Anni Zhao

Anni Zhao, Alex Bateh, Tyler Baldridge et al.

Defining vascular age in terms of physiological function has become one focal point of the extensive studies to categorize and track chronological age. Transcranial Doppler (TCD) is a method by which cerebral blood flow velocity is measured along the major arteries feeding the human brain. This study aims to use features extracted from TCD to estimate chronological age and assess accelerated aging in subjects with various brain diseases. We predict subjects with various brain diseases to present with accelerated cerebrovascular aging when tested on various regression models trained by healthy subjects. 168 healthy subjects and 277 diseased subjects with bilateral TCD recordings of the middle cerebral artery were analyzed using the Morphological Analysis and Clustering of Intracranial Pressure (MOCAIP) algorithm. MOCAIP-generated features and heart rate variability features were used as input features for regression models to predict the brain vascular age. 66 subjects with acute stroke, 27 subjects with post stroke, 26 subjects with Alzheimer's disease, 23 subjects with mild cognitive impairment, and 135 established subjects were tested against the machine learning model to assess for accelerated cerebrovascular age. The trained model, on average, predicted healthy subjects' cerebrovascular age to be 3.69 years above their chronological age. Subjects with different disease conditions exhibited varying levels of age acceleration. The differences in healthy and diseased subjects' performances suggest that features generated using TCD may be relevant when evaluating accelerated cerebrovascular aging. Moreover, imbalanced datasets have been observed to affect the performance of machine-learning-based brain age prediction models.

Anni Zhao, Ayca Ermis, Jeffrey Robert Vitt et al.

Objective: Accurate noninvasive estimation of intracranial pressure (ICP) remains a major challenge in critical care. We developed a bespoke machine learning algorithm that integrates system identification and ranking-constrained optimization to estimate mean ICP from noninvasive signals. Methods: A machine learning framework was proposed to obtain accurate mean ICP values using arbitrary noninvasive signals. The subspace system identification algorithm is employed to identify cerebral hemodynamics models for ICP simulation using arterial blood pressure (ABP), cerebral blood velocity (CBv), and R-wave to R-wave interval (R-R interval) signals in a comprehensive database. A mapping function to describe the relationship between the features of noninvasive signals and the estimation errors is learned using innovative ranking constraints through convex optimization. Patients across multiple clinical settings were randomly split into testing and training datasets for performance evaluation of the mapping function. Results: The results indicate that about 31.88% of testing entries achieved estimation errors within 2 mmHg and 34.07% of testing entries between 2 mmHg to 6 mmHg from the nonlinear mapping with constraints. Conclusion: Our results demonstrate the feasibility of the proposed noninvasive ICP estimation approach. Significance: Further validation and technical refinement are required before clinical deployment, but this work lays the foundation for safe and broadly accessible ICP monitoring in patients with acute brain injury and related conditions.