title: A novel automatic method for monitoring Tourette motor tics through a wearable device.
abstract: The aim of this study was to propose a novel automatic method for quantifying motor-tics caused by the Tourette Syndrome (TS). In this preliminary report, the feasibility of the monitoring process was tested over a series of standard clinical trials in a population of 12 subjects affected by TS. A wearable instrument with an embedded three-axial accelerometer was used to detect and classify motor tics during standing and walking activities. An algorithm was devised to analyze acceleration data by: eliminating noise; detecting peaks connected to pathological events; and classifying intensity and frequency of motor tics into quantitative scores. These indexes were compared with the video-based ones provided by expert clinicians, which were taken as the gold-standard. Sensitivity, specificity, and accuracy of tic detection were estimated, and an agreement analysis was performed through the least square regression and the Bland-Altman test. The tic recognition algorithm showed sensitivity = 80.8% ± 8.5% (mean ± SD), specificity = 75.8% ± 17.3%, and accuracy = 80.5% ± 12.2%. The agreement study showed that automatic detection tended to overestimate the number of tics occurred. Although, it appeared this may be a systematic error due to the different recognition principles of the wearable and video-based systems. Furthermore, there was substantial concurrency with the gold-standard in estimating the severity indexes. The proposed methodology gave promising performances in terms of automatic motor-tics detection and classification in a standard clinical context. The system may provide physicians with a quantitative aid for TS assessment. Further developments will focus on the extension of its application to everyday long-term monitoring out of clinical environments.
authors.affiliation: Dipartimento di Bioingegneria, Politecnico di Milano, Milan, Italy.
authors.forename: Michel
authors.initials: M
authors.lastname: Bernabei
authors.forename: Ezio
authors.initials: E
authors.lastname: Preatoni
authors.forename: Martin
authors.initials: M
authors.lastname: Mendez
authors.forename: Luca
authors.initials: L
authors.lastname: Piccini
authors.forename: Mauro
authors.initials: M
authors.lastname: Porta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Andreoni
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020323:Tics / Q000175:diagnosis* / Q000503:physiopathology; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D014741:Video Recording