Assessing visuo-spatial neglect through feature selection from shape drawing performance and sequence analysis

The reported work aims to objectively and accurately assess the post-stroke clinical condition of visuo-spatial neglect using a series of standardized geometric shape drawing tasks. We present a method implementing existing pencil-and-paper diagnostic methods and define a set of static and dynamic features that can be extracted from drawing responses captured online using a graphics tablet. We also present a method for automatically assessing the constructional sequence of the drawing using Hidden Markov Models. The method enables the automated extraction, position identification and drawing order of individual sides of a shape within a drawing. Discrimination between two populations (a neglect population and stroke subjects without neglect as determined by existing standard assessment methods) using a combination of performance features and constructional sequence is examined across three separate drawing tasks. Results from experimentation show how a combination of sequence and performance features is able to generalize across a wide variety of input samples and obtain a diagnostic classification which can be used alongside other forms of conventional assessment. Furthermore, the application of a multi-classifier combination strategy leads to a significant increase in recognition ability.