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. 2025 Aug 26;20(8):e0317968.
doi: 10.1371/journal.pone.0317968. eCollection 2025.

Enhancing the early detection of Alzheimer's disease using an integrated CNN-LSTM framework: A robust approach for fMRI-based multi-stage classification

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Enhancing the early detection of Alzheimer's disease using an integrated CNN-LSTM framework: A robust approach for fMRI-based multi-stage classification

Saima Farhan et al. PLoS One. .

Abstract

Alzheimer's Disease poses a significant challenge as a progressive and irreversible neurological condition striking the elderly population. Its incurable nature correlates with a significant rise in death rates. However, early detection can slow its progression and facilitate prompt intervention, thereby mitigating mortality risks. Functional Magnetic Resonance Imaging (fMRI) provides valuable insights into the functional changes within distinct brain regions associated with the disease. The recent research efforts have extracted functional connectivity measures for the classification. These handcrafted functional connectivity features are usually not robust and are computationally intensive. To address the issue, this study introduces an integrated deep-learning framework based on CNN and LSTM networks. This framework autonomously learns both intra-volume and inter-volume features critical for classification tasks. CNNs facilitate feature extraction, while LSTM networks govern the selection of significant features for classification. The key aim of this study is to classify Alzheimer's disease and its prodromal stage, Mild Cognitive Impairment (MCI). MCI is further categorized as early MCI (EMCI) and late MCI (LMCI). We have evaluated the framework in three dimensions, binary classification, multi-class classification with 3-classes, and multi-class classification with 4-classes. For each dimension, multiple classifications were performed. The results depict the proposed CNN-LSTM framework to attain 99% accuracy and 100% average area under the curve for the majority of the classification.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The overall architecture of the proposed study.
Fig 2
Fig 2. Data preprocessing steps.
Fig 3
Fig 3. Intra volume feature extraction.
Fig 4
Fig 4. Inter volume feature extraction using LSTM layer, FV: feature vector.
Fig 5
Fig 5. ROC curves of all classification, a) to h) represent the binary classification, i) to k) represent the 3-class classification, and l) represent the 4-class classification.

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