Artificial Intelligence > A Cognitive Compass: AI and the Aging Brain

A Cognitive Compass: AI and the Aging Brain

By Anne Connor Photography by Paul Flessland Illustrations by Alex Williamson

When David Jones, M.D., was a student at Georgetown University School of Medicine, his grandmother developed Alzheimer’s disease. Like millions of families impacted by Alzheimer’s, Dr. Jones’ family was devastated. Her disease came with anosognosia, right-hemisphere brain damage that kept her from understanding that she had memory trouble.

It also affected her vision in an indirect way, making it difficult for her to process visual signals, yet she thought she was “fine.” “With cortical blindness, you can’t see, but you don’t know it,” Dr. Jones says. “None of her caregivers realized she couldn’t see. In my practice, I see that same sequence of events, leading from mild memory syndrome to denial to cortical blindness. It’s easy to predict how the brain will look in those cases.”

After receiving his M.D. in neurology years later and starting his research lab, Dr. Jones named a phenotype of the disease after his grandmother, the “MFB variant.” The name is used internally for teaching purposes.

A Human Touch

For decades, Alzheimer’s and dementia have been the subjects of intense study. Today, Dr. Jones and researchers of his caliber can recognize brain changes as neurodegenerative conditions progress. By spotting patterns linked to a particular condition, healthcare professionals can identify dementia before symptoms become clinical, allowing early interventions.

But there are limits to what even the world’s top scientists can observe — limits that Dr. Jones is helping overcome as the director of artificial intelligence in the Department of Neurology at Mayo Clinic. Dr. Jones heads the Neurology Artificial Intelligence Program (NAIP), which helps clinicians diagnose neurological disorders through pattern recognition.

A significant advantage of artificial intelligence (AI) is its ability to find patterns in datasets with more inputs than any physician can consider. AI doesn’t replace human knowledge or physician expertise — it strengthens them.

“If physicians are aided by a technology that tells them about a pattern, they can provide better care,” Dr. Jones says. The Mayo Clinic Cloud includes some 16,000 brain images dating back about 15 years. That’s a lot of fodder for pattern recognition.

Dr. Jones sees a parallel between how physicians think when diagnosing and the work of his NAIP team. Physicians traditionally use tests and questions to spot patterns that fit what they know and have observed about diseases. AI does this too, but faster and with the ability to capture a vastly larger quantity of data. In building the NAIP’s tools, Dr. Jones and his team strive to capture that synergy.

“When we consult experts for diagnosis, they often tell a story about the outcome of a case where a patient had a particular feature,” he says. “That’s usually what solves the problem. The algorithm digitizes that process.”

Working with AI has clarified Dr. Jones’ thoughts about brain aging and degeneration and vice versa.

If physicians are aided by a technology that tells them about a pattern, they can provide better care.

“You want AI to recognize patterns, to speak and to reason. Degenerative diseases can take those abilities away from people,” he says. “All these things that we want to build into AI systems are things brains do. So they all inform each other.”

A Change of Direction

Little did Dr. Jones know early in life that his route would take him to the intersection of the human mind and AI. Instead, he trained as a thespian in high school, receiving a theater scholarship. But two transformative moments planted a seed in Dr. Jones’ life.

The first came when he went to a bookstore and accidentally purchased a copy of “Gödel, Escher, Bach: an Eternal Golden Braid,” by Douglas Hofstadter and decided to read it anyway. The 1979 Pulitzer Prize-winning nonfiction book wove together music, art, math and the then-distant possibility that AI could mimic human thought.

The second inclination of his fascination with the human mind came from a script he helped write based on characters from “The Man Who Mistook His Wife for a Hat,” by Oliver Sacks.

Dr. Jones played a person who lacked awareness of the body’s position in space, known as proprioception.

“I actually didn’t understand the condition at the time, so I didn’t play the role very well,” he recalls.

A Shift to Science

It was at Georgetown University that he became fascinated with neuroimaging and brain networks. He grasped the immense potential of machine learning technology and its ability to detect patterns.

After medical school, Dr. Jones joined Mayo Clinic and worked in the brain-imaging and cognitive-aging laboratory of Clifford Jack Jr., M.D., which further brought his scientific passions into focus.

From the day he arrived at Mayo, Dr. Jones has taken Mayo’s core value to heart: “The patient’s needs come first.” This value, he says, guides his teams in building systems that work well for patients.

“Physicians at Mayo now stand shoulder to shoulder with data scientists and software engineers. We understand enough about each others’ disciplines to speak a common language as a care team,” says Dr. Jones.

Dr. Jones is working toward a compassionate way to predict multiple neurological disorders based on a single brain scan. The current diagnostic process often requires numerous blood samples and other uncomfortable procedures. The new method offers many advantages to the patient: less travel, less time and expense, less invasive measures, and an earlier diagnosis.

Brain scans are just the beginning of AI’s usefulness. Dr. Jones sees a future where other diagnostic data can be digitized and overlaid on the same platform. That includes videos, voice samples, eye tracking, cognitive tests and more.

And who better to leverage AI than an organization world-renowned for its patient-centered approach? “Change should be led by people who understand the patient’s needs,” says Dr. Jones. And shoulder to shoulder, his multidisciplinary care team does just that.