Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Electrovestibulography (EVestG)
2.3. Signal Analysis
2.4. Feature Extraction
2.5. Feature Reduction and Selection
2.6. Binary Classification
2.7. Diagnostic Hierarchy Algorithm
2.8. Statistical Analysis
3. Results
Statistical Analysis
4. Discussion
5. Conclusions
6. Limitations and the Future of the Study
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
Aβ | Amyloid-β |
AβO | Amyloid-β oligomers |
Acc | Accuracy |
AD | Alzheimer’s disease |
AD-CVD | AD mixed with levels of cerebrovascular disease symptomology |
AUC | Area under the curve |
BGi | Background segment |
C | Control |
CT | Contralateral tilt |
CVD | Cerebrovascular disease |
EVestG | Electrovestibulography |
FP | Field potential |
FPave | Average of spontaneous and driven vestibular field potentials |
GABA | Gamma-aminobutyric acid |
HIS | Hachinski ischemic score |
IH | Interval histogram |
IH33 | 33-Interval histogram |
IT | Ipsilateral tilt |
L | left |
LC | Locus Coeruleus |
LR | Summation of left and right signals |
L-R | Subtraction of left and right signals |
µ | Mean |
MADRS | Montgomery–Asberg Depression Rating Scale |
MANCOVA | Multivariate analysis of covariance |
MoCA | Montreal Cognitive Assessment |
MRI | Magnetic resonance imaging |
NEER | Neural Event Extraction Routine |
NINDS-AIREN | National Institute of Neurological Disorders and Stroke–Association Internationale pour la Recherche et l’Enseignement en Neurosciences |
OnAA | Acceleration segment |
OnBB | Deceleration segment |
R | right |
ROC | Receiver operating characteristic |
RTC | Return to center |
SD | Standard deviation |
Sens | Sensitivity |
Spec | Specificity |
SVM | Supervised support vector machine |
VaD | Vascular dementia |
VN | Vestibular nucleus |
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Age (µ ± SD) | Sex | MoCA (µ ± SD) | Modified HIS (µ ± SD) | MADRS (µ ± SD) | |
---|---|---|---|---|---|
Control, N = 24 | 65.3 ± 7 | 9 M | 27.6 ± 1.7 | - | 2.6 ± 5.7 |
AD, N = 16 | 72.5 ± 7.5 | 11 M | 16.4 ± 4.8 | 1.8 ± 1.2 | 1.9 ± 2.8 |
AD-CVD, N = 13 | 75.8 ± 7.3 | 9 M | 17 ± 4.4 | 5.6 ± 1.4 | 3.1 ± 4 |
Blind testing AD, N = 12 | 67.2 ± 7.1 | 9 M | 16 ± 6.7 | 1.3 ± 1.3 | 4.7 ± 4.7 |
Blind testing AD-CVD, N = 9 | 71.3 ± 7.7 | 6 M | 16.8 ± 6.7 | 4.6 ± 1 | 2.2 ± 3.6 |
Blind testing controls: | |||||
| 69.4 ± 5 | 4 M | 26 ± 2.5 | - | 4 ± 3.4 |
| 69.8 ± 4.1 | 3 M | 27 ± 1.8 | - | 3 ± 3.2 |
Averaged Test Performances of the Binary Classifiers on Training Dataset | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
AD-vs.-AD-CVD | Control-vs.-AD | AD-CVD-vs.-Control | |||||||||
Tilt | Sens (%) | Spec (%) | Acc (%) | Tilt | Sens (%) | Spec (%) | Acc (%) | Tilt | Sens (%) | Spec (%) | Acc (%) |
Back/forward a | 95 | 60 | 80 | Supine up/down a | 86.7 | 80 | 82.3 | Supine up/down a | 60 | 90 | 80.3 |
Supine up/down a | 70 | 80 | 76.7 | Back/forward | 75 | 70 | 73 | IT a | 55 | 88.3 | 77 |
Up/down a | 80 | 70 | 75 | Supine rotation | 80 | 60 | 70.3 | Rotation | 45 | 85 | 72.1 |
IT | 85 | 60 | 74.2 | Up/down | 86.7 | 45 | 69.7 | Back/forward | 30 | 88.3 | 68.3 |
CT | 70 | 60 | 65.8 | IT | 76.7 | 55 | 68 | Supine rotation | 25 | 86.7 | 65.5 |
Supine rotation | 80 | 40 | 62.5 | CT | 83.3 | 35 | 63.5 | Up/down | 10 | 85 | 59 |
Rotation | 80 | 40 | 61.7 | Rotation | 75 | 25 | 54 | CT | 15 | 76.6 | 54.8 |
Selected Most Informative Features of the Binary Classifiers | ||||
---|---|---|---|---|
Tilt | Signal Type | Segment_Side | AUC | |
AD-vs.-AD-CVD | F1—Upright average | IH33 | BGi_LR | 0.64 |
F2—Up/down | IH33 | OnBB_R | 0.77 | |
F3—Supine up/down | IH33 | OnBB_R | 0.79 | |
Control-vs.-AD | F1—Supine average | IH33 | BGi_L | 0.62 |
F2—Supine up/down | IH33 | RTC_BGi_L | 0.78 | |
F3—Supine up/down | IH33 | RTC_BGi_LR | 0.82 | |
AD-CVD-vs.-Control | F1—Supine up/down | IH33 | OnAA_L | 0.51 |
F2—Supine up/down | IH33 | OnAA_R | 0.78 | |
F3—Supine up/down | IH33 | OnBB_R | 0.51 |
Averaged Test Performances of the Binary Classifiers on the Blind Testing Dataset | ||||
---|---|---|---|---|
Sens (%) | Spec (%) | Acc (%) | AUC | |
AD-vs.-AD-CVD | 75.11 | 88.9 | 80.9 | F1 = 0.66, F2 = 0.77, F3 = 0.79 |
Control-vs.-AD | 87.6 | 66.4 | 74.9 | F1 = 0.62, F2 = 0.8, F3 = 0.82 |
AD-CVD-vs.-Control | 72.5 | 67 | 70.2 | F1 = 0.5, F2 = 0.77, F3 = 0.51 |
Train, Test Dataset Classification Results | True Class | ||||||
---|---|---|---|---|---|---|---|
Total Number = 54, 27 | AD | AD-CVD | Control | Sens vs. Rest (%) | Spec vs. Rest (%) | Balanced Accuracy (%) | |
Predicted Class | AD | 15, 10 | 2, 0 | 2, 0 | 93.8, 83.3 | 89.2, 100 | 85.7, 79.6 |
AD-CVD | 1, 2 | 11, 8 | 3, 2 | 84.6, 88.9 | 90, 77.8 | ||
Control | 0, 0 | 0, 1 | 19, 4 | 79.2, 66.7 | 100, 95.2 |
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Dastgheib, Z.A.; Lithgow, B.J.; Moussavi, Z.K. Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study. Medicina 2023, 59, 2091. https://doi.org/10.3390/medicina59122091
Dastgheib ZA, Lithgow BJ, Moussavi ZK. Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study. Medicina. 2023; 59(12):2091. https://doi.org/10.3390/medicina59122091
Chicago/Turabian StyleDastgheib, Zeinab A., Brian J. Lithgow, and Zahra K. Moussavi. 2023. "Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study" Medicina 59, no. 12: 2091. https://doi.org/10.3390/medicina59122091