Unmasking Parkinson's Disease with Smile: An AI-enabled Screening Framework

TL;DR

This study develops an AI-based facial expression analysis framework using videos of smiling to accurately screen for Parkinson's Disease across diverse populations, demonstrating high accuracy and generalizability.

Contribution

The paper introduces a novel, accessible PD screening method leveraging a large, diverse video dataset and machine learning models focused on facial expressions, especially smiling.

Findings

Achieved 87.9% accuracy in PD detection on held-out data.

Model maintained high accuracy (>79%) on external test sets from different countries.

No significant bias detected across sex and ethnicity, except in Bangladesh cohort.

Abstract

We present an efficient and accessible PD screening method by leveraging AI-driven models enabled by the largest video dataset of facial expressions from 1,059 unique participants. This dataset includes 256 individuals with PD, 165 clinically diagnosed, and 91 self-reported. Participants used webcams to record themselves mimicking three facial expressions (smile, disgust, and surprise) from diverse sources encompassing their homes across multiple countries, a US clinic, and a PD wellness center in the US. Facial landmarks are automatically tracked from the recordings to extract features related to hypomimia, a prominent PD symptom characterized by reduced facial expressions. Machine learning algorithms are trained on these features to distinguish between individuals with and without PD. The model was tested for generalizability on external (unseen during training) test videos collected from a US clinic and Bangladesh. An ensemble of machine learning models trained on smile videos achieved an accuracy of 87.9+-0.1% (95% Confidence Interval) with an AUROC of 89.3+-0.3% as evaluated on held-out data (using k-fold cross-validation). In external test settings, the ensemble model achieved 79.8+-0.6% accuracy with 81.9+-0.3% AUROC on the clinical test set and 84.9+-0.4% accuracy with 81.2+-0.6% AUROC on participants from Bangladesh. In every setting, the model was free from detectable bias across sex and ethnic subgroups, except in the cohorts from Bangladesh, where the model performed significantly better for female participants than males. Smiling videos can effectively differentiate between individuals with and without PD, offering a potentially easy, accessible, and cost-efficient way to screen for PD, especially when a clinical diagnosis is difficult to access.