Emergence of Transfer Learning towards Specific Identification of Alzheimer's Disease A Prospective Approach

When there is not enough labeled data to properly train deep learning models, transfer learning can help. We still do not fully understand how effective it is in neuroimaging, especially for Alzheimer's disease research. It is also not clear if these transferred models can work on new datasets without being retrained for each specific task. We evaluate whether a compact, supervised pretrained model can serve as a reusable foundation model for downstream neuroimaging tasks. We freeze the 7.18 million weights of a 3D CNN previously trained for brain-age prediction, and adapt it to each task using Low-Rank Adaptation (LoRA), requiring only ~1% additional trainable parameters. We evaluate generalizability in six experiments. Adapting the model to classify cognitively normal versus Dementia on ADNI gave an AUC of 0.964 on held-out folds (Experiment #1). Applying that adapted model unchanged to OASIS-3, with no retraining, gave an AUC of 0.871 (Experiment #2). Reusing its output logit together with age and a cognitive score distinguished stable from progressing MCI with an AUC of 0.828 (Experiment #3). Adapting the same backbone to predict amyloid positivity from structural MRI gave an AUC of 0.804 (Experiment #4). Finally, the same approach estimated ICV-normalized hippocampal and white matter hypointensity volumes directly from the T1w image, with R^2 of 0.80 and 0.91 respectively, tasks normally addressed with much larger U-Net networks (Experiments #5 and #6). A compact model supervised on brain age can therefore serve as a reusable backbone, adapting to each task with ~1% additional parameters and transferring to an unseen cohort without any training. Our findings suggest that a carefully trained brain age model can serve as an effective foundation model for Alzheimer's related tasks, even under strict data constraints.

INTRODUCTION: Accurate MRI-based identification of Alzheimer's disease (AD), mild cognitive impairment (MCI), and related dementias remains challenging because disease-related structural changes are often subtle and heterogeneous. We developed NeuroBridge, a clinically guided multi-task MRI framework for neurodegenerative disease diagnosis. METHODS: NeuroBridge integrates large-scale self-supervised MRI pretraining with hippocampal segmentation, hippocampal atrophy classification, and reconstruction objectives, followed by gated fusion fine-tuning. Performance was evaluated across ADNI and OASIS cohorts, including cross-cohort transfer, probability-based analysis, and opportunistic screening. RESULTS: NeuroBridge achieved the highest performance across evaluated classification tasks, reaching 88.17% accuracy for AD versus cognitively normal controls in ADNI and 82.78% in OASIS. The largest gains occurred in MCI-related and mixed-diagnosis settings. The framework demonstrated strong cross-cohort generalization, systematic associations between predicted-class probability and accuracy, and the feasibility of probability-based opportunistic screening. DISCUSSION: Clinically guided multi-task representation learning improves neurodegenerative MRI diagnosis beyond conventional single-task approaches. NeuroBridge provides a robust and scalable framework for dementia assessment and MRI-based opportunistic screening.

Alzheimer's disease is a leading cause of death with no cure. Therefore, early detection is critical to slow progression and preserve quality of life. Diagnosis relies on medical history, cognitive tests, physical exams, and MRI brain scans, making deep learning suitable for Alzheimer's classification. This work proposes a benchmark that evaluates ten different convolutional neural network (CNN) architectures (including ResNet, DenseNet, MobileNet, EfficientNet, and VGG family models) under the same held-out test split protocol. A two-stage transfer learning and full fine-tuning pipeline is introduced to perform training using a class-balanced subset (3,900 images) derived from the OASIS medical imaging dataset, comprising 86,437 single-view MRI brain scans labeled into four classifications of Alzheimer's disease: Non-Demented, Very Mild Dementia, Mild Dementia, and Moderate Dementia. The best results were achieved by VGG16, with a 0.9637 validation accuracy and a 0.9533 test accuracy score. A key finding documented in this work is the difficulty of classifying the transition from Non-Demented to Very Mild Demented stages, observed consistently across all ten architectures.