Novotny Michal, Tykalova Tereza, Ruzickova Hana, Ruzicka Evzen, Dusek Petr, Rusz Jan
Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University, Prague, Czech Republic.
NPJ Digit Med. 2022 Jul 18;5(1):98. doi: 10.1038/s41746-022-00642-5.
Even though hypomimia is a hallmark of Parkinson's disease (PD), objective and easily interpretable tools to capture the disruption of spontaneous and deliberate facial movements are lacking. This study aimed to develop a fully automatic video-based hypomimia assessment tool and estimate the prevalence and characteristics of hypomimia in de-novo PD patients with relation to clinical and dopamine transporter imaging markers. For this cross-sectional study, video samples of spontaneous speech were collected from 91 de-novo, drug-naïve PD participants and 75 age and sex-matched healthy controls. Twelve facial markers covering areas of forehead, nose root, eyebrows, eyes, lateral canthal areas, cheeks, mouth, and jaw were used to quantitatively describe facial dynamics. All patients were evaluated using Movement Disorder Society-Unified PD Rating Scale and Dopamine Transporter Single-Photon Emission Computed Tomography. Newly developed automated facial analysis tool enabled high-accuracy discrimination between PD and controls with area under the curve of 0.87. The prevalence of hypomimia in de-novo PD cohort was 57%, mainly associated with dysfunction of mouth and jaw movements, and decreased variability in forehead and nose root wrinkles (p < 0.001). Strongest correlation was found between reduction of lower lip movements and nigro-putaminal dopaminergic loss (r = 0.32, p = 0.002) as well as limb bradykinesia/rigidity scores (r = -0.37 p < 0.001). Hypomimia represents a frequent, early marker of motor impairment in PD that can be robustly assessed via automatic video-based analysis. Our results support an association between striatal dopaminergic deficit and hypomimia in PD.
尽管面部表情减少是帕金森病（PD）的一个标志，但目前缺乏客观且易于解释的工具来捕捉自发和刻意面部运动的破坏情况。本研究旨在开发一种基于视频的全自动面部表情减少评估工具，并估计初发PD患者面部表情减少的患病率及其与临床和多巴胺转运体成像标志物相关的特征。在这项横断面研究中，收集了91名初发、未用药的PD参与者以及75名年龄和性别匹配的健康对照者的自发言语视频样本。使用12个面部标记物，覆盖额头、鼻根、眉毛、眼睛、外眦区域、脸颊、嘴巴和下巴等部位，以定量描述面部动态。所有患者均使用运动障碍协会统一PD评定量表和多巴胺转运体单光子发射计算机断层扫描进行评估。新开发的自动面部分析工具能够以0.87的曲线下面积在PD患者和对照者之间实现高精度区分。初发PD队列中面部表情减少的患病率为57%，主要与嘴巴和下巴运动功能障碍以及额头和鼻根皱纹变异性降低有关（p < 0.001）。在下唇运动减少与黑质纹状体多巴胺能缺失（r = 0.32，p = 0.002）以及肢体运动迟缓/强直评分（r = -0.37，p < 0.001）之间发现了最强的相关性。面部表情减少是PD运动障碍的一个常见早期标志物，可通过基于视频的自动分析进行可靠评估。我们的结果支持PD中纹状体多巴胺能缺陷与面部表情减少之间存在关联。
