title: Classification algorithms with multi-modal data fusion could accurately distinguish neuromyelitis optica from multiple sclerosis.
abstract: Neuromyelitis optica (NMO) exhibits substantial similarities to multiple sclerosis (MS) in clinical manifestations and imaging results and has long been considered a variant of MS. With the advent of a specific biomarker in NMO, known as anti-aquaporin 4, this assumption has changed; however, the differential diagnosis remains challenging and it is still not clear whether a combination of neuroimaging and clinical data could be used to aid clinical decision-making. Computer-aided diagnosis is a rapidly evolving process that holds great promise to facilitate objective differential diagnoses of disorders that show similar presentations. In this study, we aimed to use a powerful method for multi-modal data fusion, known as a multi-kernel learning and performed automatic diagnosis of subjects. We included 30 patients with NMO, 25 patients with MS and 35 healthy volunteers and performed multi-modal imaging with T1-weighted high resolution scans, diffusion tensor imaging (DTI) and resting-state functional MRI (fMRI). In addition, subjects underwent clinical examinations and cognitive assessments. We included 18 a priori predictors from neuroimaging, clinical and cognitive measures in the initial model. We used 10-fold cross-validation to learn the importance of each modality, train and finally test the model performance. The mean accuracy in differentiating between MS and NMO was 88%, where visible white matter lesion load, normal appearing white matter (DTI) and functional connectivity had the most important contributions to the final classification. In a multi-class classification problem we distinguished between all of 3 groups (MS, NMO and healthy controls) with an average accuracy of 84%. In this classification, visible white matter lesion load, functional connectivity, and cognitive scores were the 3 most important modalities. Our work provides preliminary evidence that computational tools can be used to help make an objective differential diagnosis of NMO and MS.
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ; Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arman
authors.initials: A
authors.lastname: Eshaghi
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sadjad
authors.initials: S
authors.lastname: Riyahi-Alam
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Roghayyeh
authors.initials: R
authors.lastname: Saeedi
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ; Interdisciplinary Neuroscience Research Program, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Tina
authors.initials: T
authors.lastname: Roostaei
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ; Interdisciplinary Neuroscience Research Program, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Nazeri
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Aida
authors.initials: A
authors.lastname: Aghsaei
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Rozita
authors.initials: R
authors.lastname: Doosti
authors.affiliation: National Brain Mapping Center, Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Habib
authors.initials: H
authors.lastname: Ganjgahi
authors.affiliation: Centre de Recherche de l'Institut du Cerveau et de la Moelle Pinire, Universitat Pierre et Marie Curie, Inserm, Paris U975, France.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Bodini
authors.affiliation: Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Iranian Center of Neurological Research, Neuroscience Institute, University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Shakourirad
authors.affiliation: Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Manijeh
authors.initials: M
authors.lastname: Pakravan
authors.affiliation: Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ghana'ati
authors.affiliation: Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Kavous
authors.initials: K
authors.lastname: Firouznia
authors.affiliation: National Brain Mapping Center, Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Zarei
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Azimi
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran ; Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran ; Iranian Center of Neurological Research, Neuroscience Institute, University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sahraian
mesh_terms: D000328:Adult; D000465:Algorithms; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis*; D009471:Neuromyelitis Optica / Q000175:diagnosis*
keywords: Computational diagnosis; Differential diagnosis; Multi-modal imaging; Multiple sclerosis; Neuromyelitis optica