Motor Impairment Estimates via Touchscreen Typing Dynamics Toward Parkinson's Disease Detection From Data Harvested In-the-Wild (original) (raw)
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JAMA neurology, 2018
Current Parkinson disease (PD) measures are subjective, rater-dependent, and assessed in clinic. Smartphones can measure PD features, yet no smartphone-derived rating score exists to assess motor symptom severity in real-world settings. To develop an objective measure of PD severity and test construct validity by evaluating the ability of the measure to capture intraday symptom fluctuations, correlate with current standard PD outcome measures, and respond to dopaminergic therapy. This observational study assessed individuals with PD who remotely completed 5 tasks (voice, finger tapping, gait, balance, and reaction time) on the smartphone application. We used a novel machine-learning-based approach to generate a mobile Parkinson disease score (mPDS) that objectively weighs features derived from each smartphone activity (eg, stride length from the gait activity) and is scaled from 0 to 100 (where higher scores indicate greater severity). Individuals with and without PD additionally co...
Scientific reports, 2018
Parkinson's disease (PD) is a degenerative movement disorder causing progressive disability that severely affects patients' quality of life. While early treatment can produce significant benefits for patients, the mildness of many early signs combined with the lack of accessible high-frequency monitoring tools may delay clinical diagnosis. To meet this need, user interaction data from consumer technologies have recently been exploited towards unsupervised screening for PD symptoms in daily life. Similarly, this work proposes a method for detecting fine motor skills decline in early PD patients via analysis of patterns emerging from finger interaction with touchscreen smartphones during natural typing. Our approach relies on low-/higher-order statistical features of keystrokes timing and pressure variables, computed from short typing sessions. Features are fed into a two-stage multi-model classification pipeline that reaches a decision on the subject's status (PD patient/...
Physiological measurement, 2018
To better understand the longitudinal characteristics of Parkinson's disease (PD) through the analysis of finger tapping and memory tests collected remotely using smartphones. Using a large cohort (312 PD subjects and 236 controls) of participants in the mPower study, we extract clinically validated features from a finger tapping and memory test to monitor the longitudinal behaviour of study participants. We investigate any discrepancy in learning rates associated with motor and non-motor tasks between PD subjects and healthy controls. The ability of these features to predict self-assigned severity measures is assessed whilst simultaneously inspecting the severity scoring system for floor-ceiling effects. Finally, we study the relationship between motor and non-motor longitudinal behaviour to determine if separate aspects of the disease are dependent on one another. We find that the test performances of the most severe subjects show significant correlations with self-assigned se...
The aim of this study is to accurately distinguish Parkinson's disease (PD) participants from healthy controls using self-administered tests of gait and postural sway. Using consumer-grade smartphones with in-built accelerometers, we objectively measure and quantify key movement severity symptoms of Parkinson's disease. Specifically, we record tri-axial accelerations, and extract a range of different features based on the time and frequencydomain properties of the acceleration time series. The features quantify key characteristics of the acceleration time series, and enhance the underlying differences in the gait and postural sway accelerations between PD participants and controls. Using a random forest classifier, we demonstrate an average sensitivity of 98.5% and average specificity of 97.5% in discriminating PD participants from controls.
Deep learning Parkinson's from smartphone data
2017 IEEE International Conference on Pervasive Computing and Communications (PerCom), 2017
The cloudUPDRS app is a Class I medical device, namely an active transient non-invasive instrument, certified by the Medicines and Healthcare products Regulatory Agency in the UK for the clinical assessment of the motor symptoms of Parkinson's Disease. The app follows closely the Unified Parkinson's Disease Rating Scale which is the most commonly used protocol in the clinical study of PD; can be used by patients and their carers at home or in the community; and, requires the user to perform a sequence of iterated movements which are recorded by the phone sensors. This paper discusses how the cloudUPDRS system addresses two key challenges towards meeting essential consistency and efficiency requirements, namely: (i) How to ensure high-quality data collection especially considering the unsupervised nature of the test, in particular, how to achieve firm user adherence to the prescribed movements; and (ii) How to reduce test duration from approximately 25 minutes typically required by an experienced patient, to below 4 minutes, a threshold identified as critical to obtain significant improvements in clinical compliance. To address the former, we combine a bespoke design of the user experience tailored so as to constrain context, with a deep learning approach used to identify failures to follow the movement protocol while at the same time limiting false positives to avoid unnecessary repetition. We address the latter by developing a machine learning approach to personalise assessments by selecting those elements of the UPDRS protocol that most closely match individual symptom profiles and thus offer the highest inferential power hence closely estimating the patent's overall UPRDS score. • Personalised tests reducing the time required to carry out an assessment to less than 4 minutes. These so-called quick tests are created using machine learning to select a subset of UPDRS observations that closely estimate the motor performance of a particular patient.
2014 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP), 2014
The aim of this study is to accurately distinguish Parkinson's disease (PD) participants from healthy controls using self-administered tests of gait and postural sway. Using consumer-grade smartphones with in-built accelerometers, we objectively measure and quantify key movement severity symptoms of Parkinson's disease. Specifically, we record tri-axial accelerations, and extract a range of different features based on the time and frequencydomain properties of the acceleration time series. The features quantify key characteristics of the acceleration time series, and enhance the underlying differences in the gait and postural sway accelerations between PD participants and controls. Using a random forest classifier, we demonstrate an average sensitivity of 98.5% and average specificity of 97.5% in discriminating PD participants from controls.
Building a Machine-Learning Framework to Remotely Assess Parkinson's Disease Using Smartphones
IEEE Transactions on Biomedical Engineering, 2020
Parkinson's disease (PD) is a neurodegenerative disorder that affects multiple neurological systems. Traditional PD assessment is conducted by a physician during infrequent clinic visits. Using smartphones, remote patient monitoring has the potential to obtain objective behavioral data semicontinuously, track disease fluctuations, and avoid rater dependency. Methods: Smartphones collect sensor data during various active tests and passive monitoring, including balance (postural instability), dexterity (skill in performing tasks using hands), gait (the pattern of walking), tremor (involuntary muscle contraction and relaxation), and voice. Some of the features extracted from smartphone data are potentially associated with specific PD symptoms identified by physicians. To leverage large-scale crossmodality smartphone features, we propose a machine-learning framework for performing automated disease assessment. The framework consists of a two-step feature selection procedure and a generic model based on the elastic-net regularization. Results: Using this framework, we map the PD-specific architecture of behaviors using data obtained from both PD participants and healthy controls (HCs). Utilizing these atlases of features, the framework shows promises to (a) discriminate PD participants from HCs, and (b) estimate the disease severity of individuals with PD. Significance: Data analysis results from 437 behavioral features obtained from 72 subjects (37 PD and 35 HC) sampled from 17 separate days during a period of up to six months suggest that this framework is potentially useful for the analysis of remotely collected smartphone sensor data in individuals with PD.
2019
Objective: To provide clinically-corroborated evidence of the Parkinson's disease (PD) diagnostic potential of machine learning-based approaches for motor symptoms severity inference via multimodal data, passively captured during the natural use of smartphones. Background: PD symptoms can be mild in the early stages and they usually go unnoticed, leaving the disease undiagnosed for years [1]. Subtle motor manifestations may start five to six years prior to PD clinical diagnosis and thereafter progress quickly [2]. Motor impairment affects daily activities and can severely impact patients' quality over the course of the disease. Information derived from mobile electronic sensors can provide, via algorithmic transformation, objective and dense information of an individual's motor status, allowing for frequent relevant symptoms early screening and subsequent monitoring.<br> Methodology: We analyzed longitudinal recordings of tri-axial accelerometer, voice and keystrok...
A smartphone-based system to quantify dexterity in Parkinson's disease patients
Informatics in Medicine Unlocked
Objectives: The aim of this paper is to investigate whether a smartphone-based system can be used to quantify dexterity in Parkinson's disease (PD). More specifically, the aim was to develop datadriven methods to quantify and characterize dexterity in PD. Methods: Nineteen advanced PD patients and 22 healthy controls participated in a clinical trial in Uppsala, Sweden. The subjects were asked to perform tapping and spiral drawing tests using a smartphone. Patients performed the tests before, and at pre-specified time points after they received 150% of their usual levodopa morning dose. Patients were video recorded and their motor symptoms were assessed by three movement disorder specialists using three Unified PD Rating Scale (UPDRS) motor items from part III, the dyskinesia scoring and the treatment response scale (TRS). The raw tapping and spiral data were processed and analyzed with time series analysis techniques to extract 37 spatiotemporal features. For each of the five scales, separate machine learning models were built and tested by using principal components of the features as predictors and mean ratings of the three specialists as target variables. Results: There were weak to moderate correlations between smartphone-based scores and mean ratings of UPDRS item #23 (0.52; finger tapping), UPDRS #25 (0.47; rapid alternating movements of hands), UPDRS #31 (0.57; body bradykinesia and hypokinesia), sum of the three UPDRS items (0.46), dyskinesia (0.64), and TRS (0.59). When assessing the test-retest reliability of the scores it was found that, in general, the clinical scores had better test-retest reliability than the smartphone-based scores. Only the smartphone-based predicted scores on the TRS and dyskinesia scales had good repeatability with intra-class correlation coefficients of 0.51 and 0.84, respectively. Clinician-based scores had higher effect sizes than smartphone-based scores indicating a better responsiveness in detecting changes in relation to treatment interventions. However, the first principal component of the 37 features was able to capture changes throughout the levodopa cycle and had trends similar to the clinical TRS and dyskinesia scales. Smartphone-based scores differed significantly between patients and healthy controls. Conclusions: Quantifying PD motor symptoms via instrumented, dexterity tests employed in a smartphone is feasible and data from such tests can also be used for measuring treatment-related changes in patients.