Deep Multimodal Learning From MRI and Clinical Data for Early Prediction of Neurodevelopmental Deficits in Very Preterm Infants

The prevalence of disabled survivors of prematurity has increased dramatically in the past 3 decades. These survivors, especially, very preterm infants (VPIs), born ≤ 32 weeks gestational age, are at high risk for neurodevelopmental impairments. Early and clinically effective personalized prediction of outcomes, which forms the basis for early treatment decisions, is urgently needed during the peak neuroplasticity window—the first couple of years after birth—for at-risk infants, when intervention is likely to be most effective. Advances in MRI enable the noninvasive visualization of infants' brains through acquired multimodal images, which are more informative than unimodal MRI data by providing complementary/supplementary depicting of brain tissue characteristics and pathology. Thus, analyzing quantitative multimodal MRI features affords unique opportunities to study early postnatal brain development and neurodevelopmental outcome prediction in VPIs. In this study, we investigated the predictive power of multimodal MRI data, including T2-weighted anatomical MRI, diffusion tensor imaging, resting-state functional MRI, and clinical data for the prediction of neurodevelopmental deficits. We hypothesize that integrating multimodal MRI and clinical data improves the prediction over using each individual data modality. Employing the aforementioned multimodal data, we proposed novel end-to-end deep multimodal models to predict neurodevelopmental (i.e., cognitive, language, and motor) deficits independently at 2 years corrected age. We found that the proposed models can predict cognitive, language, and motor deficits at 2 years corrected age with an accuracy of 88.4, 87.2, and 86.7%, respectively, significantly better than using individual data modalities. This current study can be considered as proof-of-concept. A larger study with external validation is important to validate our approach to further assess its clinical utility and overall generalizability.