Towards Automated and Marker-less Parkinson Disease Assessment: Predicting UPDRS Scores using Sit-stand videos (original) (raw)
Related papers
Sensors
Wearable sensors provide a tool for at-home monitoring of motor impairment progression in neurological conditions such as Parkinson’s disease (PD). This study examined the ability of deep learning approaches to grade the motor impairment severity in a modified version of the Movement Disorders Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) using low-cost wearable sensors. We hypothesized that expanding training datasets with motion data from healthy older adults (HOAs) and initializing classifiers with weights learned from unsupervised pre-training would lead to an improvement in performance when classifying lower vs. higher motor impairment relative to a baseline deep learning model (XceptionTime). This study evaluated the change in classification performance after using expanded training datasets with HOAs and transferring weights from unsupervised pre-training compared to a baseline deep learning model (XceptionTime) using both upper extrem...
Quantifying Parkinson’s disease motor severity under uncertainty using MDS-UPDRS videos
Medical Image Analysis, 2021
Parkinson's disease (PD) is a brain disorder that primarily affects motor function, leading to slow movement, tremor, and stiffness, as well as postural instability and difficulty with walking/balance. The severity of PD motor impairments is clinically assessed by part III of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), a universally-accepted rating scale. However, experts often disagree on the exact scoring of individuals. In the presence of label noise, training a machine learning model using only scores from a single rater may introduce bias, while training models with multiple noisy ratings is a challenging task due to the inter-rater variabilities. In this paper, we introduce an ordinal focal neural network to estimate the MDS-UPDRS scores from input videos, to leverage the ordinal nature of MDS-UPDRS scores and combat class imbalance. To handle multiple noisy labels per exam, the training of the network is regularized via rater confusion estimation (RCE), which encodes the rating habits and skills of raters via a confusion matrix.
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.
Using AI to measure Parkinson’s disease severity at home
npj Digital Medicine, 2023
We present an artificial intelligence (AI) system to remotely assess the motor performance of individuals with Parkinson's disease (PD). In our study, 250 global participants performed a standardized motor task involving finger-tapping in front of a webcam. To establish the severity of Parkinsonian symptoms based on the finger-tapping task, three expert neurologists independently rated the recorded videos on a scale of 0-4, following the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The inter-rater reliability was excellent, with an intra-class correlation coefficient (ICC) of 0.88. We developed computer algorithms to obtain objective measurements that align with the MDS-UPDRS guideline and are strongly correlated with the neurologists' ratings. Our machine learning model trained on these measures outperformed two MDS-UPDRS certified raters, with a mean absolute error (MAE) of 0.58 points compared to the raters' average MAE of 0.83 points. However, the model performed slightly worse than the expert neurologists (0.53 MAE). The methodology can be replicated for similar motor tasks, providing the possibility of evaluating individuals with PD and other movement disorders remotely, objectively, and in areas with limited access to neurological care.
Multimodal assessment of Parkinson's disease: a deep learning approach
IEEE journal of biomedical and health informatics, 2018
Parkinson's disease is a neurodegenerative disorder characterized by a variety of motor symptoms. Particularly, difficulties to start/stop movements have been observed in patients. From a technical/diagnostic point of view, these movement changes can be assessed by modeling the transitions between voiced and unvoiced segments in speech, the movement when the patient starts or stops a new stroke in handwriting, or the movement when the patient starts or stops the walking process. This study proposes a methodology to model such difficulties to start or to stop movements considering information from speech, handwriting, and gait. We used those transitions to train convolutional neural networks to classify patients and healthy subjects. The neurological state of the patients was also evaluated according to different stages of the disease (initial, intermediate, and advanced). In addition, we evaluated the robustness of the proposed approach when considering speech signals in three d...
Clinically Informed Automated Assessment of Finger Tapping Videos in Parkinson’s Disease
Sensors
The utilization of Artificial Intelligence (AI) for assessing motor performance in Parkinson’s Disease (PD) offers substantial potential, particularly if the results can be integrated into clinical decision-making processes. However, the precise quantification of PD symptoms remains a persistent challenge. The current standard Unified Parkinson’s Disease Rating Scale (UPDRS) and its variations serve as the primary clinical tools for evaluating motor symptoms in PD, but are time-intensive and prone to inter-rater variability. Recent work has applied data-driven machine learning techniques to analyze videos of PD patients performing motor tasks, such as finger tapping, a UPDRS task to assess bradykinesia. However, these methods often use abstract features that are not closely related to clinical experience. In this paper, we introduce a customized machine learning approach for the automated scoring of UPDRS bradykinesia using single-view RGB videos of finger tapping, based on the extr...
Applied Sciences
As the world’s population is living longer, age-related neurodegenerative diseases are becoming a more significant global issue. Neurodegenerative diseases cause worsening motor, cognitive and autonomic dysfunction over time and reduce functional abilities required for daily living. Compromised motor performance is one of the first and most evident manifestations. In the case of Parkinson’s disease, these impairments are currently evaluated by experts through the use of rating scales. Although this method is widely used by experts worldwide, it includes subjective and error-prone motor examinations that also fail in the characterization of symptoms’ fluctuations. The aim of this study is to evaluate whether artificial intelligence techniques can be used to objectively assess gait impairment in subjects with Parkinson’s disease. This paper presents the results of a cohort of ten subjects, five with a Parkinson’s disease diagnosis at different degrees of severity. We experimentally de...
Video-based automated analysis of MDS-UPDRS III parameters in Parkinson disease
ABSTRACTBackgroundAmong motor symptoms of Parkinson’s disease (PD), including rigidity and resting tremor, bradykinesia is a mandatory feature to define the parkinsonian syndrome. MDS-UPDRS III is the worldwide reference scale to evaluate the parkinsonian motor impairment, especially bradykinesia. However, MDS-UPDRS III constitutes an agent-based score making reproducible measurements and follow-up challenging.ObjectivesUsing a deep learning approach, we developed a tool to compute an objective score of bradykinesia based on the gold-standard MDS-UPDRS III.MethodsIn the Movement Disorder unit of Avicenne University Hospital, we acquired a large database of videos of parkinsonian patients performing MDS-UPDRS III protocols. We applied two deep learning algorithms to detect a two-dimensional (2D) skeleton of the hand composed of 21 predefined points, and transposed it into a three-dimensional (3D) skeleton.ResultsWe developed a 2D and 3D automated analysis tool to study the evolution ...
Accessible, At-Home Detection of Parkinson's Disease via Multi-task Video Analysis
arXiv (Cornell University), 2024
Background Limited access to neurological care leads to missed diagnoses of Parkinson's disease (PD), leaving many individuals unidentified and untreated. While AI-driven video analysis has identified Parkinsonian symptoms from single motor or speech tasks, models trained on multiple tasks will be more robust. Methods We trained a novel neural network based fusion architecture to detect Parkinson's disease (PD) by analyzing features extracted from webcam recordings of three tasks: finger tapping, facial expression (smiling), and speech (uttering a sentence containing all letters of the alphabet). Additionally, the model incorporated Monte Carlo Dropout to improve prediction accuracy by considering uncertainties. The study participants were randomly split into three sets: 60% for training, 20% for model selection (hyper-parameter tuning), and 20% for final performance evaluation. An online demonstration of the tool is available at https://parktest.net/demo. Results The dataset consists of 1102 sessions from 845 participants (with PD: 272, female: 445, mean age: 61.9), each session containing videos of all three tasks. Our proposed model achieved significantly better accuracy, area under the ROC curve (AUROC), and sensitivity at non-inferior specificity compared to any single-task model. Withholding uncertain predictions further boosted the performance, achieving 88.0% (95% CI: 87.7%-88.4%) accuracy, 93.0% (92.8%-93.2%) AUROC, 79.3% (78.4%-80.2%) sensitivity, and 92.6% (92.3%-92.8%) specificity, at the expense of not being able to predict for 2.3% (2.0%-2.6%) data. Further analysis suggests that the trained model does not exhibit any detectable bias across sex and ethnic subgroups and is most effective for individuals aged between 50 and 80. Conclusions A video analytics tool assessing finger tapping, facial expression, and voice demonstrates promising accuracy in differentiating individuals with PD from those without. This accessible, low-cost approach requiring only an internet-enabled device with webcam and microphone paves the way for convenient PD screening at home, particularly in regions with limited access to clinical specialists.