Intellectual and Developmental Disabilities (IDDs), such as Down syndrome, Fragile X syndrome, Rett syndrome, and autism spectrum disorder, usually manifest at birth or early childhood. IDDs are characterized by significant impairment in intellectual and adaptive functioning, and both genetic and environmental factors underpin IDD biology. Molecular and genetic stratification of IDDs remain challenging mainly due to overlapping factors and comorbidity. Advances in high throughput sequencing, imaging, and tools to record behavioral data at scale have greatly enhanced our understanding of the molecular, cellular, structural, and environmental basis of some IDDs. Fueled by the “big data” revolution, artificial intelligence (AI) and machine learning (ML) technologies have brought a whole new paradigm shift in computational biology. Evidently, the ML-driven approach to clinical diagnoses has the potential to augment classical methods that use symptoms and external observations, hoping to push the personalized treatment plan forward. Therefore, integrative analyses and applications of ML technology have a direct bearing on discoveries in IDDs. The application of ML to IDDs can potentially improve screening and early diagnosis, advance our understanding of the complexity of comorbidity, and accelerate the identification of biomarkers for clinical research and drug development. For more than five decades, the IDDRC network has supported a nexus of investigators at centers across the USA, all striving to understand the interplay between various factors underlying IDDs. In this review, we introduced fast-increasing multi-modal data types, highlighted example studies that employed ML technologies to illuminate factors and biological mechanisms underlying IDDs, as well as recent advances in ML technologies and their applications to IDDs and other neurological diseases. We discussed various molecular, clinical, and environmental data collection modes, including genetic, imaging, phenotypical, and behavioral data types, along with multiple repositories that store and share such data. Furthermore, we outlined some fundamental concepts of machine learning algorithms and presented our opinion on specific gaps that will need to be filled to accomplish, for example, reliable implementation of ML-based diagnosis technology in IDD clinics. We anticipate that this review will guide researchers to formulate AI and ML-based approaches to investigate IDDs and related conditions.

Genotype-phenotype association is found in many biological systems, such as brain-related diseases and behavioral traits. Despite the recent improvement in the prediction of phenotypes from genotypes, they can be further improved and explainability of these predictions remains challenging, primarily due to complex underlying molecular and cellular mechanisms. Emerging multimodal data enables studying such mechanisms at different scales from genotype to phenotypes involving intermediate phenotypes like gene expression. However, due to the black-box nature of many machine learning techniques, it is challenging to integrate these multi-modalities and interpret the biological insights in prediction, especially when some modality is missing. Biological knowledge has recently been incorporated into machine learning modeling to help understand the reasoning behind the choices made by these models. To this end, we developed DeepGAMI, an interpretable deep learning model to improve genotype-phenotype prediction from multimodal data. DeepGAMI uses prior biological knowledge to define the neural network architecture. Notably, it embeds an auxiliary-learning layer for cross-modal imputation while training the model from multimodal data. Using this pre-trained layer, we can impute latent features of additional modalities and thus enable predicting phenotypes from a single modality only. Finally, the model uses integrated gradient to prioritize multimodal features and links for phenotypes. We applied DeepGAMI to multiple emerging multimodal datasets: (1) population-level genotype and bulk-tissue gene expression data for predicting schizophrenia, (2) population-level genotype and gene expression data for predicting clinical phenotypes in Alzheimer's Disease, (3) gene expression and electrophysiological data of single neuronal cells in the mouse visual cortex, and (4) cell-type gene expression and genotype data for predicting schizophrenia. We found that DeepGAMI outperforms existing state-of-the-art methods and provides a profound understanding of gene regulatory mechanisms from genotype to phenotype, especially at cellular resolution.

Organoids have become valuable models for understanding cellular and molecular mechanisms in human development including brains. However, whether developmental gene expression programs are preserved between human organoids and brains, especially in specific cell types, remains unclear. Importantly, there is a lack of effective computational approaches for comparative data analyses between organoids and developing humans. To address this, by considering the public data availability and research significance, we developed a machine learning framework, Brain and Organoid Manifold Alignment (BOMA) for comparative gene expression analysis of brains and organoids, to identify conserved and specific developmental trajectories as well as developmentally expressed genes and functions, especially at cellular resolution. BOMA first performs a global alignment and then uses manifold learning to locally refine the alignment, revealing conserved developmental trajectories between brains and organoids. Using BOMA, we found that human cortical organoids better align with certain brain cortical regions than other non-cortical regions, implying organoid-preserved developmental gene expression programs specific to brain regions. Additionally, our alignment of non-human primate and human brains reveals highly conserved gene expression around birth. Also, we integrated and analyzed developmental scRNA-seq data of human brains and organoids, showing conserved and specific cell trajectories and clusters. Further identification of expressed genes of such clusters and enrichment analyses reveal brain- or organoid-specific developmental functions and pathways. Finally, we experimentally validated important specific expressed genes using immunofluorescence. BOMA is open-source available as a web tool for general community use.

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