scholarly journals Using Machine Learning for Predicting the Best Outcomes With Electrical Muscle Stimulation for Tremors in Parkinson’s Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Onanong Phokaewvarangkul ◽  
Peerapon Vateekul ◽  
Itsara Wichakam ◽  
Chanawat Anan ◽  
Roongroj Bhidayasiri

Recent studies have identified that peripheral stimulation in Parkinson’s disease (PD) is effective in tremor reduction, indicating that a peripheral feedback loop plays an important role in the tremor reset mechanism. This was an open-label, quasi-experimental, pre- and post-test design, single-blind, single-group study involving 20 tremor-dominant PD patients. The objective of this study is to explore the effect of electrical muscle stimulation (EMS) as an adjunctive treatment for resting tremor during “on” period and to identify the best machine learning model to predict the suitable stimulation level that will yield the longest period of tremor reduction or tremor reset time. In this study, we used a Parkinson’s glove to evaluate, stimulate, and quantify the tremors of PD patients. This adjustable glove incorporates a 3-axis gyroscope to measure tremor signals and an EMS to provide an on-demand muscle stimulation to suppress tremors. Machine learning models were applied to identify the suitable pulse amplitude (stimulation level) in five classes that led to the longest tremor reset time. The study was registered at the www.clinicaltrials.gov under the name “The Study of Rest Tremor Suppression by Using Electrical Muscle Stimulation” (NCT02370108). Twenty tremor-dominant PD patients were recruited. After applying an average pulse amplitude of 6.25 (SD 2.84) mA and stimulation period of 440.7 (SD 560.82) seconds, the total time of tremor reduction, or tremor reset time, was 329.90 (SD 340.91) seconds. A significant reduction in tremor parameters during stimulation was demonstrated by a reduction of Unified Parkinson’s Disease Rating Scale (UPDRS) scores, and objectively, with a reduction of gyroscopic data (p < 0.05, each). None of the subjects reported any serious adverse events. We also compared gyroscopic data with five machine learning techniques: Logistic Regression, Random Forest, Support Vector Machine (SVM), Neural Network (NN), and Long-Short-Term-Memory (LSTM). The machine learning model that gave the highest accuracy was LSTM, which obtained: accuracy = 0.865 and macro-F1 = 0.736. This study confirms the efficacy of EMS in the reduction of resting tremors in PD. LSTM was identified as the most effective model for predicting pulse amplitude that would elicit the longest tremor reset time. Our study provides further insight on the tremor reset mechanism in PD.

Author(s):  
Sophie V. Adama ◽  
Martin Bogdan

This article describes how Stroke and Parkinson's disease are two illnesses that particularly affect motor functions. With the advancements in technology, there is a lot of research focusing on finding solutions: to contribute to neuroplasticity in the first case, and to reduce symptoms in the second case. This manuscript describes the design of a brain-computer interface system (BCI) system paired with an electrical muscle stimulation suit for stroke rehabilitation and the reduction of tremors caused by Parkinson's disease. The idea is to strengthen the sensory-motor feedback loop, which will allow a more stabilized control of the affected extremities by taking into account the patient's motivation. To do so, his brain signals are measured to detect his intention to attempt to execute a movement, in contrast to the classical approach where the movement executions are imposed. A first feasibility study was completed. The author's next step is planning to test the system first with healthy subjects and finally with patients.


Author(s):  
Hwayoung Park ◽  
Sungtae Shin ◽  
Changhong Youm ◽  
Sang-Myung Cheon ◽  
Myeounggon Lee ◽  
...  

Abstract Background Freezing of gait (FOG) is a sensitive problem, which is caused by motor control deficits and requires greater attention during postural transitions such as turning in people with Parkinson’s disease (PD). However, the turning characteristics have not yet been extensively investigated to distinguish between people with PD with and without FOG (freezers and non-freezers) based on full-body kinematic analysis during the turning task. The objectives of this study were to identify the machine learning model that best classifies people with PD and freezers and reveal the associations between clinical characteristics and turning features based on feature selection through stepwise regression. Methods The study recruited 77 people with PD (31 freezers and 46 non-freezers) and 34 age-matched older adults. The 360° turning task was performed at the preferred speed for the inner step of the more affected limb. All experiments on the people with PD were performed in the “Off” state of medication. The full-body kinematic features during the turning task were extracted using the three-dimensional motion capture system. These features were selected via stepwise regression. Results In feature selection through stepwise regression, five and six features were identified to distinguish between people with PD and controls and between freezers and non-freezers (PD and FOG classification problem), respectively. The machine learning model accuracies revealed that the random forest (RF) model had 98.1% accuracy when using all turning features and 98.0% accuracy when using the five features selected for PD classification. In addition, RF and logistic regression showed accuracies of 79.4% when using all turning features and 72.9% when using the six selected features for FOG classification. Conclusion We suggest that our study leads to understanding of the turning characteristics of people with PD and freezers during the 360° turning task for the inner step of the more affected limb and may help improve the objective classification and clinical assessment by disease progression using turning features.


Author(s):  
Sophie V. Adama ◽  
Martin Bogdan

This article describes how Stroke and Parkinson's disease are two illnesses that particularly affect motor functions. With the advancements in technology, there is a lot of research focusing on finding solutions: to contribute to neuroplasticity in the first case, and to reduce symptoms in the second case. This manuscript describes the design of a brain-computer interface system (BCI) system paired with an electrical muscle stimulation suit for stroke rehabilitation and the reduction of tremors caused by Parkinson's disease. The idea is to strengthen the sensory-motor feedback loop, which will allow a more stabilized control of the affected extremities by taking into account the patient's motivation. To do so, his brain signals are measured to detect his intention to attempt to execute a movement, in contrast to the classical approach where the movement executions are imposed. A first feasibility study was completed. The author's next step is planning to test the system first with healthy subjects and finally with patients.


Author(s):  
Mohimenol Islam Fahim ◽  
Syful Islam ◽  
Sumaiya Tun Noor ◽  
Md. Javed Hossain ◽  
Md. Shahriar Setu

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