Individual Prediction of Behavioral Variant Frontotemporal Dementia Development Using Multivariate Pattern Analysis of Magnetic Resonance Imaging Data

Article type: Research Article

Authors: Zhutovsky, Paul^{a; *} | Vijverberg, Everard G.B.^{b; c} | Bruin, Willem B.^a | Thomas, Rajat M.^a | Wattjes, Mike P.^{d; e} | Pijnenburg, Yolande A.L.^b | van Wingen, Guido A.^{a; 1} | Dols, Annemiek^{b; f; 1}

Affiliations: [a] Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands | [b] Amsterdam UMC, VU University Medical Center, Department of Neurology and Alzheimer Centre, Amsterdam Neuroscience, Amsterdam, The Netherlands | [c] Department of Neurology, HagaZiekenhuis, The Hague, The Netherlands | [d] Amsterdam UMC, VU University Medical Center, Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam, The Netherlands | [e] Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany | [f] Department of Old Age Psychiatry, GGZ InGeest, Amsterdam, The Netherlands

Correspondence: [*] Correspondence to: Paul Zhutovsky, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, PA3-118, 1105 AZ, Amsterdam, The Netherlands. E-mail: paul.zhutovsky@gmail.com.

Note: [1] These authors share senior authorship.

Abstract: Background:Patients with behavioral variant of frontotemporal dementia (bvFTD) initially may only show behavioral and/or cognitive symptoms that overlap with other neurological and psychiatric disorders. The diagnostic accuracy is dependent on progressive symptoms worsening and frontotemporal abnormalities on neuroimaging findings. Predictive biomarkers could facilitate the early detection of bvFTD. Objective:To determine the prognostic accuracy of clinical and structural MRI data using a support vector machine (SVM) classification to predict the 2-year clinical follow-up diagnosis in a group of patients presenting late-onset behavioral changes. Methods:Data from 73 patients were included and divided into probable/definite bvFTD (n = 18), neurological (n = 28), and psychiatric (n = 27) groups based on 2-year follow-up diagnosis. Grey-matter volumes were extracted from baseline structural MRI scans. SVM classifiers were used to perform three binary classifications: bvFTD versus neurological and psychiatric, bvFTD versus neurological, and bvFTD versus psychiatric group(s), and one multi-class classification. Classification performance was determined for clinical and neuroimaging data separately and their combination using 5-fold cross-validation. Results:Accuracy of the binary classification tasks ranged from 72–82% (p < 0.001) with adequate sensitivity (67–79%), specificity (77–88%), and area-under-the-receiver-operator-curve (0.80–0.9). Multi-class accuracy ranged between 55–59% (p < 0.001). The combination of clinical and voxel-wise whole brain data showed the best performance overall. Conclusion:These results show the potential for automated early confirmation of diagnosis for bvFTD using machine learning analysis of clinical and neuroimaging data in a diverse and clinically relevant sample of patients.

Keywords: behavioral variant frontotemporal dementia, classification, magnetic resonance imaging, prognosis, support vector machine

DOI: 10.3233/JAD-181004

Journal: Journal of Alzheimer's Disease, vol. 68, no. 3, pp. 1229-1241, 2019