Automatic Assessment of Expanded Disability Status Scale (EDSS) in Multiple Sclerosis Using a Decision Tree

The expanded disability status scale (EDSS) is frequently used to classify the patients with multiple sclerosis (MS). We presented in this paper a novel method to automatically assess the EDSS score from posturologic data (center of pres-sure signals) using a decision tree. Two groups of participants (one for learning and the other for test) with EDSS rang-ing from 0 to 4.5 performed our balance experiment with eyes closed. Two linear measures (the length and the surface) and twelve non-linear measures (the recurrence rate, the Shannon entropy, the averaged diagonal line length and the trapping time for the position, the instantaneous velocity and the instantaneous acceleration of the center of pressure respectively) were calculated for all the participants. Several decision trees were constructed with learning data and tested with test data. By comparing clinical and estimated EDSS scores in the test group, we selected one decision tree with five measures which revealed a 75% of agreement. The results have signified that our tree model is able to auto-matically assess the EDSS scores and that it is possible to distinguish the EDSS scores by using linear and non-linear postural sway measures.

Correlation between cerebral cortex changes and clinical features in patients with neuromyelitis optica spectrum disorder with normal-appearing brain tissue:a case-control study

Neuro myelitis optica spectrum disorder(NMOSD) is an inflammatory demyelinating disease of the central nervous system.However,whether and how cortical changes occur in NMOSD with normal-appearing brain tissue,or whether any cortical changes correlate with clinical chara cteristics,is not completely clear.The current study recruited 43 patients with NMOSD who had normal-appearing brain tissue and 45 healthy controls matched for age,sex,and educational background from December 2020 to February 2022.A surface-based morphological analysis of high-resolution T1-weighted structural magnetic resonance images was used to calculate the cortical thickness,sulcal depth,and gyrification index.Analysis showed that cortical thickness in the bilate ral rostral middle frontal gyrus and left superior frontal gyrus was lower in the patients with NMOSD than in the control participants.Subgroup analysis of the patients with NMOSD indicated that compared with those who did not have any optic neuritis episodes,those who did have such episodes exhibited noticeably thinner cortex in the bilateral cuneus,superior parietal co rtex,and pericalcarine co rtex.Correlation analysis indicated that co rtical thickness in the bilateral rostral middle frontal gyrus was positively correlated with scores on the Digit Symbol Substitution Test and negatively correlated with scores on the Trail Making Test and the Expanded Disability Status Scale.These results are evidence that cortical thinning of the bilateral regional frontal cortex occurs in patients with NMOSD who have normal-appearing brain tissue,and that the degree of thinning is correlated with clinical disability and cognitive function.These findings will help im prove our understanding of the imaging chara cteristics in NMOSD and their potential clinical significance.