbatim content or appealing to the gist, or bottom-line meaning of the information may influence juror understanding of that evidence. Application of Fuzzy Trace Theory in the medical field has shown that gist representations are beneficial for helping laypeople better understand risk and benefits of medical treatment (Brust-Renck, Reyna, Wilhelms, & Lazar, 2016). Yet, little research has applied Fuzzy Trace Theory to information comprehension and application within the context of a jury (c.f. Reyna et. al., 2015). Additionally, it is likely that jurors’ individual characteristics, such as scientific reasoning abilities and cognitive tendencies, influence their ability to understand and apply complex scientific information (Coutinho, 2006). Methods The purpose of this study was to examine how jurors calibrate to the strength of scientific information, and whether individual difference variables and gist aids inspired by Fuzzy Trace Theory help jurors better understand complicated science of differing quality. We used a 2 (quality of scientific evidence: high vs. low) x 2 (decision aid to improve calibration - gist information vs. no gist information), between-subjects design. All hypotheses were preregistered on the Open Science Framework. Jury-eligible community participants (430 jurors across 90 juries; Mage = 37.58, SD = 16.17, 58% female, 56.93% White). Each jury was randomly assigned to one of the four possible conditions. Participants were asked to individually fill out measures related to their scientific reasoning skills prior to watching a mock jury trial. The trial was about an armed bank robbery and consisted of various pieces of testimony and evidence (e.g. an eyewitness testimony, police lineup identification, and a sweatshirt found with the stolen bank money). The key piece of evidence was mitochondrial DNA (mtDNA) evidence collected from hair on a sweatshirt (materials from Hans et al., 2011). Two experts presented opposing opinions about the scientific evidence related to the mtDNA match estimate for the defendant’s identification. The quality and content of this mtDNA evidence differed based on the two conditions. The high quality evidence condition used a larger database than the low quality evidence to compare to the mtDNA sample and could exclude a larger percentage of people. In the decision aid condition, experts in the gist information group presented gist aid inspired visuals and examples to help explain the proportion of people that could not be excluded as a match. Those in the no gist information group were not given any aid to help them understand the mtDNA evidence presented. After viewing the trial, participants filled out a questionnaire on how well they understood the mtDNA evidence and their overall judgments of the case (e.g. verdict, witness credibility, scientific evidence strength). They filled this questionnaire out again after a 45-minute deliberation. Measures We measured Attitudes Toward Science (ATS) with indices of scientific promise and scientific reservations (Hans et al., 2011; originally developed by National Science Board, 2004; 2006). We used Drummond and Fischhoff’s (2015) Scientific Reasoning Scale (SRS) to measure scientific reasoning skills. Weller et al.’s (2012) Numeracy Scale (WNS) measured proficiency in reasoning with quantitative information. The NFC-Short Form (Cacioppo et al., 1984) measured need for cognition. We developed a 20-item multiple-choice comprehension test for the mtDNA scientific information in the cases (modeled on Hans et al., 2011, and McAuliff et al., 2009). Participants were shown 20 statements related to DNA evidence and asked whether these statements were True or False. The test was then scored out of 20 points. Results For this project, we measured calibration to the scientific evidence in a few different ways. We are building a full model with these various operationalizations to be presented at APLS, but focus only on one of the calibration DVs (i.e., objective understanding of the mtDNA evidence) in the current proposal. We conducted a general linear model with total score on the mtDNA understanding measure as the DV and quality of scientific evidence condition, decision aid condition, and the four individual difference measures (i.e., NFC, ATS, WNS, and SRS) as predictors. Contrary to our main hypotheses, neither evidence quality nor decision aid condition affected juror understanding. However, the individual difference variables did: we found significant main effects for Scientific Reasoning Skills, F(1, 427) = 16.03, p <.001, np2 = .04, Weller Numeracy Scale, F(1, 427) = 15.19, p <.001, np2 = .03, and Need for Cognition, F(1, 427) = 16.80, p <.001, np2 = .04, such that those who scored higher on these measures displayed better understanding of the scientific evidence. In addition there was a significant interaction of evidence quality condition and scores on the Weller’s Numeracy Scale, F(1, 427) = 4.10, p = .04, np2 = .01. Further results will be discussed. Discussion These data suggest jurors are not sensitive to differences in the quality of scientific mtDNA evidence, and also that our attempt at helping sensitize them with Fuzzy Trace Theory-inspired aids did not improve calibration. Individual scientific reasoning abilities and general cognition styles were better predictors of understanding this scientific information. These results suggest a need for further exploration of approaches to help jurors differentiate between high and low quality evidence. Note: The 3rd author was supported by an AP-LS AP Award for her role in this research. Learning Objective: Participants will be able to describe how individual differences in scientific reasoning skills help jurors understand complex scientific evidence.more » « less
- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1109/CSCI51800.2020.00144
