Title
Automatic Spiral Analysis for Objective Assessment of Motor Symptoms in Parkinson's Disease
Abstract
A challenge for the clinical management of advanced Parkinson's disease (PD) patients is the emergence of fluctuations in motor performance, which represents a significant source of disability during activities of daily living of the patients. There is a lack of objective measurement of treatment effects for in-clinic and at-home use that can provide an overview of the treatment response. The objective of this paper was to develop a method for objective quantification of advanced PD motor symptoms related to off episodes and peak dose dyskinesia, using spiral data gathered by a touch screen telemetry device. More specifically, the aim was to objectively characterize motor symptoms (bradykinesia and dyskinesia), to help in automating the process of visual interpretation of movement anomalies in spirals as rated by movement disorder specialists. Digitized upper limb movement data of 65 advanced PD patients and 10 healthy (HE) subjects were recorded as they performed spiral drawing tasks on a touch screen device in their home environment settings. Several spatiotemporal features were extracted from the time series and used as inputs to machine learning methods. The methods were validated against ratings on animated spirals scored by four movement disorder specialists who visually assessed a set of kinematic features and the motor symptom. The ability of the method to discriminate between PD patients and HE subjects and the test-retest reliability of the computed scores were also evaluated. Computed scores correlated well with mean visual ratings of individual kinematic features. The best performing classifier (Multilayer Perceptron) classified the motor symptom (bradykinesia or dyskinesia) with an accuracy of 84% and area under the receiver operating characteristics curve of 0.86 in relation to visual classifications of the raters. In addition, the method provided high discriminating power when distinguishing between PD patients and HE subjects as well as had good test-retest reliability. This study demonstrated the potential of using digital spiral analysis for objective quantification of PD-specific and/or treatment-induced motor symptoms.
Year
DOI
Venue
2015
10.3390/s150923727
SENSORS
Keywords
Field
DocType
bradykinesia,digital spiral analysis,dyskinesia,machine learning,motor fluctuations,objective measures,Parkinson's disease,remote monitoring,time series analysis,visualization
Informatics,Spiral,Parkinson's disease,Activities of daily living,Receiver operating characteristic,Computer science,Neurology,Hypokinesia,Electronic engineering,Dyskinesia,Artificial intelligence,Physical medicine and rehabilitation
Journal
Volume
Issue
ISSN
15
9.0
1424-8220
Citations 
PageRank 
References 
4
0.61
11
Authors
9
Name
Order
Citations
PageRank
Mevludin Memedi1378.43
Aleksander Sadikov2539.96
Vida Groznik3193.45
Jure Žabkar4515.25
Martin Možina522316.90
filip bergquist6121.96
anders johansson791.09
dietrich haubenberger840.61
Dag Nyholm96911.95