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A Deep Learning Approach for Automated Diagnosis and Multi-Class Classification of Alzheimer’s Disease Stages Using Resting-State fMRI and Residual Neural Networks

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Alzheimer’s disease (AD) is an incurable neurodegenerative disorder accounting for 70%–80% dementia cases worldwide. Although, research on AD has increased in recent years, however, the complexity associated with brain structure and functions makes the early diagnosis of this disease a challenging task. Resting-state functional magnetic resonance imaging (rs-fMRI) is a neuroimaging technology that has been widely used to study the pathogenesis of neurodegenerative diseases. In literature, the computer-aided diagnosis of AD is limited to binary classification or diagnosis of AD and MCI stages. However, its applicability to diagnose multiple progressive stages of AD is relatively under-studied. This study explores the effectiveness of rs-fMRI for multi-class classification of AD and its associated stages including CN, SMC, EMCI, MCI, LMCI, and AD. A longitudinal cohort of resting-state fMRI of 138 subjects (25 CN, 25 SMC, 25 EMCI, 25 LMCI, 13 MCI, and 25 AD) from Alzheimer’s Disease Neuroimaging Initiative (ADNI) is studied. To provide a better insight into deep learning approaches and their applications to AD classification, we investigate ResNet-18 architecture in detail. We consider the training of the network from scratch by using single-channel input as well as performed transfer learning with and without fine-tuning using an extended network architecture. We experimented with residual neural networks to perform AD classification task and compared it with former research in this domain. The performance of the models is evaluated using precision, recall, f1-measure, AUC and ROC curves. We found that our networks were able to significantly classify the subjects. We achieved improved results with our fine-tuned model for all the AD stages with an accuracy of 100%, 96.85%, 97.38%, 97.43%, 97.40% and 98.01% for CN, SMC, EMCI, LMCI, MCI, and AD respectively. However, in terms of overall performance, we achieved state-of-the-art results with an average accuracy of 97.92% and 97.88% for off-the-shelf and fine-tuned models respectively. The Analysis of results indicate that classification and prediction of neurodegenerative brain disorders such as AD using functional magnetic resonance imaging and advanced deep learning methods is promising for clinical decision making and have the potential to assist in early diagnosis of AD and its associated stages.

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This work was supported by NRPU-4223 from HEC Pakistan. Data collection and sharing for this project was funded by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer’s Association; Alzheimer’s Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd. and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health ( The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer’s Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California. This work was also supported by Artificial Intelligence and Data Analytics (AIDA) Lab Prince Sultan University Riyadh Saudi Arabia. Authors are thankful for the support.

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Correspondence to Sajid Iqbal.

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Ramzan, F., Khan, M.U.G., Rehmat, A. et al. A Deep Learning Approach for Automated Diagnosis and Multi-Class Classification of Alzheimer’s Disease Stages Using Resting-State fMRI and Residual Neural Networks. J Med Syst 44, 37 (2020).

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