Rule based fuzzy logic approach for classification of fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) is a chronic muscle and skeletal system disease observed generally in women, manifesting itself with a widespread pain and impairing the individual's quality of life. FMS diagnosis is made based on the American College of Rheumatology (ACR) criteria. However, recently the employability and sufficiency of ACR criteria are under debate. In this context, several evaluation methods, including clinical evaluation methods were proposed by researchers. Accordingly, ACR had to update their criteria announced back in 1990, 2010 and 2011. Proposed rule based fuzzy logic method aims to evaluate FMS at a different angle as well. This method contains a rule base derived from the 1990 ACR criteria and the individual experiences of specialists. The study was conducted using the data collected from 60 inpatient and 30 healthy volunteers. Several tests and physical examination were administered to the participants. The fuzzy logic rule base was structured using the parameters of tender point count, chronic widespread pain period, pain severity, fatigue severity and sleep disturbance level, which were deemed important in FMS diagnosis. It has been observed that generally fuzzy predictor was 95.56 % consistent with at least of the specialists, who are not a creator of the fuzzy rule base. Thus, in diagnosis classification where the severity of FMS was classified as well, consistent findings were obtained from the comparison of interpretations and experiences of specialists and the fuzzy logic approach. The study proposes a rule base, which could eliminate the shortcomings of 1990 ACR criteria during the FMS evaluation process. Furthermore, the proposed method presents a classification on the severity of the disease, which was not available with the ACR criteria. The study was not limited to only disease classification but at the same time the probability of occurrence and severity was classified. In addition, those who were not suffering from FMS were evaluated for their conditions in other patient groups.

A Study on the Effects of Sympathetic Skin Response Parameters in Diagnosis of Fibromyalgia Using Artificial Neural Networks.

Fibromyalgia syndrome (FMS), usually observed commonly in females over age 30, is a rheumatic disease accompanied by extensive chronic pain. In the diagnosis of the disease non-objective psychological tests and physiological tests and laboratory test results are evaluated and clinical experiences stand out. However, these tests are insufficient in differentiating FMS with similar diseases that demonstrate symptoms of extensive pain. Thus, objective tests that would help the diagnosis are needed. This study analyzes the effect of sympathetic skin response (SSR) parameters on the auxiliary tests used in FMS diagnosis, the laboratory tests and physiological tests. The study was conducted in Suleyman Demirel University, Faculty of Medicine, Physical Medicine and Rehabilitation Clinic in Turkey with 60 patients diagnosed with FMS for the first time and a control group of 30 healthy individuals. In the study all participants underwent laboratory tests (blood tests), certain physiological tests (pulsation, skin temperature, respiration) and SSR measurements. The test data and SSR parameters obtained were classified using artificial neural network (ANN). Finally, in the ANN framework, where only laboratory and physiological test results were used as input, a simulation result of 96.51 % was obtained, which demonstrated diagnostic accuracy. This data, with the addition of SSR parameter values obtained increased to 97.67 %. This result including SSR parameters - meaning a higher diagnostic accuracy - demonstrated that SSR could be a new auxillary diagnostic method that could be used in the diagnosis of FMS.

Investigation of the relationship between anxiety and heart rate variability in fibromyalgia: A new quantitative approach to evaluate anxiety level in fibromyalgia syndrome.

BACKGROUND: Fibromyalgia syndrome (FMS) is identified by widespread musculoskeletal pain, sleep disturbance, nonrestorative sleep, fatigue, morning stiffness and anxiety. Anxiety is very common in Fibromyalgia and generally leads to a misdiagnosis. Self-rated Beck Anxiety Inventory (BAI) and doctor-rated Hamilton Anxiety Inventory (HAM-A) are frequently used by specialists to determine anxiety that accompanies fibromyalgia. However, these semi-quantitative anxiety tests are still subjective as the tests are scored using doctor-rated or self-rated scales. METHOD: In this study, we investigated the relationship between heart rate variability (HRV) frequency subbands and anxiety tests. The study was conducted with 56 FMS patients and 34 healthy controls. BAI and HAM-A test scores were determined for each participant. ECG signals were then recruited and 71 HRV subbands were obtained from these ECG signals using Wavelet Packet Transform (WPT). The subbands and anxiety tests scores were analyzed and compared using multilayer perceptron neural networks (MLPNN). RESULTS: The results show that a HRV high frequency (HF) subband in the range of 0.15235Hz to 0.40235Hz, is correlated with BAI scores and another HRV HF subband, frequency range of 0.15235Hz to 0.28907Hz is correlated with HAM-A scores. The overall accuracy is 91.11% for HAM-A and 90% for BAI with MLPNN analysis. CONCLUSION: Doctor-rated or self-rated anxiety tests should be supported with quantitative and more objective methods. Our results show that the HRV parameters will be able to support the anxiety tests in the clinical evaluation of fibromyalgia. In other words, HRV parameters can potentially be used as an auxiliary diagnostic method in conjunction with anxiety tests.

Determination of Fatigue Following Maximal Loaded Treadmill Exercise by Using Wavelet Packet Transform Analysis and MLPNN from MMG-EMG Data Combinations.

The muscle fatigue can be expressed as decrease in maximal voluntary force generating capacity of the neuromuscular system as a result of peripheral changes at the level of the muscle, and also failure of the central nervous system to drive the motoneurons adequately. In this study, a muscle fatigue detection method based on frequency spectrum of electromyogram (EMG) and mechanomyogram (MMG) has been presented. The EMG and MMG data were obtained from 31 healthy, recreationally active men at the onset, and following exercise. All participants were performed a maximally exercise session in a motor-driven treadmill by using standard Bruce protocol which is the most widely used test to predict functional capacity. The method used in the present study consists of pre-processing, determination of the energy value based on wavelet packet transform, and classification phases. The results of the study demonstrated that changes in the MMG 176-234 Hz and EMG 254-313 Hz bands are critical to determine for muscle fatigue occurred following maximally exercise session. In conclusion, our study revealed that an algorithm with EMG and MMG combination based on frequency spectrum is more effective for the detection of muscle fatigue than EMG or MMG alone.

The correlation of laboratory tests and Sympathetic Skin Response parameters by using artificial neural networks in fibromyalgia patients.

Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disease which causes dysfunction of the autonomic nervous system. Sympathetic Skin Response (SSR) is a part of electrical impedance of body which is affected by the autonomic nervous system dysfunctions. In this study, values obtained from the results of the patients diagnosed with fibromyalgia syndrome, and healthy subjects blood samples in the laboratory conditions are recorded in Suleyman Demirel University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation. SSR measurements are recorded from patients and healthy controls. Values of latency time, maximum amplitude and elapsed time between two stimulus parameters are obtained from recorded sympathetic skin response data by using Matlab software. The relationship between SSR parameters and laboratory tests is investigated by using artificial neural networks. As a result SSR seems to be a valid parameter in the classification of FMS.

Measuring the sympathetic skin response on body and using as diagnosis-purposed for lung cancer patients by artificial neural networks.

In this study, the points of Sympathetic skin response that can be measured from different zones on body of healthy and patient subjects are determined. The Sympathetic skin responses on these points are obtained using a measurement device that is called Grass Model 7 Polygraph 1. The database is formed in Cerrahpasa University, Faculty of Medicine and data is taken from healthy and patient subjects who are volunteer. Some parameters of the subjects which are more effective on SSR such as height, weight, age must be chosen between the specific limits to obtain results more clearly. The symmetric points on human body are chosen for the measurement. After that, the Sympathetic skin response values which are measured from a human body are simulated and tested by using artificial neural network toolbox on Matlab software. The structure of the chosen neural network is a multilayer feedforward neural network. According to simulation results, the application method as diagnosis-purposed of the lung cancer patients is explained by using the differences related to these values on the skin.

Determination of a new VLF band in HRV for ventricular tachyarrhythmia patients.

This study presents a new very low frequency (VLF) band range in ventricular tachyarrhythmia patients and involves an approach for estimation of effect of VLF band on ventricular tachyarrhythmia patients. A model based on wavelet packets (WP) and multilayer perceptron neural network (MLPNN) is used for determination of effective VLF band in heart rate variability (HRV) signals. HRV is decomposed into sub-bands including very low frequency parts and variations of energy are analyzed. Domination test is done using MLPNN and dominant band is determined. As a result, a new VLF band was described in 0.0039063-0.03125 Hz frequency range. This method can be used for other bands or other arrhythmia patients. Especially, estimation of dominant band energy using this method can be helped to diagnose for applications where have important effect of characteristic band.

Weak signal propagation through noisy feedforward neuronal networks.

We determine under which conditions the propagation of weak periodic signals through a feedforward Hodgkin-Huxley neuronal network is optimal. We find that successive neuronal layers are able to amplify weak signals introduced to the neurons forming the first layer only above a certain intensity of intrinsic noise. Furthermore, we show that as low as 4% of all possible interlayer links are sufficient for an optimal propagation of weak signals to great depths of the feedforward neuronal network, provided the signal frequency and the intensity of intrinsic noise are appropriately adjusted.

Comparison of subspace-based methods with AR parametric methods in epileptic seizure detection.

Electroencephalography is an important clinical tool for the evaluation and treatment of neurophysiologic disorders related to epilepsy. Careful analyses of the electroencephalograph (EEG) records can provide valuable insight and improved understanding of the mechanisms causing epileptic disorders. The detection of epileptiform discharges in the EEG is an important component in the diagnosis of epilepsy. In this study, we have proposed subspace-based methods to analyze and characterize epileptiform discharges in the form of 3-Hz spike and wave complex in patients with absence seizure. The variations in the shape of the EEG power spectra were examined in order to obtain medical information. These power spectra were then used to compare the applied methods in terms of their frequency resolution and the effects in determination of epileptic seizure. Global performance of the proposed methods was evaluated by means of the visual inspection of power spectral densities (PSDs). Graphical results comparing the performance of the proposed methods with that of the autoregressive techniques were given. The results demonstrate consistently superior performance of the proposed methods over the autoregressive ones.

Automatic seizure detection in EEG using logistic regression and artificial neural network.

The detection of epileptiform discharges in the EEG is an important component in the diagnosis of epilepsy. In this study, multiple signal classification (MUSIC), autoregressive (AR) and periodogram methods were used to get power spectra in patients with absence seizure. The EEG power spectra were used as an input to a classifier. We introduce two fundamentally different approaches for designing classification models (classifiers); the traditional statistical method based on logistic regression (LR) and the emerging computationally powerful techniques based on artificial neural networks (ANNs). LR as well as multilayer perceptron neural network (MLPNN) based classifiers were developed and compared in relation to their accuracy in classification of EEG signals. The comparisons between the developed classifiers were primarily based on analysis of the receiver operating characteristic (ROC) curves as well as a number of scalar performance measures pertaining to the classification. The MLPNN based classifier outperformed the LR based counterpart. Within the same group, the MLPNN-based classifier was more accurate than the LR-based classifier.

Wavelet neural network classification of EEG signals by using AR model with MLE preprocessing.

Since EEG is one of the most important sources of information in therapy of epilepsy, several researchers tried to address the issue of decision support for such a data. In this paper, we introduce two fundamentally different approaches for designing classification models (classifiers); the traditional statistical method based on logistic regression and the emerging computationally powerful techniques based on artificial neural networks (ANNs). Logistic regression as well as feedforward error backpropagation artificial neural networks (FEBANN) and wavelet neural networks (WNN) based classifiers were developed and compared in relation to their accuracy in classification of EEG signals. In these methods we used FFT and autoregressive (AR) model by using maximum likelihood estimation (MLE) of EEG signals as an input to classification system with two discrete outputs: epileptic seizure or nonepileptic seizure. By identifying features in the signal we want to provide an automatic system that will support a physician in the diagnosing process. By applying AR with MLE in connection with WNN, we obtained novel and reliable classifier architecture. The network is constructed by the error backpropagation neural network using Morlet mother wavelet basic function as node activation function. The comparisons between the developed classifiers were primarily based on analysis of the receiver operating characteristic (ROC) curves as well as a number of scalar performance measures pertaining to the classification. The WNN-based classifier outperformed the FEBANN and logistic regression based counterpart. Within the same group, the WNN-based classifier was more accurate than the FEBANN-based classifier, and the logistic regression-based classifier.