Patrick C. M. Wong

Yanlin Wang, Di Yuan, Shani Dettman et al.

Cochlear implants (CI) significantly improve spoken language in children with severe-to-profound sensorineural hearing loss (SNHL), yet outcomes remain more variable than in children with normal hearing. This variability cannot be reliably predicted for individual children using age at implantation or residual hearing. This study aims to compare the accuracy of traditional machine learning (ML) to deep transfer learning (DTL) algorithms to predict post-CI spoken language development of children with bilateral SNHL using a binary classification model of high versus low language improvers. A total of 278 implanted children enrolled from three centers. The accuracy, sensitivity and specificity of prediction models based upon brain neuroanatomic features using traditional ML and DTL learning. DTL prediction models using bilinear attention-based fusion strategy achieved: accuracy of 92.39% (95% CI, 90.70%-94.07%), sensitivity of 91.22% (95% CI, 89.98%-92.47%), specificity of 93.56% (95% CI, 90.91%-96.21%), and area under the curve (AUC) of 0.977 (95% CI, 0.969-0.986). DTL outperformed traditional ML models in all outcome measures. DTL was significantly improved by direct capture of discriminative and task-specific information that are advantages of representation learning enabled by this approach over ML. The results support the feasibility of a single DTL prediction model for language prediction of children served by CI programs worldwide.

Yanlin Wang, Nancy M Young, Patrick C M Wong

Neural prediction offers a promising approach to forecasting the individual variability of neurocognitive functions and disorders and providing prognostic indicators for personalized invention. However, it is challenging to translate neural predictive models into medical artificial intelligent applications due to the limitations of domain shift and label scarcity. Here, we propose the directed evolution model (DEM), a novel computational model that mimics the trial-and-error processes of biological directed evolution to approximate optimal solutions for predictive modeling tasks. We demonstrated that the directed evolution algorithm is an effective strategy for uncertainty exploration, enhancing generalization in reinforcement learning. Furthermore, by incorporating replay buffer and continual backpropagate methods into DEM, we provide evidence of achieving better trade-off between exploitation and exploration in continuous learning settings. We conducted experiments on four different datasets for children with cochlear implants whose spoken language developmental outcomes vary considerably on the individual-child level. Preoperative neural MRI data has shown to accurately predict the post-operative outcome of these children within but not across datasets. Our results show that DEM can efficiently improve the performance of cross-domain pre-implantation neural predictions while addressing the challenge of label scarcity in target domain.

Yuejiao Wang, Xianmin Gong, Xixin Wu et al.

Early detection is crucial for timely intervention aimed at preventing and slowing the progression of neurocognitive disorder (NCD), a common and significant health problem among the aging population. Recent evidence has suggested that language-related functional magnetic resonance imaging (fMRI) may be a promising approach for detecting cognitive decline and early NCD. In this paper, we proposed a novel, naturalistic language-related fMRI task for this purpose. We examined the effectiveness of this task among 97 non-demented Chinese older adults from Hong Kong. The results showed that machine-learning classification models based on fMRI features extracted from the task and demographics (age, gender, and education year) achieved an average area under the curve of 0.86 when classifying participants' cognitive status (labeled as NORMAL vs DECLINE based on their scores on a standard neurcognitive test). Feature localization revealed that the fMRI features most frequently selected by the data-driven approach came primarily from brain regions associated with language processing, such as the superior temporal gyrus, middle temporal gyrus, and right cerebellum. The study demonstrated the potential of the naturalistic language-related fMRI task for early detection of aging-related cognitive decline and NCD.

Jinchao Li, Yuejiao Wang, Junan Li et al.

Early detection of neurocognitive disorders (NCDs) is crucial for timely intervention and disease management. Given that language impairments manifest early in NCD progression, visual-stimulated narrative (VSN)-based analysis offers a promising avenue for NCD detection. Current VSN-based NCD detection methods primarily focus on linguistic microstructures (e.g., lexical diversity) that are closely tied to bottom-up, stimulus-driven cognitive processes. While these features illuminate basic language abilities, the higher-order linguistic macrostructures (e.g., topic development) that may reflect top-down, concept-driven cognitive abilities remain underexplored. These macrostructural patterns are crucial for NCD detection, yet challenging to quantify due to their abstract and complex nature. To bridge this gap, we propose two novel macrostructural approaches: (1) a Dynamic Topic Model (DTM) to track topic evolution over time, and (2) a Text-Image Temporal Alignment Network (TITAN) to measure cross-modal consistency between narrative and visual stimuli. Experimental results show the effectiveness of the proposed approaches in NCD detection, with TITAN achieving superior performance across three corpora: ADReSS (F1=0.8889), ADReSSo (F1=0.8504), and CU-MARVEL-RABBIT (F1=0.7238). Feature contribution analysis reveals that macrostructural features (e.g., topic variability, topic change rate, and topic consistency) constitute the most significant contributors to the model's decision pathways, outperforming the investigated microstructural features. These findings underscore the value of macrostructural analysis for understanding linguistic-cognitive interactions associated with NCDs.