Neuronal Spike Shapes (NSS): A straightforward approach to investigate heterogeneity in neuronal excitability states.

The mammalian brain exhibits a remarkable diversity of neurons, contributing to its intricate architecture and functional complexity. The analysis of multimodal single-cell datasets enables the investigation of cell types and states heterogeneity. In this study, we introduce the Neuronal Spike Shapes (NSS), a straightforward approach for the exploration of excitability states of neurons based on their Action Potential (AP) waveforms. The NSS method describes the AP waveform based on a triangular representation complemented by a set of derived electrophysiological (EP) features. To support this hypothesis, we validate the proposed approach on two datasets of murine cortical neurons, focusing it on GABAergic neurons. The validation process involves a combination of NSS-based clustering analysis, features exploration, Differential Expression (DE), and Gene Ontology (GO) enrichment analysis. Results show that the NSS-based analysis captures neuronal excitability states that possess biological relevance independently of cell subtype. In particular, Neuronal Spike Shapes (NSS) captures, among others, a well-characterized fast-spiking excitability state, supported by both electrophysiological and transcriptomic validation. Gene Ontology Enrichment Analysis reveals voltage-gated potassium (K+) channels as specific markers of the identified NSS partitions. This finding strongly corroborates the biological relevance of NSS partitions as excitability states, as the expression of voltage-gated K+ channels regulates the hyperpolarization phase of the AP, being directly implicated in the regulation of neuronal excitability.

Robust and language-independent acoustic features in Parkinson's disease.

Introduction: The analysis of vocal samples from patients with Parkinson's disease (PDP) can be relevant in supporting early diagnosis and disease monitoring. Intriguingly, speech analysis embeds several complexities influenced by speaker characteristics (e.g., gender and language) and recording conditions (e.g., professional microphones or smartphones, supervised, or non-supervised data collection). Moreover, the set of vocal tasks performed, such as sustained phonation, reading text, or monologue, strongly affects the speech dimension investigated, the feature extracted, and, as a consequence, the performance of the overall algorithm. Methods: We employed six datasets, including a cohort of 176 Healthy Control (HC) participants and 178 PDP from different nationalities (i.e., Italian, Spanish, Czech), recorded in variable scenarios through various devices (i.e., professional microphones and smartphones), and performing several speech exercises (i.e., vowel phonation, sentence repetition). Aiming to identify the effectiveness of different vocal tasks and the trustworthiness of features independent of external co-factors such as language, gender, and data collection modality, we performed several intra- and inter-corpora statistical analyses. In addition, we compared the performance of different feature selection and classification models to evaluate the most robust and performing pipeline. Results: According to our results, the combined use of sustained phonation and sentence repetition should be preferred over a single exercise. As for the set of features, the Mel Frequency Cepstral Coefficients demonstrated to be among the most effective parameters in discriminating between HC and PDP, also in the presence of heterogeneous languages and acquisition techniques. Conclusion: Even though preliminary, the results of this work can be exploited to define a speech protocol that can effectively capture vocal alterations while minimizing the effort required to the patient. Moreover, the statistical analysis identified a set of features minimally dependent on gender, language, and recording modalities. This discloses the feasibility of extensive cross-corpora tests to develop robust and reliable tools for disease monitoring and staging and PDP follow-up.

Context Recognition Algorithms for Energy-Efficient Freezing-of-Gait Detection in Parkinson's Disease.

Freezing of gait (FoG) is a disabling clinical phenomenon of Parkinson's disease (PD) characterized by the inability to move the feet forward despite the intention to walk. It is one of the most troublesome symptoms of PD, leading to an increased risk of falls and reduced quality of life. The combination of wearable inertial sensors and machine learning (ML) algorithms represents a feasible solution to monitor FoG in real-world scenarios. However, traditional FoG detection algorithms process all data indiscriminately without considering the context of the activity during which FoG occurs. This study aimed to develop a lightweight, context-aware algorithm that can activate FoG detection systems only under certain circumstances, thus reducing the computational burden. Several approaches were implemented, including ML and deep learning (DL) gait recognition methods, as well as a single-threshold method based on acceleration magnitude. To train and evaluate the context algorithms, data from a single inertial sensor were extracted using three different datasets encompassing a total of eighty-one PD patients. Sensitivity and specificity for gait recognition ranged from 0.95 to 0.96 and 0.80 to 0.93, respectively, with the one-dimensional convolutional neural network providing the best results. The threshold approach performed better than ML- and DL-based methods when evaluating the effect of context awareness on FoG detection performance. Overall, context algorithms allow for discarding more than 55% of non-FoG data and less than 4% of FoG episodes. The results indicate that a context classifier can reduce the computational burden of FoG detection algorithms without significantly affecting the FoG detection rate. Thus, implementation of context awareness can present an energy-efficient solution for long-term FoG monitoring in ambulatory and free-living settings.

Real-time detection of freezing of gait in Parkinson's disease using multi-head convolutional neural networks and a single inertial sensor.

BACKGROUND: Freezing of gait (FOG) is one of the most disabling symptoms of Parkinson's disease (PD), contributing to poor quality of life and increased risk of falls. Wearable sensors represent a valuable means for detecting FOG in the home environment. Moreover, real-time feedback has proven to help reduce the duration of FOG episodes. This work proposes a robust real-time FOG detection algorithm, which is easy to implement in stand-alone devices working in non-supervised conditions. METHOD: Data from three different data sets were used in this study, with two employed as independent test sets. Acceleration recordings from 118 PD patients and 21 healthy elderly subjects were collected while they performed simulated daily living activities. A single inertial sensor was attached to the waist of each subject. More than 17 h of valid data and a total number of 1110 FOG episodes were analyzed in this study. The implemented algorithm consisted of a multi-head convolutional neural network, which exploited different spatial resolutions in the analysis of inertial data. The architecture and the model parameters were designed to provide optimal performance while reducing computational complexity and testing time. RESULTS: The developed algorithm demonstrated good to excellent classification performance, with more than 50% (30%) of FOG episodes predicted on average 3.1 s (1.3 s) before the actual onset in the main (independent) data set. Around 50% of FOG was detected with an average delay of 0.8 s (1.1 s) in the main (independent) data set. Moreover, a specificity above 88% (93%) was obtained when testing the algorithm on the main (independent) test set, while 100% specificity was obtained on healthy elderly subjects. CONCLUSION: The algorithm proved robust, with low computational complexity and processing time, thus paving the way to a real-time implementation in a stand-alone device that can be used in non-supervised environments.

How resistant are levodopa-resistant axial symptoms? Response of freezing, posture, and voice to increasing levodopa intestinal infusion rates in Parkinson disease.

BACKGROUND AND PURPOSE: Treatment of freezing of gait (FoG) and other Parkinson disease (PD) axial symptoms is challenging. Systematic assessments of axial symptoms at progressively increasing levodopa doses are lacking. We sought to analyze the resistance to high levodopa doses of FoG, posture, speech, and altered gait features presenting in daily-ON therapeutic condition. METHODS: We performed a pre-/postinterventional study including patients treated with levodopa/carbidopa intestinal gel infusion (LCIG) with disabling FoG in daily-ON condition. Patients were evaluated at their usual LCIG infusion rate (T1), and 1 h after 1.5× (T2) and 2× (T3) increase of the LCIG infusion rate by quantitative outcome measures. The number of FoG episodes (primary outcome), posture, speech, and gait features were objectively quantified during a standardized test by a blinded rater. Changes in motor symptoms, dyskinesia, and plasma levodopa concentrations were also analyzed. RESULTS: We evaluated 16 patients with a mean age of 69 ± 9.4 years and treated with LCIG for a mean of 2.2 ± 2.1 years. FoG improved in 83.3% of patients by increasing the levodopa doses. The number of FoG episodes significantly decreased (mean = 2.3 at T1, 1.7 at T2, 1.2 at T3; p = 0.013). Posture and speech features did not show significant changes, whereas stride length (p = 0.049), turn duration (p = 0.001), and turn velocity (p = 0.024) significantly improved on doubling the levodopa infusion rate. CONCLUSIONS: In a short-term evaluation, the increase of LCIG dose can improve "dopa-resistant" FoG and gait issues in most advanced PD patients with overall good control of motor symptoms in the absence of clinically significant dyskinesia.

High-accuracy wearable detection of freezing of gait in Parkinson's disease based on pseudo-multimodal features.

OBJECTIVE: Freezing of gait (FoG) is a serious symptom of Parkinson's disease and prompt detection of FoG is crucial for fall prevention. Although multimodal data combining electroencephalography (EEG) benefit accurate FoG detection, the preparation, acquisition, and analysis of EEG signals are time-consuming and costly, which impedes the application of multimodal information in FoG detection. This work proposes a wearable FoG detection method that merges multimodal information from acceleration and EEG while avoiding the acquisition of real EEG data. METHODS: A proxy measurement (PM) model based on long-short-term-memory (LSTM) network was proposed to measure EEG features from accelerations, and pseudo-multimodal features, i.e., pseudo-EEG and acceleration, could be extracted using a highly wearable inertial sensor for FoG detection. RESULTS: Based on a self-collected FoG dataset, the performance of different feature combinations were compared in terms of subject-dependent and cross-subject settings. In both settings, pseudo-multimodal features achieved the most promising performance, with a geometric mean of 91.0 ± 5.0% in subject-dependent setting and 91.0 ± 3.5% in cross-subject setting. CONCLUSION: Our study suggests that wearable FoG detection can be enhanced through leveraging cross-modal information fusion. SIGNIFICANCE: The new method provides a promising path for multimodal information fusion and the long-term monitoring of FoG in living environments.

A Multi-Modal Analysis of the Freezing of Gait Phenomenon in Parkinson's Disease.

BACKGROUND: Freezing of Gait (FOG) is one of the most disabling motor complications of Parkinson's disease, and consists of an episodic inability to move forward, despite the intention to walk. FOG increases the risk of falls and reduces the quality of life of patients and their caregivers. The phenomenon is difficult to appreciate during outpatients visits; hence, its automatic recognition is of great clinical importance. Many types of sensors and different locations on the body have been proposed. However, the advantages of a multi-sensor configuration with respect to a single-sensor one are not clear, whereas this latter would be advisable for use in a non-supervised environment. METHODS: In this study, we used a multi-modal dataset and machine learning algorithms to perform different classifications between FOG and non-FOG periods. Moreover, we explored the relevance of features in the time and frequency domains extracted from inertial sensors, electroencephalogram and skin conductance. We developed both a subject-independent and a subject-dependent algorithm, considering different sensor subsets. RESULTS: The subject-independent and subject-dependent algorithms yielded accuracies of 85% and 88% in the leave-one-subject-out and leave-one-task-out test, respectively. Results suggest that the inertial sensors positioned on the lower limb are generally the most significant in recognizing FOG. Moreover, the performance impairment experienced when using a single tibial accelerometer instead of the optimal multi-modal configuration is limited to 2-3%. CONCLUSIONS: The achieved results disclose the possibility of getting a good FOG recognition using a minimally invasive set-up made of a single inertial sensor. This is very significant in the perspective of implementing a long-term monitoring of patients in their homes, during activities of daily living.

Predicting Axial Impairment in Parkinson's Disease through a Single Inertial Sensor.

BACKGROUND: Current telemedicine approaches lack standardised procedures for the remote assessment of axial impairment in Parkinson's disease (PD). Unobtrusive wearable sensors may be a feasible tool to provide clinicians with practical medical indices reflecting axial dysfunction in PD. This study aims to predict the postural instability/gait difficulty (PIGD) score in PD patients by monitoring gait through a single inertial measurement unit (IMU) and machine-learning algorithms. METHODS: Thirty-one PD patients underwent a 7-m timed-up-and-go test while monitored through an IMU placed on the thigh, both under (ON) and not under (OFF) dopaminergic therapy. After pre-processing procedures and feature selection, a support vector regression model was implemented to predict PIGD scores and to investigate the impact of L-Dopa and freezing of gait (FOG) on regression models. RESULTS: Specific time- and frequency-domain features correlated with PIGD scores. After optimizing the dimensionality reduction methods and the model parameters, regression algorithms demonstrated different performance in the PIGD prediction in patients OFF and ON therapy (r = 0.79 and 0.75 and RMSE = 0.19 and 0.20, respectively). Similarly, regression models showed different performances in the PIGD prediction, in patients with FOG, ON and OFF therapy (r = 0.71 and RMSE = 0.27; r = 0.83 and RMSE = 0.22, respectively) and in those without FOG, ON and OFF therapy (r = 0.85 and RMSE = 0.19; r = 0.79 and RMSE = 0.21, respectively). CONCLUSIONS: Optimized support vector regression models have high feasibility in predicting PIGD scores in PD. L-Dopa and FOG affect regression model performances. Overall, a single inertial sensor may help to remotely assess axial motor impairment in PD patients.

An algorithm for Parkinson's disease speech classification based on isolated words analysis.

INTRODUCTION: Automatic assessment of speech impairment is a cutting edge topic in Parkinson's disease (PD). Language disorders are known to occur several years earlier than typical motor symptoms, thus speech analysis may contribute to the early diagnosis of the disease. Moreover, the remote monitoring of dysphonia could allow achieving an effective follow-up of PD clinical condition, possibly performed in the home environment. METHODS: In this work, we performed a multi-level analysis, progressively combining features extracted from the entire signal, the voiced segments, and the on-set/off-set regions, leading to a total number of 126 features. Furthermore, we compared the performance of early and late feature fusion schemes, aiming to identify the best model configuration and taking advantage of having 25 isolated words pronounced by each subject. We employed data from the PC-GITA database (50 healthy controls and 50 PD patients) for validation and testing. RESULTS: We implemented an optimized k-Nearest Neighbours model for the binary classification of PD patients versus healthy controls. We achieved an accuracy of 99.4% in 10-fold cross-validation and 94.3% in testing on the PC-GITA database (average value of male and female subjects). CONCLUSION: The promising performance yielded by our model confirms the feasibility of automatic assessment of PD using voice recordings. Moreover, a post-hoc analysis of the most relevant features discloses the option of voice processing using a simple smartphone application.

Single-channel EEG classification of sleep stages based on REM microstructure.

Rapid-eye movement (REM) sleep, or paradoxical sleep, accounts for 20-25% of total night-time sleep in healthy adults and may be related, in pathological cases, to parasomnias. A large percentage of Parkinson's disease patients suffer from sleep disorders, including REM sleep behaviour disorder and hypokinesia; monitoring their sleep cycle and related activities would help to improve their quality of life. There is a need to accurately classify REM and the other stages of sleep in order to properly identify and monitor parasomnias. This study proposes a method for the identification of REM sleep from raw single-channel electroencephalogram data, employing novel features based on REM microstructures. Sleep stage classification was performed by means of random forest (RF) classifier, K-nearest neighbour (K-NN) classifier and random Under sampling boosted trees (RUSBoost); the classifiers were trained using a set of published and novel features. REM detection accuracy ranges from 89% to 92.7%, and the classifiers achieved a F-1 score (REM class) of about 0.83 (RF), 0.80 (K-NN), and 0.70 (RUSBoost). These methods provide encouraging outcomes in automatic sleep scoring and REM detection based on raw single-channel electroencephalogram, assessing the feasibility of a home sleep monitoring device with fewer channels.

Prediction of Freezing of Gait in Parkinson's Disease Using Wearables and Machine Learning.

Freezing of gait (FOG) is one of the most troublesome symptoms of Parkinson's disease, affecting more than 50% of patients in advanced stages of the disease. Wearable technology has been widely used for its automatic detection, and some papers have been recently published in the direction of its prediction. Such predictions may be used for the administration of cues, in order to prevent the occurrence of gait freezing. The aim of the present study was to propose a wearable system able to catch the typical degradation of the walking pattern preceding FOG episodes, to achieve reliable FOG prediction using machine learning algorithms and verify whether dopaminergic therapy affects the ability of our system to detect and predict FOG. METHODS: A cohort of 11 Parkinson's disease patients receiving (on) and not receiving (off) dopaminergic therapy was equipped with two inertial sensors placed on each shin, and asked to perform a timed up and go test. We performed a step-to-step segmentation of the angular velocity signals and subsequent feature extraction from both time and frequency domains. We employed a wrapper approach for feature selection and optimized different machine learning classifiers in order to catch FOG and pre-FOG episodes. RESULTS: The implemented FOG detection algorithm achieved excellent performance in a leave-one-subject-out validation, in patients both on and off therapy. As for pre-FOG detection, the implemented classification algorithm achieved 84.1% (85.5%) sensitivity, 85.9% (86.3%) specificity and 85.5% (86.1%) accuracy in leave-one-subject-out validation, in patients on (off) therapy. When the classification model was trained with data from patients on (off) and tested on patients off (on), we found 84.0% (56.6%) sensitivity, 88.3% (92.5%) specificity and 87.4% (86.3%) accuracy. CONCLUSIONS: Machine learning models are capable of predicting FOG before its actual occurrence with adequate accuracy. The dopaminergic therapy affects pre-FOG gait patterns, thereby influencing the algorithm's effectiveness.

Assessing REM Sleep Behaviour Disorder: From Machine Learning Classification to the Definition of a Continuous Dissociation Index.

Objectives: Rapid Eye Movement Sleep Behaviour Disorder (RBD) is regarded as a prodrome of neurodegeneration, with a high conversion rate to α-synucleinopathies such as Parkinson's Disease (PD). The clinical diagnosis of RBD co-exists with evidence of REM Sleep Without Atonia (RSWA), a parasomnia that features loss of physiological muscular atonia during REM sleep. The objectives of this study are to implement an automatic detection of RSWA from polysomnographic traces, and to propose a continuous index (the Dissociation Index) to assess the level of dissociation between REM sleep stage and atonia. This is performed using Euclidean distance in proper vector spaces. Each subject is assigned a dissociation degree based on their distance from a reference, encompassing healthy subjects and clinically diagnosed RBD patients at the two extremes. Methods: Machine Learning models were employed to perform automatic identification of patients with RSWA through clinical polysomnographic scores, together with variables derived from electromyography. Proper distance metrics are proposed and tested to achieve a dissociation measure. Results: The method proved efficient in classifying RSWA vs. not-RSWA subjects, achieving an overall accuracy, sensitivity and precision of 87%, 93% and 87.5%, respectively. On its part, the Dissociation Index proved to be promising in measuring the impairment level of patients. Conclusions: The proposed method moves a step forward in the direction of automatically identifying REM sleep disorders and evaluating the impairment degree. We believe that this index may be correlated with the patients' neurodegeneration process; this assumption will undergo a robust clinical validation process involving healthy, RSWA, RBD and PD subjects.

Smartphone-Based Estimation of Item 3.8 of the MDS-UPDRS-III for Assessing Leg Agility in People With Parkinson's Disease.

Goal: In this paper we investigated the use of smartphone sensors and Artificial Intelligence techniques for the automatic quantification of the MDS-UPDRS-Part III Leg Agility (LA) task, representative of lower limb bradykinesia. Methods: We collected inertial data from 93 PD subjects. Four expert neurologists provided clinical evaluations. We employed a novel Artificial Neural Network approach in order to get a continuous output, going beyond the MDS-UPDRS score discretization. Results: We found a Pearson correlation of 0.92 between algorithm output and average clinical score, compared to an inter-rater agreement index of 0.88. Furthermore, the classification error was less than 0.5 scale point in about 80% cases. Conclusions: We proposed an objective and reliable tool for the automatic quantification of the MDS-UPDRS Leg Agility task. In perspective, this tool is part of a larger monitoring program to be carried out during activities of daily living, and managed by the patients themselves.

Unequal protection of video data according to slice relevance.

In this paper, we devise a procedure that mimics the behavior of a progressive video stream starting from a non progressive one such as H.264/AVC encoded video. This allows one to unequally protect the video data in an efficient way, according to their importance and the network state. The reported results demonstrate the superior performance of the proposed approach in comparison to state-of-the-art methods for resilient transmission of H.264/AVC data. Moreover, the flexibility in terms of redundancy insertion and achieved quality levels, allows one to span different applications, possibly including P2P video streaming.

Multiple descriptions based on multirate coding for JPEG 2000 and H.264/AVC.

Multiple description coding (MDC) makes use of redundant representations of multimedia data to achieve resiliency. Descriptions should be generated so that the quality obtained when decoding a subset of them only depends on their number and not on the particular received subset. In this paper, we propose a method based on the principle of encoding the source at several rates, and properly blending the data encoded at different rates to generate the descriptions. The aim is to achieve efficient redundancy exploitation, and easy adaptation to different network scenarios by means of fine tuning of the encoder parameters. We apply this principle to both JPEG 2000 images and H.264/AVC video data. We consider as the reference scenario the distribution of contents on application-layer overlays with multiple-tree topology. The experimental results reveal that our method favorably compares with state-of-art MDC techniques.

Sliding-window raptor codes for efficient scalable wireless video broadcasting with unequal loss protection.

Digital fountain codes have emerged as a low-complexity alternative to Reed-Solomon codes for erasure correction. The applications of these codes are relevant especially in the field of wireless video, where low encoding and decoding complexity is crucial. In this paper, we introduce a new class of digital fountain codes based on a sliding-window approach applied to Raptor codes. These codes have several properties useful for video applications, and provide better performance than classical digital fountains. Then, we propose an application of sliding-window Raptor codes to wireless video broadcasting using scalable video coding. The rates of the base and enhancement layers, as well as the number of coded packets generated for each layer, are optimized so as to yield the best possible expected quality at the receiver side, and providing unequal loss protection to the different layers according to their importance. The proposed system has been validated in a UMTS broadcast scenario, showing that it improves the end-to-end quality, and is robust towards fluctuations in the packet loss rate.

Iterative decoding of serially concatenated arithmetic and channel codes with JPEG 2000 applications.

In this paper, an innovative joint-source channel coding scheme is presented. The proposed approach enables iterative soft decoding of arithmetic codes by means of a soft-in soft- out decoder based on suboptimal search and pruning of a binary tree. An error-resilient arithmetic coder with a forbidden symbol is used in order to improve the performance of the joint source/channel scheme. The performance in the case of transmission across the AWGN channel is evaluated in terms of word error probability and compared to a traditional separated approach. The interleaver gain, the convergence property of the system, and the optimal source/channel rate allocation are investigated. Finally, the practical relevance of the proposed joint decoding approach is demonstrated within the JPEG 2000 coding standard. In particular, an iterative channel and JPEG 2000 decoder is designed and tested in the case of image transmission across the AWGN channel.

Data-dependent pre- and postprocessing multiple description coding of images.

Multiple description coding can be implemented as pre- and postprocessing to all standards for image and video communications, with obvious advantages. This can be achieved by generating two subsets from the original data; a controllable amount of extra redundancy between the descriptions has to be inserted to help the estimation of the possibly lost description from the received one. This redundancy can be in the form of spatial oversampling. In this paper, we propose and develop a mathematical framework for two descriptions pre- and postprocessing methods, which exploit the correlation characteristics of the visual data in order to better implement the multiple description coding paradigm. Simulation results show a noticeable performance improvement of both the proposed methods with respect to state-of-the art algorithms, in terms of both rate/redundancy/distortion tradeoff and computational complexity.

Multiple description image coding based on Lagrangian rate allocation.

In this paper, a novel multiple description coding technique is proposed, based on optimal Lagrangian rate allocation. The method assumes the coded data consists of independently coded blocks. Initially, all the blocks are coded at two different rates. Then blocks are split into two subsets with similar rate distortion characteristics; two balanced descriptions are generated by combining code blocks belonging to the two subsets encoded at opposite rates. A theoretical analysis of the approach is carried out, and the optimal rate distortion conditions are worked out. The method is successfully applied to the JPEG 2000 standard and simulation results show a noticeable performance improvement with respect to state-of-the art algorithms. The proposed technique enables easy tuning of the required coding redundancy. Moreover, the generated streams are fully compatible with Part 1 of the standard.

A syntax-preserving error resilience tool for JPEG 2000 based on error correcting arithmetic coding.

JPEG 2000 is the novel ISO standard for image and video coding. Besides its improved coding efficiency, it also provides a few error resilience tools in order to limit the effect of errors in the codestream, which can occur when the compressed image or video data are transmitted over an error-prone channel, as typically occurs in wireless communication scenarios. However, for very harsh channels, these tools often do not provide an adequate degree of error protection. In this paper, we propose a novel error-resilience tool for JPEG 2000, based on the concept of ternary arithmetic coders employing a forbidden symbol. Such coders introduce a controlled degree of redundancy during the encoding process, which can be exploited at the decoder side in order to detect and correct errors. We propose a maximum likelihood and a maximum a posteriori context-based decoder, specifically tailored to the JPEG 2000 arithmetic coder, which are able to carry out both hard and soft decoding of a corrupted code-stream. The proposed decoder extends the JPEG 2000 capabilities in error-prone scenarios, without violating the standard syntax. Extensive simulations on video sequences show that the proposed decoders largely outperform the standard in terms of PSNR and visual quality.