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@ARTICLE{Lohner:280259,
author = {Lohner, Valerie and Badhwar, Amanpreet and Detcheverry,
Flavie E and García, Cindy L and Gellersen, Helena M and
Khodakarami, Zahra and Lattmann, Rene and Li, Rui and Low,
Audrey and Mazo, Claudia and Metz, Amelie and Parent,
Olivier and Phillips, Veronica and Saeed, Usman and Tan,
Sean Y W and Tamburin, Stefano and Llewellyn, David J and
Rittman, Timothy and Waters, Sheena and Bernal, Jose},
title = {{M}achine learning applications in vascular neuroimaging
for the diagnosis and prognosis of cognitive impairment and
dementia: a systematic review and meta-analysis.},
journal = {Alzheimer's research $\&$ therapy},
volume = {17},
number = {1},
issn = {1758-9193},
address = {London},
publisher = {BioMed Central},
reportid = {DZNE-2025-00937},
pages = {183},
year = {2025},
abstract = {Background:Cerebral small vessel disease (CSVD) is a common
neurological condition that contributes to strokes,
dementia, disability, and mortality worldwide. We conducted
a systematic review and meta-analysis to investigate the use
of neuroimaging CSVD markers in machine learning (ML) based
diagnosis and prognosis of cognitive impairment and
dementia, and identify both methodological changes over time
and barriers to clinical translation.Methods:Following the
PRISMA guidelines, we systematically searched for original
studies that used both neuroimaging CSVD markers and ML
methods for diagnosing and prognosing neurodegenerative
diseases (preregistration in PROSPERO: CRD42022366767). Each
paper was independently reviewed by a pair of reviewers at
all stages, with a third consulted to resolve conflicts. We
meta-analysed the effectiveness of ML models to distinguish
healthy controls from Alzheimer’s dementia and cognitive
impairment, using area under the curve (AUC) as the
performance metric.Results:We identified 75 studies: 43 on
diagnosis, 27 on prognosis, and 5 on both. Nearly $60\%$ of
studies were published in the past two years, reflecting a
growing interest in using CSVD markers in ML-based diagnosis
and prognosis of neurodegenerative diseases, especially
Alzheimer’s dementia. This rising interest may be linked
to the strong performance of such models: according to our
meta-analysis, ML approaches using CSVD markers perform well
in differentiating healthy controls from Alzheimer’s
dementia (AUC 0.88 $[95\%-CI$ 0.85–0.92]) and cognitive
impairment (AUC 0.84 $[95\%-CI$ 0.74–0.95]). However, the
growing interest has not been matched by methodological
rigour: only 16 studies met the criteria for inclusion in
the meta-analysis due to inconsistent reporting, only five
assessed the generalisability of their models on external
datasets, and six lacked clear diagnostic
criteria.Conclusions:Interest in incorporating CSVD markers
into ML models for neurodegenerative disease classification
is on the rise, and their performance suggests that this is
worth further exploration. Serious methodological issues,
including inconsistent reporting, limited generalisability
testing, and other potential biases, are unfortunately
common and hinder further adoption. Our targeted
recommendations provide a roadmap to accelerate the
integration of ML into clinical practice.},
keywords = {Alzheimer’s dementia (Other) / Artificial intelligence
(Other) / Cerebral small vessel disease (Other) / Cognitive
impairment (Other) / Dementia (Other) / Machine learning
(Other) / Neurodegenerative diseases (Other) / Neuroimaging
(Other)},
cin = {AG Berron / AG Düzel},
ddc = {610},
cid = {I:(DE-2719)5000070 / I:(DE-2719)5000006},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:40775365},
doi = {10.1186/s13195-025-01815-6},
url = {https://pub.dzne.de/record/280259},
}