@article{26c05c0885de4e1b8074aef48d88cc93,
title = "Hold that pose: capturing cervical dystonia's head deviation severity from video",
abstract = "Objective: Deviated head posture is a defining characteristic of cervical dystonia (CD). Head posture severity is typically quantified with clinical rating scales such as the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Because clinical rating scales are inherently subjective, they are susceptible to variability that reduces their sensitivity as outcome measures. The variability could be circumvented with methods to measure CD head posture objectively. However, previously used objective methods require specialized equipment and have been limited to studies with a small number of cases. The objective of this study was to evaluate a novel software system—the Computational Motor Objective Rater (CMOR)—to quantify multi-axis directionality and severity of head posture in CD using only conventional video camera recordings. Methods: CMOR is based on computer vision and machine learning technology that captures 3D head angle from video. We used CMOR to quantify the axial patterns and severity of predominant head posture in a retrospective, cross-sectional study of 185 patients with isolated CD recruited from 10 sites in the Dystonia Coalition. Results: The predominant head posture involved more than one axis in 80.5% of patients and all three axes in 44.4%. CMOR's metrics for head posture severity correlated with severity ratings from movement disorders neurologists using both the TWSTRS-2 and an adapted version of the Global Dystonia Rating Scale (rho = 0.59–0.68, all p <0.001). Conclusions: CMOR's convergent validity with clinical rating scales and reliance upon only conventional video recordings supports its future potential for large scale multisite clinical trials.",
author = "Zheng Zhang and Elizabeth Cisneros and Lee, {Ha Yeon} and Vu, {Jeanne P.} and Qiyu Chen and Benadof, {Casey N.} and Jacob Whitehill and Ryin Rouzbehani and Sy, {Dominique T.} and Huang, {Jeannie S.} and Sejnowski, {Terrence J.} and Joseph Jankovic and Stewart Factor and Goetz, {Christopher G.} and Barbano, {Richard L.} and Perlmutter, {Joel S.} and Jinnah, {Hyder A.} and Berman, {Brian D.} and Richardson, {Sarah Pirio} and Stebbins, {Glenn T.} and Comella, {Cynthia L.} and Peterson, {David A.}",
note = "Funding Information: This research was conducted under the auspices of the Dystonia Coalition, which is part of the Rare Diseases Clinical Research Network, an initiative funded by the Office of Rare Diseases Research at the National Center for Advancing Translational Sciences (U54 TR001456) in collaboration with the National Institute of Neurological Disorders and Stroke (U54 NS065701 and U54 NS116025) at the National Institutes of Health (NIH). This work was also supported by the Kavli Institute for Brain and Mind at UCSD, and the Office of the Assistant Secretary of Defense for Health Affairs, through the Peer‐Reviewed Medical Research Program under Awards W81XWH‐17‐1‐0393 and W81XWH‐19‐1‐0146. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense. Funding Information Funding Information: The authors thank the patients who participated in this study. The authors also gratefully acknowledge assistance from the WUSM Biorepository team, including Laura Wright for managing video recording and clinical data intake, and Matt Hicks for technical support. Publisher Copyright: {\textcopyright} 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.",
year = "2022",
month = may,
doi = "10.1002/acn3.51549",
language = "English",
volume = "9",
pages = "684--694",
journal = "Annals of Clinical and Translational Neurology",
issn = "2328-9503",
number = "5",
}