Abstract Details

Title Face Validity: Digital Facial Analysis Recapitulates Clinical Findings of Neurological Disease

Topic General Neurology

Presentation(s) P10 - Poster Session 10 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-002

Objective To distinguish characteristic facial phenotypes of neurologic disease using computer vision-based facial movement analysis.

Background Neurological diseases can present with differences in facial expressions and movements that are often characteristic. Facial expression recognition and monitoring could assist in telehealth diagnostic processes. Digital facial expressivity is an objective and unbiased metric to assess facial movements.

Design/Methods Using untargeted recruitment, 124 individuals with multiple sclerosis (MS) and Parkinson’s disease (PD), and healthy controls (HC) are recruited to an ongoing digital phenotyping study. The task evaluated involves video recording of participant faces while engaging in a spontaneous language task. Videos are processed using OpenFace 2.0, an open-access digital tool pre-trained for facial landmark detection and facial action unit (AU) recognition. Average instances of AU activation were averaged across number of frames. Current analyses explored smiling (“cheek raiser,” “lip corner puller”) and eye expression (“brow furrow” and “blink”) AUs. Student’s t-tests were used to compare means between groups.

Results Mean age was 47 (SD 12.6) for MS (n=98), 67.3 (SD 10.8) for PD (n=15), and 58.5 (SD 25) for HCs (n=11). Analysis of video metrics revealed significant differences between the groups. Individuals with PD had increased brow-furrowing compared to both MS (difference 0.44, 95% CI 0.29-0.61, p<0.001) and HCs (difference 0.37, 95%CI 0.13-0.61, p=0.002), as well as decreased eye-blinking (MS: difference 0.11 95% CI 0.06-0.15, p<0.001; HC: difference 0.11, 95%CI 0.05-0.17, p=0.0003). Individuals with MS smiled more than those with PD (difference 0.20, 95%CI 0.04-0.36, p=0.01) and also crinkled their eyes less than HC (difference 0.19, 95%CI 0.01-0.37, p=0.04). Recruitment is ongoing. Machine learning will be further applied to the data to increase specificity.

Conclusions Digitally identified facial phenotypes recapitulate known clinical characteristics of PD, and differentiate between PD, MS, and HC.

Authors/Disclosures
Alyssa Nylander, MD, PhD (UCSF) PRESENTER	Dr. Nylander has nothing to disclose.
Kyra Henderson (UCSF)	Kyra Henderson has nothing to disclose.
Kanishka Koshal	No disclosure on file
Nikki Sisodia (University of California San Francisco)	Nikki Sisodia has nothing to disclose.
Jaeleene Wijangco	Jaeleene Wijangco has nothing to disclose.
Shane Poole (UCSF)	Shane Poole has nothing to disclose.
Jim Rowson (131000)	No disclosure on file
Cathra Halabi, MD (UCSF Department of Neurology)	The institution of Dr. Halabi has received research support from UC Noyce Initiative. The institution of Dr. Halabi has received research support from Weill Institute for Neurosciences Neurohub. The institution of Dr. Halabi has received research support from NIH/NIDCD. The institution of Dr. Halabi has received research support from NIH/StrokeNet. Dr. Halabi has a non-compensated relationship as a Working Group Member with National Academies of Sciences, Engineering, and Medicine Action Collaborative on TBI Care that is relevant to AAN interests or activities. Dr. Halabi has a non-compensated relationship as a Working Group Member with NIH/StrokeNet Recovery and Rehabilitation Working Group that is relevant to AAN interests or activities.
Jill L. Ostrem, MD, FAAN (UCSF)	Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz . Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Superness. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AcureX. Dr. Ostrem has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Larimar. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aspen. Dr. Ostrem has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorders. The institution of Dr. Ostrem has received research support from Neuroderm. The institution of Dr. Ostrem has received research support from Boston Scientific. The institution of Dr. Ostrem has received research support from Medtronic. The institution of Dr. Ostrem has received research support from Rune.
Simon Little (UCSF)	Simon Little has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Iota Biosciences.
Ethan G. Brown, MD (University of California, San Francisco)	Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Rune Labs, Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Guidepoint Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brown has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Knowledge Plus. Dr. Brown has stock in 153 Therapeutics. The institution of Dr. Brown has received research support from Michael J. Fox Foundation. The institution of Dr. Brown has received research support from NIH.
Adam Staffaroni	Adam Staffaroni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alector. Adam Staffaroni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Aviado Bio. Adam Staffaroni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CervoMed. Adam Staffaroni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Prevail Therepeutics/Eli Lilly. Adam Staffaroni has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Takeda. The institution of Adam Staffaroni has received research support from NIH. The institution of Adam Staffaroni has received research support from Bluefield Project To Cure FTD. The institution of Adam Staffaroni has received research support from AFTD/ALSA. Adam Staffaroni has received personal compensation in the range of $500-$4,999 for serving as a Scientific Advisory Board member with AADF.
Riley Bove, MD, FAAN (University of California, San Francisco)	Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genzyme-Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG Therapeutics. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD-Serono. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cadenza. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Eli Lilly. The institution of Dr. Bove has received research support from Novartis. The institution of Dr. Bove has received research support from Roche Genentech.

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