用拓扑分析脚部抬升动态,提升帕金森综合征鉴别准确率。
Topological descriptors of foot clearance gait dynamics improve differential diagnosis of Parkinsonism
- 通过拓扑数据分析足部抬升时间序列的隐藏结构特征。
- 在用药状态下区分帕金森与血管性帕金森病达83%准确率。
- 适合临床辅助诊断及药物反应评估的研究者使用。
帕金森综合征的鉴别诊断因运动症状重叠和细微步态异常而具挑战性,准确区分对治疗与预后至关重要。尽管步态分析是评估运动障碍的成熟方法,传统手段常忽略足部抬升模式中蕴含的非线性与结构特征。本研究评估了拓扑数据分析(TDA)作为帕金森病分类的补充工具,利用持续同调生成贝蒂曲线、持久景观与轮廓图作为随机森林分类器的特征。数据集包含15名对照组(CO)、15名特发性帕金森病(IPD)患者和14名血管性帕金森病(VaP)患者。采用留一法交叉验证(LOOCV)。贝蒂曲线描述符表现最优。在用药状态(On)下,足部抬升变量中的最小趾离地高度、最大脚跟摆动期抬升和最大脚尖离地高度组合实现83%准确率与AUC=0.89。性能在用药状态更优,且结合用药前后状态进一步提升,表明拓扑特征对左旋多巴引起的步态变化敏感。结果支持将拓扑数据分析与机器学习融合,以提升临床步态分析能力,助力帕金森综合征的鉴别诊断。
原文摘要 · Abstract (English)
Differential diagnosis among parkinsonian syndromes remains a clinical challenge due to overlapping motor symptoms and subtle gait abnormalities. Accurate differentiation is crucial for treatment planning and prognosis. While gait analysis is a well established approach for assessing motor impairments, conventional methods often overlook hidden nonlinear and structural features embedded in foot clearance patterns. We evaluated Topological Data Analysis (TDA) as a complementary tool for Parkinsonism classification using foot clearance time series. Persistent homology produced Betti curves, persistence landscapes, and silhouettes, which were used as features for a Random Forest classifier. The dataset comprised 15 controls (CO), 15 idiopathic Parkinson's disease (IPD), and 14 vascular Parkinsonism (VaP). Models were assessed with leave-one-out cross-validation (LOOCV). Betti-curve descriptors consistently yielded the strongest results. For IPD vs VaP, foot clearance variables minimum toe clearance, maximum toe late swing, and maximum heel clearance achieved 83% accuracy and AUC=0.89 under LOOCV in the medicated (On) state. Performance improved in the On state and further when both Off and On states were considered, indicating sensitivity of the topological features to levodopa related gait changes. These findings support integrating TDA with machine learning to improve clinical gait analysis and aid differential diagnosis across parkinsonian disorders.
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