Abstract
BackgroundAssessment and rating of Parkinson’s Disease (PD) are commonly based on the medical observation of several clinical manifestations, including the analysis of motor activities. In particular, medical specialists refer to the MDS-UPDRS (Movement Disorder Society – sponsored revision of Unified Parkinson’s Disease Rating Scale) that is the most widely used clinical scale for PD rating. However, clinical scales rely on the observation of some subtle motor phenomena that are either difficult to capture with human eyes or could be misclassified. This limitation motivated several researchers to develop intelligent systems based on machine learning algorithms able to automatically recognize the PD. Nevertheless, most of the previous studies investigated the classification between healthy subjects and PD patients without considering the automatic rating of different levels of severity.MethodsIn this context, we implemented a simple and low-cost clinical tool that can extract postural and kinematic features with the Microsoft Kinect v2 sensor in order to classify and rate PD. Thirty participants were enrolled for the purpose of the present study: sixteen PD patients rated according to MDS-UPDRS and fourteen healthy paired subjects. In order to investigate the motor abilities of the upper and lower body, we acquired and analyzed three main motor tasks: (1) gait, (2) finger tapping, and (3) foot tapping. After preliminary feature selection, different classifiers based on Support Vector Machine (SVM) and Artificial Neural Networks (ANN) were trained and evaluated for the best solution.ResultsConcerning the gait analysis, results showed that the ANN classifier performed the best by reaching 89.4% of accuracy with only nine features in diagnosis PD and 95.0% of accuracy with only six features in rating PD severity. Regarding the finger and foot tapping analysis, results showed that an SVM using the extracted features was able to classify healthy subjects versus PD patients with great performances by reaching 87.1% of accuracy. The results of the classification between mild and moderate PD patients indicated that the foot tapping features were the most representative ones to discriminate (81.0% of accuracy).ConclusionsThe results of this study have shown how a low-cost vision-based system can automatically detect subtle phenomena featuring the PD. Our findings suggest that the proposed tool can support medical specialists in the assessment and rating of PD patients in a real clinical scenario.
Highlights
Assessment and rating of Parkinson’s Disease (PD) are commonly based on the medical observation of several clinical manifestations, including the analysis of motor activities
Considering the Case A, i.e. "Healthy subjects vs PD patients" classification, we reported the results of the best trained Support Vector Machine (SVM)-based classifier: the Gaussian SVM reached an accuracy of 71.0% (±2.4), a sensitivity of 75.7% (±1.4) and a specificity of 65.5% (±1.4); the Gaussian SVM reached an accuracy of 85.5% (±1.7), a sensitivity of 91.0% (±4.2) and a specificity of 79.0% (±5.2); the Quadratic SVM reached an accuracy of 87.1% (±3.6), a sensitivity of 87.8% (±3.1) and a specificity of 86.0% (±1.7)
We found out that postural features were relevant in both cases and to our knowledge no previous studies have investigated in depth the role of these components in classification and rating of PD
Summary
Assessment and rating of Parkinson’s Disease (PD) are commonly based on the medical observation of several clinical manifestations, including the analysis of motor activities. Regarding the finger and foot tapping analysis, results showed that an SVM using the extracted features was able to classify healthy subjects versus PD patients with great performances by reaching 87.1% of accuracy. PD diagnosis is typically made by analyzing motor symptoms with clinical scales, such as the Movement Disorder Society – sponsored revision of Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) [5] and the Hoehn & Yahr (HY) [6]. PD early signs may be mild and go unnoticed and symptoms often begin on one side of the body and usually remain worse on that side, even after symptoms begin to affect both sides With this evidence, the development of computer-assisted diagnosis and computer-expert systems is very important [7, 8], especially when dealing with motor features. A tool that can help neurologists to objectively quantify small changes in motion performance is needed to have a quantitative assessment of the disease
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