Wrist sensor-based tremor severity quantification in Parkinson's disease using convolutional neural network

Tremor is a commonly observed symptom in patients of Parkinson's disease (PD), and accurate measurement of tremor severity is essential in prescribing appropriate treatment to relieve its symptoms. We propose a tremor assessment system based on the use of a convolutional neural network (CNN) to differentiate the severity of symptoms as measured in data collected from a wearable device. Tremor signals were recorded from 92 PD patients using a custom-developed device (SNUMAP) equipped with an accelerometer and gyroscope mounted on a wrist module. Neurologists assessed the tremor symptoms on the Unified Parkinson's Disease Rating Scale (UPDRS) from simultaneously recorded video footages. The measured data were transformed into the frequency domain and used to construct a two-dimensional image for training the network, and the CNN model was trained by convolving tremor signal images with kernels. The proposed CNN architecture was compared to previously studied machine learning algorithms and found to outperform them (accuracy = 0.85, linear weighted kappa = 0.85). More precise monitoring of PD tremor symptoms in daily life could be possible using our proposed method.

[1]  Thomas O. Mera,et al.  Feasibility of home-based automated Parkinson's disease motor assessment , 2012, Journal of Neuroscience Methods.

[2]  Gaël Varoquaux,et al.  Scikit-learn: Machine Learning in Python , 2011, J. Mach. Learn. Res..

[3]  Tim Lüth,et al.  Quantitative Assessment of Parkinsonian Tremor Based on an Inertial Measurement Unit , 2015, Sensors.

[4]  Jimmy Ba,et al.  Adam: A Method for Stochastic Optimization , 2014, ICLR.

[5]  Kamiar Aminian,et al.  Quantification of Tremor and Bradykinesia in Parkinson's Disease Using a Novel Ambulatory Monitoring System , 2007, IEEE Transactions on Biomedical Engineering.

[6]  R. Elble Gravitational artifact in accelerometric measurements of tremor , 2005, Clinical Neurophysiology.

[7]  J. Jankovic,et al.  Correlation between Kinesia system assessments and clinical tremor scores in patients with essential tremor , 2010, Movement disorders : official journal of the Movement Disorder Society.

[8]  J. Jankovic,et al.  Continuous in-home monitoring of essential tremor. , 2014, Parkinsonism & related disorders.

[9]  J. Jankovic Parkinson’s disease: clinical features and diagnosis , 2008, Journal of Neurology, Neurosurgery, and Psychiatry.

[10]  Martín Abadi,et al.  TensorFlow: Large-Scale Machine Learning on Heterogeneous Distributed Systems , 2016, ArXiv.

[11]  James McNames,et al.  Using Portable Transducers to Measure Tremor Severity , 2016, Tremor and other hyperkinetic movements.

[12]  Lawrence D. Jackel,et al.  Handwritten Digit Recognition with a Back-Propagation Network , 1989, NIPS.

[13]  D. Heldman,et al.  Clinician versus machine: reliability and responsiveness of motor endpoints in Parkinson's disease. , 2014, Parkinsonism & related disorders.

[14]  Jan Raethjen,et al.  Assessment of Head Tremor with Accelerometers Versus Gyroscopic Transducers , 2017, Movement disorders clinical practice.

[15]  Dimitrios I. Fotiadis,et al.  Assessment of Tremor Activity in the Parkinson’s Disease Using a Set of Wearable Sensors , 2012, IEEE Transactions on Information Technology in Biomedicine.

[16]  Joseph P. Giuffrida,et al.  Clinically deployable Kinesia™ technology for automated tremor assessment , 2009, Movement disorders : official journal of the Movement Disorder Society.

[17]  Rodger J Elble,et al.  Digitizing Tablet and Fahn–Tolosa–Marín Ratings of Archimedes Spirals have Comparable Minimum Detectable Change in Essential Tremor , 2017, Tremor and other hyperkinetic movements.

[18]  Giovanni Mostile,et al.  Amplitude fluctuations in essential tremor. , 2012, Parkinsonism & related disorders.

[19]  P. O'Suilleabhain,et al.  Validation for tremor quantification of an electromagnetic tracking device , 2001, Movement disorders : official journal of the Movement Disorder Society.

[20]  Tim Lüth,et al.  Quantitative evaluation of Parkinson's disease using sensor based smart glove , 2011, 2011 24th International Symposium on Computer-Based Medical Systems (CBMS).

[21]  Hugh J. McDermott,et al.  Clinical validation of a precision electromagnetic tremor measurement system in participants receiving deep brain stimulation for essential tremor , 2016, Physiological measurement.

[22]  Marios Politis,et al.  Parkinson's disease symptoms: The patient's perspective , 2010, Movement disorders : official journal of the Movement Disorder Society.

[23]  Damien Querlioz,et al.  Using the Accelerometers Integrated in Smartphones to Evaluate Essential Tremor , 2015, Stereotactic and Functional Neurosurgery.

[24]  P. Thompson,et al.  Assessing tremor severity. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[25]  Max A. Little,et al.  Detecting and monitoring the symptoms of Parkinson's disease using smartphones: A pilot study. , 2015, Parkinsonism & related disorders.

[26]  Richard Walker,et al.  PD Disease State Assessment in Naturalistic Environments Using Deep Learning , 2015, AAAI.

[27]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[28]  Nathalie Japkowicz,et al.  The class imbalance problem: A systematic study , 2002, Intell. Data Anal..

[29]  Hugh J. McDermott,et al.  Evaluating machine learning algorithms estimating tremor severity ratings on the Bain–Findley scale , 2016 .

[30]  H. Diener,et al.  24 hour continuous tremor quantification based on EMG recording. , 1989, Electroencephalography and clinical neurophysiology.

[31]  J. Jankovic,et al.  Essential tremor quantification during activities of daily living. , 2011, Parkinsonism & related disorders.

[32]  J. Jankovic,et al.  Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results , 2008, Movement disorders : official journal of the Movement Disorder Society.

[33]  Mika P. Tarvainen,et al.  Linear and nonlinear tremor acceleration characteristics in patients with Parkinson's disease , 2012, Physiological measurement.

[34]  Paolo Bonato,et al.  Recent machine learning advancements in sensor-based mobility analysis: Deep learning for Parkinson's disease assessment , 2016, 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[35]  Tara N. Sainath,et al.  Deep Neural Networks for Acoustic Modeling in Speech Recognition: The Shared Views of Four Research Groups , 2012, IEEE Signal Processing Magazine.

[36]  Philip R. Cohen,et al.  Application of machine learning and numerical analysis to classify tremor in patients affected with essential tremor or Parkinson's disease , 2012 .