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: Multi-Shared-Task Self-Supervised CNN-LSTM for Monitoring Free-Body Movement UPDRS-III Using Wearable Sensors
The Unified Parkinson’s Disease Rating Scale (UPDRS) is used to recognize patients with Parkinson’s disease (PD) and rate its severity. The rating is crucial for disease progression monitoring and treatment adjustment. This study aims to advance the capabilities of PD management by developing an innovative framework that integrates deep learning with wearable sensor technology to enhance the precision of UPDRS assessments. We introduce a series of deep learning models to estimate UPDRS Part III scores, utilizing motion data from wearable sensors. Our approach leverages a novel Multi-shared-task Self-supervised Convolutional Neural Network–Long Short-Term Memory (CNN-LSTM) framework that processes raw gyroscope signals and their spectrogram representations. This technique aims to refine the estimation accuracy of PD severity during naturalistic human activities. Utilizing 526 min of data from 24 PD patients engaged in everyday activities, our methodology demonstrates a strong correlation of 0.89 between estimated and clinically assessed UPDRS-III scores. This model outperforms the benchmark set by single and multichannel CNN, LSTM, and CNN-LSTM models and establishes a new standard in UPDRS-III score estimation for free-body movements compared to recent state-of-the-art methods. These results signify a substantial step forward in bioengineering applications for PD monitoring, providing a robust framework for reliable and continuous assessment of PD symptoms in daily living settings.  more » « less
Award ID(s):
1942669 1936586
PAR ID:
10579103
Author(s) / Creator(s):
; ;
Publisher / Repository:
MDPI
Date Published:
Journal Name:
Bioengineering
Volume:
11
Issue:
7
ISSN:
2306-5354
Page Range / eLocation ID:
689
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. null (Ed.)
    Abstract Background Unified Parkinson Disease Rating Scale-part III (UPDRS III) is part of the standard clinical examination performed to track the severity of Parkinson’s disease (PD) motor complications. Wearable technologies could be used to reduce the need for on-site clinical examinations of people with Parkinson’s disease (PwP) and provide a reliable and continuous estimation of the severity of PD at home. The reported estimation can be used to successfully adjust the dose and interval of PD medications. Methods We developed a novel algorithm for unobtrusive and continuous UPDRS-III estimation at home using two wearable inertial sensors mounted on the wrist and ankle. We used the ensemble of three deep-learning models to detect UPDRS-III-related patterns from a combination of hand-crafted features, raw temporal signals, and their time–frequency representation. Specifically, we used a dual-channel, Long Short-Term Memory (LSTM) for hand-crafted features, 1D Convolutional Neural Network (CNN)-LSTM for raw signals, and 2D CNN-LSTM for time–frequency data. We utilized transfer learning from activity recognition data and proposed a two-stage training for the CNN-LSTM networks to cope with the limited amount of data. Results The algorithm was evaluated on gyroscope data from 24 PwP as they performed different daily living activities. The estimated UPDRS-III scores had a correlation of $$0.79\, (\textit{p}<0.0001)$$ 0.79 ( p < 0.0001 ) and a mean absolute error of 5.95 with the clinical examination scores without requiring the patients to perform any specific tasks. Conclusion Our analysis demonstrates the potential of our algorithm for estimating PD severity scores unobtrusively at home. Such an algorithm could provide the required motor-complication measurements without unnecessary clinical visits and help the treating physician provide effective management of the disease. 
    more » « less
  2. 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
  3. null (Ed.)
    Abstract Levodopa-induced dyskinesias are abnormal involuntary movements experienced by the majority of persons with Parkinson’s disease (PwP) at some point over the course of the disease. Choreiform as the most common phenomenology of levodopa-induced dyskinesias can be managed by adjusting the dose/frequency of PD medication(s) based on a PwP’s motor fluctuations over a typical day. We developed a sensor-based assessment system to provide such information. We used movement data collected from the upper and lower extremities of 15 PwPs along with a deep recurrent model to estimate dyskinesia severity as they perform different activities of daily living (ADL). Subjects performed a variety of ADLs during a 4-h period while their dyskinesia severity was rated by the movement disorder experts. The estimated dyskinesia severity scores from our model correlated highly with the expert-rated scores ( r = 0.87 ( p < 0.001)), which was higher than the performance of linear regression that is commonly used for dyskinesia estimation ( r = 0.81 ( p < 0.001)). Our model provided consistent performance at different ADLs with minimum r = 0.70 (during walking) to maximum r = 0.84 (drinking) in comparison to linear regression with r = 0.00 (walking) to r = 0.76 (cutting food). These findings suggest that when our model is applied to at-home sensor data, it can provide an accurate picture of changes of dyskinesia severity facilitating effective medication adjustments. 
    more » « less
  4. IntroductionParkinson’s disease (PD) is a neurodegenerative disorder affecting millions of patients. Closed-Loop Deep Brain Stimulation (CL-DBS) is a therapy that can alleviate the symptoms of PD. The CL-DBS system consists of an electrode sending electrical stimulation signals to a specific region of the brain and a battery-powered stimulator implanted in the chest. The electrical stimuli in CL-DBS systems need to be adjusted in real-time in accordance with the state of PD symptoms. Therefore, fast and precise monitoring of PD symptoms is a critical function for CL-DBS systems. However, the current CL-DBS techniques suffer from high computational demands for real-time PD symptom monitoring, which are not feasible for implanted and wearable medical devices. MethodsIn this paper, we present an energy-efficient neuromorphic PD symptom detector using memristive three-dimensional integrated circuits (3D-ICs). The excessive oscillation at beta frequencies (13–35 Hz) at the subthalamic nucleus (STN) is used as a biomarker of PD symptoms. ResultsSimulation results demonstrate that our neuromorphic PD detector, implemented with an 8-layer spiking Long Short-Term Memory (S-LSTM), excels in recognizing PD symptoms, achieving a training accuracy of 99.74% and a validation accuracy of 99.52% for a 75%–25% data split. Furthermore, we evaluated the improvement of our neuromorphic CL-DBS detector using NeuroSIM. The chip area, latency, energy, and power consumption of our CL-DBS detector were reduced by 47.4%, 66.63%, 65.6%, and 67.5%, respectively, for monolithic 3D-ICs. Similarly, for heterogeneous 3D-ICs, employing memristive synapses to replace traditional Static Random Access Memory (SRAM) resulted in reductions of 44.8%, 64.75%, 65.28%, and 67.7% in chip area, latency, and power usage. DiscussionThis study introduces a novel approach for PD symptom evaluation by directly utilizing spiking signals from neural activities in the time domain. This method significantly reduces the time and energy required for signal conversion compared to traditional frequency domain approaches. The study pioneers the use of neuromorphic computing and memristors in designing CL-DBS systems, surpassing SRAM-based designs in chip design area, latency, and energy efficiency. Lastly, the proposed neuromorphic PD detector demonstrates high resilience to timing variations in brain neural signals, as confirmed by robustness analysis. 
    more » « less
  5. Abstract BackgroundThe research gap addressed in this study is the applicability of deep neural network (NN) models on wearable sensor data to recognize different activities performed by patients with Parkinson’s Disease (PwPD) and the generalizability of these models to PwPD using labeled healthy data. MethodsThe experiments were carried out utilizing three datasets containing wearable motion sensor readings on common activities of daily living. The collected readings were from two accelerometer sensors. PAMAP2 and MHEALTH are publicly available datasets collected from 10 and 9 healthy, young subjects, respectively. A private dataset of a similar nature collected from 14 PwPD patients was utilized as well. Deep NN models were implemented with varying levels of complexity to investigate the impact of data augmentation, manual axis reorientation, model complexity, and domain adaptation on activity recognition performance. ResultsA moderately complex model trained on the augmented PAMAP2 dataset and adapted to the Parkinson domain using domain adaptation achieved the best activity recognition performance with an accuracy of 73.02%, which was significantly higher than the accuracy of 63% reported in previous studies. The model’s F1 score of 49.79% significantly improved compared to the best cross-testing of 33.66% F1 score with only data augmentation and 2.88% F1 score without data augmentation or domain adaptation. ConclusionThese findings suggest that deep NN models originating on healthy data have the potential to recognize activities performed by PwPD accurately and that data augmentation and domain adaptation can improve the generalizability of models in the healthy-to-PwPD transfer scenario. The simple/moderately complex architectures tested in this study could generalize better to the PwPD domain when trained on a healthy dataset compared to the most complex architectures used. The findings of this study could contribute to the development of accurate wearable-based activity monitoring solutions for PwPD, improving clinical decision-making and patient outcomes based on patient activity levels. 
    more » « less