Automatic identification of Parkinsonism using clinical multi-contrast brain MRI: a large self-supervised vision foundation model strategy

作者：Xueling Suo, Mengyao Chen, Li Chen, Chunyan Luo, Graham J. Kemp, Su Lui, Huaiqiang Sun · 发表于：EBioMedicine · 年份：2025 · DOI：10.1016/j.ebiom.2025.105773 · 被引用次数：11 · 研究领域：Parkinson's Disease Mechanisms and Treatments、Voice and Speech Disorders、Neurological disorders and treatments

BACKGROUND: Valid non-invasive biomarkers for Parkinson's disease (PD) and Parkinson-plus syndrome (PPS) are urgently needed. Based on our recent self-supervised vision foundation model the Shift Window UNET TRansformer (Swin UNETR), which uses clinical multi-contrast whole brain MRI, we aimed to develop an efficient and practical model ('SwinClassifier') for the discrimination of PD vs PPS using routine clinical MRI scans. METHODS: We used 75,861 clinical head MRI scans including T1-weighted, T2-weighted and fluid attenuated inversion recovery imaging as a pre-training dataset to develop a foundation model, using self-supervised learning with a cross-contrast context recovery task. Then clinical head MRI scans from n = 1992 participants with PD and n = 1989 participants with PPS were used as a downstream PD vs PPS classification dataset. We then assessed SwinClassifier's performance in confusion matrices compared to a comparative self-supervised vanilla Vision Transformer (ViT) autoencoder ('ViTClassifier'), and to two convolutional neural networks (DenseNet121 and ResNet50) trained from scratch. FINDINGS: SwinClassifier showed very good performance (F1 score 0.83, 95% confidence interval [CI] [0.79-0.87], AUC 0.89) in PD vs PPS discrimination in independent test datasets (n = 173 participants with PD and n = 165 participants with PPS). This self-supervised classifier with pretrained weights outperformed the ViTClassifier and convolutional classifiers trained from scratch (F...