Uncover Governing Law of Pathology Propagation Mechanism Through A Mean-Field Game

Alzheimer’s disease (AD) is marked by cognitive decline along with the widespread of tau aggregates across the brain cortex. Due to the challenges of imaging pathology spreading flows *in vivo*, however, quantitative analysis on the cortical pathways of tau propagation and its interaction with the cascade of amyloid-beta (A$\beta$) plaques lags behind the experimental insights of underlying pathophysiological mechanisms. To address this challenge, we present a physics-informed neural network, empowered by mean-field theory, to uncover the biologically meaningful spreading pathways of tau aggregates between two longitudinal snapshots. Following the notion of `prion-like' mechanism in AD, we first formulate the dynamics of tau propagation as a mean-field game (MFG), where the spread of tau aggregate at each location (aka. agent) depends on the collective behavior of the surrounding agents as well as the potential field formed by amyloid burden. Given the governing equation of propagation dynamics, MFG reaches an equilibrium that allows us to model the evolution of tau aggregates as an optimal transport with the lowest cost in *Wasserstein* space. By leveraging the variational primal-dual structure in MFG, we propose a *Wasserstein*-1 Lagrangian generative adversarial network (GAN), in which a Lipschitz critic seeks the appropriate transport cost at the population level and a generator parameterizes the flow fields of optimal transport across individuals. Additionally, we incorporate a symbolic regression module to derive an explicit formulation capturing the A$\beta$-tau crosstalk. Experimental results on public neuroimaging datasets demonstrate that our explainable deep model not only yields precise and reliable predictions of future tau progression for unseen new subjects but also provides a new window to uncover new understanding of pathology propagation in AD through learning-based approaches.