Identification of metabolic correlates of mild cognitive impairment in Parkinson's disease using magnetic resonance spectroscopic imaging and machine learning.

OBJECTIVE: To investigate metabolic changes of mild cognitive impairment in Parkinson's disease (PD-MCI) using proton magnetic resonance spectroscopic imaging (1H-MRSI). METHODS: Sixteen healthy controls (HC), 26 cognitively normal Parkinson's disease (PD-CN) patients, and 34 PD-MCI patients were scanned in this prospective study. Neuropsychological tests were performed, and three-dimensional 1H-MRSI was obtained at 3 T. Metabolic parameters and neuropsychological test scores were compared between PD-MCI, PD-CN, and HC. The correlations between neuropsychological test scores and metabolic intensities were also assessed. Supervised machine learning algorithms were applied to classify HC, PD-CN, and PD-MCI groups based on metabolite levels. RESULTS: PD-MCI had a lower corrected total N-acetylaspartate over total creatine ratio (tNAA/tCr) in the right precentral gyrus, corresponding to the sensorimotor network (p = 0.01), and a lower tNAA over myoinositol ratio (tNAA/mI) at a part of the default mode network, corresponding to the retrosplenial cortex (p = 0.04) than PD-CN. The HC and PD-MCI patients were classified with an accuracy of 86.4% (sensitivity = 72.7% and specificity = 81.8%) using bagged trees. CONCLUSION: 1H-MRSI revealed metabolic changes in the default mode, ventral attention/salience, and sensorimotor networks of PD-MCI patients, which could be summarized mainly as 'posterior cortical metabolic changes' related with cognitive dysfunction.

The cerebral blood flow deficits in Parkinson's disease with mild cognitive impairment using arterial spin labeling MRI.

Parkinson's disease (PD) with mild cognitive impairment (PD-MCI) is currently diagnosed based on an arbitrarily predefined standard deviation of neuropsychological test scores, and more objective biomarkers for PD-MCI diagnosis are needed. The purpose of this study was to define possible brain perfusion-based biomarkers of not only mild cognitive impairment, but also risky gene carriers in PD using arterial spin labeling magnetic resonance imaging (ASL-MRI). Fifteen healthy controls (HC), 26 cognitively normal PD (PD-CN), and 27 PD-MCI subjects participated in this study. ASL-MRI data were acquired by signal targeting with alternating radio-frequency labeling with Look-Locker sequence at 3 T. Single nucleotide polymorphism genotyping for rs9468 [microtubule-associated protein tau (MAPT) H1/H1 versus H1/H2 haplotype] was performed using a Stratagene Mx3005p real-time polymerase chain-reaction system (Agilent Technologies, USA). There were 15 subjects with MAPT H1/H1 and 11 subjects with MAPT H1/H2 within PD-MCI, and 33 subjects with MAPT H1/H1 and 19 subjects with MAPT H1/H2 within all PD. Voxel-wise differences of cerebral blood flow (CBF) values between HC, PD-CN and PD-MCI were assessed by one-way analysis of variance followed by pairwise post hoc comparisons. Further, the subgroup of PD patients carrying the risky MAPT H1/H1 haplotype was compared with noncarriers (MAPT H1/H2 haplotype) in terms of CBF by a two-sample t test. A pattern that could be summarized as "posterior hypoperfusion" (PH) differentiated the PD-MCI group from the HC group with an accuracy of 92.6% (sensitivity = 93%, specificity = 93%). Additionally, the PD patients with MAPT H1/H1 haplotype had decreased perfusion than the ones with H1/H2 haplotype at the posterior areas of the visual network (VN), default mode network (DMN), and dorsal attention network (DAN). The PH-type pattern in ASL-MRI could be employed as a biomarker of both current cognitive impairment and future cognitive decline in PD.

Like/dislike analysis using EEG: determination of most discriminative channels and frequencies.

In this study, we have analyzed electroencephalography (EEG) signals to investigate the following issues, (i) which frequencies and EEG channels could be relatively better indicators of preference (like or dislike decisions) of consumer products, (ii) timing characteristic of "like" decisions during such mental processes. For this purpose, we have obtained multichannel EEG recordings from 15 subjects, during total of 16 epochs of 10 s long, while they were presented with some shoe photographs. When they liked a specific shoe, they pressed on a button and marked the time of this activity and the particular epoch was labeled as a LIKE case. No button press meant that the subject did not like the particular shoe that was displayed and corresponding epoch designated as a DISLIKE case. After preprocessing, power spectral density (PSD) of EEG data was estimated at different frequencies (4, 5, …, 40 Hz) using the Burg method, for each epoch corresponding to one shoe presentation. Each subject's data consisted of normalized PSD values (NPVs) from all LIKE and DISLIKE cases/epochs coming from all 19 EEG channels. In order to determine the most discriminative frequencies and channels, we have utilized logistic regression, where LIKE/DISLIKE status was used as a categorical (binary) response variable and corresponding NPVs were the continuously valued input variables or predictors. We observed that when all the NPVs (total of 37) are used as predictors, the regression problem was becoming ill-posed due to large number of predictors (compared to the number of samples) and high correlation among predictors. To circumvent this issue, we have divided the frequency band into low frequency (LF) 4-19 Hz and high frequency (HF) 20-40 Hz bands and analyzed the influence of the NPV in these bands separately. Then, using the p-values that indicate how significantly estimated predictor weights are different than zero, we have determined the NPVs and channels that are more influential in determining the outcome, i.e., like/dislike decision. In the LF band, 4 and 5 Hz were found to be the most discriminative frequencies (MDFs). In the HF band, none of the frequencies seemed offer significant information. When both male and female data was used, in the LF band, a frontal channel on the left (F7-A1) and a temporal channel on the right (T6-A2) were found to be the most discriminative channels (MDCs). In the HF band, MDCs were central (Cz-A1) and occipital on the left (O1-A1) channels. The results of like timings suggest that male and female behavior for this set of stimulant images were similar.