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Fractal analysis for cognitive impairment classification in DAVF using machine learning
Jithin Sivan Sulaja1, Santhosh Kumar Kannath1, Ramshekhar N Menon2
1Dept. of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Trivandrum, Kerala, 695011, India.
Biomedical Physics & Engineering Express
|July 24, 2025
Summary
Nonfractal connectivity analysis of brain signals effectively identifies cognitive impairment in patients with intracranial dural arteriovenous fistulas (DAVFs), offering a promising biomarker for diagnosis.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Medical Imaging Analysis
Background:
- Intracranial dural arteriovenous fistulas (DAVFs) are acquired vascular abnormalities.
- Cognitive impairment is a common symptom in DAVFs, linked to disrupted brain network connectivity.
- Resting-state functional MRI (rsfMRI) is used to study brain connectivity, but fractal patterns in signals complicate analysis.
Purpose of the Study:
- To explore nonfractal connectivity as a potential biomarker for cognitive impairment in DAVF patients.
- To isolate short-memory components in BOLD signals to improve connectivity analysis.
- To differentiate cognitive impairment in DAVF patients using machine learning.
Main Methods:
- 50 DAVF patients and 50 controls underwent neuropsychological assessments and rsfMRI.
- Wavelet transforms decomposed BOLD signals into fractal and nonfractal components.
- Machine learning classifiers (SVM, decision trees) were trained on connectivity matrices for classification.
Main Results:
- Nonfractal connectivity achieved 89.82% accuracy in classifying cognitive impairment using SVM.
- Nonfractal measures outperformed fractal and Pearson correlation methods.
- High sensitivity (86.54%), specificity (92.4%), and AUC (0.96) were obtained for nonfractal connectivity.
Conclusions:
- Nonfractal connectivity shows promise as a biomarker for cognitive impairment in DAVF patients.
- This approach may aid in early diagnosis and intervention for DAVF-related cognitive deficits.
- Further validation with larger datasets is recommended to confirm findings and explore broader applications.

