Abstract Details

Title MRI-Based Machine Learning Classifier and its Association with Motor Progression in Parkinson’s Disease Based on Clinical Measures

Topic Movement Disorders

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 16-006

Objective To determine whether a structural MRI–based machine learning classifier, originally trained on OFF-medication motor outcomes, can predict clinical outcomes commonly used in care.

Background

Parkinson’s disease (PD) progresses at variable rates, and reliable tools to identify patients at risk for rapid decline are limited. We previously developed an MRI-based classifier that distinguished faster from slower motor progressors using OFF-medication MDS-UPDRS Part III scores. Because OFF assessments are rarely performed in routine practice, this study tested whether the classifier also relates to outcomes commonly collected in clinical care.

Design/Methods A support vector machine classifier integrating multivariate gray matter volumetric distance with baseline demographic and clinical features was applied to de novo PD patients in the Parkinson’s Progression Markers Initiative. Outcomes over 48 months included change in MDS-UPDRS Part II (motor experiences of daily living), Schwab & England Activities of Daily Living (S&E ADL), and levodopa equivalent daily dose (LEDD). Secondary analyses assessed thresholds for worsening: ≥2.5-point increase in MDS-UPDRS-II, ≥10% S&E ADL decline, ≥100 mg/day/year LEDD slope, and ≥1-stage Hoehn & Yahr (HY) progression.

Results The cohort included 88 patients with PD, classified as faster (n=42) or slower (n=46) progressors. Groups were similar at baseline except that slower progressors had higher MDS-UPDRS-III scores (22.4 vs 16.7, p=0.002). At 48 months, faster progressors showed greater decline in daily function (ΔMDS-UPDRS-II: 5.3 vs 2.8, p=0.01), independence (ΔS&E ADL: −9.3% vs −4.9%, p=0.009), and medication use (LEDD: 423 vs 278 mg/day, p=0.006). Clinically meaningful worsening was more common in faster progressors for MDS-UPDRS-II (81% vs 52%, OR=3.9, p=0.009) and HY progression (62% vs 28%, OR=4.1, p=0.003). Differences in S&E ADL and LEDD slope were not significant.

Conclusions An MRI-based classifier identified PD subgroups with distinct trajectories in motor function and treatment needs, highlighting its potential value for future studies of progression.

Authors/Disclosures
Anupa Ambili Vijayakumari, PhD (Cleveland Clinic) PRESENTER	Dr. Ambili Vijayakumari has nothing to disclose.
Daniel Teixeira dos Santos, Sr., MD	Dr. Teixeira dos Santos has nothing to disclose.
Hubert H. Fernandez, MD, FAAN (Center for Neurological Restoration, Cleveland Clinic)	Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Intrance. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. Dr. Fernandez has received publishing royalties from a publication relating to health care. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as a Steering Committee/Advisory Committee Member with Parkinson Study Group.
Benjamin L. Walter, MD (Cleveland Clinic)	Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Acorda. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Medtronic. Dr. Walter has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Walter has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbott.

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