通过联合预测认知量表子项,提升阿尔茨海默病预测的可解释性。
Improving Interpretability in Alzheimer's Prediction via Joint Learning of ADAS-Cog Scores
- 设计多任务学习框架,同时预测13个子项和整体量表分。
- 发现记忆相关子项(如词表回忆)对整体评分影响最大。
- 揭示临床数据主导导致模型不稳定,需优化多模态融合策略。
准确预测临床评分对阿尔茨海默病的早期检测与预后至关重要。现有方法主要关注全局ADAS-Cog评分的预测,却忽略了其13个子项(涵盖特定认知领域衰退)的预测价值。本研究提出一种多任务学习框架,基于基线MRI和基线、6个月时的纵向临床评分,联合预测24个月时的全局评分及其13个子项。核心目标是探究各子项(尤其是与影像特征相关的)对全局评分的贡献,这一问题在以往多任务研究中被忽视。采用Vision Transformer(ViT)和Swin Transformer提取影像特征,与纵向临床输入融合以建模认知进展。结果表明,引入子项学习可提升全局评分预测性能。子项层面分析显示,少数关键子项——特别是Q1(词表回忆)、Q4(延迟回忆)和Q8(词识别)——持续主导全局评分预测。然而,这些重要子项存在较高预测误差,反映模型不稳定性。进一步分析表明,这是由于临床特征主导效应:模型更倾向于预测易预测的临床评分,而非复杂的影像特征。该发现强调需改进多模态融合与自适应损失加权,以实现更均衡的学习。本研究验证了子项信息驱动建模的价值,并为构建更具可解释性和临床鲁棒性的阿尔茨海默病预测框架提供洞见。(提供GitHub代码库)
原文摘要 · Abstract (English)
Accurate prediction of clinical scores is critical for early detection and prognosis of Alzheimers disease (AD). While existing approaches primarily focus on forecasting the ADAS-Cog global score, they often overlook the predictive value of its sub-scores (13 items), which capture domain-specific cognitive decline. In this study, we propose a multi task learning (MTL) framework that jointly predicts the global ADAS-Cog score and its sub-scores (13 items) at Month 24 using baseline MRI and longitudinal clinical scores from baseline and Month 6. The main goal is to examine how each sub scores particularly those associated with MRI features contribute to the prediction of the global score, an aspect largely neglected in prior MTL studies. We employ Vision Transformer (ViT) and Swin Transformer architectures to extract imaging features, which are fused with longitudinal clinical inputs to model cognitive progression. Our results show that incorporating sub-score learning improves global score prediction. Subscore level analysis reveals that a small subset especially Q1 (Word Recall), Q4 (Delayed Recall), and Q8 (Word Recognition) consistently dominates the predicted global score. However, some of these influential sub-scores exhibit high prediction errors, pointing to model instability. Further analysis suggests that this is caused by clinical feature dominance, where the model prioritizes easily predictable clinical scores over more complex MRI derived features. These findings emphasize the need for improved multimodal fusion and adaptive loss weighting to achieve more balanced learning. Our study demonstrates the value of sub score informed modeling and provides insights into building more interpretable and clinically robust AD prediction frameworks. (Github repo provided)
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