Differentiating tremor from everyday motion and Classification of different types of tremor

1. Team: Udayan Ghosh and Elizabeth Wright
Physics 6760
Characterizing Upper Extremity
Parkinsonian Tremors to Monitor
LevaDopa Levels

2. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
• Goal:
• Monitor upper extremity
Parkinsonian tremors
• Monitor effects of medication,
symptom fluctuations, disease
progression
• Motivation:
• Diagnostic tool used to inform
LevaDopa dosing and scheduling
• Prolong effective long-term use of
LevaDopa
Project Goal and Motivation
2
Tremor
Identification
Symptom
Fluctuations
Dosage &
Medication
Schedule
Reduced
Complications
Increase
Quality of Life
Disease
Progression
Assess Patient
Needs
Reduce
Medication
Dependency

3. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Background
3
• Parkinson’s Disease (PD):
• Progressive nervous system disorder
• Dopamine
• LevaDopa (LDopa):
• Treats PD effects on autonomic nervous
system
• Side effects
• Orthostatic Hypotension, dyskinesia,
confusion, dementia, hallucinations,
paranoia, autonomic regulation
• Risk for side effects:
• Peak dosages
• Duration of use
Resting
tremor I
• 3-5 Hz
• Resting
(inactive)Tremor
• Pill Rolling
• Periodic, Rhythmic,
Smooth, Repetitive
• Consistent Amplitude
Resting
tremor
ii
• 5-10 Hz
• Resting
(inactive)Tremor
• Periodic, Rhythmic,
Smooth, Repetitive
• Consistent Amplitude
Dyskinesia
• 10+ Hz
• Active Tremor
• Non-Rhythmic,
Erratic, discontinuous
• Inconsistent
Amplitude, High
Amplitude
Motor
Fluctuat
ions
• Involuntary
Movement
• Non-repetitive,
Discontinuous
• Writhing, Spasms,
Ticks
• Erratic, Non-Rhythmic
Parkinsonian
Tremors and
Fluctuations

4. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Indications
4
Resting Tremor
Periodic Pattern
Fluctuations
Dopamine Flux
Adjust Dosage
Adjust Schedule
Overall Increase,
Disease
progression
Supplemental
Medication
Motor
Fluctuations
Low LDopa,
Off Periods
Adjust
Schedule
Add CR to IR
LDopa
Dyskinesia
Peak LDopa
Levels
Dosage too
High
Reduce LDopa
Schedule too
Frequent
Reduce LDopa
Adjust
Schedule
Max Duration
LDopa
Supplemental
Medication
Switch from
CR to IR LDopa

5. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Calibration of Accelerometer
5
• Goal:
• To measure gravitational acceleration and compare
with known value
• Approach:
• We tested gravity by two approach:
• Pendulum
• Reading from accelerometer using oscilloscope
• Result summary: Figure: Setup for pendulum approach for measuring gravity
Figure: Oscilloscope reading for measuring period
Gravity from pendulum
experiment (m/s^2)
Theoretically expected
gravity (m/s^2)
% difference
11.73 10.71 9.5%
Gravity from pendulum
experiment (m/s^2)
Theoretically expected
gravity (m/s^2)
% difference
10.72 10.71 0.09%

6. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Device and Setup
6
Figure: Circuit diagram of the setup
• Accelerometer:
• Model: ADXL 337
• 3 axis accelerometer
• Range: ±3 g
• Band pass Filter:
• 2Hz – 25Hz

7. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Model: RestingTremorType I
7

8. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Model: RestingTremorType II
8

9. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Model: Dyskinesia
9
Close-up

10. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set 1
10
Person 1 Person 2
Decision: Match with Tremor 1 Decision: Match with Tremor 1
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.22 RMS = 0.16

11. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set 2
12
Person 1
Decision: Match with Tremor 2
Person 2
Decision: Match with Tremor 2
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.84 RMS = 0.75

12. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set 3
13
Person 1 Person 2
Decision: Match with Dyskinesia Decision: Match with Dyskinesia
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.49 RMS = 0.63

13. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set 4 (Typing)
14
Person 1 Person 2
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.09 RMS = 0.07
Decision: Although FFT is similar to
Dyskinesia, RMS value is small
Decision: Although FFT is similar to
Dyskinesia, RMS value is small

14. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set 5 (Writing)
15
Person 1 Person 2
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.09 RMS = 0.05
Decision: Although FFT is similar to
Dyskinesia, RMS value is small
Decision: Although FFT is similar to
Dyskinesia, RMS value is small

15. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Analysis: Sample Set (RestingTremor + Dyskinesia)
16
Person 1
Decision: FFT is similar to resting tremor 2 but from
oscilloscope profile we observe combination of
resting tremor and dyskinesia
Person 2
Standardvalue
Tremor1Tremor2Dyskinesia
RMS = 0.33 RMS = 0.47
Decision: FFT is similar to dyskinesia but from
oscilloscope profile we observe combination of
resting tremor and dyskinesia

16. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
R1 R2 R3 R4 R5 R6
Expected
motion type
Resting
tremor I
Resting
tremor II
Dyskinesia Typing Writing
Resting
tremor I and
Dyskinesia
RMS Value 0.22 0.84 0.49 0.09 0.09 0.33
Frequency 4 5.5 - - - ~ 8 Hz
Periodic
Motion
Yes Yes No - - Inconclusive
Approx.
Consistent
Amplitude
Yes Yes No No No No
Summary: Person 1
17

17. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
R1 R2 R3 R4 R5 R6
Expected
motion type
Resting
tremor I
Resting
tremor II
Dyskinesia Typing Writing
Resting
tremor I and
Dyskinesia
RMS Value 0.16 0.75 0.63 0.07 0.05 0.47
Frequency 3.5 5.5 - - - Inconclusive
Periodic
Motion
Yes Yes No - - Inconclusive
Approx.
Consistent
Amplitude
Yes Yes No No No No
Summary: Person 2
18

18. Introduction Background Setup and Calibration Standardization of Model Sample Data Analysis Summary
Summary
19
• Key conclusion
• Differentiating tremor from
everyday motion – reasonably
successful
• Classification of differnet types of
tremor – reasonably successful
• Combination of different type of
tremor - unsuccessful
• Future opportunities
• To improve standard model by
using a large set of data
• Characterizing combined tremor
type
• Considering Z axis motion in the
decision making process