Locomotion Traces Data Mining for Supporting Frail People with Cognitive Impairment

The rapid increase in the senior population is posing serious challenges to national healthcare systems. Hence, innovative tools are needed to early detect health issues, including cognitive decline. Several clinical studies show that it is possible to identify cognitive impairment based on the locomotion patterns of older people. Thus, this thesis at first focused on providing a systematic literature review of locomotion data mining systems for supporting Neuro-Degenerative Diseases (NDD) diagnosis, identifying locomotion anomaly indicators and movement patterns for discovering low-level locomotion indicators, sensor data acquisition, and processing methods, as well as NDD detection algorithms considering their pros and cons. Then, we investigated the use of sensor data and Deep Learning (DL) to recognize abnormal movement patterns in instrumented smart-homes. In order to get rid of the noise introduced by indoor constraints and activity execution, we introduced novel visual feature extraction methods for locomotion data. Our solutions rely on locomotion traces segmentation, image-based extraction of salient features from locomotion segments, and vision-based DL. Furthermore, we proposed a data augmentation strategy to increase the volume of collected data and generalize the solution to different smart-homes with different layouts. We carried out extensive experiments with a large real-world dataset acquired in a smart-home test-bed from older people, including people with cognitive diseases. Experimental comparisons show that our system outperforms state-of-the-art methods

Implementation of a Computer-Vision System as a Supportive Diagnostic Tool for Parkinson’s Disease

Parkinson’s disease is the second most common neurodegenerative disorder, affecting nearly 1 million people in the US and it is predicted that the number will keep increasing. Parkinson’s disease is difficult to diagnose due to its similarity with other diseases that share the parkinsonian symptoms and the subjectivity of its assessment, thus increasing the probabilities of misdiagnosis. Therefore, it is relevant to develop diagnostic tools that are quantitatively based and monitoring tools to improve the patient’s quality of life. Computer-based assessment systems have shown to be successful in this field through diverse approaches that can be classified into two main categories: sensor-based and computer vision-based systems. In this thesis, the implementation of a computer vision system to detect Parkinson’s disease is explored. As Parkinson’s diseases has characteristic motor symptoms, and gait is mainly affected, a computer vision system is proposed to analyze the gait features to classify subjects with Parkinson’s disease. Using Microsoft’s Kinect sensor and Azure Kinect sensor, the position of body joints in a 3D space was obtained and angles between those were calculated. The standard deviation of 7 different angles over time was calculated for each and used as features in a support vector machine with the purpose of classifying Parkinson’s disease patients versus controls. Moreover, challenges and future perspectives for the implementation of computer-vision systems as supportive diagnostic tools for Parkinson’s disease are discussed

Human Gait Analysis using Spatiotemporal Data Obtained from Gait Videos

Mit der Entwicklung von Deep-Learning-Techniken sind Deep-acNN-basierte Methoden zum Standard für Bildverarbeitungsaufgaben geworden, wie z. B. die Verfolgung menschlicher Bewegungen und Posenschätzung, die Erkennung menschlicher Aktivitäten und die Erkennung von Gesichtern. Deep-Learning-Techniken haben den Entwurf, die Implementierung und den Einsatz komplexer und vielfältiger Anwendungen verbessert, die nun in einer Vielzahl von Bereichen, einschließlich der Biomedizintechnik, eingesetzt werden. Die Anwendung von Computer-Vision-Techniken auf die medizinische Bild- und Videoanalyse hat zu bemerkenswerten Ergebnissen bei der Erkennung von Ereignissen geführt. Die eingebaute Fähigkeit von convolutional neural network (CNN), Merkmale aus komplexen medizinischen Bildern zu extrahieren, hat in Verbindung mit der Fähigkeit von long short term memory network (LSTM), die zeitlichen Informationen zwischen Ereignissen zu erhalten, viele neue Horizonte für die medizinische Forschung geschaffen. Der Gang ist einer der kritischen physiologischen Bereiche, der viele Störungen im Zusammenhang mit Alterung und Neurodegeneration widerspiegeln kann. Eine umfassende und genaue Ganganalyse kann Einblicke in die physiologischen Bedingungen des Menschen geben. Bestehende Ganganalyseverfahren erfordern eine spezielle Umgebung, komplexe medizinische Geräte und geschultes Personal für die Erfassung der Gangdaten. Im Falle von tragbaren Systemen kann ein solches System die kognitiven Fähigkeiten beeinträchtigen und für die Patienten unangenehm sein. Außerdem wurde berichtet, dass die Patienten in der Regel versuchen, während des Labortests bessere Leistungen zu erbringen, was möglicherweise nicht ihrem tatsächlichen Gang entspricht. Trotz technologischer Fortschritte stoßen wir bei der Messung des menschlichen Gehens in klinischen und Laborumgebungen nach wie vor an Grenzen. Der Einsatz aktueller Ganganalyseverfahren ist nach wie vor teuer und zeitaufwändig und erschwert den Zugang zu Spezialgeräten und Fachwissen. Daher ist es zwingend erforderlich, über Methoden zu verfügen, die langfristige Daten über den Gesundheitszustand des Patienten liefern, ohne doppelte kognitive Aufgaben oder Unannehmlichkeiten bei der Verwendung tragbarer Sensoren. In dieser Arbeit wird daher eine einfache, leicht zu implementierende und kostengünstige Methode zur Erfassung von Gangdaten vorgeschlagen. Diese Methode basiert auf der Aufnahme von Gehvideos mit einer Smartphone-Kamera in einer häuslichen Umgebung unter freien Bedingungen. Deep neural network (NN) verarbeitet dann diese Videos, um die Gangereignisse zu extrahieren. Die erkannten Ereignisse werden dann weiter verwendet, um verschiedene räumlich-zeitliche Parameter des Gangs zu quantifizieren, die für jedes Ganganalysesystem wichtig sind. In dieser Arbeit wurden Gangvideos verwendet, die mit einer Smartphone-Kamera mit geringer Auflösung außerhalb der Laborumgebung aufgenommen wurden. Viele Deep- Learning-basierte NNs wurden implementiert, um die grundlegenden Gangereignisse wie die Fußposition in Bezug auf den Boden aus diesen Videos zu erkennen. In der ersten Studie wurde die Architektur von AlexNet verwendet, um das Modell anhand von Gehvideos und öffentlich verfügbaren Datensätzen von Grund auf zu trainieren. Mit diesem Modell wurde eine Gesamtgenauigkeit von 74% erreicht. Im nächsten Schritt wurde jedoch die LSTM-Schicht in dieselbe Architektur integriert. Die eingebaute Fähigkeit von LSTM in Bezug auf die zeitliche Information führte zu einer verbesserten Vorhersage der Etiketten für die Fußposition, und es wurde eine Genauigkeit von 91% erreicht. Allerdings gibt es Schwierigkeiten bei der Vorhersage der richtigen Bezeichnungen in der letzten Phase des Schwungs und der Standphase jedes Fußes. Im nächsten Schritt wird das Transfer-Lernen eingesetzt, um die Vorteile von bereits trainierten tiefen NNs zu nutzen, indem vortrainierte Gewichte verwendet werden. Zwei bekannte Modelle, inceptionresnetv2 (IRNV-2) und densenet201 (DN-201), wurden mit ihren gelernten Gewichten für das erneute Training des NN auf neuen Daten verwendet. Das auf Transfer-Lernen basierende vortrainierte NN verbesserte die Vorhersage von Kennzeichnungen für verschiedene Fußpositionen. Es reduzierte insbesondere die Schwankungen in den Vorhersagen in der letzten Phase des Gangschwungs und der Standphase. Bei der Vorhersage der Klassenbezeichnungen der Testdaten wurde eine Genauigkeit von 94% erreicht. Da die Abweichung bei der Vorhersage des wahren Labels hauptsächlich ein Bild betrug, konnte sie bei einer Bildrate von 30 Bildern pro Sekunde ignoriert werden. Die vorhergesagten Markierungen wurden verwendet, um verschiedene räumlich-zeitliche Parameter des Gangs zu extrahieren, die für jedes Ganganalysesystem entscheidend sind. Insgesamt wurden 12 Gangparameter quantifiziert und mit der durch Beobachtungsmethoden gewonnenen Grundwahrheit verglichen. Die NN-basierten räumlich-zeitlichen Parameter zeigten eine hohe Korrelation mit der Grundwahrheit, und in einigen Fällen wurde eine sehr hohe Korrelation erzielt. Die Ergebnisse belegen die Nützlichkeit der vorgeschlagenen Methode. DerWert des Parameters über die Zeit ergab eine Zeitreihe, eine langfristige Darstellung des Ganges. Diese Zeitreihe konnte mit verschiedenen mathematischen Methoden weiter analysiert werden. Als dritter Beitrag in dieser Dissertation wurden Verbesserungen an den bestehenden mathematischen Methoden der Zeitreihenanalyse von zeitlichen Gangdaten vorgeschlagen. Zu diesem Zweck werden zwei Verfeinerungen bestehender entropiebasierter Methoden zur Analyse von Schrittintervall-Zeitreihen vorgeschlagen. Diese Verfeinerungen wurden an Schrittintervall-Zeitseriendaten von normalen und neurodegenerativen Erkrankungen validiert, die aus der öffentlich zugänglichen Datenbank PhysioNet heruntergeladen wurden. Die Ergebnisse zeigten, dass die von uns vorgeschlagene Methode eine klare Trennung zwischen gesunden und kranken Gruppen ermöglicht. In Zukunft könnten fortschrittliche medizinische Unterstützungssysteme, die künstliche Intelligenz nutzen und von den hier vorgestellten Methoden abgeleitet sind, Ärzte bei der Diagnose und langfristigen Überwachung des Gangs von Patienten unterstützen und so die klinische Arbeitsbelastung verringern und die Patientensicherheit verbessern

Automated, high accuracy classification of Parkinsonian disorders: a pattern recognition approach

Progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and idiopathic Parkinson’s disease (IPD) can be clinically indistinguishable, especially in the early stages, despite distinct patterns of molecular pathology. Structural neuroimaging holds promise for providing objective biomarkers for discriminating these diseases at the single subject level but all studies to date have reported incomplete separation of disease groups. In this study, we employed multi-class pattern recognition to assess the value of anatomical patterns derived from a widely available structural neuroimaging sequence for automated classification of these disorders. To achieve this, 17 patients with PSP, 14 with IPD and 19 with MSA were scanned using structural MRI along with 19 healthy controls (HCs). An advanced probabilistic pattern recognition approach was employed to evaluate the diagnostic value of several pre-defined anatomical patterns for discriminating the disorders, including: (i) a subcortical motor network; (ii) each of its component regions and (iii) the whole brain. All disease groups could be discriminated simultaneously with high accuracy using the subcortical motor network. The region providing the most accurate predictions overall was the midbrain/brainstem, which discriminated all disease groups from one another and from HCs. The subcortical network also produced more accurate predictions than the whole brain and all of its constituent regions. PSP was accurately predicted from the midbrain/brainstem, cerebellum and all basal ganglia compartments; MSA from the midbrain/brainstem and cerebellum and IPD from the midbrain/brainstem only. This study demonstrates that automated analysis of structural MRI can accurately predict diagnosis in individual patients with Parkinsonian disorders, and identifies distinct patterns of regional atrophy particularly useful for this process

Gait Analysis for Early Neurodegenerative Diseases Classification through the Kinematic Theory of Rapid Human Movements

Neurodegenerative diseases are particular diseases whose decline can partially or completely compromise the normal course of life of a human being. In order to increase the quality of patient's life, a timely diagnosis plays a major role. The analysis of neurodegenerative diseases, and their stage, is also carried out by means of gait analysis. Performing early stage neurodegenerative disease assessment is still an open problem. In this paper, the focus is on modeling the human gait movement pattern by using the kinematic theory of rapid human movements and its sigma-lognormal model. The hypothesis is that the kinematic theory of rapid human movements, originally developed to describe handwriting patterns, and used in conjunction with other spatio-temporal features, can discriminate neurodegenerative diseases patterns, especially in early stages, while analyzing human gait with 2D cameras. The thesis empirically demonstrates its effectiveness in describing neurodegenerative patterns, when used in conjunction with state-of-the-art pose estimation and feature extraction techniques. The solution developed achieved 99.1% of accuracy using velocity-based, angle-based and sigma-lognormal features and left walk orientation

Human Gait Analysis in Neurodegenerative Diseases: a Review

This paper reviews the recent literature on technologies and methodologies for quantitative human gait analysis in the context of neurodegnerative diseases. The use of technological instruments can be of great support in both clinical diagnosis and severity assessment of these pathologies. In this paper, sensors, features and processing methodologies have been reviewed in order to provide a highly consistent work that explores the issues related to gait analysis. First, the phases of the human gait cycle are briefly explained, along with some non-normal gait patterns (gait abnormalities) typical of some neurodegenerative diseases. The work continues with a survey on the publicly available datasets principally used for comparing results. Then the paper reports the most common processing techniques for both feature selection and extraction and for classification and clustering. Finally, a conclusive discussion on current open problems and future directions is outlined

Algorithmes de détection des maladies neurodégénératives à partir de la démarche d'un individu

Le diagnostic des maladies neurodégénératives est un défi en médecine. Il repose principalement sur l’interprétation des symptômes par les médecins. Il existe donc un besoin important d’outils automatiques pouvant assister les médecins dans leurs prises de décision. Dans ce contexte, l’objectif de ce travail est de développer des algorithmes de détection des maladies neurodégénératives à partir des données de la démarche des patients. Dans un premier temps, nous avons développé un algorithme de détection de la maladie du Parkinson. En entrée, l’algorithme utilise les forces de réaction verticale du sol (vertical ground reaction force-VGRF) enregistrées par plusieurs capteurs placés sous les pieds. La première composante de notre algorithme est constituée de 18 réseaux neuronaux convolutifs 1D (1D-Convnets) parallèles, traitant chacun un signal de VGRF. Chacun de ces 1D-Convnets extrait un vecteur de caractéristiques propre au signal traité. Ensuite, tous ces vecteurs de caractéristiques sont concaténés et envoyés à un réseau pleinement connecté qui les intègre et donne en sortie la classification finale. L’algorithme a été comparé à d’autres méthodes récentes dans la littérature et a démontré une amélioration de la précision de classification. Dans un deuxième temps, nous avons utilisé les données spatio-temporelles de la démarche pour développer quatre détecteurs de maladies neurodégénératives : détecteur de Parkinson, de Huntington, de sclérose latérale amyotrophique et un détecteur de l’ensemble de ces maladies neurodégénératives combinées. Puisque la base de données était de taille réduite, nous avons utilisé les algorithmes d’apprentissage machine classiques. Pour ce faire, nous avons extrait les caractéristiques de l’amplitude et de la dynamique des fluctuations des données spatio-temporelles. Ensuite, nous avons entraîné différents classificateurs à classifier ces vecteurs. Les meilleurs résultats ont été obtenus avec une machine à support de vecteurs. Les résultats obtenus confirment la performance des algorithmes développés. Ceux-ci pourraient être utilisés en milieu clinique dans le but d’effectuer des tests précoces pour identifier les patients qui peuvent être atteints de maladies neurodégénératives.----------ABSTRACT: Neurodegenerative disease diagnosis is still a very challenging problem in medicine. It relies mainly on physician expertise and interpretation of patient’s physical symptoms. Therefore, there is a great need for automatic tools that can assist physicians in their decision making. In this context, the objective of this research work is to develop algorithms for the detection of neurodegenerative diseases. First, we developed a detection algorithm for Parkinson’s disease. As input, the algorithm uses vertical ground reaction forces (VGRF) recorded from several sensors placed under the subjects’ feet. The first component of our algorithm consists of 18 parallel 1D convolution neural networks (1D-Convnets), each processing a VGRF signal. Each of these convolution networks extracts a feature vector of the processed signal. Then, all these feature vectors are concatenated and sent to a fully connected network that integrates them and outputs the final classification. The algorithm has been compared to recent state-of-the-art methods and has shown an improved classification accuracy. Second, we used spatiotemporal data of gait to develop four detectors of neurodegenerative diseases: a detector of Parkinson, Huntington, of amyotrophic lateral sclerosis and a detector of all these neurodegenerative diseases combined. Since the database was smaller, we explored classic machine learning algorithms. We first extracted fluctuation magnitudes and dynamic features of the spatiotemporal data. Then we trained different classifiers to classify these vectors. The best results were obtained with a support vector machine. The obtained results confirm the performance of our algorithms. Our method could be used clinically to screen patients in order to identify those who may potentially have neurodegenerative diseases

Determining the severity of Parkinson’s disease in patients using a multi task neural network

[EN] Parkinson’s disease is easy to diagnose when it is advanced, but it is very difficult to diagnose in its early stages. Early diagnosis is essential to be able to treat the symptoms. It impacts on daily activities and reduces the quality of life of both the patients and their families and it is also the second most prevalent neurodegenerative disorder after Alzheimer in people over the age of 60. Most current studies on the prediction of Parkinson’s severity are carried out in advanced stages of the disease. In this work, the study analyzes a set of variables that can be easily extracted from voice analysis, making it a very non-intrusive technique. In this paper, a method based on different deep learning techniques is proposed with two purposes. On the one hand, to find out if a person has severe or non-severe Parkinson’s disease, and on the other hand, to determine by means of regression techniques the degree of evolution of the disease in a given patient. The UPDRS (Unified Parkinson’s Disease Rating Scale) has been used by taking into account both the motor and total labels, and the best results have been obtained using a mixed multi-layer perceptron (MLP) that classifies and regresses at the same time and the most important features of the data obtained are taken as input, using an autoencoder. A success rate of 99.15% has been achieved in the problem of predicting whether a person suffers from severe Parkinson’s disease or non-severe Parkinson’s disease. In the degree of disease involvement prediction problem case, a MSE (Mean Squared Error) of 0.15 has been obtained. Using a full deep learning pipeline for data preprocessing and classification has proven to be very promising in the field Parkinson’s outperforming the state-of-the-art proposals.SIPublicación en abierto financiada por el Consorcio de Bibliotecas Universitarias de Castilla y León (BUCLE), con cargo al Programa Operativo 2014ES16RFOP009 FEDER 2014-2020 DE CASTILLA Y LEÓN, Actuación:20007-CL - Apoyo Consorcio BUCL

Early Detection of Neurodegenerative Diseases from Bio-Signals: A Machine Learning Approach

Given the fact that people, especially in advanced countries, are living longer due to the advancements in medical sciences which resulted in the prevalence of age-related diseases like Alzheimer’s and dementia. The occurrence of such diseases continues to increase and ultimately the cost of caring for these groups will become unsustainable. Addressing this issue has reached a critical point and failing to provide a strategic way forward will negatively affect patients, national health services and society as a whole.Three distinctive development stages of neurodegenerative diseases (Retrogenesis, Cognitive Impairment and Gait Impairment) motivated me to divide this research work into two main parts. To fully achieve the purpose of early detection/diagnosis, I aimed at analysing the gait signals as well as EEG signals, separately, as both of these signals severely get affected by any neurological disease.The first part of this research work focuses on the discrimination analysis of gait signals of different neurodegenerative diseases (Parkinson’s, Huntington, and Amyotrophic Lateral Sclerosis) and also of control subjects. This involves relevant feature extraction, solving the issues of imbalanced datasets and missing entries and lastly classification of multiclass datasets. For the classification and discrimination of gait signals, eleven (11) classifiers are selected representing linear, non-linear and Bayes normal classification techniques. Results revealed that three classifiers have provided us with higher accuracy rate which are UDC, LDC and PARZEN with 65%, 62.5% and 60% accuracy, respectively. Further, I proposed and developed a new classifier fusion strategy that combined classification algorithms with combining rules (voting, product, mean, median, maximum and minimum). It generates better results and classifies subjects more accurately than base-level classifiers.The last part of this research work is based on the rectification and computation of EEG signals of mild Alzheimer’s disease patients and control subjects. To detect the perturbation in EEG signals of Alzheimer’s patients, three neural synchrony measurement techniques; phase synchrony, magnitude squared coherence and cross correlation are applied on three different databases of mild Alzheimer’s disease (MiAD) patients and healthy subjects. I have compared right and left temporal parts of brain with rest of the brain area (frontal, central and occipital), as temporal regions are relatively the first ones to be affected by Alzheimer’s. Two novel methods are proposed to compute the neural synchronization of the brain; Average synchrony measure and PCA based synchrony measure. These techniques are evaluated for three different datasets of MiAD patients and control subjects using the Wilcoxon ranksum test (Mann-Whitney U test). Results demonstrated that PCA based method helped us to find more significant features that can be used as biomarkers for the early diagnosis of Alzheimer’s

Diagnostic approach to paediatric movement disorders:a clinical practice guide

Paediatric movement disorders (PMDs) comprise a large group of disorders (tics, myoclonus, tremor, dystonia, chorea, Parkinsonism, ataxia), often with mixed phenotypes. Determination of the underlying aetiology can be difficult given the broad differential diagnosis and the complexity of the genotype-phenotype relationships. This can make the diagnostic process time-consuming and difficult. In this overview, we present a diagnostic approach for PMDs, with emphasis on genetic causes. This approach can serve as a framework to lead the clinician through the diagnostic process in eight consecutive steps, including recognition of the different movement disorders, identification of a clinical syndrome, consideration of acquired causes, genetic testing including next-generation sequencing, post-sequencing phenotyping, and interpretation of test results. The aim of this approach is to increase the recognition and diagnostic yield in PMDs.</p