Abstract

Machine learning algorithms that use data streams captured from soft wearable sensors have the potential to automatically detect PD symptoms and inform clinicians about the progression of disease. However, these algorithms must be trained with annotated data from clinical experts who can recognize symptoms, and collecting such data are costly. Understanding how many sensors and how much labeled data are required is key to successfully deploying these models outside of the clinic. Here we recorded movement data using 6 flexible wearable sensors in 20 individuals with PD over the course of multiple clinical assessments conducted on 1 day and repeated 2 weeks later. Participants performed 13 common tasks, such as walking or typing, and a clinician rated the severity of symptoms (bradykinesia and tremor). We then trained convolutional neural networks and statistical ensembles to detect whether a segment of movement showed signs of bradykinesia or tremor based on data from tasks performed by other individuals. Our results show that a single wearable sensor on the back of the hand is sufficient for detecting bradykinesia and tremor in the upper extremities, whereas using sensors on both sides does not improve performance. Increasing the amount of training data by adding other individuals can lead to improved performance, but repeating assessments with the same individuals—even at different medication states—does not substantially improve detection across days. Our results suggest that PD symptoms can be detected during a variety of activities and are best modeled by a dataset incorporating many individuals.

Highlights

  • Parkinson’s disease (PD) is a neurological movement disorder that affects ~1% of people above 60 years of age in industrialized countries.[1,2] Cardinal motor symptoms of PD that are responsive to levodopa therapy include tremors, rigidity, and slowness of movements

  • Random forest models trained on hand data yielded the highest mean Area under the receiver operating characteristic curve (AUROC) for both the detection of bradykinesia (0.73, 95% CI: 0.68–0.77) and tremor (0.79, 95% CI: 0.74–0.84) across all activities tremor or bradykinesia in upper extremities, as individuals with PD performed a series of common daily activities and standard tasks used in clinical assessments

  • We evaluated the effects on model performance of number and location of wearable sensors used, types of tasks performed by participants, and number of data npj Digital Medicine (2018) 64

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Summary

Introduction

Parkinson’s disease (PD) is a neurological movement disorder that affects ~1% of people above 60 years of age in industrialized countries.[1,2] Cardinal motor symptoms of PD that are responsive to levodopa therapy include tremors ( while at rest), rigidity, and slowness of movements (bradykinesia). Some individuals experience frequent changes in symptoms (‘OFF/ON’ state) or involuntary movements (dyskinesia) as a medication side effect,[5] which in turn, forces individual adjustments in dosing. Tracking how motor symptoms and their response to medication change over time is crucial in quantifying the progression of PD for a given individual, in order to craft personalized treatment regimens

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