Semi-global Parameterization of Online Handwriting Features for Characterizing Early-Stage Alzheimer and Mild Cognitive Impairment

Abstract Background Because of the rich set of spatiotemporal features it allows to extract, online handwriting is being increasingly investigated for characterizing neurodegenerative diseases like Parkinson and Alzheimer. The state of the art on the latter is dominated by methods that extract global (average) kinematic parameters, and then apply basic classification techniques or standard statistical tests to assess the statistical significance of each parameter in discriminating a pathological population from a healthy control one. Methods We propose a new approach for characterizing Early-Stage Alzheimer disease (ES-AD), and Mild Cognitive Impairment (MCI) w.r.t Healthy Controls (HC) that, instead of considering average kinematic HW parameters, which discards the dynamics related to each subject, is based on a semi-global parameterization scheme encoding the distribution of each kinematic parameter over a fixed number of bins. Such a distribution characterizes the gross dynamics associated with each parameter. A semi-supervised learning is proposed, in which a Normalized Mutual Information (NMI) selection scheme guides a hierarchical clustering algorithm to choose the best tradeoff between the number of clusters and the discriminative power of each w.r.t to the three cognitive profiles. Results For both global and semi-global parameters, the semi-supervised learning scheme uncovers clusters with two trends, one cluster that consists essentially of HC and MCI, and one cluster essentially composed of MCI and ES-AD. The clusters obtained with semi-global parameters are more informative than those with global parameters as reflected by a better NMI value. Conclusion A semi-global parametrization of handwriting spatiotemporal parameters allows for a better discrimination between the HC, MCI and ES-AD profiles, than a global one does. Unlike the latter, the former encodes the distribution of the dynamics of each parameter, which offers a larger parameter space in which discrimination is easier.

[1]  H. Möller,et al.  Kinematic Analysis of Handwriting Movements in Patients with Alzheimer’s Disease, Mild Cognitive Impairment, Depression and Healthy Subjects , 2003, Dementia and Geriatric Cognitive Disorders.

[2]  J. Bradshaw,et al.  Consistency of handwriting movements in dementia of the Alzheimer's type: A comparison with Huntington's and Parkinson's diseases , 1999, Journal of the International Neuropsychological Society.

[3]  H. Teulings,et al.  Advances in graphonomics: studies on fine motor control, its development and disorders. , 2006, Human movement science.

[4]  J. Hollerbach An oscillation theory of handwriting , 2004, Biological Cybernetics.

[5]  Lambert Schomaker Simulation and recognition of handwriting movements: a vertical approach to modeling human motor behavior , 1991 .

[6]  Shao-Hsia Chang,et al.  Kinematic Analyses of Graphomotor Functions in Individuals with Alzheimer’s Disease and Amnestic Mild Cognitive Impairment , 2016 .

[7]  G. Stelmach,et al.  Parkinsonism Reduces Coordination of Fingers, Wrist, and Arm in Fine Motor Control , 1997, Experimental Neurology.

[8]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[9]  Christian O'Reilly,et al.  Design of a neuromuscular disorders diagnostic system using human movement analysis , 2012, 2012 11th International Conference on Information Science, Signal Processing and their Applications (ISSPA).

[10]  E. Tangalos,et al.  Mild Cognitive Impairment Clinical Characterization and Outcome , 1999 .

[11]  C. E. SHANNON,et al.  A mathematical theory of communication , 1948, MOCO.

[12]  R. Leker,et al.  Anticardiolipin Antibodies—Reply , 1999 .

[13]  Jirí Mekyska,et al.  A new modality for quantitative evaluation of Parkinson's disease: In-air movement , 2013, 13th IEEE International Conference on BioInformatics and BioEngineering.

[14]  Jin H. Yan,et al.  Alzheimer's disease and mild cognitive impairment deteriorate fine movement control. , 2008, Journal of psychiatric research.

[15]  Gerard P. van Galen,et al.  Handwriting: Issues for a psychomotor theory ☆ , 1991 .

[16]  J. A. Hartigan,et al.  A k-means clustering algorithm , 1979 .

[17]  Monika Bugdol,et al.  Spatial and dynamical handwriting analysis in mild cognitive impairment , 2017, Comput. Biol. Medicine.

[18]  G. Stelmach,et al.  The influence of mental and motor load on handwriting movements in parkinsonian patients. , 1998, Acta psychologica.

[19]  M. Samuel,et al.  Handwriting as an objective tool for Parkinson’s disease diagnosis , 2013, Journal of Neurology.

[20]  Isabelle Guyon,et al.  Design of a neural network character recognizer for a touch terminal , 1991, Pattern Recognit..

[21]  A. Korczyn,et al.  Handwriting process variables discriminating mild Alzheimer's disease and mild cognitive impairment. , 2006, The journals of gerontology. Series B, Psychological sciences and social sciences.

[22]  J. H. Ward Hierarchical Grouping to Optimize an Objective Function , 1963 .

[23]  G. Stelmach,et al.  Control of stroke size, peak acceleration, and stroke duration in Parkinsonian handwriting , 1991 .