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Artificial intelligence for understanding concussion: Retrospective cluster analysis on the balance and vestibular diagnostic data of concussion patients

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  • Rosa M S Visscher
  • Nina Feddermann-Demont
  • Fausto Romano
  • Dominik Straumann
  • Giovanni Bertolini

Abstract

Objectives: We propose a bottom-up, machine-learning approach, for the objective vestibular and balance diagnostic data of concussion patients, to provide insight into the differences in patients’ phenotypes, independent of existing diagnoses (unsupervised learning). Methods: Diagnostic data from a battery of validated balance and vestibular assessments were extracted from the database of the Swiss Concussion Center. The desired number of clusters within the patient database was estimated using Calinski-Harabasz criteria. Complex (self-organizing map, SOM) and standard (k-means) clustering tools were used, and the formed clusters were compared. Results: A total of 96 patients (81.3% male, age (median [IQR]): 25.0[10.8]) who were expected to suffer from sports-related concussion or post-concussive syndrome (52[140] days between diagnostic testing and the concussive episode) were included. The cluster evaluation indicated dividing the data into two groups. Only the SOM gave a stable clustering outcome, dividing the patients in group-1 (n = 38) and group-2 (n = 58). A large significant difference was found for the caloric summary score for the maximal speed of the slow phase, where group-1 scored 30.7% lower than group-2 (27.6[18.2] vs. 51.0[31.0]). Group-1 also scored significantly lower on the sensory organisation test composite score (69.0[22.3] vs. 79.0[10.5]) and higher on the visual acuity (-0.03[0.33] vs. -0.14[0.12]) and dynamic visual acuity (0.38[0.84] vs. 0.20[0.20]) tests. The importance of caloric, SOT and DVA, was supported by the PCA outcomes. Group-1 tended to report headaches, blurred vision and balance problems more frequently than group-2 (>10% difference). Conclusion: The SOM divided the data into one group with prominent vestibular disorders and another with no clear vestibular or balance problems, suggesting that artificial intelligence might help improve the diagnostic process.

Suggested Citation

  • Rosa M S Visscher & Nina Feddermann-Demont & Fausto Romano & Dominik Straumann & Giovanni Bertolini, 2019. "Artificial intelligence for understanding concussion: Retrospective cluster analysis on the balance and vestibular diagnostic data of concussion patients," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-15, April.
    • Handle: RePEc:plo:pone00:0214525
    DOI: 10.1371/journal.pone.0214525
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    References listed on IDEAS

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    1. Robert Tibshirani & Guenther Walther & Trevor Hastie, 2001. "Estimating the number of clusters in a data set via the gap statistic," Journal of the Royal Statistical Society Series B, Royal Statistical Society, vol. 63(2), pages 411-423.
    2. Douglas Arneson & Guanglin Zhang & Zhe Ying & Yumei Zhuang & Hyae Ran Byun & In Sook Ahn & Fernando Gomez-Pinilla & Xia Yang, 2018. "Single cell molecular alterations reveal target cells and pathways of concussive brain injury," Nature Communications, Nature, vol. 9(1), pages 1-18, December.
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