Murad Taslim, Miao Hui-Yuan, Thakuri Deepa S, Darekar Gauri, Chand Ganesh B
Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.
Department of Medicine, University of Missouri, School of Medicine, Columbia, MO, USA.
medRxiv. 2025 Jul 11:2025.07.09.25331194. doi: 10.1101/2025.07.09.25331194.
Neurodegeneration and cognitive impairment are commonly reported in Alzheimer's disease (AD); however, their multivariate links are not well understood. To map the multivariate relationships between whole brain neurodegenerative (WBN) markers, global cognition, and clinical severity in the AD continuum, we developed the explainable artificial intelligence (AI) methods, validated on semi-simulated data, and applied the outperforming method systematically to large-scale experimental data (N=1,756). The outperforming explainable AI method showed robust performance in predicting cognition from regional WBN markers and identified the ground-truth simulated dominant brain regions contributing to cognition. This method also showed excellent performance on experimental data and identified several prominent WBN regions hierarchically and simultaneously associated with cognitive declines across the AD continuum. These multivariate regional features also correlated with clinical severity, suggesting their clinical relevance. Overall, this study innovatively mapped the multivariate regional WBN-cognitive-clinical severity relationships in the AD continuum, thereby significantly advancing AD-relevant neurobiological pathways.
神经退行性变和认知障碍在阿尔茨海默病(AD)中很常见;然而,它们之间的多变量联系尚未得到很好的理解。为了描绘AD连续体中全脑神经退行性变(WBN)标志物、整体认知和临床严重程度之间的多变量关系,我们开发了可解释人工智能(AI)方法,并在半模拟数据上进行了验证,然后将性能最佳的方法系统地应用于大规模实验数据(N = 1756)。性能最佳的可解释AI方法在从区域WBN标志物预测认知方面表现出稳健的性能,并确定了对认知有贡献的真实模拟主导脑区。该方法在实验数据上也表现出色,并分层且同时识别出几个与AD连续体中认知衰退相关的突出WBN区域。这些多变量区域特征也与临床严重程度相关,表明它们具有临床相关性。总体而言,本研究创新性地描绘了AD连续体中多变量区域WBN - 认知 - 临床严重程度的关系,从而显著推进了与AD相关的神经生物学途径。