Motor activity patterns can distinguish between interepisode bipolar disorder patients and healthy controls.

BACKGROUND: Bipolar disorder (BD) is linked to circadian rhythm disruptions resulting in aberrant motor activity patterns. We aimed to explore whether motor activity alone, as assessed by longitudinal actigraphy, can be used to classify accurately BD patients and healthy controls (HCs) into their respective groups. METHODS: Ninety-day actigraphy records from 25 interepisode BD patients (ie, Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) < 15) and 25 sex- and age-matched HCs were used in order to identify latent actigraphic biomarkers capable of discriminating between BD patients and HCs. Mean values and time variations of a set of standard actigraphy features were analyzed and further validated using the random forest classifier. RESULTS: Using all actigraphy features, this method correctly assigned 88% (sensitivity = 85%, specificity = 91%) of BD patients and HCs to their respective group. The classification success may be confounded by differences in employment between BD patients and HCs. When motor activity features resistant to the employment status were used (the strongest feature being time variation of intradaily variability, Cohen's d = 1.33), 79% of the subjects (sensitivity = 76%, specificity = 81%) were correctly classified. CONCLUSION: A machine-learning actigraphy-based model was capable of distinguishing between interepisode BD patients and HCs solely on the basis of motor activity. The classification remained valid even when features influenced by employment status were omitted. The findings suggest that temporal variability of actigraphic parameters may provide discriminative power for differentiating between BD patients and HCs while being less affected by employment status.

Classification of Actigraphy Records from Bipolar Disorder Patients Using Slope Entropy: A Feasibility Study.

Bipolar Disorder (BD) is an illness with high prevalence and a huge social and economic impact. It is recurrent, with a long-term evolution in most cases. Early treatment and continuous monitoring have proven to be very effective in mitigating the causes and consequences of BD. However, no tools are currently available for a massive and semi-automatic BD patient monitoring and control. Taking advantage of recent technological developments in the field of wearables, this paper studies the feasibility of a BD episodes classification analysis while using entropy measures, an approach successfully applied in a myriad of other physiological frameworks. This is a very difficult task, since actigraphy records are highly non-stationary and corrupted with artifacts (no activity). The method devised uses a preprocessing stage to extract epochs of activity, and then applies a quantification measure, Slope Entropy, recently proposed, which outperforms the most common entropy measures used in biomedical time series. The results confirm the feasibility of the approach proposed, since the three states that are involved in BD, depression, mania, and remission, can be significantly distinguished.

Distinct populations of neurons respond to emotional valence and arousal in the human subthalamic nucleus.

Both animal studies and studies using deep brain stimulation in humans have demonstrated the involvement of the subthalamic nucleus (STN) in motivational and emotional processes; however, participation of this nucleus in processing human emotion has not been investigated directly at the single-neuron level. We analyzed the relationship between the neuronal firing from intraoperative microrecordings from the STN during affective picture presentation in patients with Parkinson's disease (PD) and the affective ratings of emotional valence and arousal performed subsequently. We observed that 17% of neurons responded to emotional valence and arousal of visual stimuli according to individual ratings. The activity of some neurons was related to emotional valence, whereas different neurons responded to arousal. In addition, 14% of neurons responded to visual stimuli. Our results suggest the existence of neurons involved in processing or transmission of visual and emotional information in the human STN, and provide evidence of separate processing of the affective dimensions of valence and arousal at the level of single neurons as well.

Topography of emotional valence and arousal within the motor part of the subthalamic nucleus in Parkinson's disease.

Clinical motor and non-motor effects of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD) seem to depend on the stimulation site within the STN. We analysed the effects of the position of the stimulation electrode within the motor STN on subjective emotional experience, expressed as emotional valence and arousal ratings to pictures representing primary rewards and aversive fearful stimuli in 20 PD patients. Patients' ratings from both aversive and erotic stimuli matched the mean ratings from a group of 20 control subjects at similar position within the STN. Patients with electrodes located more posteriorly reported both valence and arousal ratings from both the rewarding and aversive pictures as more extreme. Moreover, posterior electrode positions were associated with a higher occurrence of depression at a long-term follow-up. This brain-behavior relationship suggests a complex emotion topography in the motor part of the STN. Both valence and arousal representations overlapped and were uniformly arranged anterior-posteriorly in a gradient-like manner, suggesting a specific spatial organization needed for the coding of the motivational salience of the stimuli. This finding is relevant for our understanding of neuropsychiatric side effects in STN DBS and potentially for optimal electrode placement.

Methods for automatic detection of artifacts in microelectrode recordings.

BACKGROUND: Extracellular microelectrode recording (MER) is a prominent technique for studies of extracellular single-unit neuronal activity. In order to achieve robust results in more complex analysis pipelines, it is necessary to have high quality input data with a low amount of artifacts. We show that noise (mainly electromagnetic interference and motion artifacts) may affect more than 25% of the recording length in a clinical MER database. NEW METHOD: We present several methods for automatic detection of noise in MER signals, based on (i) unsupervised detection of stationary segments, (ii) large peaks in the power spectral density, and (iii) a classifier based on multiple time- and frequency-domain features. We evaluate the proposed methods on a manually annotated database of 5735 ten-second MER signals from 58 Parkinson's disease patients. COMPARISON WITH EXISTING METHODS: The existing methods for artifact detection in single-channel MER that have been rigorously tested, are based on unsupervised change-point detection. We show on an extensive real MER database that the presented techniques are better suited for the task of artifact identification and achieve much better results. RESULTS: The best-performing classifiers (bagging and decision tree) achieved artifact classification accuracy of up to 89% on an unseen test set and outperformed the unsupervised techniques by 5-10%. This was close to the level of agreement among raters using manual annotation (93.5%). CONCLUSION: We conclude that the proposed methods are suitable for automatic MER denoising and may help in the efficient elimination of undesirable signal artifacts.

Performance comparison of publicly available retinal blood vessel segmentation methods.

Retinal blood vessel structure is an important indicator of many retinal and systemic diseases, which has motivated the development of various image segmentation methods for the blood vessels. In this study, two supervised and three unsupervised segmentation methods with a publicly available implementation are reviewed and quantitatively compared with each other on five public databases with ground truth segmentation of the vessels. Each method is tested under consistent conditions with two types of preprocessing, and the parameters of the methods are optimized for each database. Additionally, possibility to predict the parameters of the methods by the linear regression model is tested for each database. Resolution of the input images and amount of the vessel pixels in the ground truth are used as predictors. The results show the positive influence of preprocessing on the performance of the unsupervised methods. The methods show similar performance for segmentation accuracy, with the best performance achieved by the method by Azzopardi et al. (Acc 94.0) on ARIADB, the method by Soares et al. (Acc 94.6, 94.7) on CHASEDB1 and DRIVE, and the method by Nguyen et al. (Acc 95.8, 95.5) on HRF and STARE. The method by Soares et al. performed better with regard to the area under the ROC curve. Qualitative differences between the methods are discussed. Finally, it was possible to predict the parameter settings that give performance close to the optimized performance of each method.

Diaphragm postural function analysis using magnetic resonance imaging.

We present a postural analysis of diaphragm function using magnetic resonance imaging (MRI). The main aim of the study was to identify changes in diaphragm motion and shape when postural demands on the body were increased (loading applied to a distal part of the extended lower extremities against the flexion of the hips was used). Sixteen healthy subjects were compared with 17 subjects suffering from chronic low back pain and in whom structural spine disorders had been identified. Two sets of features were calculated from MRI recordings: dynamic parameters reflecting diaphragm action, and static parameters reflecting diaphragm anatomic characteristics. A statistical analysis showed that the diaphragm respiratory and postural changes were significantly slower, bigger in size and better balanced in the control group. When a load was applied to the lower limbs, the pathological subjects were mostly not able to maintain the respiratory diaphragm function, which was lowered significantly. Subjects from the control group showed more stable parameters of both respiratory and postural function. Our findings consistently affirmed worse muscle cooperation in the low back pain population subgroup. A clear relation with spinal findings and with low back pain remains undecided, but various findings in the literature were confirmed. The most important finding is the need to further address various mechanisms used by patients to compensate deep muscle insufficiency.

Wrapper feature selection for small sample size data driven by complete error estimates.

This paper focuses on wrapper-based feature selection for a 1-nearest neighbor classifier. We consider in particular the case of a small sample size with a few hundred instances, which is common in biomedical applications. We propose a technique for calculating the complete bootstrap for a 1-nearest-neighbor classifier (i.e., averaging over all desired test/train partitions of the data). The complete bootstrap and the complete cross-validation error estimate with lower variance are applied as novel selection criteria and are compared with the standard bootstrap and cross-validation in combination with three optimization techniques - sequential forward selection (SFS), binary particle swarm optimization (BPSO) and simplified social impact theory based optimization (SSITO). The experimental comparison based on ten datasets draws the following conclusions: for all three search methods examined here, the complete criteria are a significantly better choice than standard 2-fold cross-validation, 10-fold cross-validation and bootstrap with 50 trials irrespective of the selected output number of iterations. All the complete criterion-based 1NN wrappers with SFS search performed better than the widely-used FILTER and SIMBA methods. We also demonstrate the benefits and properties of our approaches on an important and novel real-world application of automatic detection of the subthalamic nucleus.