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Machine Learning Methods Predict Individual Upper-Limb Motor Impairment Following Therapy in Chronic Stroke
Journal article   Peer reviewed

Machine Learning Methods Predict Individual Upper-Limb Motor Impairment Following Therapy in Chronic Stroke

Ceren Tozlu, Dylan Edwards, Aaron Boes, Douglas Labar, K Zoe Tsagaris, Joshua Silverstein, Heather Pepper Lane, Mert R Sabuncu, Charles Liu and Amy Kuceyeski
Neurorehabilitation and neural repair, Vol.34(5), pp.428-439
05/2020
DOI: 10.1177/1545968320909796
PMCID: PMC7217740
PMID: 32193984
url
https://ro.ecu.edu.au/ecuworkspost2013/8522View
Open Access

Abstract

. Accurate prediction of clinical impairment in upper-extremity motor function following therapy in chronic stroke patients is a difficult task for clinicians but is key in prescribing appropriate therapeutic strategies. Machine learning is a highly promising avenue with which to improve prediction accuracy in clinical practice. . The objective was to evaluate the performance of 5 machine learning methods in predicting postintervention upper-extremity motor impairment in chronic stroke patients using demographic, clinical, neurophysiological, and imaging input variables. . A total of 102 patients (female: 31%, age 61 ± 11 years) were included. The upper-extremity Fugl-Meyer Assessment (UE-FMA) was used to assess motor impairment of the upper limb before and after intervention. Elastic net (EN), support vector machines, artificial neural networks, classification and regression trees, and random forest were used to predict postintervention UE-FMA. The performances of methods were compared using cross-validated . . EN performed significantly better than other methods in predicting postintervention UE-FMA using demographic and baseline clinical data (median < .05). Preintervention UE-FMA and the difference in motor threshold (MT) between the affected and unaffected hemispheres were the strongest predictors. The difference in MT had greater importance than the absence or presence of a motor-evoked potential (MEP) in the affected hemisphere. . Machine learning methods may enable clinicians to accurately predict a chronic stroke patient's postintervention UE-FMA. Interhemispheric difference in the MT is an important predictor of chronic stroke patients' response to therapy and, therefore, could be included in prospective studies.
Exercise Therapy - methods Severity of Illness Index Neural Networks, Computer Evoked Potentials, Motor - physiology Humans Middle Aged Male Motor Cortex - physiopathology Stroke Rehabilitation - methods Support Vector Machine Machine Learning Stroke - physiopathology Motor Cortex - diagnostic imaging Transcranial Magnetic Stimulation Upper Extremity - physiopathology Magnetic Resonance Imaging Female Aged Outcome Assessment, Health Care Chronic Disease Stroke - therapy

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