Background: Hand tremor is one of the consequences of MS disease degrading quality of patient’s life. Recently DBS is used as a prominent treatment to reduce this effect. Evaluation of this approach has significant importance because of the prevalence rate of disease. Objective: The purpose of this study was the nonlinear analysis of tremor signal in order to evaluate the quantitative effect of DBS on reducing MS tremor and differentiating between them using pattern recognition algorithms. Material and Methods: In this analytical study, nine features were extracted from the tremor signal. Through statistical analysis, the significance level of each feature was examined. Finally, tremor signals were categorized by SVM, weighted KNN and NN classifiers. The performance of methods was compared with an ROC graph. Results: The results have demonstrated that dominant frequency, maximum amplitude and energy of the first IMF, deviation of the direct path, sample entropy and fuzzy entropy have the potential to create a significant difference between the tremor signals. The classification accuracy rate of tremor signals in three groups for Weighted KNN, NN and SVM with Gaussian and Quadratic kernels resulted in 95.1%, 93.2%, 91.3% and 88.3%, respectively. Conclusion: Generally, nonlinear and nonstationary analyses have a high potential for a quantitative and objective measure of MS tremor. Weighted KNN has shown the best performance of classification with the accuracy of more than 95%. It has been indicated that DBS has a positive influence on reducing the MS tremor. Therefore, DBS can be used in the objective improvement of tremor in MS patients. |
- Ghaffarpasand F. Neurosurgical Approaches in Demyelinating Disorders; Where are We Now? Galen Medical Journal. 2015;4:60-1.
- Jeyalan V, Eljamel S. Efficacy & Safety of Deep Brain Stimulation on Tremor in Multiple Sclerosis Patients. Scottish Universities Medical Journal. 2012;1:42-55.
- Alusi SH, Worthington J, Glickman S, Bain PG. A study of tremor in multiple sclerosis. Brain. 2001;124:720-30. doi: 10.1093/brain/124.4.720. PubMed PMID: 11287372.
- Liu X, Aziz TZ, Miall RC, Rowe J, et al. Frequency analysis of involuntary movements during wrist tracking: a way to identify ms patients with tremor who benefit from thalamotomy. Stereotact Funct Neurosurg. 2000;74:53-62. doi: 10.1159/000056464. PubMed PMID: 11251395.
- Ayache SS, Al-ani T, Farhat WH, et al. Analysis of tremor in multiple sclerosis using Hilbert-Huang Transform. Neurophysiol Clin. 2015;45:475-84. doi: 10.1016/j.neucli.2015.09.013. PubMed PMID: 26776079.
- Blahak C, Wohrle JC, Capelle HH, et al. Tremor reduction by subthalamic nucleus stimulation and medication in advanced Parkinson’s disease. J Neurol. 2007;254:169-78. doi: 10.1007/s00415-006-0305-x. PubMed PMID: 17334951.
- Rissanen SM, Kankaanpaa M, Tarvainen MP, et al. Analysis of EMG and acceleration signals for quantifying the effects of deep brain stimulation in Parkinson’s disease. IEEE Trans Biomed Eng. 2011;58:2545-53. doi: 10.1109/TBME.2011.2159380. PubMed PMID: 21672674. PubMed PMCID: PMC3873135.
- Esteki A, Hodgson T, Honey C. The effect of deep brain stimulation on target directed movement of the hand in multiple sclerosis patients. Gait Posture. 2006;24:S230-S1. doi: 10.1016/j.gaitpost.2006.11.158.
- Esteki A, Hodgson T. Quantitative Measurement of Hand’s Action Tremor in Patients with Multiple Sclerosis and the Effects of Thalamic Deep Brain Stimulation. Pajoohandeh Journal. 2007;12:345-51.
- Esmailpour H, Esteki A, Seddighi A. Quantitative assessment of deep brain stimulation on tremor in multiple sclerosis disease. International Clinical Neuroscience Journal. 2015;2:87-90.
- Sandstrom R. Measuring ataxia: Quantification based on the standard neurological examination. Phys Ther. 1995;75:332.
- Notermans NC, Van Dijk GW, Van Der Graaf Y, et al. Measuring ataxia: quantification based on the standard neurological examination. J Neurol Neurosurg Psychiatry. 1994;57:22-6. doi: 10.1136/jnnp.57.1.22. PubMed PMID: 8301300. PubMed PMCID: PMC485035.
- Erasmus LP, Sarno S, Albrecht H, et al. Measurement of ataxic symptoms with a graphic tablet: standard values in controls and validity in Multiple Sclerosis patients. J Neurosci Methods. 2001;108:25-37. doi: 10.1016/s0165-0270(01)00373-9. PubMed PMID: 11459615.
- Ai L, Wang J, Yao R. Classification of parkinsonian and essential tremor using empirical mode decomposition and support vector machine. Digital Signal Processing. 2011;21:543-50. doi: 10.1016/j.dsp.2011.01.010.
- Ur Rehman N, Mandic DP. Empirical mode decomposition for trivariate signals. IEEE Transactions on signal processing. 2010;58:1059-68. doi: 10.1109/tsp.2009.2033730.
- Spyers-Ashby J, Bain P, Roberts S. A comparison of fast Fourier transform (FFT) and autoregressive (AR) spectral estimation techniques for the analysis of tremor data. J Neurosci Methods. 1998;83:35-43. doi: 10.1016/s0165-0270(98)00064-8.
- De Lima ER, Andrade AO, Pons JL, Kyberd P, Nasuto SJ. Empirical mode decomposition: a novel technique for the study of tremor time series. Med Biol Eng Comput. 2006;44:569-82. doi: 10.1007/s11517-006-0065-x. PubMed PMID: 16937193.
- Pincus SM. Approximate entropy as a measure of system complexity. Proc Natl Acad Sci U S A. 1991;88:2297-301. doi: 10.1073/pnas.88.6.2297. PubMed PMID: 11607165. PubMed PMCID: PMC51218.
- Richman JS, Moorman JR. Physiological time-series analysis using approximate entropy and sample entropy. Am J Physiol Heart Circ Physiol. 2000;278:H2039-49. doi: 10.1152/ajpheart.2000.278.6.H2039. PubMed PMID: 10843903.
- Zhang X, Zhou P. Sample entropy analysis of surface EMG for improved muscle activity onset detection against spurious background spikes. J Electromyogr Kinesiol. 2012;22:901-7. doi: 10.1016/j.jelekin.2012.06.005. PubMed PMID: 22800657. PubMed PMCID: PMC3514830.
- Chen Y, Hu H, Ma C, Zhan Y, Chen N, Li L, et al. Stroke-Related Changes in the Complexity of Muscle Activation during Obstacle Crossing Using Fuzzy Approximate Entropy Analysis. Front Neurol. 2018;9:131. doi: 10.3389/fneur.2018.00131. PubMed PMID: 29593632. PubMed PMCID: PMC5857544.
- Shi J, Zhao P, Cai Y, Jia J. Classification of Hand Motions from Surface Electromyography with Rough Entropy. Journal of Medical Imaging and Health Informatics. 2015;5:328-34.
- Sengur A. Wavelet transform and adaptive neuro-fuzzy inference system for color texture classification. Expert Systems with Applications. 2008;34:2120-8. doi: 10.1016/j.eswa.2007.02.032.
- Sezgin N, Emin Tagluk M. Energy based feature extraction for classification of sleep apnea syndrome. Comput Biol Med. 2009;39:1043-50. doi: 10.1016/j.compbiomed.2009.08.005. PubMed PMID: 19762012.
- Oung QW, Muthusamy H, Basah SN, Lee H, Vijean V. Empirical Wavelet Transform Based Features for Classification of Parkinson’s Disease Severity. J Med Syst. 2017;42:29. doi: 10.1007/s10916-017-0877-2. PubMed PMID: 29288342.
- Pan S, Iplikci S, Warwick K, Aziz TZ. Parkinson’s Disease tremor classification–A comparison between Support Vector Machines and neural networks. Expert Systems with Applications. 2012;39:10764-71.
- Duda RO, Hart PE, Stork DG. Pattern classification. New Jersey: John Wiley & Sons; 2012.
- Pan S, Warwick K, Stein J, et al. Prediction of Parkinson’s disease tremor onset using artificial neural networks. Proceedings of the fifth IASTED International Conference: biomedical engineering; USA: ACTA Press; 2007.
- Schiaffino L, Muñoz AR, Villora JF, et al. Feature selection for KNN classifier to improve accurate detection of subthalamic nucleus during deep brain stimulation surgery in Parkinson’s patients. VII Latin American Congress on Biomedical Engineering CLAIB 2016, Bucaramanga, Santander, Colombia; Springer, Singapore; 2016. doi: 10.1007/978-981-10-4086-3_111.
- Chen W, Zhuang J, Yu W, Wang Z. Measuring complexity using FuzzyEn, ApEn, and SampEn. Med Eng Phys. 2009;31:61-8. doi: 10.1016/j.medengphy.2008.04.005. PubMed PMID: 18538625.
- Little MA, McSharry PE, Hunter EJ, Spielman J, Ramig LO. Suitability of dysphonia measurements for telemonitoring of Parkinson’s disease. IEEE Trans Biomed Eng. 2009;56:1015. doi: 10.1109/TBME.2008.2005954. PubMed PMID: 21399744. PubMed PMCID: PMC3051371.
|