Adaptive Temporal Gating of Longitudinal Magnetic Resonance Imaging for Alzheimer's Prediction
For clinicians, this enables early Alzheimer's prediction using only structural MRI, potentially reducing reliance on expensive or invasive biomarkers.
TAF-Net, a hybrid CNN-Transformer with an adaptive temporal gate, uses longitudinal MRI to predict MCI-to-AD conversion, achieving state-of-the-art performance (outperforming the strongest baseline) and reducing predictive variance by 48% compared to single-timepoint evaluation.
Predicting conversion from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) is critical for early intervention. Current deep learning paradigms predominantly rely on cross-sectional structural MRI, neglecting prognostic value in patient-specific anatomical trajectories. We introduce the Temporal Adaptive Fusion Network (TAF-Net), a hybrid CNN-Transformer architecture that models paired longitudinal 3D MRI scans. Central to TAF-Net is a Temporal Fusion Module governed by an Adaptive Temporal Gate, which learns patient-specific weightings to synthesize three spatiotemporal representations: explicit structural change, region-to-region temporal cross-attention, and bilateral feature concatenation. Evaluated on the Alzheimer's Disease Neuroimaging Initiative cohort for three-year MCI-to-AD conversion prediction, TAF-Net achieved the highest discriminative performance among all evaluated methods using only structural MRI, significantly outperforming the strongest baseline and approaching multimodal methods requiring PET, CSF, or genetic data. The architecture exhibited exceptional data efficiency, matching baseline performance with a fraction of training data. Ablation studies demonstrate that longitudinal fusion improves discrimination while reducing predictive variance by 48% compared to single-timepoint evaluation. Interpretability analyses reveal spatial attention aligned with established AD pathology in the medial temporal lobe and ventricles, while the gating mechanism prioritizes explicit volumetric change with strong positive correlation to conversion risk.