Prognosis of stroke upper limb recovery with physiological variables using regression tree ensembles
- 27 April 2021
- journal article
- research article
- Published by IOP Publishing in Journal of Neural Engineering
- Vol. 18 (4), 046057
- https://doi.org/10.1088/1741-2552/abfc1e
Abstract
Objective: This study assesses upper limb recovery prognosis after stroke with solely physiological information, which can provide an objective estimation of recovery. Approach: Clinical recovery was forecasted using EEG-derived Event-Related Desynchronization/Synchronization and coherence, in addition to Transcranial Magnetic Stimulation elicited Motor-Evoked Potentials and upper limb grip and pinch strength. A Regression Tree Ensemble predicted clinical recovery of a stroke database (n=10) measured after a two-month intervention with the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) and the Action Research Arm Test (ARAT). Main results: There were no significant differences between predicted and actual outcomes with FMA-UE (p=0.29) and ARAT (p=0.5). Median prediction error for FMA-UE and ARAT were of 0.3 (IQR=6.2) and 3.4 (IQR=9.4) points, respectively. Predictions with the most pronounced errors were due to an underestimation of high upper limb recovery. The best features for FMA-UE prediction included mostly beta activity over the sensorimotor cortex. Best ARAT prediction features were cortical beta activity, corticospinal tract integrity of the unaffected hemisphere, and upper limb strength. Significance: Results highlighted the importance of measuring cortical activity related to motor control processes, the unaffected hemisphere's integrity, and upper limb strength for prognosis. It was also implied that stroke upper limb recovery prediction is feasible using solely physiological variables with a Regression Tree Ensemble, which can also be used to analyze physiological relationships with recovery.Funding Information
- Consejo Nacional de Ciencia y Tecnología (SALUD-2015-2-262061)
This publication has 52 references indexed in Scilit:
- Variable selection using random forestsPattern Recognition Letters, 2010
- Estimating Minimal Clinically Important Differences of Upper-Extremity Measures Early After StrokeArchives of Physical Medicine and Rehabilitation, 2008
- Transcranial Magnetic Stimulation: A PrimerNeuron, 2007
- Measurement of Upper-Extremity Function Early After Stroke: Properties of the Action Research Arm TestArchives of Physical Medicine and Rehabilitation, 2006
- Comparison of the Action Research Arm Test and the Fugl-Meyer Assessment as Measures of Upper-Extremity Motor Weakness After StrokeArchives of Physical Medicine and Rehabilitation, 2006
- Rehabilitation after StrokeThe New England Journal of Medicine, 2005
- Neural correlates of motor recovery after stroke: a longitudinal fMRI studyBrain, 2003
- EEG coherency: I: statistics, reference electrode, volume conduction, Laplacians, cortical imaging, and interpretation at multiple scalesElectroencephalography and Clinical Neurophysiology, 1997
- A theoretical justification of the average reference in topographic evoked potential studiesElectroencephalography and Clinical Neurophysiology/Evoked Potentials Section, 1985
- A performance test for assessment of upper limb function in physical rehabilitation treatment and researchInternational Journal of Rehabilitation Research, 1981