Stanford Psychiatry’s Ehsan Adeli Awarded Grant Examining Neural Mechanisms of Gait Disturbances

October 2024

Ehsan Adeli, PhD

We are pleased to announce that Stanford Psychiatry’s Ehsan Adeli, assistant professor of psychiatry and behavioral sciences, has received a grant from the National Institute on Aging titled, “Neural mechanisms of gait disturbances as individualized digital biomarker trajectories in preclinical dementia.”

Alzheimer's disease and related dementias (AD/ADRD) rank prominently among age-associated neurodegenerative disorders, with Parkinson’s disease trailing as the second most common. Recent studies on AD and Mild Cognitive Impairment (MCI) have uncovered cognitive decline indicators mirrored in nuances within gait and hand movements. These indications often emerge long before AD or MCI diagnoses are confirmed. Consistently, research has correlated slowed gait with cognitive deterioration, elevated brain amyloid levels, and an augmented AD risk. However, the interplay between systems influencing both cognition and movement has largely been explored in separate studies. The depth of understanding around the cognitive efforts required for gait initiation or motor planning remains scant. Though dementia screening traditionally hinges on comprehensive neuropsychological evaluations and neuroimaging biomarker studies, gait and movement assessment offers a more direct approach. Crucially, motor features remain unaffected by language, educational background, or cognitive capabilities, positioning them as unbiased and consistent evaluative instruments.

This project will use cutting-edge AI and computer vision (CV) tools to aid in distinguishing diverse dementia and MCI subtypes, such as AD-related MCI versus MCI with PD pathologies. The study’s approach integrates multi-modal brain imaging with gait and movement data from videos, aiming to extract nuanced markers for phenotyping (pre)clinical AD. These markers can then serve as precise digital trackers for both the progression and distinction of age-related degenerative disorders. Ultimately, Dr. Adeli and his study team aspire to enhance the understanding of the intricate links between gait, movement, and cognition in aging and AD/ADRD scenarios.

“In this project, we uncover the neural mechanisms of gait and mobility disturbances in preclinical dementia and identify trackable individualized digital biomarkers (from videos). We evaluate the specificity and sensitivity of these gait-based biomarkers and relate those to neural mechanisms and clinical phenotypes,” says Dr. Adeli. “By leveraging these identified markers, we can monitor the disease's progression, potentially minimizing or even replacing the demand for expensive neuropsychological or neuroimaging evaluations.” He adds “Ultimately, this approach has the potential to expand early detection and care to broader and underserved communities, as these digital biomarkers are inexpensive and can be easily captured, even using everyday devices such as smartphones.”

Recent publications related to this work include “Data-driven discovery of movement-linked heterogeneity in neurodegenerative diseases” in the journal Nature Machine Intelligence and “An Explainable Geometric-Weighted Graph Attention Network for Identifying Functional Networks Associated with Gait Impairment” published in Medical Image Computing and Computer Assisted Intervention proceedings, a Springer Lecture Notes. Preliminary results were also presented orally at the Alzheimer's Association International Conference 2024 entitled “Automated Physical Performance Battery as a Digital Marker for Alzheimer's Disease and Mild Cognitive Impairment.”

 

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