Abstract:
:The heterogeneity of neurodegenerative diseases is a key confound to disease understanding and treatment development, as study cohorts typically include multiple phenotypes on distinct disease trajectories. Here we introduce a machine-learning technique-Subtype and Stage Inference (SuStaIn)-able to uncover data-driven disease phenotypes with distinct temporal progression patterns, from widely available cross-sectional patient studies. Results from imaging studies in two neurodegenerative diseases reveal subgroups and their distinct trajectories of regional neurodegeneration. In genetic frontotemporal dementia, SuStaIn identifies genotypes from imaging alone, validating its ability to identify subtypes; further the technique reveals within-genotype heterogeneity. In Alzheimer's disease, SuStaIn uncovers three subtypes, uniquely characterising their temporal complexity. SuStaIn provides fine-grained patient stratification, which substantially enhances the ability to predict conversion between diagnostic categories over standard models that ignore subtype (p = 7.18 × 10-4) or temporal stage (p = 3.96 × 10-5). SuStaIn offers new promise for enabling disease subtype discovery and precision medicine.
journal_name
Nat Communjournal_title
Nature communicationsauthors
Young AL,Marinescu RV,Oxtoby NP,Bocchetta M,Yong K,Firth NC,Cash DM,Thomas DL,Dick KM,Cardoso J,van Swieten J,Borroni B,Galimberti D,Masellis M,Tartaglia MC,Rowe JB,Graff C,Tagliavini F,Frisoni GB,Laforce R Jr,Findoi
10.1038/s41467-018-05892-0subject
Has Abstractpub_date
2018-10-15 00:00:00pages
4273issue
1issn
2041-1723pii
10.1038/s41467-018-05892-0journal_volume
9pub_type
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