Artificial Intelligence-assisted MDS-UPDRS Assessment for Parkinson's Disease

Condition(s) studied

Investigational drug(s) / intervention(s)

Observational: clinical profile, MDS-UPDRS III, Video Recording

Study summary

Idiopathic Parkinson's disease (PD) is a neurodegenerative disease that progressively causes both motor and non-motor symptoms. As the second most common neurodegenerative disease and most common movement disorder, it affects over 8.5 million people worldwide and 13,000 people in Hong Kong. The most classical symptoms of PD are resting tremors, rigidity of the muscles, bradykinesia (slowing of movement), and gait difficulty. Other symptoms include sleep disorders, psychiatric symptoms, cognitive impairment, and autonomic dysfunction. Its pathophysiology is marked by the loss of dopaminergic neurons and the accumulation of aggregates called Lewy bodies.

The severity of PD-related motor symptoms is usually semi-quantitatively ("normal", "slight", "mild", "moderate", and "severe") evaluated by expert physicians and physiotherapists according to the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III). However, the MDS-UPDRS III is semiquantitative and subjective, which might mask mild treatment effects or even provide false-positive results. Moreover, it takes significant time and effort for assessment with expected inter-observer variations.

To address these issues, various artificial intelligence (AI) technologies and telemedicine approaches have been investigated for patient evaluation. However, previous studies did not incorporate items assessing rigidity and postural stability, which require physical contact as per the MDS-UPDRS III instructions. Zhu et al. explored a motor symptom machine-rating system for the complete MDS-UPDRS III. Nevertheless, they employed a depth camera and conducted the tests within a strictly controlled ideal laboratory environment. For the widespread implementation of AI-assisted rating, the RGB camera is a more accessible alternative.

Eligibility

Primary outcome measure(s)

• AI-based motor assessment tool — Baseline to 3 years
  AI-based motor assessment tool utilizing RGB video for reliable and objective ratings of MDS-UPDRS III motor symptoms, including rigidity and postural stability.
• Feasibility of implementing RGB camera-based assessments — 3 years
  Feasibility of implementing RGB camera-based assessments in routine clinical settings will be assessed by the proportion of assessments in which the AI system is able to generate an estimated MDS-UPDRS Part III total score based on RGB video that can be directly compared with clinician-rated MDS-UPDRS Part III scores. Patients perform standardized motor tasks under physician guidance while RGB video is recorded using a smartphone. Clinician-rated MDS-UPDRS Part III scores are used as the ground truth. Feasibility outcomes will be reported as the percentage (%) of assessments with valid AI-generated scores over a 3-year study period.

Trial sites (2)

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