Jeanne P Vu1, Elizabeth Cisneros1, Ha Yeon Lee1, Linh Le1, Qiyu Chen1, Xiaoyan A Guo1, Ryin Rouzbehani1, Joseph Jankovic2, Stewart Factor3, Christopher G Goetz4, Richard L Barbano5, Joel S Perlmutter6, Hyder A Jinnah7, Sarah Pirio Richardson8, Glenn T Stebbins4, Rodger Elble9, Cynthia L Comella4, David A Peterson10. 1. Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA. 2. Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA. 3. Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA. 4. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA. 5. Department of Neurology, University of Rochester, Rochester, NY, USA. 6. Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Departments of Radiology, Neuroscience, Physical Therapy, and Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA. 7. Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Departments of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA. 8. Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Neurology Service, New Mexico Veterans Affairs Health Care System, Albuquerque, NM, USA. 9. Department of Neurology, Southern Illinois University School of Medicine, Springfield, IL, USA. 10. Institute for Neural Computation, University of California, San Diego, La Jolla, CA, USA; Computational Neurobiology Laboratory, Salk Institute for Biological Studies, La Jolla, CA, USA. Electronic address: dap@salk.edu.
Abstract
BACKGROUND: Head tremor (HT) is a common feature of cervical dystonia (CD), usually quantified by subjective observation. Technological developments offer alternatives for measuring HT severity that are objective and amenable to automation. OBJECTIVES: Our objectives were to develop CMOR (Computational Motor Objective Rater; a computer vision-based software system) to quantify oscillatory and directional aspects of HT from video recordings during a clinical examination and to test its convergent validity with clinical rating scales. METHODS: For 93 participants with isolated CD and HT enrolled by the Dystonia Coalition, we analyzed video recordings from an examination segment in which participants were instructed to let their head drift to its most comfortable dystonic position. We evaluated peak power, frequency, and directional dominance, and used Spearman's correlation to measure the agreement between CMOR and clinical ratings. RESULTS: Power averaged 0.90 (SD 1.80) deg2/Hz, and peak frequency 1.95 (SD 0.94) Hz. The dominant HT axis was pitch (antero/retrocollis) for 50%, roll (laterocollis) for 6%, and yaw (torticollis) for 44% of participants. One-sided t-tests showed substantial contributions from the secondary (t = 18.17, p < 0.0001) and tertiary (t = 12.89, p < 0.0001) HT axes. CMOR's HT severity measure positively correlated with the HT item on the Toronto Western Spasmodic Torticollis Rating Scale-2 (Spearman's rho = 0.54, p < 0.001). CONCLUSIONS: We demonstrate a new objective method to measure HT severity that requires only conventional video recordings, quantifies the complexities of HT in CD, and exhibits convergent validity with clinical severity ratings.
BACKGROUND: Head tremor (HT) is a common feature of cervical dystonia (CD), usually quantified by subjective observation. Technological developments offer alternatives for measuring HT severity that are objective and amenable to automation. OBJECTIVES: Our objectives were to develop CMOR (Computational Motor Objective Rater; a computer vision-based software system) to quantify oscillatory and directional aspects of HT from video recordings during a clinical examination and to test its convergent validity with clinical rating scales. METHODS: For 93 participants with isolated CD and HT enrolled by the Dystonia Coalition, we analyzed video recordings from an examination segment in which participants were instructed to let their head drift to its most comfortable dystonic position. We evaluated peak power, frequency, and directional dominance, and used Spearman's correlation to measure the agreement between CMOR and clinical ratings. RESULTS: Power averaged 0.90 (SD 1.80) deg2/Hz, and peak frequency 1.95 (SD 0.94) Hz. The dominant HT axis was pitch (antero/retrocollis) for 50%, roll (laterocollis) for 6%, and yaw (torticollis) for 44% of participants. One-sided t-tests showed substantial contributions from the secondary (t = 18.17, p < 0.0001) and tertiary (t = 12.89, p < 0.0001) HT axes. CMOR's HT severity measure positively correlated with the HT item on the Toronto Western Spasmodic Torticollis Rating Scale-2 (Spearman's rho = 0.54, p < 0.001). CONCLUSIONS: We demonstrate a new objective method to measure HT severity that requires only conventional video recordings, quantifies the complexities of HT in CD, and exhibits convergent validity with clinical severity ratings.
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Authors: Zheng Zhang; Elizabeth Cisneros; Ha Yeon Lee; Jeanne P Vu; Qiyu Chen; Casey N Benadof; Jacob Whitehill; Ryin Rouzbehani; Dominique T Sy; Jeannie S Huang; Terrence J Sejnowski; Joseph Jankovic; Stewart Factor; Christopher G Goetz; Richard L Barbano; Joel S Perlmutter; Hyder A Jinnah; Brian D Berman; Sarah Pirio Richardson; Glenn T Stebbins; Cynthia L Comella; David A Peterson Journal: Ann Clin Transl Neurol Date: 2022-03-25 Impact factor: 5.430