4.7 Article

A tree-structure-guided graph convolutional network with contrastive learning for the assessment of parkinsonian hand movements

Journal

MEDICAL IMAGE ANALYSIS
Volume 81, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.media.2022.102560

Keywords

Parkinson's disease, Hand movements; MDS-UPDRS; Tree structure; Graph convolutional network; Contrastive learning

Funding

  1. National Natural Science Foundation of China [62171273]
  2. Innovation Research Plan from the Shanghai Municipal Education Commission [WF220408215, ZXWF082101/072]

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This paper proposes an automated assessment scheme for bradykinesia in Parkinson's disease using a tree-structure-guided graph convolutional network with contrastive learning. The method achieves accurate evaluation of PD bradykinesia through video analysis, providing a convenient tool for PD telemedicine applications.
Bradykinesia is one of the core motor symptoms of Parkinson's disease (PD). Neurologists typically perform faceto-face bradykinesia assessment in PD patients according to the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS). As this human-expert assessment lacks objectivity and consistency, an automated and objective assessment scheme for bradykinesia is critically needed. In this paper, we propose a tree-structure-guided graph convolutional network with contrastive learning scheme to solve the challenge of difficulty in fine-grained feature extraction and insufficient model stability, finally achieving the video-based automated assessment of Parkinsonian hand movements, which represent a vital MDSUPDRS component for examining upper-limb bradykinesia. Specifically, a tri-directional skeleton tree scheme is proposed to achieve effective fine-grained modeling of spatial hand dependencies. In this scheme, hand skeletons are extracted from videos, and then the spatial structures of these skeletons are constructed through depth-first tree traversal. Afterwards, a tree max-pooling module is employed to establish remote exchange between outer and inner nodes, hierarchically gather the most salient motion features, and hence achieve fine-grained mining. Finally, a group-sparsity-induced momentum contrast is also developed to learn similar motion patterns under different interference through contrastive learning. This can promote stable learning of discriminative spatialtemporal features with invariant motion semantics. Comprehensive experiments on a large clinical video dataset reveal that our method achieves competitive results, and outperforms other sensor-based and RGB-depth methods. The proposed method leads to accurate assessment of PD bradykinesia through videos collected by low-cost consumer cameras of limited capabilities. Hence, our work provides a convenient tool for PD telemedicine applications with modest hardware requirements.

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