Quantitative Assessment of Ataxia in Multiple Sclerosis Patients using Spatiotemporal Parameters: A Relief-Based Machine Learning Analysis

Abstract

Abstract Background and Objective Multiple sclerosis (MS) is a chronic, progressive, and autoimmune disease of the central nervous system (CNS) characterized by inflammation, demyelination, and axonal injury. In patients with newly diagnosed MS (ndMS), ataxia can present either as mild or severe and can be difficult to diagnose in the absence of clinical disability. Such difficulties can be eliminated by using decision support systems supported by machine learning methods. The present study aimed to achieve early diagnosis of ataxia in ndMS patients by using machine learning methods with spatiotemporal parameters. Materials and Methods The prospective study included 32 ndMS patients with an Expanded Disability Status Scale (EDSS) score of≤2.0 and 32 healthy volunteers. A total of 14 parameters were elicited by using a Win-Track platform. The ndMS patients were differentiated from healthy individuals using multiple classifiers including Artificial Neural Network (ANN), Support Vector Machine (SVM), the k-nearest neighbors (K-NN) algorithm, and Decision Tree Learning (DTL). To improve the performance of the classification, a Relief-based feature selection algorithm was applied to select the subset that best represented the whole dataset. Performance evaluation was achieved based on several criteria such as Accuracy (ACC), Sensitivity (SN), Specificity (SP), and Precision (PREC). Results ANN had a higher classification performance compared to other classifiers, whereby it provided an accuracy, sensitivity, and specificity of 89, 87.8, 90.3% with the use of all parameters and provided the values of 93.7, 96.6%, and 91.1% with the use of parameters selected by the Relief algorithm, respectively. Significance To our knowledge, this is the first study of its kind in the literature to investigate the diagnosis of ataxia in ndMS patients by using machine learning methods with spatiotemporal parameters. The proposed method, i. e. Relief-based ANN method, successfully diagnosed ataxia by using a lower number of parameters compared to the numbers of parameters reported in clinical studies, thereby reducing the costs and increasing the performance of the diagnosis. The method also provided higher rates of accuracy, sensitivity, and specificity in the diagnosis of ataxia in ndMS patients compared to other methods. Taken together, these findings indicate that the proposed method could be helpful in the diagnosis of ataxia in minimally impaired ndMS patients and could be a pathfinder for future studies.