Mapping Individual Differences in Intermodal Coupling in Neurodevelopment.

Within-individual coupling between measures of brain structure and function evolves in development and may underlie differential risk for neuropsychiatric disorders. Despite increasing interest in the development of structure-function relationships, rigorous methods to quantify and test individual differences in coupling remain nascent. In this article, we explore and address gaps in approaches for testing and spatially localizing individual differences in intermodal coupling. We propose a new method, called CIDeR, which is designed to simultaneously perform hypothesis testing in a way that limits false positive results and improve detection of true positive results. Through a comparison across different approaches to testing individual differences in intermodal coupling, we delineate subtle differences in the hypotheses they test, which may ultimately lead researchers to arrive at different results. Finally, we illustrate the utility of CIDeR in two applications to brain development using data from the Philadelphia Neurodevelopmental Cohort.

Understanding the Temporal Dynamics of Accelerated Brain Aging and Resilient Brain Aging: Insights from Discriminative Event-Based Analysis of UK Biobank Data.

The intricate dynamics of brain aging, especially the neurodegenerative mechanisms driving accelerated (ABA) and resilient brain aging (RBA), are pivotal in neuroscience. Understanding the temporal dynamics of these phenotypes is crucial for identifying vulnerabilities to cognitive decline and neurodegenerative diseases. Currently, there is a lack of comprehensive understanding of the temporal dynamics and neuroimaging biomarkers linked to ABA and RBA. This study addressed this gap by utilizing a large-scale UK Biobank (UKB) cohort, with the aim to elucidate brain aging heterogeneity and establish the foundation for targeted interventions. Employing Lasso regression on multimodal neuroimaging data, structural MRI (sMRI), diffusion MRI (dMRI), and resting-state functional MRI (rsfMRI), we predicted the brain age and classified individuals into ABA and RBA cohorts. Our findings identified 1949 subjects (6.2%) as representative of the ABA subpopulation and 3203 subjects (10.1%) as representative of the RBA subpopulation. Additionally, the Discriminative Event-Based Model (DEBM) was applied to estimate the sequence of biomarker changes across aging trajectories. Our analysis unveiled distinct central ordering patterns between the ABA and RBA cohorts, with profound implications for understanding cognitive decline and vulnerability to neurodegenerative disorders. Specifically, the ABA cohort exhibited early degeneration in four functional networks and two cognitive domains, with cortical thinning initially observed in the right hemisphere, followed by the temporal lobe. In contrast, the RBA cohort demonstrated initial degeneration in the three functional networks, with cortical thinning predominantly in the left hemisphere and white matter microstructural degeneration occurring at more advanced stages. The detailed aging progression timeline constructed through our DEBM analysis positioned subjects according to their estimated stage of aging, offering a nuanced view of the aging brain's alterations. This study holds promise for the development of targeted interventions aimed at mitigating age-related cognitive decline.

Brain alterations in individuals with exercise dependence: A multimodal neuroimaging investigation.

Background: Exercise dependence (ED) is characterised by behavioural and psychological symptoms that resemble those of substance use disorders. However, it remains inconclusive whether ED is accompanied by similar brain alterations as seen in substance use disorders. Therefore, we investigated brain alterations in individuals with ED and inactive control participants. Methods: In this cross-sectional neuroimaging investigation, 29 individuals with ED as assessed with the Exercise Dependence Scale (EDS) and 28 inactive control participants (max one hour exercising per week) underwent structural and functional resting-state magnetic resonance imaging (MRI). Group differences were explored using voxel-based morphometry and functional connectivity analyses. Analyses were restricted to the striatum, amygdala, and inferior frontal gyrus (IFG). Exploratory analyses tested whether relationships between brain structure and function were differently related to EDS subscales among groups. Results: No structural differences were found between the two groups. However, right IFG and bilateral putamen volumes were differently related to the EDS subscales "time" and "tolerance", respectively, between the two groups. Resting-state functional connectivity was increased from right IFG to right superior parietal lobule in individuals with ED compared to inactive control participants. Furthermore, functional connectivity of the angular gyrus to the left IFG and bilateral caudate showed divergent relationships to the EDS subscale "tolerance" among groups. Discussion: The findings suggest that ED may be accompanied by alterations in cognition-related brain structures, but also functional changes that may drive compulsive habitual behaviour. Further prospective studies are needed to disentangle beneficial and detrimental brain effects of ED.

Machine learning with multimodal neuroimaging data to classify stages of Alzheimer's disease: a systematic review and meta-analysis.

In recent years, Alzheimer's disease (AD) has been a serious threat to human health. Researchers and clinicians alike encounter a significant obstacle when trying to accurately identify and classify AD stages. Several studies have shown that multimodal neuroimaging input can assist in providing valuable insights into the structural and functional changes in the brain related to AD. Machine learning (ML) algorithms can accurately categorize AD phases by identifying patterns and linkages in multimodal neuroimaging data using powerful computational methods. This study aims to assess the contribution of ML methods to the accurate classification of the stages of AD using multimodal neuroimaging data. A systematic search is carried out in IEEE Xplore, Science Direct/Elsevier, ACM DigitalLibrary, and PubMed databases with forward snowballing performed on Google Scholar. The quantitative analysis used 47 studies. The explainable analysis was performed on the classification algorithm and fusion methods used in the selected studies. The pooled sensitivity and specificity, including diagnostic efficiency, were evaluated by conducting a meta-analysis based on a bivariate model with the hierarchical summary receiver operating characteristics (ROC) curve of multimodal neuroimaging data and ML methods in the classification of AD stages. Wilcoxon signed-rank test is further used to statistically compare the accuracy scores of the existing models. With a 95% confidence interval of 78.87-87.71%, the combined sensitivity for separating participants with mild cognitive impairment (MCI) from healthy control (NC) participants was 83.77%; for separating participants with AD from NC, it was 94.60% (90.76%, 96.89%); for separating participants with progressive MCI (pMCI) from stable MCI (sMCI), it was 80.41% (74.73%, 85.06%). With a 95% confidence interval (78.87%, 87.71%), the Pooled sensitivity for distinguishing mild cognitive impairment (MCI) from healthy control (NC) participants was 83.77%, with a 95% confidence interval (90.76%, 96.89%), the Pooled sensitivity for distinguishing AD from NC was 94.60%, likewise (MCI) from healthy control (NC) participants was 83.77% progressive MCI (pMCI) from stable MCI (sMCI) was 80.41% (74.73%, 85.06%), and early MCI (EMCI) from NC was 86.63% (82.43%, 89.95%). Pooled specificity for differentiating MCI from NC was 79.16% (70.97%, 87.71%), AD from NC was 93.49% (91.60%, 94.90%), pMCI from sMCI was 81.44% (76.32%, 85.66%), and EMCI from NC was 85.68% (81.62%, 88.96%). The Wilcoxon signed rank test showed a low P-value across all the classification tasks. Multimodal neuroimaging data with ML is a promising future in classifying the stages of AD but more research is required to increase the validity of its application in clinical practice.

Altered Structural Connectivity and Functional Brain Dynamics in Individuals With Heavy Alcohol Use Elucidated via Network Control Theory.

BACKGROUND: Heavy alcohol use and its associated conditions, such as alcohol use disorder, impact millions of individuals worldwide. While our understanding of the neurobiological correlates of alcohol use has evolved substantially, we still lack models that incorporate whole-brain neuroanatomical, functional, and pharmacological information under one framework. METHODS: Here, we utilized diffusion and functional magnetic resonance imaging to investigate alterations to brain dynamics in 130 individuals with a high amount of current alcohol use. We compared these alcohol-using individuals to 308 individuals with minimal use of any substances. RESULTS: We found that individuals with heavy alcohol use had less dynamic and complex brain activity, and through leveraging network control theory, had increased control energy to complete transitions between activation states. Furthermore, using separately acquired positron emission tomography data, we deployed an in silico evaluation demonstrating that decreased D2 receptor levels, as found previously in individuals with alcohol use disorder, may relate to our observed findings. CONCLUSIONS: This work demonstrates that whole-brain, multimodal imaging information can be combined under a network control framework to identify and evaluate neurobiological correlates and mechanisms of heavy alcohol use.

Peaglet: A user-friendly probabilistic Kernel density estimation of intracranial cortical and subcortical stimulation sites.

BACKGROUND: Data on human brain function obtained with direct electrical stimulation (DES) in neurosurgical patients have been recently integrated and combined with modern neuroimaging techniques, allowing a connectome-based approach fed by intraoperative DES data. Within this framework is crucial to develop reliable methods for spatial localization of DES-derived information to be integrated within the neuroimaging workflow. NEW METHOD: To this aim, we applied the Kernel Density Estimation for modelling the distribution of DES sites from different patients into the MNI space. The algorithm has been embedded in a MATLAB-based User Interface, Peaglet. It allows an accurate probabilistic weighted and unweighted estimation of DES sites location both at cortical level, by using shortest path calculation along the brain 3D geometric topology, and subcortical level, by using a volume-based approach. RESULTS: We applied Peaglet to investigate spatial estimation of cortical and subcortical stimulation sites provided by recent brain tumour studies. The resulting NIfTI maps have been anatomically investigated with neuroimaging open-source tools. COMPARISON WITH EXISTING METHODS: Peaglet processes differently cortical and subcortical data following their distinguishing geometrical features, increasing anatomical specificity of DES-related results and their reliability within neuroimaging environments. CONCLUSIONS: Peaglet provides a robust probabilistic estimation of the cortical and subcortical distribution of DES sites going beyond a region of interest approach, respecting cortical and subcortical intrinsic geometrical features. Results can be easily integrated within the neuroimaging workflow to drive connectomic analysis.

Unveiling Promising Neuroimaging Biomarkers for Schizophrenia Through Clinical and Genetic Perspectives.

Schizophrenia is a complex and serious brain disorder. Neuroscientists have become increasingly interested in using magnetic resonance-based brain imaging-derived phenotypes (IDPs) to investigate the etiology of psychiatric disorders. IDPs capture valuable clinical advantages and hold biological significance in identifying brain abnormalities. In this review, we aim to discuss current and prospective approaches to identify potential biomarkers for schizophrenia using clinical multimodal neuroimaging and imaging genetics. We first described IDPs through their phenotypic classification and neuroimaging genomics. Secondly, we discussed the applications of multimodal neuroimaging by clinical evidence in observational studies and randomized controlled trials. Thirdly, considering the genetic evidence of IDPs, we discussed how can utilize neuroimaging data as an intermediate phenotype to make association inferences by polygenic risk scores and Mendelian randomization. Finally, we discussed machine learning as an optimum approach for validating biomarkers. Together, future research efforts focused on neuroimaging biomarkers aim to enhance our understanding of schizophrenia.

Towards a multimodal neuroimaging-based risk score for mild cognitive impairment by combining clinical studies with a large (N>37000) population-based study.

Alzheimer's disease (AD) is the most common form of age-related dementia, leading to a decline in memory, reasoning, and social skills. While numerous studies have investigated the genetic risk factors associated with AD, less attention has been given to identifying a brain imaging-based measure of AD risk. This study introduces a novel approach to assess mild cognitive impairment MCI, as a stage before AD, risk using neuroimaging data, referred to as a brain-wide risk score (BRS), which incorporates multimodal brain imaging. To begin, we first categorized participants from the Open Access Series of Imaging Studies (OASIS)-3 cohort into two groups: controls (CN) and individuals with MCI. Next, we computed structure and functional imaging features from all the OASIS data as well as all the UK Biobank data. For resting functional magnetic resonance imaging (fMRI) data, we computed functional network connectivity (FNC) matrices using fully automated spatially constrained independent component analysis. For structural MRI data we computed gray matter (GM) segmentation maps. We then evaluated the similarity between each participant's neuroimaging features from the UK Biobank and the difference in the average of those features between CN individuals and those with MCI, which we refer to as the brain-wide risk score (BRS). Both GM and FNC features were utilized in determining the BRS. We first evaluated the differences in the distribution of the BRS for CN vs MCI within the OASIS-3 (using OASIS-3 as the reference group). Next, we evaluated the BRS in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort (using OASIS-3 as the reference group), showing that the BRS can differentiate MCI from CN in an independent data set. Subsequently, using the sMRI BRS, we identified 10 distinct subgroups and similarly, we identified another set of 10 subgroups using the FNC BRS. For sMRI and FNC we observed results that mutually validate each other, with certain aspects being complementary. For the unimodal analysis, sMRI provides greater differentiation between MCI and CN individuals than the fMRI data, consistent with prior work. Additionally, by utilizing a multimodal BRS approach, which combines both GM and FNC assessments, we identified two groups of subjects using the multimodal BRS scores. One group exhibits high MCI risk with both negative GM and FNC BRS, while the other shows low MCI risk with both positive GM and FNC BRS. Moreover, in the UKBB we have 46 participants diagnosed with AD showed FNC and GM patterns similar to those in high-risk groups, defined in both unimodal and multimodal BRS. Finally, to ensure the reproducibility of our findings, we conducted a validation analysis using the ADNI as an additional reference dataset and repeated the above analysis. The results were consistently replicated across different reference groups, highlighting the potential of FNC and sMRI-based BRS in early Alzheimer's detection.

Two multimodal neuroimaging subtypes of obsessive-compulsive disorder disclosed by semi-supervised machine learning.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a highly heterogeneous mental condition with a diverse symptom. Existing studies classified OCD on the basis of conventional phenomenology-based taxonomy ignoring the fact that the same subtype identified in accordance with clinical symptom may have different mechanisms and treatment responses. METHODS: This research involved 50 medicine-free patients with OCD and 50 matched healthy controls (HCs). All the participants were subjected to structural and functional magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) and amplitude of low frequency fluctuation (ALFF) were used to evaluate gray matter volume (GMV) and spontaneous neuronal activities at rest respectively. Similarity network fusion (SNF) was utilized to integrate GMVs and spontaneous neuronal activities, and heterogeneity by discriminant analysis was applied to characterise OCD subtypes. RESULTS: Two OCD subtypes were identified: Subtype 1 exhibited decreased GMVs (i.e., left inferior temporal gyrus, right supplementary motor area and right lingual gyrus) and increased ALFF value (i.e., right orbitofrontal cortex), whereas subtype 2 exhibited increased GMVs (i.e., left cuneus, right precentral gyrus, left postcentral gyrus and left hippocampus) and decreased ALFF value (i.e., right caudate nucleus). Furthermore, the altered GMVs was negatively correlated with abnormal ALFF values in both subtype 1 and 2. LIMITATIONS: This study requires further validation via a larger, independent dataset and should consider the potential influences of psychotropic medication on OCD patients' brain activities. CONCLUSIONS: Results revealed two reproducible subtypes of OCD based on underlying multimodal neuroimaging and provided new perspectives on the classification of OCD.

Reduced covariation between brain morphometry and local spontaneous activity in young children with ASD.

While disruptions in brain maturation in the first years of life in ASD are well documented, little is known about how the brain structure and function are related in young children with ASD compared to typically developing peers. We applied a multivariate pattern analysis to examine the covariation patterns between brain morphometry and local brain spontaneous activity in 38 toddlers and preschoolers with ASD and 31 typically developing children using T1-weighted structural MRI and resting-state fMRI data acquired during natural sleep. The results revealed significantly reduced brain structure-function correlations in ASD. The resultant brain structure and function composite indices were associated with age among typically developing children, but not among those with ASD, suggesting mistiming of typical brain maturational trajectories early in life in autism. Additionally, the brain function composite indices were associated with the overall developmental and adaptive behavior skills in the ASD group, highlighting the neurodevelopmental significance of early local brain activity in autism.

Local structural and functional MRI markers of compulsive behaviors and obsessive-compulsive disorder diagnosis within striatum-based circuits.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a classic disorder on the compulsivity spectrum, with diverse comorbidities. In the current study, we sought to understand OCD from a dimensional perspective by identifying multimodal neuroimaging patterns correlated with multiple phenotypic characteristics within the striatum-based circuits known to be affected by OCD. METHODS: Neuroimaging measurements of local functional and structural features and clinical information were collected from 110 subjects, including 51 patients with OCD and 59 healthy control subjects. Linked independent component analysis (LICA) and correlation analysis were applied to identify associations between local neuroimaging patterns across modalities (including gray matter volume, white matter integrity, and spontaneous functional activity) and clinical factors. RESULTS: LICA identified eight multimodal neuroimaging patterns related to phenotypic variations, including three related to symptoms and diagnosis. One imaging pattern (IC9) that included both the amplitude of low-frequency fluctuation measure of spontaneous functional activity and white matter integrity measures correlated negatively with OCD diagnosis and diagnostic scales. Two imaging patterns (IC10 and IC27) correlated with compulsion symptoms: IC10 included primarily anatomical measures and IC27 included primarily functional measures. In addition, we identified imaging patterns associated with age, gender, and emotional expression across subjects. CONCLUSIONS: We established that data fusion techniques can identify local multimodal neuroimaging patterns associated with OCD phenotypes. The results inform our understanding of the neurobiological underpinnings of compulsive behaviors and OCD diagnosis.

Reciprocal relationships between stress and depressive symptoms: the essential role of the nucleus accumbens.

BACKGROUND: Stress and depression have a reciprocal relationship, but the neural underpinnings of this reciprocity are unclear. We investigated neuroimaging phenotypes that facilitate the reciprocity between stress and depressive symptoms. METHODS: In total, 22 195 participants (52.0% females) from the population-based UK Biobank study completed two visits (initial visit: 2006-2010, age = 55.0 ± 7.5 [40-70] years; second visit: 2014-2019; age = 62.7 ± 7.5 [44-80] years). Structural equation modeling was used to examine the longitudinal relationship between self-report stressful life events (SLEs) and depressive symptoms. Cross-sectional data were used to examine the overlap between neuroimaging correlates of SLEs and depressive symptoms on the second visit among 138 multimodal imaging phenotypes. RESULTS: Longitudinal data were consistent with significant bidirectional causal relationship between SLEs and depressive symptoms. In cross-sectional analyses, SLEs were significantly associated with lower bilateral nucleus accumbal volume and lower fractional anisotropy of the forceps major. Depressive symptoms were significantly associated with extensive white matter hyperintensities, thinner cortex, lower subcortical volume, and white matter microstructural deficits, mainly in corticostriatal-limbic structures. Lower bilateral nucleus accumbal volume were the only imaging phenotypes with overlapping effects of depressive symptoms and SLEs (B = -0.032 to -0.023, p = 0.006-0.034). Depressive symptoms and SLEs significantly partially mediated the effects of each other on left and right nucleus accumbens volume (proportion of effects mediated = 12.7-14.3%, p < 0.001-p = 0.008). For the left nucleus accumbens, post-hoc seed-based analysis showed lower resting-state functional connectivity with the left orbitofrontal cortex (cluster size = 83 voxels, p = 5.4 × 10-5) in participants with high v. no SLEs. CONCLUSIONS: The nucleus accumbens may play a key role in the reciprocity between stress and depressive symptoms.

Investigation of electro-vascular phase-amplitude coupling during an auditory task.

Multimodal neuroimaging using electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) provides complementary views of cortical processes, including those related to auditory processing. However, current multimodal approaches often overlook potential insights that can be gained from nonlinear interactions between electrical and hemodynamic signals. Here, we explore electro-vascular phase-amplitude coupling (PAC) between low-frequency hemodynamic and high-frequency electrical oscillations during an auditory task. We further apply a temporally embedded canonical correlation analysis (tCCA)-general linear model (GLM)-based correction approach to reduce the possible effect of systemic physiology on fNIRS recordings. Before correction, we observed significant PAC between fNIRS and broadband EEG in the frontal region (p ≪ 0.05), ß (p ≪ 0.05) and γ (p = 0.010) in the left temporal/temporoparietal (left auditory; LA) region, and γ (p = 0.032) in the right temporal/temporoparietal (right auditory; RA) region across the entire dataset. Significant differences in PAC across conditions (task versus silence) were observed in LA (p = 0.023) and RA (p = 0.049) γ sub-bands and in lower frequency (5-20 Hz) frontal activity (p = 0.005). After correction, significant fNIRS-γ-band PAC was observed in the frontal (p = 0.021) and LA (p = 0.025) regions, while fNIRS-α (p = 0.003) and fNIRS-ß (p = 0.041) PAC were observed in RA. Decreased frontal γ-band (p = 0.008) and increased ß-band (p ≪ 0.05) PAC were observed during the task. These outcomes represent the first characterization of electro-vascular PAC between fNIRS and EEG signals during an auditory task, providing insights into electro-vascular coupling in auditory processing.

Age-related differences in fMRI subsequent memory effects are directly linked to local grey matter volume differences.

Episodic memory performance declines with increasing age, and older adults typically show reduced activation of inferior temporo-parietal cortices in functional magnetic resonance imaging (fMRI) studies of episodic memory formation. Given the age-related cortical volume loss, it is conceivable that age-related reduction of memory-related fMRI activity may be partially attributable to reduced grey matter volume (GMV). We performed a voxel-wise multimodal neuroimaging analysis of fMRI correlates of successful memory encoding, using regional GMV as covariate. In a large cohort of healthy adults (106 young, 111 older), older adults showed reduced GMV across the entire neocortex and reduced encoding-related activation of inferior temporal and parieto-occipital cortices compared to young adults. Importantly, these reduced fMRI activations during successful encoding could in part be attributed to lower regional GMV. Our results highlight the importance of controlling for structural MRI differences in fMRI studies in older adults but also demonstrate that age-related differences in memory-related fMRI activity cannot be attributed to structural variability alone.

Distinct spatiotemporal brainstem pathways of outcome valence during reward- and punishment-based learning.

Learning to seek rewards and avoid punishments, based on positive and negative choice outcomes, is essential for human survival. Yet, the neural underpinnings of outcome valence in the human brainstem and the extent to which they differ in reward and punishment learning contexts remain largely elusive. Here, using simultaneously acquired electroencephalography and functional magnetic resonance imaging data, we show that during reward learning the substantia nigra (SN)/ventral tegmental area (VTA) and locus coeruleus are initially activated following negative outcomes, while the VTA subsequently re-engages exhibiting greater responses for positive than negative outcomes, consistent with an early arousal/avoidance response and a later value-updating process, respectively. During punishment learning, we show that distinct raphe nucleus and SN subregions are activated only by negative outcomes with a sustained post-outcome activity across time, supporting the involvement of these brainstem subregions in avoidance behavior. Finally, we demonstrate that the coupling of these brainstem structures with other subcortical and cortical areas helps to shape participants' serial choice behavior in each context.

Generalized Liquid Association Analysis for Multimodal Data Integration.

Multimodal data are now prevailing in scientific research. One of the central questions in multimodal integrative analysis is to understand how two data modalities associate and interact with each other given another modality or demographic variables. The problem can be formulated as studying the associations among three sets of random variables, a question that has received relatively less attention in the literature. In this article, we propose a novel generalized liquid association analysis method, which offers a new and unique angle to this important class of problems of studying three-way associations. We extend the notion of liquid association of Li (2002) from the univariate setting to the sparse, multivariate, and high-dimensional setting. We establish a population dimension reduction model, transform the problem to sparse Tucker decomposition of a three-way tensor, and develop a higher-order orthogonal iteration algorithm for parameter estimation. We derive the non-asymptotic error bound and asymptotic consistency of the proposed estimator, while allowing the variable dimensions to be larger than and diverge with the sample size. We demonstrate the efficacy of the method through both simulations and a multimodal neuroimaging application for Alzheimer's disease research.

Optimized Convolutional Fusion for Multimodal Neuroimaging in Alzheimer's Disease Diagnosis: Enhancing Data Integration and Feature Extraction.

Multimodal neuroimaging has gained traction in Alzheimer's Disease (AD) diagnosis by integrating information from multiple imaging modalities to enhance classification accuracy. However, effectively handling heterogeneous data sources and overcoming the challenges posed by multiscale transform methods remains a significant hurdle. This article proposes a novel approach to address these challenges. To harness the power of diverse neuroimaging data, we employ a strategy that leverages optimized convolution techniques. These optimizations include varying kernel sizes and the incorporation of instance normalization, both of which play crucial roles in feature extraction from magnetic resonance imaging (MRI) and positron emission tomography (PET) images. Specifically, varying kernel sizes allow us to adapt the receptive field to different image characteristics, enhancing the model's ability to capture relevant information. Furthermore, we employ transposed convolution, which increases spatial resolution of feature maps, and it is optimized with varying kernel sizes and instance normalization. This heightened resolution facilitates the alignment and integration of data from disparate MRI and PET data. The use of larger kernels and strides in transposed convolution expands the receptive field, enabling the model to capture essential cross-modal relationships. Instance normalization, applied to each modality during the fusion process, mitigates potential biases stemming from differences in intensity, contrast, or scale between modalities. This enhancement contributes to improved model performance by reducing complexity and ensuring robust fusion. The performance of the proposed fusion method is assessed on three distinct neuroimaging datasets, which include: Alzheimer's Disease Neuroimaging Initiative (ADNI), consisting of 50 participants each at various stages of AD for both MRI and PET (Cognitive Normal, AD, and Early Mild Cognitive); Open Access Series of Imaging Studies (OASIS), consisting of 50 participants each at various stages of AD for both MRI and PET (Cognitive Normal, Mild Dementia, Very Mild Dementia); and whole-brain atlas neuroimaging (AANLIB) (consisting of 50 participants each at various stages of AD for both MRI and PET (Cognitive Normal, AD). To evaluate the quality of the fused images generated via our method, we employ a comprehensive set of evaluation metrics, including Structural Similarity Index Measurement (SSIM), which assesses the structural similarity between two images; Peak Signal-to-Noise Ratio (PSNR), which measures how closely the generated image resembles the ground truth; Entropy (E), which assesses the amount of information preserved or lost during fusion; the Feature Similarity Indexing Method (FSIM), which assesses the structural and feature similarities between two images; and Edge-Based Similarity (EBS), which measures the similarity of edges between the fused and ground truth images. The obtained fused image is further evaluated using a Mobile Vision Transformer. In the classification of AD vs. Cognitive Normal, the model achieved an accuracy of 99.00%, specificity of 99.00%, and sensitivity of 98.44% on the AANLIB dataset.

The Spectrum of Cognitive Dysfunction in Amyotrophic Lateral Sclerosis: An Update.

Cognitive dysfunction is an important non-motor symptom in amyotrophic lateral sclerosis (ALS) that has a negative impact on survival and caregiver burden. It shows a wide spectrum ranging from subjective cognitive decline to frontotemporal dementia (FTD) and covers various cognitive domains, mainly executive/attention, language and verbal memory deficits. The frequency of cognitive impairment across the different ALS phenotypes ranges from 30% to 75%, with up to 45% fulfilling the criteria of FTD. Significant genetic, clinical, and pathological heterogeneity reflects deficits in various cognitive domains. Modern neuroimaging studies revealed frontotemporal degeneration and widespread involvement of limbic and white matter systems, with hypometabolism of the relevant areas. Morphological substrates are frontotemporal and hippocampal atrophy with synaptic loss, associated with TDP-43 and other co-pathologies, including tau deposition. Widespread functional disruptions of motor and extramotor networks, as well as of frontoparietal, frontostriatal and other connectivities, are markers for cognitive deficits in ALS. Cognitive reserve may moderate the effect of brain damage but is not protective against cognitive decline. The natural history of cognitive dysfunction in ALS and its relationship to FTD are not fully understood, although there is an overlap between the ALS variants and ALS-related frontotemporal syndromes, suggesting a differential vulnerability of motor and non-motor networks. An assessment of risks or the early detection of brain connectivity signatures before structural changes may be helpful in investigating the pathophysiological mechanisms of cognitive impairment in ALS, which might even serve as novel targets for effective disease-modifying therapies.