skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: A deep explainable artificial intelligent framework for neurological disorders discrimination
Abstract Pathological hand tremor (PHT) is a common symptom of Parkinson’s disease (PD) and essential tremor (ET), which affects manual targeting, motor coordination, and movement kinetics. Effective treatment and management of the symptoms relies on the correct and in-time diagnosis of the affected individuals, where the characteristics of PHT serve as an imperative metric for this purpose. Due to the overlapping features of the corresponding symptoms, however, a high level of expertise and specialized diagnostic methodologies are required to correctly distinguish PD from ET. In this work, we propose the data-driven $$\text {NeurDNet}$$ NeurDNet model, which processes the kinematics of the hand in the affected individuals and classifies the patients into PD or ET. $$\text {NeurDNet}$$ NeurDNet is trained over 90 hours of hand motion signals consisting of 250 tremor assessments from 81 patients, recorded at the London Movement Disorders Centre, ON, Canada. The $$\text {NeurDNet}$$ NeurDNet outperforms its state-of-the-art counterparts achieving exceptional differential diagnosis accuracy of $$95.55\%$$ 95.55 % . In addition, using the explainability and interpretability measures for machine learning models, clinically viable and statistically significant insights on how the data-driven model discriminates between the two groups of patients are achieved.  more » « less
Award ID(s):
2037878 2031594
PAR ID:
10232327
Author(s) / Creator(s):
; ; ; ;
Date Published:
Journal Name:
Scientific Reports
Volume:
11
Issue:
1
ISSN:
2045-2322
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Tremor is one of the main symptoms of Parkinson’s Disease (PD) that reduces the quality of life. Tremor is measured as part of the Unified Parkinson Disease Rating Scale (UPDRS) part III. However, the assessment is based on onsite physical examinations and does not fully represent the patients’ tremor experience in their day-to-day life. Our objective in this paper was to develop algorithms that, combined with wearable sensors, can estimate total Parkinsonian tremor as the patients performed a variety of free body movements. We developed two methods: an ensemble model based on gradient tree boosting and a deep learning model based on long short-term memory (LSTM) networks. The developed methods were assessed on gyroscope sensor data from 24 PD subjects. Our analysis demonstrated that the method based on gradient tree boosting provided a high correlation (r = 0.96 using held-out testing and r = 0.93 using subject-based, leave-one-out cross-validation) between the estimated and clinically assessed tremor subscores in comparison to the LSTM-based method with a moderate correlation (r = 0.84 using held-out testing and r = 0.77 using subject-based, leave-one-out cross-validation). These results indicate that our approach holds great promise in providing a full spectrum of the patients’ tremor from continuous monitoring of the subjects’ movement in their natural environment. 
    more » « less
  2. Essential tremor (ET) is the most prevalent type of movement disorder responsible for inducing tremor in an individual’s limbs. Various scales, such as the Fahn-Tolosa-Marin (FTM) tremor rating scale and The Essential Tremor Rating Assessment Scale (TETRAS), have been developed and used by physicians to classify the severity of ET. While the FTM scale is highly utilized in ET severity diagnosis, it relies on subjective assessments of the tremor. TETRAS, on the other hand, provides a more quantitative analysis of ET severity by ranking the severity of the tremor based on tremor magnitude. However, TETRAS requires a trained professional (such as a neurologist) to be present, and even in such cases, physicians use TETRAS as a metric baseline to visually approximate the severity of the tremor. In this pilot study, a deep neural network (DNN)-based scale is developed to accurately classify ET severity without the presence of trained experts. To validate the developed DNN-based ET classification scale, a preliminary experiment is performed on a single healthy participant during a leg extension exercise. Tremor was artificially induced at the knee using a motorized lower-limb exoskeleton. To enable near real-time ET classification and to enable rapid DNN response, the DNN assessed the severity of ET every 0.5 seconds; utilizing the previous 0.5 seconds of knee-angle data for DNN training and ET severity classification. The results of the preliminary experiment showed that the DNN achieved a training accuracy of 94.80% and a validation accuracy of 95.18%. Additionally, the DNN achieved a training accuracy of 93.63% and a validation accuracy of 94.05% using computer generated knee-angle measurements. 
    more » « less
  3. Parkinson’s disease (PD) is a neurological progressive movement disorder, affecting more than 10 million people globally. PD demands a longitudinal assessment of symptoms to monitor the disease progression and manage the treatments. Existing assessment methods require patients with PD (PwPD) to visit a clinic every 3–6 months to perform movement assessments conducted by trained clinicians. However, periodic visits pose barriers as PwPDs have limited mobility, and healthcare cost increases. Hence, there is a strong demand for using telemedicine technologies for assessing PwPDs in remote settings. In this work, we present an in-home telemedicine kit, named iTex (intelligent Textile), which is a patient-centered design to carry out accessible tele-assessments of movement symptoms in people with PD. iTex is composed of a pair of smart textile gloves connected to a customized embedded tablet. iTex gloves are integrated with flex sensors on the fingers and inertial measurement unit (IMU) and have an onboard microcontroller unit with IoT (Internet of Things) capabilities including data storage and wireless communication. The gloves acquire the sensor data wirelessly to monitor various hand movements such as finger tapping, hand opening and closing, and other movement tasks. The gloves are connected to a customized tablet computer acting as an IoT device, configured to host a wireless access point, and host an MQTT broker and a time-series database server. The tablet also employs a patient-centered interface to guide PwPDs through the movement exam protocol. The system was deployed in four PwPDs who used iTex at home independently for a week. They performed the test independently before and after medication intake. Later, we performed data analysis of the in-home study and created a feature set. The study findings reported that the iTex gloves were capable to collect movement-related data and distinguish between pre-medication and post-medication cases in a majority of the participants. The IoT infrastructure demonstrated robust performance in home settings and offered minimum barriers for the assessment exams and the data communication with a remote server. In the post-study survey, all four participants expressed that the system was easy to use and poses a minimum barrier to performing the test independently. The present findings indicate that the iTex glove system has the potential for periodic and objective assessment of PD motor symptoms in remote settings. 
    more » « less
  4. This study investigated the effects of Parkinson’s disease (PD) and various linguistic factors on the degree of lenition in Spanish stops. Lenition was estimated from posterior probabilities calculated by recurrent neural networks trained to recognize sonorant and continuant phonological features. Firstly, individuals with PD exhibited a higher degree of lenition in their voiceless stops compared to healthy controls, suggesting that PD significantly impacts the articulatory control of stops, resulting in more pronounced lenition. Secondly, lenition was significantly more advanced for dental stops than bilabial stops, further suggesting that the muscles controlling tongue tip movement are more affected than those involved in lip movement among PD patients. These findings are consistent with previous literature. Importantly, the results highlight the sensitivity of Phonet in quantifying lenition in this group of PD patients. 
    more » « less
  5. Essential tremor (ET) is among the most prevalent movement disorders, but its origins are elusive. The inferior olivary nucleus (ION) has been hypothesized as the prime generator of tremor because of the pacemaker properties of ION neurons, but structural and functional changes in ION are unlikely under ET. Abnormalities have instead been reported in the cerebello-thalamo-cortical network, including dysfunctions of the GABAergic projections from the cerebellar cortex to the dentate nucleus. It remains unclear, though, how tremor would relate to a dysfunction of cerebellar connectivity. To address this question, we built a computational model of the cortico-cerebello-thalamo-cortical loop. We simulated the effects of a progressive loss of GABA A α 1 -receptor subunits and up-regulation of α 2/3 -receptor subunits in the dentate nucleus, and correspondingly, we studied the evolution of the firing patterns along the loop. The model closely reproduced experimental evidence for each structure in the loop. It showed that an alteration of amplitudes and decay times of the GABAergic currents to the dentate nucleus can facilitate sustained oscillatory activity at tremor frequency throughout the network as well as a robust bursting activity in the thalamus, which is consistent with observations of thalamic tremor cells in ET patients. Tremor-related oscillations initiated in small neural populations and spread to a larger network as the synaptic dysfunction increased, while thalamic high-frequency stimulation suppressed tremor-related activity in thalamus but increased the oscillation frequency in the olivocerebellar loop. These results suggest a mechanism for tremor generation under cerebellar dysfunction, which may explain the origin of ET. 
    more » « less