Quantitative Cluster Headache Analysis for Neurological Diagnosis Support Using Statistical Classification

Cluster headache (CH) belongs to the group III of The International Classification of Headaches. It is characterized by attacks of severe pain in the ocular/periocular area accompanied by cranial autonomic signs, including parasympathetic activation and sympathetic hypofunction on the symptomatic side. Iris pigmentation occurs in the neonatal period and depends on the sympathetic tone in each eye. We hypothesized that the presence of visible or subtle color iris changes in both eyes could be used as a quantitative biomarker for screening and early detection of CH. This work scrutinizes the scope of an automatic diagnosis-support system for early detection of CH, by using as indicator the error rate provided by a statistical classifier designed to identify the eye (left vs. right) from iris pixels in color images. Systematic tests were performed on a database with images of 11 subjects (four with CH, four with other ophthalmic diseases affecting the iris pigmentation, and three control subjects). Several aspects were addressed to design the classifier, including: (a) the most convenient color space for the statistical classifier; (b) whether the use of features associated to several color spaces is convenient; (c) the robustness of the classifier to iris spatial subregions; (d) the contribution of the pixels neighborhood. Our results showed that a reduced value for the error rate (lower than 0.25) can be used as CH marker, whereas structural regions of the iris image need to be taken into account. The iris color feature analysis using statistical classification is a potentially useful technique to investigate disorders affecting the autonomous nervous system in CH.