Prediction of Individual Progression Rate in Parkinson’s Disease Using Clinical Measures and Biomechanical Measures of Gait and Postural Stability

Parkinson’s disease (PD) is a common neurological disorder characterized by gait impairment. PD has no cure, and an impediment to developing a treatment is the lack of any accepted method to predict disease progression rate. The primary aim of this study was to develop a model using clinical measures and biomechanical measures of gait and postural stability to predict an individual’s PD progression over two years. Data from 160 PD subjects were utilized. Machine learning models, including XGBoost and Feed Forward Neural Networks, were developed using extensive model optimization and cross-validation. The highest performing model was a neural network that used a group of clinical measures, achieved a PPV of 71% in identifying fast progressors, and explained a large portion (37%) of the variance in an individual’s progression rate on held-out test data. This demonstrates the potential to predict individual PD progression rate and enrich trials by analyzing clinical and biomechanical measures with machine learning.

[1]  Luigi Iuppariello,et al.  Classifying Different Stages of Parkinson’s Disease Through Random Forests , 2019, IFMBE Proceedings.

[2]  Jian Qing Shi,et al.  Comparison of Walking Protocols and Gait Assessment Systems for Machine Learning-Based Classification of Parkinson’s Disease , 2019, Sensors.

[3]  Bijan Najafi,et al.  Motor Performance Assessment in Parkinson’s Disease: Association between Objective In-Clinic, Objective In-Home, and Subjective/Semi-Objective Measures , 2015, PloS one.

[4]  Xuemei Huang,et al.  Arm swing magnitude and asymmetry during gait in the early stages of Parkinson's disease. , 2010, Gait & posture.

[5]  Lynn Rochester,et al.  The Role of Movement Analysis in Diagnosing and Monitoring Neurodegenerative Conditions: Insights from Gait and Postural Control , 2019, Brain sciences.

[6]  Svjetlana Miocinovic,et al.  Automated gait and balance parameters diagnose and correlate with severity in Parkinson disease , 2014, Journal of the Neurological Sciences.

[7]  D. Vaillancourt,et al.  The NINDS Parkinson's disease biomarkers program , 2016, Movement disorders : official journal of the Movement Disorder Society.

[8]  Kamiar Aminian,et al.  The instrumented timed up and go test: potential outcome measure for disease modifying therapies in Parkinson's disease , 2009, Journal of Neurology, Neurosurgery & Psychiatry.

[9]  Giovanni Saggio,et al.  Assessment of Motor Impairments in Early Untreated Parkinson's Disease Patients: The Wearable Electronics Impact , 2020, IEEE Journal of Biomedical and Health Informatics.

[10]  F. Horak,et al.  Postural sway as a marker of progression in Parkinson's disease: a pilot longitudinal study. , 2012, Gait & posture.

[11]  F. Horak,et al.  iTUG, a Sensitive and Reliable Measure of Mobility , 2010, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[12]  B. Hayete,et al.  Large-scale identification of clinical and genetic predictors of Parkinson’s disease motor progression in newly-diagnosed patients: a longitudinal cohort study and validation , 2017, The Lancet Neurology.

[13]  Nilanjan Dey,et al.  Long short term memory based patient-dependent model for FOG detection in Parkinson's disease , 2020, Pattern Recognit. Lett..