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A novel hybrid CNN-KNN ensemble voting classifier for Parkinson’s disease prediction from hand sketching images

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Abstract

Parkinson's disease is a progressive neurodegenerative disorder that causes significant physical disabilities and reduces the quality of life. This disease is caused by the loss of dopamine-producing cells in the brain. Its symptoms are Speech disorders, muscle rigidity, bradykinesia and tremors that cause involuntary shaking or trembling, typically starting in the hands, fingers, or limbs at rest. In this work, we focused on predicting this disease via the hand tremor, which appears in the speed and pen pressure that vary between healthy and affected people during sketching spiral and waves. To enhance the medical services, improve lifestyle and for early detection of people with Parkinson’s disease, we proposed an ensemble voting classifier that combines the Convolutional Neural Network and K-Nearest Neighbours (KNN) to decide whether or not a person has Parkinson's disease based on predicting spiral and wave sketching separately. Contrary to the traditional Convolutional Neural Network, the proposed architecture offers better flexibility in scenarios where data may be small and imbalanced to avoid overfitting or when capturing the nuanced relationships between data points (by considering their neighbours) can be beneficial. Moreover, the proposed system has been built to automate the extraction of features from images and perform classification. This work represents several approaches, such as image processing, developing Convolutional Neural Networks models, hyper-parameters tuning, transfer learning, feature extraction and developing a hybrid classifier that combines deep learning and machine learning to enhance the performance of the prediction. We have developed six models to predict Parkinson's disease using a Spiral-Wave dataset and provided a detailed explanation and comparison between their performances. Based on these models, we built the hybrid ensemble voting CNN-KNN classifier that reached 96.67% accuracy and 93.33% and 100% sensitivity and precision, respectively. This system demonstrates better performance compared to existing systems in the literature that predict Parkinson's disease based on hand tremors.

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Data availability

The data used in this paper is available on request to corresponding author.

Notes

  1. http://wwwp.fc.unesp.br/~papa/pub/datasets/Handpd

  2. https://www.kaggle.com/datasets/kmader/parkinsons-drawings

  3. https://www.kaggle.com/code/kmader/parkinson-s-sketch-overview

References

  1. Ellis TD, Colón-Semenza C, DeAngelis TR et al (2021) Evidence for early and regular physical therapy and exercise in parkinson’s disease. Semin Neurol 41:189–205. https://doi.org/10.1055/s-0041-1725133

    Article  Google Scholar 

  2. Bloem BR, Okun MS, Klein C (2021) Parkinson’s disease. The Lancet 397:2284–2303. https://doi.org/10.1016/S0140-6736(21)00218-X

    Article  Google Scholar 

  3. Herz DM, Brown P (2023) Moving, fast and slow: behavioural insights into bradykinesia in Parkinson’s disease. Brain awad069. https://doi.org/10.1093/brain/awad069

  4. Yang Y, Tang B, Guo J (2016) Parkinson’s disease and cognitive impairment. Parkinson’s Disease 2016:1–8. https://doi.org/10.1155/2016/6734678

    Article  Google Scholar 

  5. Raggi A, Leonardi M, Carella F et al (2011) Impact of nonmotor symptoms on disability in patients with parkinson’s disease. Int J Rehabil Res 34:316–320. https://doi.org/10.1097/MRR.0b013e32834d4b66

    Article  Google Scholar 

  6. Shulman LM, Gruber-Baldini AL, Anderson KE et al (2008) The evolution of disability in parkinson disease: evolution of disability in PD. Mov Disord 23:790–796. https://doi.org/10.1002/mds.21879

    Article  Google Scholar 

  7. Joseph CB (2023) Parkinson disease. J Consum Health Internet 27:221–224. https://doi.org/10.1080/15398285.2023.2212529

    Article  Google Scholar 

  8. Dey RK, Das AK (2024) Neighbour adjusted dispersive flies optimization based deep hybrid sentiment analysis framework. Multimed Tools Appl. https://doi.org/10.1007/s11042-023-17953-8

    Article  Google Scholar 

  9. Dey RK, Das AK (2022) A Simple Strategy for Handling ‘NOT’ Can Improve the Performance of Sentiment Analysis. In: Das AK, Nayak J, Naik B et al (eds) Computational Intelligence in Pattern Recognition. Springer Nature Singapore, Singapore, pp 255–267

    Chapter  Google Scholar 

  10. Ait Ali N, Cherradi B, El Abbassi A et al (2018) GPU fuzzy c-means algorithm implementations: performance analysis on medical image segmentation. Multimed Tools Appl 77:21221–21243. https://doi.org/10.1007/s11042-017-5589-6

    Article  Google Scholar 

  11. Saleh S, Cherradi B, El Gannour O et al (2023) Healthcare monitoring system for automatic database management using mobile application in IoT environment. Bulletin EEI 12:1055–1068. https://doi.org/10.11591/eei.v12i2.4282

    Article  Google Scholar 

  12. Dritsas E, Trigka M (2023) Efficient data-driven machine learning models for cardiovascular diseases risk prediction. Sensors 23:1161. https://doi.org/10.3390/s23031161

    Article  Google Scholar 

  13. Kresoja K-P, Unterhuber M, Wachter R et al (2023) A cardiologist’s guide to machine learning in cardiovascular disease prognosis prediction. Basic Res Cardiol 118:10. https://doi.org/10.1007/s00395-023-00982-7

    Article  Google Scholar 

  14. Abunasser B, AL-Hiealy MR, Zaqout I, Abu-Naser S (2023) Convolution neural network for breast cancer detection and classification using deep learning. Asian Pac J Cancer Prev 24:531–544. https://doi.org/10.31557/APJCP.2023.24.2.531

    Article  Google Scholar 

  15. Trang NTH, Long KQ, An PL, Dang TN (2023) Development of an artificial intelligence-based breast cancer detection model by combining mammograms and medical health records. Diagnostics 13:346. https://doi.org/10.3390/diagnostics13030346

    Article  Google Scholar 

  16. Makroum MA, Adda M, Bouzouane A, Ibrahim H (2022) Machine learning and smart devices for diabetes management: systematic review. Sensors 22:1843. https://doi.org/10.3390/s22051843

    Article  Google Scholar 

  17. Daley BJ, Ni’Man M, Neves MR, et al (2022) mHealth apps for gestational diabetes mellitus that provide clinical decision support or artificial intelligence: a scoping review. Diabet Med 39. https://doi.org/10.1111/dme.14735

  18. Daanouni O, Cherradi B, Tmiri A (2021) Automatic Detection of Diabetic Retinopathy Using Custom CNN and Grad-CAM. In: Saeed F, Al-Hadhrami T, Mohammed F, Mohammed E (eds) Advances on Smart and Soft Computing. Springer Singapore, Singapore, pp 15–26

    Chapter  Google Scholar 

  19. Daanouni O, Cherradi B, Tmiri A (2020) Diabetes Diseases Prediction Using Supervised Machine Learning and Neighbourhood Components Analysis. In: Proceedings of the 3rd International Conference on Networking, Information Systems & Security. ACM, Marrakech Morocco, pp 1–5

  20. Jyothi P, Singh AR (2023) Deep learning models and traditional automated techniques for brain tumor segmentation in MRI: a review. Artif Intell Rev 56:2923–2969. https://doi.org/10.1007/s10462-022-10245-x

    Article  Google Scholar 

  21. Chandni SM, Kushwaha AKS (2023) The power of deep learning for intelligent tumor classification systems: a review. Comput Electr Eng 106:108586. https://doi.org/10.1016/j.compeleceng.2023.108586

    Article  Google Scholar 

  22. Prakash NN, Rajesh V, Namakhwa DL et al (2023) A DenseNet CNN-based liver lesion prediction and classification for future medical diagnosis. Sci Afr 20:e01629. https://doi.org/10.1016/j.sciaf.2023.e01629

    Article  Google Scholar 

  23. Sofia MA, Shabaz M, Asenso E (2023) Machine learning based model for detecting depression during covid-19 crisis. Sci Afr 20:e01716. https://doi.org/10.1016/j.sciaf.2023.e01716

    Article  Google Scholar 

  24. Vinod DN, Prabaharan SRS (2023) Elucidation of infection asperity of CT scan images of COVID-19 positive cases: a machine learning perspective. Scientific African 20:e01681. https://doi.org/10.1016/j.sciaf.2023.e01681

    Article  Google Scholar 

  25. Hamida S, Gannour OE, Lamalem Y et al (2023) Efficient Medical Diagnosis Hybrid System based on RF-DNN Mixed Model for Skin Diseases Classification. 2023 3rd International Conference on Innovative Research in Applied Science, Engineering and Technology (IRASET). IEEE, Mohammedia, Morocco, pp 01–08

    Google Scholar 

  26. Saleh S, Cherradi B, Laghmati S et al (2023) Healthcare Embedded System for Predicting Parkinson’s Disease Based on AI of Things. 2023 3rd International Conference on Innovative Research in Applied Science, Engineering and Technology (IRASET). IEEE, Mohammedia, Morocco, pp 1–7

    Google Scholar 

  27. Letanneux A, Danna J, Velay J-L et al (2014) From micrographia to parkinson’s disease dysgraphia: parkinson’s disease dysgraphia. Mov Disord 29:1467–1475. https://doi.org/10.1002/mds.25990

    Article  Google Scholar 

  28. Moetesum M, Diaz M, Masroor U et al (2022) A survey of visual and procedural handwriting analysis for neuropsychological assessment. Neural Comput & Applic 34:9561–9578. https://doi.org/10.1007/s00521-022-07185-6

    Article  Google Scholar 

  29. Rosenblum S, Samuel M, Zlotnik S et al (2013) Handwriting as an objective tool for parkinson’s disease diagnosis. J Neurol 260:2357–2361. https://doi.org/10.1007/s00415-013-6996-x

    Article  Google Scholar 

  30. Saleh S, Cherradi B, El Gannour O et al (2023) Predicting patients with parkinson’s disease using machine learning and ensemble voting technique. Multimed Tools Appl. https://doi.org/10.1007/s11042-023-16881-x

    Article  Google Scholar 

  31. Ouhmida A, Raihani A, Cherradi B, Lamalem Y (2022) Parkinson’s disease classification using machine learning algorithms: performance analysis and comparison. 2022 2nd International Conference on Innovative Research in Applied Science, Engineering and Technology (IRASET). IEEE, Meknes, Morocco, pp 1–6

    Google Scholar 

  32. Ouhmida A, Terrada O, Raihani A et al (2021) Voice-Based Deep Learning Medical Diagnosis System for Parkinson’s Disease Prediction. 2021 International Congress of Advanced Technology and Engineering (ICOTEN). IEEE, Taiz, Yemen, pp 1–5

    Google Scholar 

  33. Taleb C, Likforman-Sulem L, Mokbel C, Khachab M (2020) Detection of parkinson’s disease from handwriting using deep learning: a comparative study. Evol Intel. https://doi.org/10.1007/s12065-020-00470-0

    Article  Google Scholar 

  34. Göker H (2023) Automatic detection of parkinson’s disease from power spectral density of electroencephalography (EEG) signals using deep learning model. Phys Eng Sci Med 46:1163–1174. https://doi.org/10.1007/s13246-023-01284-x

    Article  Google Scholar 

  35. Zhang R, Jia J, Zhang R (2022) EEG analysis of Parkinson’s disease using time–frequency analysis and deep learning. Biomed Signal Process Control 78:103883. https://doi.org/10.1016/j.bspc.2022.103883

    Article  Google Scholar 

  36. Fraiwan L, Khnouf R, Mashagbeh AR (2016) Parkinson’s disease hand tremor detection system for mobile application. J Med Eng Technol 40:127–134. https://doi.org/10.3109/03091902.2016.1148792

    Article  Google Scholar 

  37. Yang Y, Yuan Y, Zhang G et al (2022) Artificial intelligence-enabled detection and assessment of parkinson’s disease using nocturnal breathing signals. Nat Med 28:2207–2215. https://doi.org/10.1038/s41591-022-01932-x

    Article  Google Scholar 

  38. Kulkarni S, Kalayil NG, James J et al (2020) Detection of Parkinson’s Disease through Smell Signatures. 2020 International Conference on Communication and Signal Processing (ICCSP). IEEE, Chennai, India, pp 808–812

    Chapter  Google Scholar 

  39. Zhu S (2022) Early Diagnosis of Parkinson’s Disease by Analyzing Magnetic Resonance Imaging Brain Scans and Patient Characteristic. 2022 10th International Conference on Bioinformatics and Computational Biology (ICBCB). IEEE, Hangzhou, China, pp 116–123

    Chapter  Google Scholar 

  40. Bhan A, Kapoor S, Gulati M, Goyal A (2021) Early Diagnosis of Parkinson’s Disease in brain MRI using Deep Learning Algorithm. 2021 Third International Conference on Intelligent Communication Technologies and Virtual Mobile Networks (ICICV). IEEE, Tirunelveli, India, pp 1467–1470

    Chapter  Google Scholar 

  41. Wang X, Hao X, Yan J et al (2023) Urine biomarkers discovery by metabolomics and machine learning for parkinson’s disease diagnoses. Chin Chem Lett 34:108230. https://doi.org/10.1016/j.cclet.2023.108230

    Article  Google Scholar 

  42. Drotár P, Mekyska J, Rektorová I et al (2016) Evaluation of handwriting kinematics and pressure for differential diagnosis of parkinson’s disease. Artif Intell Med 67:39–46. https://doi.org/10.1016/j.artmed.2016.01.004

    Article  Google Scholar 

  43. Drotár P, Mekyska J, Rektorová I et al (2014) Analysis of in-air movement in handwriting: a novel marker for parkinson’s disease. Comput Methods Programs Biomed 117:405–411. https://doi.org/10.1016/j.cmpb.2014.08.007

    Article  Google Scholar 

  44. Folador JP, Santos MCS, Luiz LMD et al (2021) On the use of histograms of oriented gradients for tremor detection from sinusoidal and spiral handwritten drawings of people with parkinson’s disease. Med Biol Eng Comput 59:195–214. https://doi.org/10.1007/s11517-020-02303-9

    Article  Google Scholar 

  45. Ouhmida A, Raihani A, Cherradi B, Terrada O (2021) A novel approach for parkinson’s disease detection based on voice classification and features selection techniques. Int J Onl Eng 17:111. https://doi.org/10.3991/ijoe.v17i10.24499

    Article  Google Scholar 

  46. Zham P, Kumar DK, Dabnichki P et al (2017) Distinguishing different stages of parkinson’s disease using composite index of speed and pen-pressure of sketching a spiral. Front Neurol 8:435. https://doi.org/10.3389/fneur.2017.00435

    Article  Google Scholar 

  47. Chakraborty S, Aich S, Jong-Seong-Sim, et al (2020) Parkinson’s Disease Detection from Spiral and Wave Drawings using Convolutional Neural Networks: A Multistage Classifier Approach. In: 2020 22nd International Conference on Advanced Communication Technology (ICACT). IEEE, Phoenix Park, PyeongChang, Korea (South), pp 298–303

  48. Das A, Das HS, Choudhury A et al (2021) Detection of Parkinson’s Disease from Hand-Drawn Images Using Deep Transfer Learning. In: Sharma H, Saraswat M, Kumar S, Bansal JC (eds) Intelligent Learning for Computer Vision. Springer Singapore, Singapore, pp 67–84

    Chapter  Google Scholar 

  49. Shaban M (2020) Deep Convolutional Neural Network for Parkinson’s Disease Based Handwriting Screening. 2020 IEEE 17th International Symposium on Biomedical Imaging Workshops (ISBI Workshops). IEEE, Iowa City, IA, USA, pp 1–4

    Google Scholar 

  50. Drotar P, Mekyska J, Smekal Z et al (2015) Contribution of different handwriting modalities to differential diagnosis of Parkinson’s Disease. 2015 IEEE International Symposium on Medical Measurements and Applications (MeMeA) Proceedings. IEEE, Torino, Italy, pp 344–348

    Chapter  Google Scholar 

  51. Drotar P, Mekyska J, Rektorova I et al (2013) A new modality for quantitative evaluation of Parkinson’s disease: In-air movement. 13th IEEE International Conference on BioInformatics and BioEngineering. IEEE, Chania, Greece, pp 1–4

    Google Scholar 

  52. Drotar P, Mekyska J, Smekal Z et al (2013) Prediction potential of different handwriting tasks for diagnosis of Parkinson’s. 2013 E-Health and Bioengineering Conference (EHB). IEEE, IASI, Romania, pp 1–4

    Google Scholar 

  53. Drotar P, Mekyska J, Rektorova I et al (2015) Decision support framework for parkinson’s disease based on novel handwriting markers. IEEE Trans Neural Syst Rehabil Eng 23:508–516. https://doi.org/10.1109/TNSRE.2014.2359997

    Article  Google Scholar 

  54. Pereira CR, Pereira DR, da Silva FA et al (2015) A Step Towards the Automated Diagnosis of Parkinson’s Disease: Analyzing Handwriting Movements. 2015 IEEE 28th International Symposium on Computer-Based Medical Systems. IEEE, Sao Carlos, Brazil, pp 171–176

    Chapter  Google Scholar 

  55. Pereira CR, Pereira DR, Papa JP et al (2016) Convolutional Neural Networks Applied for Parkinson’s Disease Identification. In: Holzinger A (ed) Machine Learning for Health Informatics. Springer International Publishing, Cham, pp 377–390

    Chapter  Google Scholar 

  56. Pereira CR, Weber SAT, Hook C et al (2016) Deep Learning-Aided Parkinson’s Disease Diagnosis from Handwritten Dynamics. 2016 29th SIBGRAPI Conference on Graphics, Patterns and Images (SIBGRAPI). IEEE, Sao Paulo, Brazil, pp 340–346

    Chapter  Google Scholar 

  57. Pereira CR, Pereira DR, Rosa GH et al (2018) Handwritten dynamics assessment through convolutional neural networks: an application to parkinson’s disease identification. Artif Intell Med 87:67–77. https://doi.org/10.1016/j.artmed.2018.04.001

    Article  Google Scholar 

  58. Khachnaoui H, Chikhaoui B, Khlifa N, Mabrouk R (2023) Enhanced parkinson’s disease diagnosis through convolutional neural network models applied to SPECT DaTSCAN images. IEEE Access 11:91157–91172. https://doi.org/10.1109/ACCESS.2023.3308075

    Article  Google Scholar 

  59. Al-Sarem M, Saeed F, Boulila W et al (2021) Feature Selection and Classification Using CatBoost Method for Improving the Performance of Predicting Parkinson’s Disease. In: Saeed F, Al-Hadhrami T, Mohammed F, Mohammed E (eds) Advances on Smart and Soft Computing. Springer Singapore, Singapore, pp 189–199

    Chapter  Google Scholar 

  60. Saeed F, Al-Sarem M, Al-Mohaimeed M et al (2022) Enhancing parkinson’s disease prediction using machine learning and feature selection methods. Comput Mater & Contin 71:5639–5658. https://doi.org/10.32604/cmc.2022.023124

    Article  Google Scholar 

  61. Rosebrock A (2019) Detecting Parkinson’s Disease with OpenCV, Computer Vision, and the Spiral/Wave Test. In: PyImageSearch. https://pyimagesearch.com/2019/04/29/detecting-parkinsons-disease-with-opencv-computer-vision-and-the-spiral-wave-test/. Accessed 3 Oct 2023

  62. Shorten C, Khoshgoftaar TM (2019) A survey on image data augmentation for deep learning. J Big Data 6:60. https://doi.org/10.1186/s40537-019-0197-0

    Article  Google Scholar 

  63. Saravanan S, Ramkumar K, Narasimhan K et al (2023) Explainable artificial intelligence (EXAI) models for early prediction of parkinson’s disease based on spiral and wave drawings. IEEE Access 11:68366–68378. https://doi.org/10.1109/ACCESS.2023.3291406

    Article  Google Scholar 

  64. Hamida S, Cherradi B, Raihani A, Ouajji H (2019) Performance Evaluation of Machine Learning Algorithms in Handwritten Digits Recognition. 2019 1st International Conference on Smart Systems and Data Science (ICSSD). IEEE, Rabat, Morocco, pp 1–6

    Google Scholar 

  65. Fan C-L, Chung Y-J (2022) Design and optimization of cnn architecture to identify the types of damage imagery. Mathematics 10:3483. https://doi.org/10.3390/math10193483

    Article  Google Scholar 

  66. Ketkar N, Moolayil J (2021) Convolutional Neural Networks. Deep Learning with Python. Apress, Berkeley, CA, pp 197–242

    Chapter  Google Scholar 

  67. Dey RK, Das AK (2023) Modified term frequency-inverse document frequency based deep hybrid framework for sentiment analysis. Multimed Tools Appl 82:32967–32990. https://doi.org/10.1007/s11042-023-14653-1

    Article  Google Scholar 

  68. Moujahid H, Cherradi B, Al-Sarem M, Bahatti L (2021) Diagnosis of COVID-19 Disease Using Convolutional Neural Network Models Based Transfer Learning. In: Saeed F, Mohammed F, Al-Nahari A (eds) Innovative Systems for Intelligent Health Informatics. Springer International Publishing, Cham, pp 148–159

    Chapter  Google Scholar 

  69. Müller P (2023) Flexible k nearest neighbors classifier: derivation and application for ion-mobility spectrometry-based indoor localization. https://doi.org/10.48550/ARXIV.2304.10151

  70. Gao X, Li G (2020) A KNN model based on manhattan distance to identify the SNARE proteins. IEEE Access 8:112922–112931. https://doi.org/10.1109/ACCESS.2020.3003086

    Article  Google Scholar 

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Acknowledgements

The authors extend their appreciation to the King Salman Center for Disability Research for funding this work through Research Group no KSRG -2023-542.

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Saleh, S., Ouhmida, A., Cherradi, B. et al. A novel hybrid CNN-KNN ensemble voting classifier for Parkinson’s disease prediction from hand sketching images. Multimed Tools Appl (2024). https://doi.org/10.1007/s11042-024-19314-5

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