Abstract
Nowadays, the treatments of neurodegenerative diseases are increasingly sophisticated, mainly thanks to innovations in the medical field. As the effectiveness of care, strategies is enhanced by the early diagnosis, in recent years there has been an increasing interest in developing reliable, non-invasive, easy to administer, and cheap diagnostics tools to support clinicians in the diagnostic processes. Among others, Alzheimer’s disease (AD) has received special attention in that it is a severe and progressive neurodegenerative disease that heavily influence the patient’s quality of life, as well as the social costs for proper care. In this context, a large variety of methods have been proposed that exploit handwriting and drawing tasks to discriminate between healthy subjects and AD patients. Most, if not all, of these methods adopt a single machine learning technique to achieve the final classification. We propose to tackle the problem by adopting a multi-classifier approach envisaging as many classifiers as the number of tasks, each of whom produces a binary output. The outputs of the classifiers are eventually combined by a majority vote to achieve the final decision. Experiments on a dataset involving 175 subjects executing 25 different handwriting and drawing tasks and 6 different machine learning techniques selected among the most used ones in the literature show that the best results are achieved by selecting the subset of tasks on which each classifier perform best and then combining the outputs of the classifier on each task, achieving an overall accuracy of 91% with a sensitivity of 83% and a specificity of 100%. Moreover, this strategy reduces the meantime to complete the test from 25 minutes to less than 10.
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References
Armstrong, M.J., et al.: Criteria for the diagnosis of corticobasal degeneration. Neurology 80(5), 496–503 (2013)
Myszczynska, M.A.: Applications of machine learning to diagnosis and treatment of neurodegenerative diseases. Nature Rev. Neurol. 16(8), 1–17 (2020)
Le, W., Dong, J., Li, S., Korczyn, A.D.: Can biomarkers help the early diagnosis of parkinson’s disease? Neurosci. Bull. 33(5), 535–542 (2017)
Li, T., Le, W.: Biomarkers for parkinson’s disease: how good are they? Neurosci. bull. 36(2), 183–194 (2020)
Morley, J.F., et al.: Optimizing olfactory testing for the diagnosis of parkinson’s disease: item analysis of the university of pennsylvania smell identification test. NPJ Parkinson’s Dis. 4(1), 1–7 (2018)
O’Hara, D.M., Kalia, S.K., Kalia, L.V.: Methods for detecting toxic \(\alpha \)-synuclein species as a biomarker for parkinson’s disease. Critical Rev. Clin. Lab. Sci. 57(5), 1–17 (2020)
Chang, C.-W., Yang, S.-Y., Yang, C.-C., Chang, C.-W., Wu, Y.-R.: Plasma and serum alpha-synuclein as a biomarker of diagnosis in patients with parkinson’s disease. Frontiers Neurol. 10, 1388 (2020)
Schapira, A.H.: Recent developments in biomarkers in parkinson disease. Current Opin. Neurol. 26(4), 395 (2013)
Broderick, M.P., Van Gemmert, A.W., Shill, H.A., Stelmach, G.E.: Hypometria and bradykinesia during drawing movements in individuals with parkinson’s disease. Exp. Brain Res. 197(3), 223–233 (2009)
Van Gemmert, A., Adler, C.H., Stelmach, G.: Parkinson’s disease patients undershoot target size in handwriting and similar tasks. J. Neurol. Neurosurg. Psychiatry 74(11), 1502–1508 (2003)
Senatore, R., Marcelli, A.: A paradigm for emulating the early learning stage of handwriting: performance comparison between healthy controls and parkinson’s disease patients in drawing loop shapes. Hum. Mov. Sci. 65, 89–101 (2019)
Teulings, H.-L., Contreras-Vidal, J.L., Stelmach, G.E., Adler, C.H.: Parkinsonism reduces coordination of fingers, wrist, and arm in fine motor control. Exp. Neurol. 146(1), 159–170 (1997)
Teulings, H.-L., Stelmach, G.E.: Control of stroke size, peak acceleration, and stroke duration in parkinsonian handwriting. Hum. Mov. Sci. 10(2–3), 315–334 (1991)
Jankovic, J.: Parkinson’s disease: clinical features and diagnosis. J. Neurol. Neurosurg. Psychiatry 79(4), 368–376 (2008)
Impedovo, D., Pirlo, G., Vessio, G.: Dynamic handwriting analysis for supporting earlier parkinson’s disease diagnosis. Information 9(10), 247 (2018)
Werner, P., Rosenblum, S., Bar-On, G., Heinik, J., Korczyn, A.: Handwriting process variables discriminating mild alzheimer’s disease and mild cognitive impairment. J. Gerontol. Ser. B Psychol. Sci. Soc. Sci. 61(4), P228–P236 (2006)
Pirlo, G., Diaz, M., Ferrer, M.A., Impedovo, D., Occhionero, F., Zurlo, U.: Early diagnosis of neurodegenerative diseases by handwritten signature analysis. In: Murino, V., Puppo, E., Sona, D., Cristani, M., Sansone, C. (eds.) ICIAP 2015. LNCS, vol. 9281, pp. 290–297. Springer, Cham (2015). https://doi.org/10.1007/978-3-319-23222-5_36
Garre-Olmo, J., Faúndez-Zanuy, M., López-de-Ipiña, K., Calvó-Perxas, L., Turró-Garriga, O.: Kinematic and pressure features of handwriting and drawing: preliminary results between patients with mild cognitive impairment, alzheimer disease and healthy controls. Current Alzheimer Res. 14(9), 960–968 (2017)
Kahindo, C., El-Yacoubi, M.A., Garcia-Salicetti, S., Rigaud, A.-S., Cristancho-Lacroix, V.: Characterizing early-stage alzheimer through spatiotemporal dynamics of handwriting. IEEE Signal Proc. Lett. 25(8), 1136–1140 (2018)
Cilia, N.D., De Stefano, C., Fontanella, F., Molinara, M., Scotto Di Freca, A.: Handwriting analysis to support alzheimer’s disease diagnosis: a preliminary study. In: Vento, M., Percannella, G. (eds.) CAIP 2019. LNCS, vol. 11679, pp. 143–151. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-29891-3_13
Cilia, N.D., De Stefano, C., Fontanella, F., Molinara, M., Scotto Di Freca, A.: Using handwriting features to characterize cognitive impairment. In: Ricci, E., Rota Bulò, S., Snoek, C., Lanz, O., Messelodi, S., Sebe, N. (eds.) ICIAP 2019. LNCS, vol. 11752, pp. 683–693. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-30645-8_62
Cilia, N.D., De Stefano, C., Fontanella, F., di Freca, A.S.: How word choice affects cognitive impairment detection by handwriting analysis: a preliminary study. In: Cicirelli, F., Guerrieri, A., Pizzuti, C., Socievole, A., Spezzano, G., Vinci, A. (eds.) WIVACE 2019. CCIS, vol. 1200, pp. 113–123. Springer, Cham (2020). https://doi.org/10.1007/978-3-030-45016-8_12
Ishikawa, T. et al.: Handwriting features of multiple drawing tests for early detection of alzheimer’s disease: a preliminary result. In: MedInfo, pp. 168–172 (2019)
Cilia, N.D., De Stefano, C., Fontanella, F., Di Freca, A.S.: An experimental protocol to support cognitive impairment diagnosis by using handwriting analysis. Procedia Comput. Sci. 141, 466–471 (2018)
Sarica, A., Cerasa, A., Quattrone, A.: Random forest algorithm for the classification of neuroimaging data in alzheimer’s disease: a systematic review. Frontiers Aging Neurosci. 9, 329 (2017)
Abdullah, M.N., Wah, Y.B., Zakaria, Y., Majeed, A.B.A., Huat, O.S.: Discovering potential blood-based cytokine biomarkers for alzheimer’s disease using firth logistic regression. Epidemiology, Biostatistics Pub. Health 16(4), 2019
El Mehdi Benyoussef, B., Elbyed, A., El Hadiri, H.: 3d MRI classification using KNN and deep neural network for alzheimer’s disease diagnosis. Advanced Intelligent Systems for Sustainable Development (AI2SD 2018): vol. 4: Advanced Intelligent Systems Applied to Health, vol. 914, p. 154 (2019)
Ghazi, M.M., et al.: Training recurrent neural networks robust to incomplete data: application to alzheimer’s disease progression modeling. Med. Image Anal. 53, 39–46 (2019)
Kruthika, K., Maheshappa, H., Initiative, A.D.N., et al.: Multistage classifier-based approach for alzheimer’s disease prediction and retrieval. Inf. Med. Unlocked 14, 34–42 (2019)
Battineni, G., Chintalapudi, N., Amenta, F.: Machine learning in medicine: performance calculation of dementia prediction by support vector machines (svm). Inf. Med. Unlocked 16, 100200 (2019)
Pereira, C.R., et al.: A step towards the automated diagnosis of parkinson’s disease: Analyzing handwriting movements. In: 2015 IEEE 28th International Symposium on Computer-Based Medical Systems, pp. 171–176 (2015)
Kittler, J., Hatef, M., Duin, R.P., Matas, J.: On combining classifiers. IEEE Trans. Pattern Anal. Mach. Intell. 20(3), 226–239 (1998)
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De Gregorio, G., Desiato, D., Marcelli, A., Polese, G. (2021). A Multi Classifier Approach for Supporting Alzheimer’s Diagnosis Based on Handwriting Analysis. In: Del Bimbo, A., et al. Pattern Recognition. ICPR International Workshops and Challenges. ICPR 2021. Lecture Notes in Computer Science(), vol 12661. Springer, Cham. https://doi.org/10.1007/978-3-030-68763-2_43
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