An Explainable Self-Attention Deep Neural Network for Detecting Mild Cognitive Impairment Using Multi-input Digital Drawing Tasks

ABSTRACT Mild cognitive impairment (MCI) is an early stage of age-inappropriate cognitive decline, which could develop into dementia – an untreatable neurodegenerative disorder. An early detection of MCI is a crucial step for timely prevention and intervention. To tackle this problem, recent studies have developed deep learning models to detect MCI and various types of dementia using data obtained from the classic clock-drawing test (CDT), a popular neuropsychological screening tool that can be easily and rapidly implemented for assessing cognitive impairments in an aging population. While these models succeed at distinguishing severe forms of dementia, it is still difficult to predict the early stage of the disease using the CDT data alone. Also, the state-of-the-art deep learning techniques still face the black-box challenges, making it questionable to implement them in the clinical setting. Here, we propose a novel deep learning modeling framework that incorporates data from multiple drawing tasks including the CDT, cube-copying, and trail-making tasks obtained from a digital platform. Using self-attention and soft-label methods, our model achieves much higher classification performance at detecting MCI compared to those of a well-established convolutional neural network model. Moreover, our model can highlight features of the MCI data that considerably deviate from those of the healthy aging population, offering accurate predictions for detecting MCI along with visual explanation that aids the interpretation of the deep learning model.