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Erschienen in: Journal of Neurology 8/2023

20.04.2023 | Original Communication

Diagnosing the benign paroxysmal positional vertigo via 1D and deep-learning composite model

verfasst von: Peixia Wu, Xuebing Liu, Qi Dai, Jiaoda Yu, Jieli Zhao, Fangzhou Yu, Yaoqian Liu, Yongbin Gao, Huawei Li, Wenyan Li

Erschienen in: Journal of Neurology | Ausgabe 8/2023

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Abstract

Background

Benign Paroxysmal Positional Vertigo (BPPV) is the leading cause of vertigo, and its characteristic nystagmus induced by positional maneuvers makes it a good model for Artificial Intelligence (AI) diagnosis. However, during the testing procedure, up to 10 min of indivisible long-range temporal correlation data are produced, making the AI-informed real-time diagnosing unlikely in clinical practice.

Methods

A combined 1D and Deep-Learning (DL) composite model was proposed. Two separate cohorts were recruited, with one for model generation and the other for evaluation of model’s real-world generalizability. Eight features, including two head traces and three eye traces and their corresponding slow phase velocity (SPV) value, were served as the inputs. Three candidate models were tested, and a sensitivity study was conducted to determine the saliently important features.

Results

The study included 2671 patients in the training cohort and 703 in the test cohort. A hybrid DL model achieved a micro-area under the receiver operating curve (AUROC) of 0.982 (95% CI 0.965, 0.994) and macro-AUROC of 0.965 (95% CI 0.898, 0.999) for overall classification. The highest accuracy was observed for right posterior BPPV, with an AUROC of 0.991 (95% CI 0.972, 1.000), followed by left posterior BPPV, with an AUROC of 0.979 (95% CI 0.940, 0.998), the lowest AUROC was 0.928 (95% CI 0.878, 0.966) for lateral BPPV. The SPV was consistently identified as the most predictive feature in the models. If the model process is carried out 100 times for a 10-min data, one single running takes 0.79 ± 0.06 s.

Conclusion

This study designed DL models which can accurately detect and categorize the subtype of BPPV, enabling a quick and straightforward diagnosis of BPPV in clinical setting. The critical feature identified in the model helps expand our understanding of this disorder.
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Literatur
1.
Zurück zum Zitat Alyono JC (2018) Vertigo and dizziness: understanding and managing fall risk. Otolaryngol Clin North Am 51:725–740CrossRefPubMed Alyono JC (2018) Vertigo and dizziness: understanding and managing fall risk. Otolaryngol Clin North Am 51:725–740CrossRefPubMed
2.
Zurück zum Zitat Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 156:S1-s47PubMed Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R, Seidman MD, Steiner RW, Do BT, Voelker CC, Waguespack RW, Corrigan MD (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 156:S1-s47PubMed
3.
Zurück zum Zitat Chicco D, Jurman G (2020) The advantages of the Matthews correlation coefficient (MCC) over F1 score and accuracy in binary classification evaluation. BMC Genomics 21:6CrossRefPubMedPubMedCentral Chicco D, Jurman G (2020) The advantages of the Matthews correlation coefficient (MCC) over F1 score and accuracy in binary classification evaluation. BMC Genomics 21:6CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Dixit S, Kulkarni P, Mahale A (2019) Role of slow phase velocity of nystagmus in posterior canal benign paroxysmal positional vertigo. J Vestib Res 29:227–234 Dixit S, Kulkarni P, Mahale A (2019) Role of slow phase velocity of nystagmus in posterior canal benign paroxysmal positional vertigo. J Vestib Res 29:227–234
5.
Zurück zum Zitat Paliulis E, Daunys G (2006) Determination of eye torsion by videooculography including cornea optics. Electron Electr Eng 5:83–86 Paliulis E, Daunys G (2006) Determination of eye torsion by videooculography including cornea optics. Electron Electr Eng 5:83–86
6.
Zurück zum Zitat Eggers SDZ, Bisdorff A, von Brevern M, Zee DS, Kim JS, Perez-Fernandez N, Welgampola MS, Della Santina CC, Newman-Toker DE (2019) Classification of vestibular signs and examination techniques: nystagmus and nystagmus-like movements. J Vestib Res 29:57–87CrossRefPubMedPubMedCentral Eggers SDZ, Bisdorff A, von Brevern M, Zee DS, Kim JS, Perez-Fernandez N, Welgampola MS, Della Santina CC, Newman-Toker DE (2019) Classification of vestibular signs and examination techniques: nystagmus and nystagmus-like movements. J Vestib Res 29:57–87CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Feil K, Feuerecker R, Goldschagg N, Strobl R, Brandt T, von Müller A, Grill E, Strupp M (2018) Predictive capability of an iPad-based medical device (medx) for the diagnosis of vertigo and dizziness. Front Neurol 9:29CrossRefPubMedPubMedCentral Feil K, Feuerecker R, Goldschagg N, Strobl R, Brandt T, von Müller A, Grill E, Strupp M (2018) Predictive capability of an iPad-based medical device (medx) for the diagnosis of vertigo and dizziness. Front Neurol 9:29CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Fife D, FitzGerald JE (2005) Do patients with benign paroxysmal positional vertigo receive prompt treatment? Analysis of waiting times and human and financial costs associated with current practice. Int J Audiol 44:50–57CrossRefPubMed Fife D, FitzGerald JE (2005) Do patients with benign paroxysmal positional vertigo receive prompt treatment? Analysis of waiting times and human and financial costs associated with current practice. Int J Audiol 44:50–57CrossRefPubMed
9.
Zurück zum Zitat Fife TD, von Brevern M (2015) Benign paroxysmal positional vertigo in the acute care setting. Neurol Clin 33:601–617 (viii–ix)CrossRefPubMed Fife TD, von Brevern M (2015) Benign paroxysmal positional vertigo in the acute care setting. Neurol Clin 33:601–617 (viii–ix)CrossRefPubMed
10.
Zurück zum Zitat Ganança FF, Gazzola JM, Ganança CF, Caovilla HH, Ganança MM, Cruz OL (2010) Elderly falls associated with benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 76:113–120CrossRefPubMed Ganança FF, Gazzola JM, Ganança CF, Caovilla HH, Ganança MM, Cruz OL (2010) Elderly falls associated with benign paroxysmal positional vertigo. Braz J Otorhinolaryngol 76:113–120CrossRefPubMed
11.
Zurück zum Zitat Hanley K, O’Dowd T, Considine N (2001) A systematic review of vertigo in primary care. Br J Gen Pract 51:666–671PubMedPubMedCentral Hanley K, O’Dowd T, Considine N (2001) A systematic review of vertigo in primary care. Br J Gen Pract 51:666–671PubMedPubMedCentral
12.
Zurück zum Zitat Imai T, Takeda N, Ikezono T, Shigeno K, Asai M, Watanabe Y, Suzuki M (2017) Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx 44:1–6CrossRefPubMed Imai T, Takeda N, Ikezono T, Shigeno K, Asai M, Watanabe Y, Suzuki M (2017) Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx 44:1–6CrossRefPubMed
13.
Zurück zum Zitat Jahn K, Kreuzpointner A, Pfefferkorn T, Zwergal A, Brandt T, Margraf A (2020) Telling friend from foe in emergency vertigo and dizziness: does season and daytime of presentation help in the differential diagnosis? J Neurol 267:118–125CrossRefPubMedPubMedCentral Jahn K, Kreuzpointner A, Pfefferkorn T, Zwergal A, Brandt T, Margraf A (2020) Telling friend from foe in emergency vertigo and dizziness: does season and daytime of presentation help in the differential diagnosis? J Neurol 267:118–125CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Kerber KA (2015) Benign paroxysmal positional vertigo: opportunities squandered. Ann NY Acad Sci 1343:106–112CrossRefPubMed Kerber KA (2015) Benign paroxysmal positional vertigo: opportunities squandered. Ann NY Acad Sci 1343:106–112CrossRefPubMed
15.
Zurück zum Zitat Kerber KA, Burke JF, Skolarus LE, Meurer WJ, Callaghan BC, Brown DL, Lisabeth LD, McLaughlin TJ, Fendrick AM, Morgenstern LB (2013) Use of BPPV processes in emergency department dizziness presentations: a population-based study. Otolaryngol Head Neck Surg 148:425–430CrossRefPubMed Kerber KA, Burke JF, Skolarus LE, Meurer WJ, Callaghan BC, Brown DL, Lisabeth LD, McLaughlin TJ, Fendrick AM, Morgenstern LB (2013) Use of BPPV processes in emergency department dizziness presentations: a population-based study. Otolaryngol Head Neck Surg 148:425–430CrossRefPubMed
16.
Zurück zum Zitat Kim HJ, Lee JO, Choi JY, Kim JS (2020) Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol 267:2252–2259CrossRefPubMed Kim HJ, Lee JO, Choi JY, Kim JS (2020) Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. J Neurol 267:2252–2259CrossRefPubMed
17.
Zurück zum Zitat Kim JS, Zee DS (2014) Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 370:1138–1147CrossRefPubMed Kim JS, Zee DS (2014) Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 370:1138–1147CrossRefPubMed
18.
Zurück zum Zitat Kiranyaz S, Ince T, Gabbouj M (2016) Real-time patient-specific ECG classification by 1-D convolutional neural networks. IEEE Trans Biomed Eng 63:664–675CrossRefPubMed Kiranyaz S, Ince T, Gabbouj M (2016) Real-time patient-specific ECG classification by 1-D convolutional neural networks. IEEE Trans Biomed Eng 63:664–675CrossRefPubMed
19.
Zurück zum Zitat Korres S, Balatsouras DG, Kaberos A, Economou C, Kandiloros D, Ferekidis E (2002) Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 23:926–932CrossRefPubMed Korres S, Balatsouras DG, Kaberos A, Economou C, Kandiloros D, Ferekidis E (2002) Occurrence of semicircular canal involvement in benign paroxysmal positional vertigo. Otol Neurotol 23:926–932CrossRefPubMed
21.
Zurück zum Zitat Lopez-Escamez JA, Gamiz MJ, Fernandez-Perez A, Gomez-Fiñana M (2005) Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 262:507–511CrossRefPubMed Lopez-Escamez JA, Gamiz MJ, Fernandez-Perez A, Gomez-Fiñana M (2005) Long-term outcome and health-related quality of life in benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 262:507–511CrossRefPubMed
22.
Zurück zum Zitat Lu W, Li Z, Li Y, Li J, Chen Z, Feng Y, Wang H, Luo Q, Wang Y, Pan J, Gu L, Yu D, Zhang Y, Shi H, Yin S (2022) A deep learning model for three-dimensional nystagmus detection and its preliminary application. Front Neurosci 16:930028CrossRefPubMedPubMedCentral Lu W, Li Z, Li Y, Li J, Chen Z, Feng Y, Wang H, Luo Q, Wang Y, Pan J, Gu L, Yu D, Zhang Y, Shi H, Yin S (2022) A deep learning model for three-dimensional nystagmus detection and its preliminary application. Front Neurosci 16:930028CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Lv QJ, Chen HY, Zhong WB, Wang YY, Song JY, Guo SD, Qi LX, Chen CY (2020) A multi-task group bi-LSTM networks application on electrocardiogram classification. IEEE J Transl Eng Health Med 8:1900111CrossRefPubMed Lv QJ, Chen HY, Zhong WB, Wang YY, Song JY, Guo SD, Qi LX, Chen CY (2020) A multi-task group bi-LSTM networks application on electrocardiogram classification. IEEE J Transl Eng Health Med 8:1900111CrossRefPubMed
24.
Zurück zum Zitat Newman-Toker DE, Camargo CA Jr, Hsieh YH, Pelletier AJ, Edlow JA (2009) Disconnect between charted vestibular diagnoses and emergency department management decisions: a cross-sectional analysis from a nationally representative sample. Acad Emerg Med 16:970–977CrossRefPubMed Newman-Toker DE, Camargo CA Jr, Hsieh YH, Pelletier AJ, Edlow JA (2009) Disconnect between charted vestibular diagnoses and emergency department management decisions: a cross-sectional analysis from a nationally representative sample. Acad Emerg Med 16:970–977CrossRefPubMed
25.
Zurück zum Zitat Newman JL, Phillips JS, Cox SJ (2021) Detecting positional vertigo using an ensemble of 2D convolutional neural networks. Biomed Signal Process Control 68:102708CrossRefPubMedPubMedCentral Newman JL, Phillips JS, Cox SJ (2021) Detecting positional vertigo using an ensemble of 2D convolutional neural networks. Biomed Signal Process Control 68:102708CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Otero-Millan J, Roberts DC, Lasker A, Zee DS, Kheradmand A (2015) Knowing what the brain is seeing in three dimensions: a novel, noninvasive, sensitive, accurate, and low-noise technique for measuring ocular torsion. J Vis 15:11–11CrossRefPubMedPubMedCentral Otero-Millan J, Roberts DC, Lasker A, Zee DS, Kheradmand A (2015) Knowing what the brain is seeing in three dimensions: a novel, noninvasive, sensitive, accurate, and low-noise technique for measuring ocular torsion. J Vis 15:11–11CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Parham K (2014) Benign paroxysmal positional vertigo: an integrated perspective. Adv Otolaryngol 2014:1–17CrossRef Parham K (2014) Benign paroxysmal positional vertigo: an integrated perspective. Adv Otolaryngol 2014:1–17CrossRef
28.
29.
Zurück zum Zitat Chien HY, Turek JS, Beckage N (2021) Slower is better: revisiting the forgetting mechanism in LSTM for Slower information decay. arXiv preprint. arXiv:2105.05944 Chien HY, Turek JS, Beckage N (2021) Slower is better: revisiting the forgetting mechanism in LSTM for Slower information decay. arXiv preprint. arXiv:​2105.​05944
31.
Zurück zum Zitat Tc H, MC (2013) Nystagmus. Neurol Clin 31:557–573 Tc H, MC (2013) Nystagmus. Neurol Clin 31:557–573
32.
Zurück zum Zitat Ullah W, Siddique I, Zulqarnain RM, Alam MM, Ahmad I, Raza UA (2021) Classification of arrhythmia in heartbeat detection using deep learning. Comput Intell Neurosci 2021:2195922CrossRefPubMedPubMedCentral Ullah W, Siddique I, Zulqarnain RM, Alam MM, Ahmad I, Raza UA (2021) Classification of arrhythmia in heartbeat detection using deep learning. Comput Intell Neurosci 2021:2195922CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Vaswani A, Shazeer N, Parmar N (2017) Attention is all you need. Adv Neural Inf Process 30:1–11 Vaswani A, Shazeer N, Parmar N (2017) Attention is all you need. Adv Neural Inf Process 30:1–11
34.
Zurück zum Zitat von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, Newman-Toker D (2015) Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 25:105–117CrossRef von Brevern M, Bertholon P, Brandt T, Fife T, Imai T, Nuti D, Newman-Toker D (2015) Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 25:105–117CrossRef
35.
Zurück zum Zitat von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78:710–715CrossRef von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78:710–715CrossRef
36.
Zurück zum Zitat Wang J, Qiao X, Liu C, Wang X, Liu Y, Yao L, Zhang H (2021) Automated ECG classification using a non-local convolutional block attention module. Comput Methods Programs Biomed 203:106006CrossRefPubMed Wang J, Qiao X, Liu C, Wang X, Liu Y, Yao L, Zhang H (2021) Automated ECG classification using a non-local convolutional block attention module. Comput Methods Programs Biomed 203:106006CrossRefPubMed
37.
Zurück zum Zitat Wibirama S, Tungjitkusolmun S, Pintavirooj C (2013) Dual-camera acquisition for accurate measurement of three-dimensional eye movements. IEE J Trans Electr Electron Eng 8:238–246CrossRef Wibirama S, Tungjitkusolmun S, Pintavirooj C (2013) Dual-camera acquisition for accurate measurement of three-dimensional eye movements. IEE J Trans Electr Electron Eng 8:238–246CrossRef
38.
Zurück zum Zitat Yiu YH, Aboulatta M, Raiser T, Ophey L, Flanagin VL, Zu Eulenburg P, Ahmadi SA (2019) DeepVOG: open-source pupil segmentation and gaze estimation in neuroscience using deep learning. J Neurosci Methods 324:108307CrossRefPubMed Yiu YH, Aboulatta M, Raiser T, Ophey L, Flanagin VL, Zu Eulenburg P, Ahmadi SA (2019) DeepVOG: open-source pupil segmentation and gaze estimation in neuroscience using deep learning. J Neurosci Methods 324:108307CrossRefPubMed
39.
Zurück zum Zitat Zhang W, Wu H, Liu Y, Zheng S, Liu Z, Li Y, Zhao Y, Zhu Z (2021) Deep learning based torsional nystagmus detection for dizziness and vertigo diagnosis. Biomed Signal Process Control 68:102616CrossRef Zhang W, Wu H, Liu Y, Zheng S, Liu Z, Li Y, Zhao Y, Zhu Z (2021) Deep learning based torsional nystagmus detection for dizziness and vertigo diagnosis. Biomed Signal Process Control 68:102616CrossRef
Metadaten
Titel
Diagnosing the benign paroxysmal positional vertigo via 1D and deep-learning composite model
verfasst von
Peixia Wu
Xuebing Liu
Qi Dai
Jiaoda Yu
Jieli Zhao
Fangzhou Yu
Yaoqian Liu
Yongbin Gao
Huawei Li
Wenyan Li
Publikationsdatum
20.04.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Neurology / Ausgabe 8/2023
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-023-11662-w

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