A Self-Supervised Metric Learning Framework for the Arising-From-Chair Assessment of Parkinsonians With Graph Convolutional Networks

The onset and progression of Parkinson’s disease (PD) gradually affect the patient’s motor functions and quality of life. The PD motor symptoms are usually assessed using the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Automated MDS-UPDRS assessment has been recently required as an invaluable tool for PD diagnosis and telemedicine, especially with the recent novel coronavirus pandemic outbreak. This paper proposes a novel vision-based method for automated assessment of the arising-from-chair task, which is one of the key MDS-UPDRS components. The proposed method is based on a self-supervised metric learning scheme with a graph convolutional network (SSM-GCN). Specifically, for human skeleton sequences extracted from videos, a self-supervised intra-video quadruplet learning strategy is proposed to construct a metric learning formulation with prior knowledge, for improving the spatial-temporal representations. Afterwards, a vertex-specific convolution operation is designed to achieve effective aggregation of all skeletal joint features, where each joint or feature is weighted differently based on its relative factor of importance. Finally, a graph representation supervised mechanism is developed to maximize the potential consistency between the joint and bone information streams. Experimental results on a clinical dataset demonstrate the superiority of the proposed method over the existing sensor-based methods, with an accuracy of 70.60% and an acceptable accuracy of 98.65%. The analysis of discriminative spatial connections makes our predictions more clinically interpretable. This method can achieve reliable automated PD assessment using only easily-obtainable videos, thus providing an effective tool for real-time PD diagnosis or remote continuous monitoring.

[1]  H. Meng,et al.  Self-Supervised Representation Learning for Videos by Segmenting via Sampling Rate Order Prediction , 2022, IEEE Transactions on Circuits and Systems for Video Technology.

[2]  Yonghong Hou,et al.  A Central Difference Graph Convolutional Operator for Skeleton-Based Action Recognition , 2021, IEEE Transactions on Circuits and Systems for Video Technology.

[3]  Josef Kittler,et al.  Graph2Net: Perceptually-Enriched Graph Learning for Skeleton-Based Action Recognition , 2021, IEEE Transactions on Circuits and Systems for Video Technology.

[4]  Chencheng Zhang,et al.  Automated assessment of Parkinsonian finger-tapping tests through a vision-based fine-grained classification model , 2021, Neurocomputing.

[5]  Min Jiang,et al.  Symmetrical Enhanced Fusion Network for Skeleton-Based Action Recognition , 2021, IEEE Transactions on Circuits and Systems for Video Technology.

[6]  Rui Guo,et al.  Sparse Adaptive Graph Convolutional Network for Leg Agility Assessment in Parkinson’s Disease , 2020, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[7]  Wenhan Yang,et al.  MS2L: Multi-Task Self-Supervised Learning for Skeleton Based Action Recognition , 2020, ACM Multimedia.

[8]  Zhang Zhang,et al.  Richly Activated Graph Convolutional Network for Robust Skeleton-Based Action Recognition , 2020, IEEE Transactions on Circuits and Systems for Video Technology.

[9]  Paolo Favaro,et al.  Video Representation Learning by Recognizing Temporal Transformations , 2020, ECCV.

[10]  B. Taati,et al.  Assessment of Parkinsonian gait in older adults with dementia via human pose tracking in video data , 2020, Journal of NeuroEngineering and Rehabilitation.

[11]  Tieniu Tan,et al.  Adversarial Self-Supervised Learning for Semi-Supervised 3D Action Recognition , 2020, ECCV.

[12]  G. Stebbins,et al.  Validation of the Polish version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). , 2020, Neurologia i neurochirurgia polska.

[13]  Yifan Zhang,et al.  Skeleton-Based Action Recognition With Shift Graph Convolutional Network , 2020, 2020 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[14]  T. Turner,et al.  Inconsistent Movement Disorders Society–Unified Parkinson's Disease Rating Scale Part III Ratings in the Parkinson's Progression Marker Initiative , 2020, Movement disorders : official journal of the Movement Disorder Society.

[15]  Shaohui Mei,et al.  Vision-Based Freezing of Gait Detection With Anatomic Directed Graph Representation , 2020, IEEE Journal of Biomedical and Health Informatics.

[16]  M. Okun,et al.  Diagnosis and Treatment of Parkinson Disease: A Review. , 2020, JAMA.

[17]  Dag Nyholm,et al.  Motion Sensor-Based Assessment of Parkinson's Disease Motor Symptoms During Leg Agility Tests: Results From Levodopa Challenge , 2020, IEEE Journal of Biomedical and Health Informatics.

[18]  Shengyong Chen,et al.  A Hierarchical Model for Human Action Recognition From Body-Parts , 2019, IEEE Transactions on Circuits and Systems for Video Technology.

[19]  Yu Liu,et al.  Vision-Based Method for Automatic Quantification of Parkinsonian Bradykinesia , 2019, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[20]  Lin Gao,et al.  Graph CNNs with Motif and Variable Temporal Block for Skeleton-Based Action Recognition , 2019, AAAI.

[21]  Chi-Chun Lee,et al.  Improving Automatic Tremor and Movement Motor Disorder Severity Assessment for Parkinson’s Disease with Deep Joint Training , 2019, 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC).

[22]  Babak Boroojerdi,et al.  Does the MDS-UPDRS provide the precision to assess progression in early Parkinson’s disease? Learnings from the Parkinson’s progression marker initiative cohort , 2019, Journal of Neurology.

[23]  Wei Liu,et al.  Self-Supervised Spatio-Temporal Representation Learning for Videos by Predicting Motion and Appearance Statistics , 2019, 2019 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[24]  Yu Tian,et al.  Semantic Graph Convolutional Networks for 3D Human Pose Regression , 2019, 2019 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[25]  Yaser Sheikh,et al.  OpenPose: Realtime Multi-Person 2D Pose Estimation Using Part Affinity Fields , 2018, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[26]  W. Rocca The burden of Parkinson's disease: a worldwide perspective , 2018, The Lancet Neurology.

[27]  Lei Shi,et al.  Two-Stream Adaptive Graph Convolutional Networks for Skeleton-Based Action Recognition , 2018, 2019 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[28]  Dahua Lin,et al.  Spatial Temporal Graph Convolutional Networks for Skeleton-Based Action Recognition , 2018, AAAI.

[29]  Kwang Suk Park,et al.  Automatic Classification of Tremor Severity in Parkinson’s Disease Using a Wearable Device , 2017, Sensors.

[30]  Michael H. Li,et al.  Vision-based assessment of parkinsonism and levodopa-induced dyskinesia with pose estimation , 2017, Journal of NeuroEngineering and Rehabilitation.

[31]  Chao Li,et al.  Skeleton-based action recognition with convolutional neural networks , 2017, 2017 IEEE International Conference on Multimedia & Expo Workshops (ICMEW).

[32]  Kaiqi Huang,et al.  Beyond Triplet Loss: A Deep Quadruplet Network for Person Re-identification , 2017, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[33]  Efstratios Gavves,et al.  Self-Supervised Video Representation Learning with Odd-One-Out Networks , 2016, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[34]  Wenjun Zeng,et al.  An End-to-End Spatio-Temporal Attention Model for Human Action Recognition from Skeleton Data , 2016, AAAI.

[35]  Max Welling,et al.  Semi-Supervised Classification with Graph Convolutional Networks , 2016, ICLR.

[36]  Natasha M. Maurits,et al.  A Method for Automatic and Objective Scoring of Bradykinesia Using Orientation Sensors and Classification Algorithms , 2016, IEEE Transactions on Biomedical Engineering.

[37]  Gianluigi Ferrari,et al.  Body-Sensor-Network-Based Kinematic Characterization and Comparative Outlook of UPDRS Scoring in Leg Agility, Sit-to-Stand, and Gait Tasks in Parkinson's Disease , 2015, IEEE Journal of Biomedical and Health Informatics.

[38]  Gianluigi Ferrari,et al.  Automatic UPDRS Evaluation in the Sit-to-Stand Task of Parkinsonians: Kinematic Analysis and Comparative Outlook on the Leg Agility Task , 2015, IEEE Journal of Biomedical and Health Informatics.

[39]  Pietro Perona,et al.  Microsoft COCO: Common Objects in Context , 2014, ECCV.

[40]  P. Patil,et al.  The MDS-UPDRS tracks motor and non-motor improvement due to subthalamic nucleus deep brain stimulation in Parkinson disease. , 2013, Parkinsonism & related disorders.

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

[42]  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.

[43]  Academisch Proefschrift,et al.  UvA-DARE ( Digital Academic Repository ) Clinimetrics , clinical profile and prognosis in early Parkinson ’ s disease , 2009 .

[44]  Chencheng Zhang,et al.  Multi-Scale Sparse Graph Convolutional Network For the Assessment of Parkinsonian Gait , 2022, IEEE Transactions on Multimedia.

[45]  Gabriella Olmo,et al.  Smartphone-Based Estimation of Item 3.8 of the MDS-UPDRS-III for Assessing Leg Agility in People With Parkinson's Disease , 2020, IEEE Open Journal of Engineering in Medicine and Biology.

[46]  Tim C. Lueth,et al.  Quantification of Parkinsonian Bradykinesia Based on Axis-Angle Representation and SVM Multiclass Classification Method , 2018, IEEE Access.

[47]  T. Foltynie,et al.  Motor and cognitive advantages persist 12 months after exenatide exposure in Parkinson's disease. , 2014, Journal of Parkinson's disease.

[48]  G. Stebbins,et al.  Expanded and independent validation of the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) , 2012, Journal of Neurology.

[49]  Geoffrey E. Hinton,et al.  Visualizing Data using t-SNE , 2008 .