Longitudinal Bayesian Learning of Continuous Disease Position across the Alzheimer's Disease Continuum

Alzheimer's disease (AD) progresses as a continuous biological process, whereas most existing neuroimaging-based artificial intelligence methods remain limited to discrete diagnosis or clinical score prediction from cross-sectional imaging. In this work, we propose Disease Continuum Positioning (DCP), a longitudinal Bayesian Learning framework that continuously estimates disease severity from longitudinal diffusion tensor imaging (DTI). Specifically, DCP models disease severity as a low-dimensional probabilistic latent variable by jointly integrating longitudinal observations with weak clinical supervision, from which the proposed Disease Continuum Score (DCS) is derived to quantify an individual's position along the Alzheimer's disease continuum together with its associated uncertainty. Extensive experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort demonstrate that DCP consistently outperforms representative disease progression methods. More importantly, comprehensive validation analyses show that DCS accurately characterizes disease severity, exhibits strong clinical relevance, preserves longitudinal disease evolution, and predicts future disease conversion. These results suggest that DCS provides a quantitative imaging-derived representation for continuous assessment of Alzheimer's disease progression beyond conventional diagnostic labels and clinical scores.

TensorLDM: A Component-Wise Latent Diffusion Model for Volumetric DTI Reconstruction from Sparse DWIs

Reconstructing diffusion tensors from sparse DWIs is critical for accelerating Diffusion Tensor Imaging (DTI) in clinical settings, yet current deep learning approaches frequently yield anatomically inconsistent or physically implausible tensors. We introduce TensorLDM, a component-wise latent diffusion model that processes the six tensor components through two group-specific encoders (for diagonal and off-diagonal elements) while maintaining anatomical consistency via shared DWI conditioning. TensorLDM uses an Anatomy-Conditioned Autoencoder that encourages the latent to focus on tensor properties rather than re-encoding structural information. A shared Cross-Component Attention (CCA) mechanism, applied in both autoencoder refinement and diffusion fine-tuning, models inter-component dependencies, while a Mixture-of-Experts (MoE) DWI conditioner provides component-adaptive conditioning. On the Human Connectome Project (HCP) dataset under a single-shell, four-volume sparse acquisition, TensorLDM produces the most accurate downstream tractography and tensors with near-ground-truth physical validity (SPD-violation rate 1.54% vs. 1.40%), with the best or comparable voxel-wise reconstruction accuracy. Geodesic tensor error measured by the Log-Euclidean Metric (LEM) corroborates these gains.