Interpretable video-based tracking and quantification of parkinsonism clinical motor states

Abstract Quantification of motor symptom progression in Parkinson’s disease (PD) patients is crucial for assessing disease progression and for optimizing therapeutic interventions, such as dopaminergic medications and deep brain stimulation. Cumulative and heuristic clinical experience has identifie...

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Main Authors: Daniel Deng, Jill L. Ostrem, Vy Nguyen, Daniel D. Cummins, Julia Sun, Anupam Pathak, Simon Little, Reza Abbasi-Asl
Format: Article
Language:English
Published: Nature Portfolio 2024-06-01
Series:npj Parkinson's Disease
Online Access:https://doi.org/10.1038/s41531-024-00742-x
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author Daniel Deng
Jill L. Ostrem
Vy Nguyen
Daniel D. Cummins
Julia Sun
Anupam Pathak
Simon Little
Reza Abbasi-Asl
author_facet Daniel Deng
Jill L. Ostrem
Vy Nguyen
Daniel D. Cummins
Julia Sun
Anupam Pathak
Simon Little
Reza Abbasi-Asl
author_sort Daniel Deng
collection DOAJ
description Abstract Quantification of motor symptom progression in Parkinson’s disease (PD) patients is crucial for assessing disease progression and for optimizing therapeutic interventions, such as dopaminergic medications and deep brain stimulation. Cumulative and heuristic clinical experience has identified various clinical signs associated with PD severity, but these are neither objectively quantifiable nor robustly validated. Video-based objective symptom quantification enabled by machine learning (ML) introduces a potential solution. However, video-based diagnostic tools often have implementation challenges due to expensive and inaccessible technology, and typical “black-box” ML implementations are not tailored to be clinically interpretable. Here, we address these needs by releasing a comprehensive kinematic dataset and developing an interpretable video-based framework that predicts high versus low PD motor symptom severity according to MDS-UPDRS Part III metrics. This data driven approach validated and robustly quantified canonical movement features and identified new clinical insights, not previously appreciated as related to clinical severity, including pinkie finger movements and lower limb and axial features of gait. Our framework is enabled by retrospective, single-view, seconds-long videos recorded on consumer-grade devices such as smartphones, tablets, and digital cameras, thereby eliminating the requirement for specialized equipment. Following interpretable ML principles, our framework enforces robustness and interpretability by integrating (1) automatic, data-driven kinematic metric evaluation guided by pre-defined digital features of movement, (2) combination of bi-domain (body and hand) kinematic features, and (3) sparsity-inducing and stability-driven ML analysis with simple-to-interpret models. These elements ensure that the proposed framework quantifies clinically meaningful motor features useful for both ML predictions and clinical analysis.
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spelling doaj-art-9d5a0933f3b245d29fce6faf6eee95852025-08-20T03:45:12ZengNature Portfolionpj Parkinson's Disease2373-80572024-06-0110111210.1038/s41531-024-00742-xInterpretable video-based tracking and quantification of parkinsonism clinical motor statesDaniel Deng0Jill L. Ostrem1Vy Nguyen2Daniel D. Cummins3Julia Sun4Anupam Pathak5Simon Little6Reza Abbasi-Asl7Department of Neurology, University of California, San FranciscoDepartment of Neurology, University of California, San FranciscoDepartment of Neurology, University of California, San FranciscoDepartment of Neurology, University of California, San FranciscoDepartment of Neurology, University of California, San FranciscoGoogle Inc., Mountain ViewDepartment of Neurology, University of California, San FranciscoDepartment of Neurology, University of California, San FranciscoAbstract Quantification of motor symptom progression in Parkinson’s disease (PD) patients is crucial for assessing disease progression and for optimizing therapeutic interventions, such as dopaminergic medications and deep brain stimulation. Cumulative and heuristic clinical experience has identified various clinical signs associated with PD severity, but these are neither objectively quantifiable nor robustly validated. Video-based objective symptom quantification enabled by machine learning (ML) introduces a potential solution. However, video-based diagnostic tools often have implementation challenges due to expensive and inaccessible technology, and typical “black-box” ML implementations are not tailored to be clinically interpretable. Here, we address these needs by releasing a comprehensive kinematic dataset and developing an interpretable video-based framework that predicts high versus low PD motor symptom severity according to MDS-UPDRS Part III metrics. This data driven approach validated and robustly quantified canonical movement features and identified new clinical insights, not previously appreciated as related to clinical severity, including pinkie finger movements and lower limb and axial features of gait. Our framework is enabled by retrospective, single-view, seconds-long videos recorded on consumer-grade devices such as smartphones, tablets, and digital cameras, thereby eliminating the requirement for specialized equipment. Following interpretable ML principles, our framework enforces robustness and interpretability by integrating (1) automatic, data-driven kinematic metric evaluation guided by pre-defined digital features of movement, (2) combination of bi-domain (body and hand) kinematic features, and (3) sparsity-inducing and stability-driven ML analysis with simple-to-interpret models. These elements ensure that the proposed framework quantifies clinically meaningful motor features useful for both ML predictions and clinical analysis.https://doi.org/10.1038/s41531-024-00742-x
spellingShingle Daniel Deng
Jill L. Ostrem
Vy Nguyen
Daniel D. Cummins
Julia Sun
Anupam Pathak
Simon Little
Reza Abbasi-Asl
Interpretable video-based tracking and quantification of parkinsonism clinical motor states
npj Parkinson's Disease
title Interpretable video-based tracking and quantification of parkinsonism clinical motor states
title_full Interpretable video-based tracking and quantification of parkinsonism clinical motor states
title_fullStr Interpretable video-based tracking and quantification of parkinsonism clinical motor states
title_full_unstemmed Interpretable video-based tracking and quantification of parkinsonism clinical motor states
title_short Interpretable video-based tracking and quantification of parkinsonism clinical motor states
title_sort interpretable video based tracking and quantification of parkinsonism clinical motor states
url https://doi.org/10.1038/s41531-024-00742-x
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