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Register a new userGranular Motor State Monitoring of Free Living Parkinsons Disease Patients via Deep Learning
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Parkinsons disease (PD) is the second most common neurodegenerative disease worldwide and affects around 1% of the (60+ years old) elderly population in industrial nations. More than 80% of PD patients suffer from motor symptoms, which could be well addressed if a personalized medication schedule and dosage could be administered to them. However, such personalized medication schedule requires a continuous, objective and precise measurement of motor symptoms experienced by the patients during their regular daily activities. In this work, we propose the use of a wrist-worn smart-watch, which is equipped with 3D motion sensors, for estimating the motor fluctuation severity of PD patients in a free-living environment. We introduce a novel network architecture, a post-training scheme and a custom loss function that accounts for label noise to improve the results of our previous work in this domain and to establish a novel benchmark for nine-level PD motor state estimation.
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One major challenge in the medication of Parkinsons disease is that the severity of the disease, reflected in the patients motor state, cannot be measured using accessible biomarkers. Therefore, we develop and examine a variety of statistical models to detect the motor state of such patients based on sensor data from a wearable device. We find that deep learning models consistently outperform a classical machine learning model applied on hand-crafted features in this time series classification task. Furthermore, our results suggest that treating this problem as a regression instead of an ordinal regression or a classification task is most appropriate. For consistent model evaluation and training, we adopt the leave-one-subject-out validation scheme to the training of deep learning models. We also employ a class-weighting scheme to successfully mitigate the problem of high multi-class imbalances in this domain. In addition, we propose a customized performance measure that reflects the requirements of the involved medical staff on the model. To solve the problem of limited availability of high quality training data, we propose a transfer learning technique which helps to improve model performance substantially. Our results suggest that deep learning techniques offer a high potential to autonomously detect motor states of patients with Parkinsons disease.
Parkinsons disease (PD) is a progressive neurological disorder primarily affecting motor function resulting in tremor at rest, rigidity, bradykinesia, and postural instability. The physical severity of PD impairments can be quantified through the Movement Disorder Society Unified Parkinsons Disease Rating Scale (MDS-UPDRS), a widely used clinical rating scale. Accurate and quantitative assessment of disease progression is critical to developing a treatment that slows or stops further advancement of the disease. Prior work has mainly focused on dopamine transport neuroimaging for diagnosis or costly and intrusive wearables evaluating motor impairments. For the first time, we propose a computer vision-based model that observes non-intrusive video recordings of individuals, extracts their 3D body skeletons, tracks them through time, and classifies the movements according to the MDS-UPDRS gait scores. Experimental results show that our proposed method performs significantly better than chance and competing methods with an F1-score of 0.83 and a balanced accuracy of 81%. This is the first benchmark for classifying PD patients based on MDS-UPDRS gait severity and could be an objective biomarker for disease severity. Our work demonstrates how computer-assisted technologies can be used to non-intrusively monitor patients and their motor impairments. The code is available at https://github.com/mlu355/PD-Motor-Severity-Estimation.
The study reports the performance of Parkinsons disease (PD) patients to operate Motor-Imagery based Brain-Computer Interface (MI-BCI) and compares three selected pre-processing and classification approaches. The experiment was conducted on 7 PD patients who performed a total of 14 MI-BCI sessions targeting lower extremities. EEG was recorded during the initial calibration phase of each session, and the specific BCI models were produced by using Spectrally weighted Common Spatial Patterns (SpecCSP), Source Power Comodulation (SPoC) and Filter-Bank Common Spatial Patterns (FBCSP) methods. The results showed that FBCSP outperformed SPoC in terms of accuracy, and both SPoC and SpecCSP in terms of the false-positive ratio. The study also demonstrates that PD patients were capable of operating MI-BCI, although with lower accuracy.
Over the years motor deficit in Parkinsons Disease (PD) patients was largely studied, however, no consistent pattern of relations between quantitative electroencephalography (qEEG) and motor scales emerged. There is a general lack of information on the relation between EEG changes and scales related to specific motor deficits. Therefore, the study aimed to investigate the relation between brain oscillatory activity alterations (EEG power bands) and most used PD-related motor deficit scales. A positive correlation was found between the freezing of the gait questionnaire (FOGQ) and delta spectral power band (rho=0.67; p=0.008), while a negative correlation with the same scale was observed in the alpha spectral power band (rho=-0.59, p=0.027). Additionally, motor scores measure by motor part of Unified Parkinsons Disease Rating Scale (UPDRS) correlated directly with theta (rho=0.55, p=0.040) and inversely with beta EEG power band (rho=-0.77, p=0.001). No significant correlation was found between spectral powers and Hoehn and Yahr (H&Y), BERG (Berg K. et. al. 1995), Modified Parkinson Activity Scale (MPAS), Six-Minute Walk Test (6MWT) and Timed Up and Go Test (TUG). In conclusion, our study supports the earlier findings suggesting a link between EEG slowing and motor decline, providing more insight into the relation between EEG alteration and deficits in different motor domains. These findings indicate that EEG assessment may be a useful biomarker for objective monitoring of progression and neurophysiological effect of rehabilitation approaches in PDs.
Motor-Imagery based BCI (MI-BCI) neurorehabilitation can improve locomotor ability and reduce the deficit symptoms in Parkinsons Disease patients. Advanced Motor-Imagery BCI methods are needed to overcome the accuracy and time-related MI BCI calibration challenges in such patients. In this study, we proposed a Multi-session FBCSP (msFBCSP) based on inter-session transfer learning and we investigated its performance compared to the single-session based FBSCP. The main result of this study is the significantly improved accuracy obtained by proposed msFBCSP compared to single-session FBCSP in PD patients (median 81.3%, range 41.2-100.0% vs median 61.1%, range 25.0-100.0%, respectively; p<0.001). In conclusion, this study proposes a transfer learning-based multi-session based FBCSP approach which allowed to significantly improve calibration accuracy in MI BCI performed on PD patients.
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