Nonlinear biomarker interactions in conversion from mild cognitive impairment to Alzheimer's disease
Author(s)
Type
Journal Article
Abstract
Multiple biomarkers can capture different facets of Alzheimer's disease. However, statistical models of biomarkers to predict outcomes in Alzheimer's rarely model nonlinear interactions between these measures. Here, we used Gaussian Processes to address this, modelling nonlinear interactions to predict progression from mild cognitive impairment (MCI) to Alzheimer's over 3 years, using Alzheimer's Disease Neuroimaging Initiative (ADNI) data. Measures included: demographics, APOE4 genotype, CSF (amyloid‐β42, total tau, phosphorylated tau), [18F]florbetapir, hippocampal volume and brain‐age. We examined: (a) the independent value of each biomarker; and (b) whether modelling nonlinear interactions between biomarkers improved predictions. Each measured added complementary information when predicting conversion to Alzheimer's. A linear model classifying stable from progressive MCI explained over half the variance (R2 = 0.51, p < .001); the strongest independently contributing biomarker was hippocampal volume (R2 = 0.13). When comparing sensitivity of different models to progressive MCI (independent biomarker models, additive models, nonlinear interaction models), we observed a significant improvement (p < .001) for various two‐way interaction models. The best performing model included an interaction between amyloid‐β‐PET and P‐tau, while accounting for hippocampal volume (sensitivity = 0.77, AUC = 0.826). Closely related biomarkers contributed uniquely to predict conversion to Alzheimer's. Nonlinear biomarker interactions were also implicated, and results showed that although for some patients adding additional biomarkers may add little value (i.e., when hippocampal volume is high), for others (i.e., with low hippocampal volume) further invasive and expensive examination may be warranted. Our framework enables visualisation of these interactions, in individual patient biomarker ‘space', providing information for personalised or stratified healthcare or clinical trial design.
Date Issued
2020-07-09
Date Acceptance
2020-06-25
Citation
Human Brain Mapping, 2020, 41 (15), pp.4406-4418
ISSN
1065-9471
Publisher
Wiley Open Access
Start Page
4406
End Page
4418
Journal / Book Title
Human Brain Mapping
Volume
41
Issue
15
Copyright Statement
© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
This is an open access article under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
UK DRI Ltd
UK DRI Ltd
UK DRI Ltd
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
National Institute for Health Research
UK DRI Ltd
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000546429000001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
N/A
N/A
4050641385
4050641385
RDC04 79560
RDA03_79560
NIHR-RP-011-048
'CR & T IMP'
Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Neuroimaging
Radiology, Nuclear Medicine & Medical Imaging
Neurosciences & Neurology
Alzheimer's disease
dementia biomarkers
Gaussian processes
mild cognitive impairment
AMYLOID DEPOSITION
BRAIN AGE
PREDICTION
BETA
DEMENTIA
PROGRESSION
FRAMEWORK
ATROPHY
PET
Publication Status
Published
Date Publish Online
2020-07-09