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AJNR. American journal of neuroradiology · 2026

Machine Learning-Driven Approach to Identify Freezing of Gait in Individuals with Parkinson Disease Using Conventional Structural MRI and Clinical Measures.

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Rathi Gaurav N, Gardner Alan, Longhurst Jason K, Mari Zoltan, Mishra Virendra R

Аннотация

BACKGROUND AND PURPOSE: Freezing of gait (FOG) presents a significant challenge in the management of Parkinson disease (PD). Our study explored the potential to predict PD-FOG using an unbiased machine learning (ML) approach that leverages conventional T1-weighted MRI and clinical measures.

MATERIALS AND METHODS: Thirty-seven participants (16 with PD-FOG, 21 PD without freezing of gate [PD-nFOG]) underwent standard isotropic 1 mm³ T1-weighted MRI. Brain morphometric measures, including subcortical volume, cortical volume, mean curvature, area, local gyrification index, and thickness, were extracted using FreeSurfer7. Participants were divided into discovery (13 PD-FOG, 17 PD-nFOG) and independent testing (3 PD-FOG, 4 PD-nFOG) data sets. We tested the predictive ability of each FreeSurfer-derived measure, each clinical measure, and every combination of those measures using 3 ML models: random forest (RF), support vector machine (SVM)-linear, and SVM-nonlinear. Feature reduction was performed using the least absolute shrinkage and selection operator before model development.

RESULTS: The SVM-linear model outperformed SVM-nonlinear and RF when tested on the independent data set (area under the curve [AUC] = 0.71, precision: 75%, sensitivity: 75%, specificity: 66.67%). FreeSurfer-derived cortical area (CA) from 27 regions predicted PD-FOG, involving several cortical and subcortical regions. None of the other measures, either in combination or isolation, predicted PD-FOG. The identified features were significantly correlated with clinical and physical therapy measures of PD-FOG using univariate and multivariate statistics, bolstering confidence in the selected feature set.

CONCLUSIONS: Our results demonstrate that FreeSurfer-derived CA measures from 27 key regions across the frontal, temporal, parietal, and occipital lobes can moderately predict FOG in PD (AUC = 0.71) using a linear SVM model. While preliminary, our work outlines an MRI-based analytical approach that may inform future external validation efforts and contribute to understanding the potential role of cortical morphology in PD-FOG risk. However, given the limited sample size and constrained independent testing cohort, these findings should be interpreted as exploratory and warrant replication in larger, multicenter studies.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты