Wearable sensor-based gait analysis to discriminate early Parkinson's disease from essential tremor

Abstract

Background: Differentiating early-stage Parkinson's disease (PD) from essential tremor (ET) is challenging since they have some overlapping clinical features. Since early-stage PD may present with slight gait impairment and ET generally does not, gait analysis could be used to differentiate PD from ET using machine learning.

Objective: To differentiate early-stage PD from ET via machine learning using gait and postural transition parameters calculated using the raw kinematic signal captured from inertial measurement unit (IMU) sensors.

Methods: Gait and postural transition parameters were collected from 84 early-stage PD and 80 ET subjects during the Time Up and Go (TUG) test. We randomly split our data into training and test data. Within the training data, we separated the TUG test into four components: standing, straight walk, turning, and sitting to build weighted average ensemble classification models. The four components' weight indices were trained using logistic regression. Several ensemble models' leave-one-out cross-validation (LOOCV) performances were compared. Independent test data were used to evaluate the model with the best LOOCV performance.

Results: The best weighted average ensemble classification model LOOCV results included an accuracy of 84%, Kappa of 0.68, sensitivity of 85.9%, specificity of 82.1%, and AUC of 0.912. Thirty-three gait and postural transition parameters, such as Arm-Symbolic Symmetry Index and 180° Turn-Max Angular Velocity, were included in Feature Group III. The independent test data achieved a 75.8% accuracy.

Conclusions: Our findings suggest that gait and postural transition parameters obtained from wearable sensors combined with machine learning had the potential to distinguish between early-stage PD and ET.

Keywords: Essential tremor; Gait; Machine learning; Parkinson’s disease; Wearable sensor.