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In Physiological measurement ; h5-index 36.0

OBJECTIVE : The quantitative assessment of Parkinsonian tremor, e.g., (0, 1, 2, 3, 4) according to the Movement Disorder Society-Unified Parkinson's Disease Rating Scale, is crucial for treating Parkinson's disease. However, the tremor amplitude constantly fluctuates due to environmental and psychological effects on the patient. In clinical practice, clinicians assess the tremor severity over a period of time, whereas manual tremor labeling relies on the clinician's physician experience. Therefore, automatic tremor quantification based on wearable inertial sensors and machine learning algorithms is affected by the manual labels of clinicians. In this study, an automatic modification method for the labels judged by clinicians is presented to improve Parkinsonian tremor quantitation.

APPROACH : For the severe overlapping of dynamic feature range between different severities, an outlier modification algorithm (PCA-IQR) based on the combination of principal component analysis (PCA) and interquartile range (IQR) statistic rule is proposed to learn the blurred borders between different severity scores, thereby optimizing the labels. Afterward, according to the modified feature vectors, a support vector machine (SVM) with a radial basis function (RBF) kernel is proposed to classify the tremor severity. The classifier models of SVM with RBF kernel, k-nearest neighbors (KNN), and SVM with the linear kernel are compared.

MAIN RESULTS : Experimental results show that the proposed method has high classification performance and excellent model generalization ability for tremor quantitation (accuracy: 97.93%, precision: 97.96%, sensitivity: 97.93%, F1-score: 97.94%).

SIGNIFICANCE : The proposed method may not only provide valuable assistance (digital biomarkers) for clinicians to assess the tremor severity accurately, but also provides self-monitoring for patients at home and improve the assessment skills of clinicians.

Li Yumin, Wang Zengwei, Dai Houde

2023-Feb-03

Accelerometer, Parkinson’s disease, interquartile range, motor symptom, support vector machine, tremor quantification