Zhang Yong, Kwon Dongjin, Esmaeili-Firidouni Pardis, Pfefferbaum Adolf, Sullivan Edith V, Javitz Harold, Valcour Victor, Pohl Kilian M
Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, California, 94305.
Center for Health Sciences, SRI International, Menlo Park, California, 94025.
Hum Brain Mapp. 2016 Dec;37(12):4523-4538. doi: 10.1002/hbm.23326. Epub 2016 Aug 4.
HIV-Associated Neurocognitive Disorder (HAND) is the most common constellation of cognitive dysfunctions in chronic HIV infected patients age 60 or older in the U.S. Only few published methods assist in distinguishing HAND from other forms of age-associated cognitive decline, such as Mild Cognitive Impairment (MCI). In this report, a data-driven, nonparameteric model to identify morphometric patterns separating HAND from MCI due to non-HIV conditions in this older age group was proposed. This model enhanced the potential for group separation by combining a smaller, longitudinal data set containing HAND samples with a larger, public data set including MCI cases. Using cross-validation, a linear model on healthy controls to harmonize the volumetric scores extracted from MRIs for demographic and acquisition differences between the two independent, disease-specific data sets was trained. Next, patterns distinguishing HAND from MCI via a group sparsity constrained logistic classifier were identified. Unlike existing approaches, our classifier directly solved the underlying minimization problem by decoupling the minimization of the logistic regression function from enforcing the group sparsity constraint. The extracted patterns consisted of eight regions that distinguished HAND from MCI on a significant level while being indifferent to differences in demographics and acquisition between the two sets. Individually selecting regions through conventional morphometric group analysis resulted in a larger number of regions that were less accurate. In conclusion, simultaneously analyzing all brain regions and time points for disease specific patterns contributed to distinguishing with high accuracy HAND-related impairment from cognitive impairment found in the HIV uninfected, MCI cohort. Hum Brain Mapp 37:4523-4538, 2016. © 2016 Wiley Periodicals, Inc.
人类免疫缺陷病毒相关神经认知障碍(HAND)是美国60岁及以上慢性HIV感染患者中最常见的认知功能障碍类型。目前仅有少数已发表的方法可用于区分HAND与其他形式的年龄相关认知衰退,如轻度认知障碍(MCI)。在本报告中,我们提出了一种数据驱动的非参数模型,用于识别在该老年人群中区分HAND与非HIV相关疾病所致MCI的形态学模式。该模型通过将包含HAND样本的较小纵向数据集与包含MCI病例的较大公共数据集相结合,增强了组间分离的潜力。通过交叉验证,我们训练了一个针对健康对照的线性模型,以协调从MRI中提取的体积分数,从而消除两个独立的疾病特异性数据集之间在人口统计学和采集方面的差异。接下来,通过组稀疏约束逻辑分类器识别区分HAND与MCI的模式。与现有方法不同,我们的分类器通过将逻辑回归函数的最小化与实施组稀疏约束解耦,直接解决了潜在的最小化问题。提取的模式由八个区域组成,这些区域在显著水平上区分了HAND与MCI,同时对两组之间的人口统计学和采集差异不敏感。通过传统形态学组分析单独选择区域会导致更多区域但准确性较低。总之,同时分析所有脑区和时间点以寻找疾病特异性模式有助于高精度地区分HAND相关损伤与未感染HIV的MCI队列中的认知损伤。《人类大脑图谱》37:4523 - 4538,2016年。© 2016威利期刊公司。