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Detecting Neurocognitive Disorders through Analyses of Topic Evolution and Cross-modal Consistency in Visual-Stimulated Narratives

Early detection of neurocognitive disorders (NCDs) is crucial for timely intervention and disease management. Given that language impairments manifest early in NCD progression, visual-stimulated narrative (VSN)-based analysis offers a promising avenue for NCD detection. Current VSN-based NCD detection methods primarily focus on linguistic microstructures (e.g., pauses, lexical diversity), which are potentially linked to bottom-up (stimulus-driven) cognitive processing. While these features illuminate basic language abilities, the higher-order linguistic macrostructures (e.g., thematic or logical development), which may reflect top-down (concept-driven) cognitive abilities, remain underexplored. These patterns are crucial for NCD detection yet challenging to quantify due to their abstract and complex nature. To bridge this gap, we propose two novel dynamic macrostructural approaches: (1) Dynamic Topic Model (DTM) to track topic evolution over time, and (2) Text-Image Temporal Alignment Network (TITAN) to measure cross-modal consistency between speech and visual stimuli. Experimental results validated the efficiency of proposed approaches in NCD detection, with TITAN achieving superior performance both on the CU-MARVEL-RABBIT corpus (F1 = 0.7238) and the ADReSS corpus (F1 = 0.8889). The feature contribution analysis revealed that macrostructural features (e.g., topic variability, topic change rate, and topic consistency) constituted the most significant contributors in the model's decision pathways, outperforming investigated microstructural features. These findings underscore the critical role of macrostructural patterns in understanding cognitive impairment mechanisms in NCDs.

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