Citation

Fleck DE, Ernest N, Asch R, Adler CM, Cohen K, Yuan W, Kunkel B, Krikorian R, Wade SL, Babcock L. J. Neurotrauma 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7018

PMID

33115345

Abstract

This pilot study explores the possibility of predicting post-concussion symptom recovery at one week post-injury using only objective diffusion tensor imaging (DTI) data inputs to a novel artificial intelligence (AI) system composed of Genetic Fuzzy Trees (GFT). Forty-three adolescents age 11 to 16 years with either mild traumatic brain injury or traumatic orthopedic injury were enrolled upon presentation to the emergency department. Participants received a DTI scan three days post-injury and their symptoms were assessed by the Post-Concussion Symptom Scale (PCSS) at six hours and one week post-injury. The GFT system was trained using 1-week total PCSS scores, 48 volumetric MRI inputs and 192 DTI inputs per participant over 225 training runs. Each training run contained a randomly selected 80% of the total sample followed by a 20% validation run. Over a different randomly selected sample distribution, GFT was also compared to six common classification methods. The cascading GFT structure controlled an effectively infinite solution space that classified participants as recovered or not recovered significantly better than chance. It demonstrated 100% and 62% classification accuracy in training and validation, respectively, better than any of the six comparison methods. Recovery sensitivity and specificity were 59% and 65% in the GFT validation set, respectively. These results provide initial evidence for the effectiveness of a GFT system to make clinical predictions of trauma symptom recovery using objective brain measures. Although clinical and research applications will require additional optimization of the system, these results highlight the future promise of AI in acute care.

Language: en

Keywords

Diffusion Tensor Imaging; HEAD TRAUMA; HUMAN STUDIES; PEDIATRIC BRAIN INJURY; RECOVERY