Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study
<i>Background and Objectives</i>: Diagnosis of dementia subtypes caused by different brain pathophysiologies, particularly Alzheimer’s disease (AD) from AD mixed with levels of cerebrovascular disease (CVD) symptomology (AD-CVD), is challenging due to overlapping symptoms. In this pilot...
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/12/2091 |
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| author | Zeinab A. Dastgheib Brian J. Lithgow Zahra K. Moussavi |
| author_facet | Zeinab A. Dastgheib Brian J. Lithgow Zahra K. Moussavi |
| author_sort | Zeinab A. Dastgheib |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Diagnosis of dementia subtypes caused by different brain pathophysiologies, particularly Alzheimer’s disease (AD) from AD mixed with levels of cerebrovascular disease (CVD) symptomology (AD-CVD), is challenging due to overlapping symptoms. In this pilot study, the potential of Electrovestibulography (EVestG) for identifying AD, AD-CVD, and healthy control populations was investigated. <i>Materials and Methods</i>: A novel hierarchical multiclass diagnostic algorithm based on the outcomes of its lower levels of binary classifications was developed using data of 16 patients with AD, 13 with AD-CVD, and 24 healthy age-matched controls, and then evaluated on a blind testing dataset made up of a new population of 12 patients diagnosed with AD, 9 with AD-CVD, and 8 healthy controls. Multivariate analysis was run to test the between population differences while controlling for sex and age covariates. <i>Results</i>: The accuracies of the multiclass diagnostic algorithm were found to be 85.7% and 79.6% for the training and blind testing datasets, respectively. While a statistically significant difference was found between the populations after accounting for sex and age, no significant effect was found for sex or age covariates. The best characteristic EVestG features were extracted from the upright sitting and supine up/down stimulus responses. <i>Conclusions</i>: Two EVestG movements (stimuli) and their most informative features that are best selective of the above-populations’ separations were identified, and a hierarchy diagnostic algorithm was developed for three-way classification. Given that the two stimuli predominantly stimulate the otholithic organs, physiological and experimental evidence supportive of the results are presented. Disruptions of inhibition associated with GABAergic activity might be responsible for the changes in the EVestG features. |
| first_indexed | 2024-03-08T20:33:25Z |
| format | Article |
| id | doaj.art-9a6ec7b461374e4499be4e2310a05428 |
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| language | English |
| last_indexed | 2024-03-08T20:33:25Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-9a6ec7b461374e4499be4e2310a054282023-12-22T14:23:46ZengMDPI AGMedicina1010-660X1648-91442023-11-015912209110.3390/medicina59122091Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot StudyZeinab A. Dastgheib0Brian J. Lithgow1Zahra K. Moussavi2Diagnostic and Neurological Processing Research Laboratory, Biomedical Engineering Program, University of Manitoba, Riverview Health Centre, Winnipeg, MB R3L 2P4, CanadaDiagnostic and Neurological Processing Research Laboratory, Biomedical Engineering Program, University of Manitoba, Riverview Health Centre, Winnipeg, MB R3L 2P4, CanadaDiagnostic and Neurological Processing Research Laboratory, Biomedical Engineering Program, University of Manitoba, Riverview Health Centre, Winnipeg, MB R3L 2P4, Canada<i>Background and Objectives</i>: Diagnosis of dementia subtypes caused by different brain pathophysiologies, particularly Alzheimer’s disease (AD) from AD mixed with levels of cerebrovascular disease (CVD) symptomology (AD-CVD), is challenging due to overlapping symptoms. In this pilot study, the potential of Electrovestibulography (EVestG) for identifying AD, AD-CVD, and healthy control populations was investigated. <i>Materials and Methods</i>: A novel hierarchical multiclass diagnostic algorithm based on the outcomes of its lower levels of binary classifications was developed using data of 16 patients with AD, 13 with AD-CVD, and 24 healthy age-matched controls, and then evaluated on a blind testing dataset made up of a new population of 12 patients diagnosed with AD, 9 with AD-CVD, and 8 healthy controls. Multivariate analysis was run to test the between population differences while controlling for sex and age covariates. <i>Results</i>: The accuracies of the multiclass diagnostic algorithm were found to be 85.7% and 79.6% for the training and blind testing datasets, respectively. While a statistically significant difference was found between the populations after accounting for sex and age, no significant effect was found for sex or age covariates. The best characteristic EVestG features were extracted from the upright sitting and supine up/down stimulus responses. <i>Conclusions</i>: Two EVestG movements (stimuli) and their most informative features that are best selective of the above-populations’ separations were identified, and a hierarchy diagnostic algorithm was developed for three-way classification. Given that the two stimuli predominantly stimulate the otholithic organs, physiological and experimental evidence supportive of the results are presented. Disruptions of inhibition associated with GABAergic activity might be responsible for the changes in the EVestG features.https://www.mdpi.com/1648-9144/59/12/2091feature selectiondiagnostic algorithmElectrovestibulographyAlzheimer’s diseasecerebrovascular pathologygamma-aminobutyric acid |
| spellingShingle | Zeinab A. Dastgheib Brian J. Lithgow Zahra K. Moussavi Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study Medicina feature selection diagnostic algorithm Electrovestibulography Alzheimer’s disease cerebrovascular pathology gamma-aminobutyric acid |
| title | Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study |
| title_full | Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study |
| title_fullStr | Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study |
| title_full_unstemmed | Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study |
| title_short | Evaluating the Diagnostic Value of Electrovestibulography (EVestG) in Alzheimer’s Patients with Mixed Pathology: A Pilot Study |
| title_sort | evaluating the diagnostic value of electrovestibulography evestg in alzheimer s patients with mixed pathology a pilot study |
| topic | feature selection diagnostic algorithm Electrovestibulography Alzheimer’s disease cerebrovascular pathology gamma-aminobutyric acid |
| url | https://www.mdpi.com/1648-9144/59/12/2091 |
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