Machine Learning for Prediction of Cognitive Deterioration in Patients with Early Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative disorder marked by motor and cognitive impairments. The early prediction of cognitive deterioration in PD is crucial. This work aims to predict the change in the Montreal Cognitive Assessment (MoCA) at years 4 and 5 from baseline in the Parkinson’s Progression Markers Initiative database. The predictors included demographic and clinical variables: motor and non-motor symptoms from the baseline visit and change scores from baseline to the first-year follow-up. Various regression models were compared, and SHAP (SHapley Additive exPlanations) values were used to assess domain importance, while model coefficients evaluated variable importance. The LASSOLARS algorithm outperforms other models, achieving lowest the MAE, 1.55±0.23 and 1.56±0.19, for the fourth- and fifth-year predictions, respectively. Moreover, when trained to predict the average MoCA score change across both time points, its performance improved, reducing its MAE by 19%. Baseline MoCA scores and MoCA deterioration over the first-year were the most influential predictors of PD (highest model coefficients). However, the cumulative effect of other cognitive variables also contributed significantly. This study demonstrates that mid-term cognitive deterioration in PD can be accurately predicted from patients’ baseline cognitive performance and short-term cognitive deterioration, along with a few easily measurable clinical measurements.