Signal processing and machine learning techniques are changing the clinical practice based on medical imaging from many perspectives. A major topic is related to (i) the development of computer aided diagnosis systems to provide clinicians with novel, non-invasive and low-cost support-tools, and (ii) to the development of new methodologies for the analysis of biomedical data for finding new disease biomarkers. Advancements have been recently achieved in the context of Alzheimer’s disease (AD) diagnosis through the use of diffusion weighted imaging (DWI) data. When combined with tractography algorithms, this imaging modality enables the reconstruction of the physical connections of the brain that can be subsequently investigated through a complex network-based approach. A graph metric particularly suited to describe the disruption of the brain connectivity due to AD is communicability. In this work, we develop a machine learning framework for the classification and feature importance analysis of AD based on communicability at the whole brain level. We fairly compare the performance of three state-of-the-art classification models, namely support vector machines, random forests and artificial neural networks, on the connectivity networks of a balanced cohort of healthy control subjects and AD patients from the ADNI database. Moreover, we clinically validate the information content of the communicability metric by performing a feature importance analysis. Both performance comparison and feature importance analysis provide evidence of the robustness of the method. The results obtained confirm that the whole brain structural communicability alterations due to AD are a valuable biomarker for the characterization and investigation of pathological conditions.

In this paper, we investigate the connectivity alterations of the subcortical brain network due to Alzheimer’s disease (AD). Mostly, the literature investigated AD connectivity abnormalities at the whole brain level or at the cortex level, while very few studies focused on the sub-network composed only by the subcortical regions, especially using diffusion-weighted imaging (DWI) data. In this work, we examine a mixed cohort including 46 healthy controls (HC) and 40 AD patients from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) data set. We reconstruct the brain connectome through the use of state of the art tractography algorithms and we propose a method based on graph communicability to enhance the information content of subcortical brain regions in discriminating AD. We develop a classification framework, achieving 77% of area under the receiver operating characteristic (ROC) curve in the binary discrimination AD vs. HC only using a $12\times 12$ subcortical features matrix. We find some interesting AD-related connectivity patterns highlighting that subcortical regions tend to increase their communicability through cortical regions to compensate the physical connectivity reduction between them due to AD. This study also suggests that AD connectivity alterations mostly regard the inter-connectivity between subcortical and cortical regions rather than the intra-subcortical connectivity.

The communicability distance between pairs of regions in human brain is used as a quantitative proxy for studying Alzheimer disease. Using this distance we obtain the shortest communicability path lengths between different regions of brain networks from Alzheimer diseased (AD) patients and healthy cohorts (HC). We show that the shortest communicability path length is significantly better than the shortest topological path length in distinguishing AD patients from HC. Based on this approach we identify 399 pairs of brain regions for which there are very significant changes in the shortest communicability path length after AD appears. We find that 42% of these regions interconnect both brain hemispheres, 28% connect regions inside the left hemisphere only and 20% affects vermis connection with brain hemispheres. These findings clearly agree with the disconnection syndrome hypothesis of Alzheimer disease. Finally, we show that in 76.9% damaged brain regions the shortest communicability path length drops in AD in relation to HC. This counterintuitive finding indicates that AD transforms the brain network into a more efficient system from the perspective of the transmission of the disease, because it drops the circulability of the disease factor around the brain regions in relation to its transmissibility to other regions.