Parkinson's disease (PD) is a neuro-degenerative disorder that affects movement, speech, and coordination. Timely diagnosis and treatment can improve the quality of life for PD patients. However, access to clinical diagnosis is limited in low and middle income countries (LMICs). Therefore, development of automated screening tools for PD can have a huge social impact, particularly in the public health sector. In this paper, we present PULSAR, a novel method to screen for PD from webcam-recorded videos of the finger-tapping task from the Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS). PULSAR is trained and evaluated on data collected from 382 participants (183 self-reported as PD patients). We used an adaptive graph convolutional neural network to dynamically learn the spatio temporal graph edges specific to the finger-tapping task. We enhanced this idea with a multi stream adaptive convolution model to learn features from different modalities of data critical to detect PD, such as relative location of the finger joints, velocity and acceleration of tapping. As the labels of the videos are self-reported, there could be cases of undiagnosed PD in the non-PD labeled samples. We leveraged the idea of Positive Unlabeled (PU) Learning that does not need labeled negative data. Our experiments show clear benefit of modeling the problem in this way. PULSAR achieved 80.95% accuracy in validation set and a mean accuracy of 71.29% (2.49% standard deviation) in independent test, despite being trained with limited amount of data. This is specially promising as labeled data is scarce in health care sector. We hope PULSAR will make PD screening more accessible to everyone. The proposed techniques could be extended for assessment of other movement disorders, such as ataxia, and Huntington's disease.
Parkinson's disease (PD) diagnosis remains challenging due to lacking a reliable biomarker and limited access to clinical care. In this study, we present an analysis of the largest video dataset containing micro-expressions to screen for PD. We collected 3,871 videos from 1,059 unique participants, including 256 self-reported PD patients. The recordings are from diverse sources encompassing participants' homes across multiple countries, a clinic, and a PD care facility in the US. Leveraging facial landmarks and action units, we extracted features relevant to Hypomimia, a prominent symptom of PD characterized by reduced facial expressions. An ensemble of AI models trained on these features achieved an accuracy of 89.7% and an Area Under the Receiver Operating Characteristic (AUROC) of 89.3% while being free from detectable bias across population subgroups based on sex and ethnicity on held-out data. Further analysis reveals that features from the smiling videos alone lead to comparable performance, even on two external test sets the model has never seen during training, suggesting the potential for PD risk assessment from smiling selfie videos.