title: Pathological tremor prediction using surface electromyogram and acceleration: potential use in 'ON-OFF' demand driven deep brain stimulator design.
abstract: OBJECTIVE
  We present a proof of concept for a novel method of predicting the onset of pathological tremor using non-invasively measured surface electromyogram (sEMG) and acceleration from tremor-affected extremities of patients with Parkinson's disease (PD) and essential tremor (ET).
  
  
  METHODS
  The tremor prediction algorithm uses a set of spectral (Fourier and wavelet) and nonlinear time series (entropy and recurrence rate) parameters extracted from the non-invasively recorded sEMG and acceleration signals.
  
  
  RESULTS
  The resulting algorithm is shown to successfully predict tremor onset for all 91 trials recorded in 4 PD patients and for all 91 trials recorded in 4 ET patients. The predictor achieves a 100% sensitivity for all trials considered, along with an overall accuracy of 85.7% for all ET trials and 80.2% for all PD trials. By using a Pearson's chi-square test, the prediction results are shown to significantly differ from a random prediction outcome.
  
  
  CONCLUSIONS
  The tremor prediction algorithm can be potentially used for designing the next generation of non-invasive closed-loop predictive ON-OFF controllers for deep brain stimulation (DBS), used for suppressing pathological tremor in such patients. Such a system is based on alternating ON and OFF DBS periods, an incoming tremor being predicted during the time intervals when DBS is OFF, so as to turn DBS back ON. The prediction should be a few seconds before tremor re-appears so that the patient is tremor-free for the entire DBS ON-OFF cycle and the tremor-free DBS OFF interval should be maximized in order to minimize the current injected in the brain and battery usage.
authors: Department of Electrical and Computer Engineering, University of Illinois at Chicago (UIC), IL, USA. ibjuslc@gmail.com
authors: Ishita
authors: I
authors: Basu
authors: Daniel
authors: D
authors: Graupe
authors: Daniela
authors: D
authors: Tuninetti
authors: Pitamber
authors: P
authors: Shukla
authors: Konstantin V
authors: KV
authors: Slavin
authors: Leo Verhagen
authors: LV
authors: Metman
authors: Daniel M
authors: DM
authors: Corcos
mesh_terms: D061725:Accelerometry / Q000379:methods*; D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods*; D046690:Deep Brain Stimulation / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods; D014202:Tremor / Q000175:diagnosis* / Q000503:physiopathology* / Q000517:prevention & control
references: Mov Disord. 2002;17 Suppl 3:S181-7
references: 11948775
references: Neurology. 2003 Oct 14;61(7):919-25
references: 14557560
references: Lancet Neurol. 2002 Aug;1(4):225-31
references: 12849455
references: Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:7711-4
references: 22256125
references: J Neurosurg. 2008 Oct;109(4):640-6
references: 18826350
references: Am J Physiol Heart Circ Physiol. 2000 Jun;278(6):H2039-49
references: 10843903
references: Lancet. 2007 Apr 7;369(9568):1152-4
references: 17416247
references: Proc Natl Acad Sci U S A. 1991 Mar 15;88(6):2297-301
references: 11607165
references: Mov Disord. 2000 Jan;15(1):3-8
references: 10634235
references: Neurology. 1999 Oct 22;53(7):1447-50
references: 10534249
references: J Neurol Neurosurg Psychiatry. 2008 May;79(5):522-9
references: 17766427
references: Stereotact Funct Neurosurg. 1995;65(1-4):11-7
references: 8916323
references: J Neural Eng. 2007 Jun;4(2):L14-21
references: 17409470
references: J Neural Eng. 2009 Dec;6(6):066003
references: 19837998
references: Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:4140-3
references: 23366839
references: Biol Cybern. 2006 Jul;95(1):69-85
references: 16614837
references: Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2329-33
references: 21096802
references: Am J Physiol. 1994 Apr;266(4 Pt 2):H1643-56
references: 8184944
references: Neuron. 2011 Oct 20;72(2):370-84
references: 22017994
references: Med Eng Phys. 1999 Jul-Sep;21(6-7):439-48
references: 10624740
references: Brain. 1998 Nov;121 ( Pt 11):2127-34
references: 9827772
references: Neurology. 2003 Jan 14;60(1):78-81
references: 12525722
references: J Neurosci Methods. 1999 Aug 1;90(1):47-55
references: 10517273
references: Bioinformatics. 2000 May;16(5):412-24
references: 10871264
references: IEEE Trans Neural Syst Rehabil Eng. 2011 Feb;19(1):15-24
references: 20889437
references: J Neurosci Methods. 2001 Jan 30;105(1):65-75
references: 11166367
references: J Appl Physiol (1985). 2002 Nov;93(5):1753-63
references: 12381763
references: Neurology. 2003 Dec 9;61(11):1601-4
references: 14663050
references: Brain. 2004 Sep;127(Pt 9):2131-43
references: 15240437
references: Neurol Res. 2010 Nov;32(9):899-904
references: 20712926