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2011 4th International Conference on Biomedical Engineering and Informatics (BMEI)

Comparison of methods for tremor frequency analysis


for patients with Parkinsons disease
K.Niazmand, A. Kalaras, H. Dai, T.C. Lueth
Dept. of Micro Technology and Medical Device Technology
Technische Universitaet Muenchen, Garching, Germany
Abstract Tremor is described as involuntary rhythmic
oscillations of one or more body parts. It is a symptom of
Parkinsons disease (PD). The severity of tremor is based on its
frequency. Using acceleration sensors, one can detect tremor of
the limbs or other body parts. Data from sensors can be
processed using spectral analysis. The most common methods for
the investigation of tremor are Fast Fourier Transformation
(FFT), Short Time Fourier Transform (STFT) and power
spectral density analysis (PSD). In this paper we investigate these
methods together with peak detection and pattern recognition
methods. We compare the various approaches with each other
with respect to frequency. A visual frequency analysis using an
optical tracking system is used as a reference. The experiments
were performed with a measuring glove with integrated
acceleration sensors on the middle finger and thumb joint. We
examined the accuracy of the various methods for the analysis of
tremor in PD patients.
Keywords frequency analysis; tremor; peak detection; pattern
recognition; Fast Fourier Transformation (FFT); Short Time
Fourier Transform (STFT); power spectral density (PSD);

I.

INTRODUCTION

Parkinsons disease (PD) is a neurodegenerative disorder


causing progressive loss of dopamine-producing brain cells.
The loss of dopamine in the midbrain often induces tremor of
one or more body parts. Tremor is an involuntary rhythmic
oscillation and the main symptom of PD.
The predominant method for evaluating the status of
tremor is the Unified Parkinsons Disease Rating Scale
(UPDRS) [1]. Rating results can vary from neurologist to
neurologist with limited reproducibility [2]. A quantifiable and
objective data acquisition providing information for the tremor
could improve diagnosis and therapy. The main parameter,
which characterizes the tremor, is its frequency. On the basis
of the frequency the evaluation of tremor is possible.
Using accelerometers to detect specific movements and
activities is a well-known approach [3]. The sensors are either
fixed with bandages to the limbs [4] or they are integrated into
clothing [5, 6]. The sensors deliver acceleration values several
times per second. A change of these values is the effect of a
movement [5]. By means of different mathematical methods,
movement and activity as well as the frequency of changes in
the movement can be detected and displayed.
This work has received funding from the Bavarian Research Foundation
(BFS) under contract number AZ-780-07. The views expressed here are those
of the authors only. The BFS is not liable for any use that may be made of the
information contained therein.

978-1-4244-9352-4/11/$26.00 2011 IEEE

II.

STATE OF THE ART

There are many systems which assess the severity of


tremor taken based on its spectrum. The main methods for the
calculation of frequency are the Fast Fourier Transformation
(FFT), the Short Time Fourier Transform (STFT) [7, 8] or
wavelet Transform [9,10].
Fourier analysis breaks down a signal into sinusoids of
different frequencies. It is a mathematical technique for
transforming a signal from the time domain to the frequency
domain. The drawback of the Fourier transform is that all
time information is lost after the transformation [11]. When
looking at the Fourier transform of a signal, it is impossible to
tell when a particular event took place. Tremor signals contain
numerous non-stationary or transitory characteristics such as
drift, trends, and abrupt changes. These characteristics are
often the most important part of a signal like tremor, and
Fourier analysis is not suited to detecting them.
Tremor is defined as an oscillatory, involuntary motion.
Because of its oscillatory characteristic, tremor is suited for
spectral analysis. The idea is to calculate the power spectral
density function which indicates the signal power at different
frequencies across the spectrum. The dominant frequency of
tremor is evident from a visible peak in the power spectral
density, while the average tremor amplitude can be determined
from the area under the peak [12, 13].
For tremor analysis specific FFT-based power estimation
techniques are often used [14, 15, 16, and 17]. In [14] an FFTbased power estimation of the signal in a specific frequency
area is calculated rather than the tremor frequency. The
acceleration data are filtered with a high pass filter with a cutoff frequency of 3Hz and the signal power is calculated for
frequencies greater than 3Hz. In [17] power spectral density
vs. frequency is estimated by the Welch method of
averaging periodograms (Fast Fourier Transform length 128,
Kaiser windowed segments overlapping 50%). The dominant
power density of signal is not necessarily the frequency of
tremor; it can also be the power of noise. In [15] two FFTbased spectral estimation techniques are used: the BlackmanTukey method and the periodogram method. These methods
have a limited performance for finite data records. In
circumstances where only short data records are available, it
may be difficult to manage the bias-variance trade-off
satisfactorily and produce spectral estimates with an
acceptable resolution. Moreover the windowing method in
FFT imposes a spectral leakage. It is a leakage of power from

693

TABLE I.

the spectral peaks of the desired spectrum to surrounding


frequencies.
On the other hand, the Short-Time Fourier Transform
(STFT) analyzes only a small section of the signal at a time
(windowing the signal). The STFT represents a signal as a
two-dimensional function of time and frequency. The STFT is
a compromise between the time- and frequency-based views
of a signal. It provides some information about both when and
at what frequencies a signal event occurs. Thus, one can obtain
this information with only limited precision. That precision is
determined by the size of the window. In [7] acceleration
sensors are fastened with bands to the skin of PD patients.
Time signals are transformed into time frequency signals. For
each data point a STFT is calculated using an interval of 2
seconds counting backwards from this point, whereby the
interval length determines frequency steps of 0.5Hz in the
spectrum. The main drawback is that if one chooses a
particular size for the time window, then that window is the
same for all frequencies. But the tremor signal requires a more
flexible approach, i.e., a variation of the window size is
desirable to obtain either better time or frequency resolution.
By contrast the wavelet transform window is scaled. Thus, the
same resolution is obtained for multiple frequency bands. A
summary of the state of the art is shown in table I.
So far there is no method to estimate the frequency of the
tremor (stochastic signal) over a specific, either short or long
time period. The accuracy of these methods in a discrete signal
is strongly dependent on the sampling frequency. The higher
the signal is sampled the more accurate the frequency analysis.
At a low sampling frequency, however, these methods are not
accurate because the fundamental frequency in the waveform
is not dominant as the noise frequency or frequency of body
vibrations. Moreover, these methods are generally unsuitable
for the analysis of stochastic signals. The estimation of the
frequency could help to evaluate the severity of tremor.
III.

TASK AND APPROACH

A new method is needed to estimate the tremor


frequency using acceleration sensors. This method should not
be based on FFT or STFT because of the drawbacks
previously described. The new method should also calculate
the frequency over brief periods of time and should deliver
good results even at low sampling rates. The accuracy of such
a method should be demonstrated. Using a reference
measurement with alternative methods of tremor frequency
analysis (e.g. optical measurement), one can compare and
evaluate all methods.
In [18] we have described the function and set-up of the
MiMed-Glove, a textile integrated measurement device,
which identifies clearly movement disorders such as tremor,
bradykinesia and rigidity from recorded sensor data. The glove
integrates acceleration sensors and a unit for data acquisition
and processing. The glove can be washed in a washing
machine. Data acquisition is provided by wireless
communication. This measuring system is used for recording
of transaction data.
IV.

Ref.
[7]
[8]
[9]
[10]

SUMMARY OF THE STATE OF THE ART

Spectral Analysis
Method
Short Time Fourier Transform
Short Time Fourier Transform
wavelet Transform
wavelet Transform

[12, 13] Fast Fourier Transformation


[14]
Fast Fourier Transformation

Power vs. Frequency


Estimation
Maximum peak in STFT
STFT-Spectrogram
Power Spectral Density
-

[15]

Fast Fourier Transformation

Blackman-Tukey, Periodogram

[16]
[17]

Fast Fourier Transformation


Fast Fourier Transformation

FFT squared,Statistical methods


Welch method

The first method is based on peak detection and the second


on pattern recognition (correlation of tremor signal with sinus
signals).
A. Peak detection:
In [19] we developed a sensor based garment to detect and
classify the tremor. The acceleration values (X[k]) from eight
sensors integrated in a garment are captured with a frequency
of 20Hz. The relative accelerations X[k] based on the
absolute acceleration X[k] are calculated as follows (equ. 1-3):
(1)

,
,

(2)
(3)

where gm is the acceleration of gravity and NTHLD refers to


the maximum noise level caused by the electronics.
The frequency of the tremor can be the number of peaks of
relative acceleration per second. We developed two techniques
for the detection of peaks. The first one offline method detects the peaks and calculates the frequency if the sensor
values are available. This means that we need to first capture
the sensor values and afterwards apply the algorithm. The
second one online method- detects the peaks and calculates
the frequency in real time with a delay of 0.05s (period
between sensor values acquisition=1/20Hz).
1)

Offline methode
The relative accelerations of a movement are calculated at
first. The time points of the maximum values of the relative
accelerations are detected. Therefore, an upper (form. 1) and a
lower threshold (form. 2, red lines in fig. 1) are calculated.

CONCEPT DESCRIPTION

We developed and evaluated two methods for the estimation


of tremor frequency.

Figure 1. Calculation of the frequency

694

The maximum, which is obtained during this process, is


defined as a signal peak. For the calculation of the upper and
lower threshold, the mean value (equ. 6) and the standard
deviation (equ. 7) of the relative accelerations are taken into
account, in order to detect all the peaks of the signal, even if
the peaks have different amplitudes.
(4)
(5)

(6)

(7)

where Xi(+) and Xi(-) refers to the ith positive and negative
acceleration and n+ and n- the number of the positive and
negative values.
When the time points of the peaks are detected, the
distances between these points are calculated (1, 2 ...).
The frequency of the signal is calculated as follows (equ. 8):

(8)

Where is the distance between the points of time of the


peaks and N is the number of the distances.
2)

Online methode
This method is a modification of the first technique. The
purpose is to calculate the frequency in real time. The upper
and lower thresholds are calculated over a period of 2s. Thus
this algorithm needs a buffer time of 2s at the beginning of a
measurement. During this time the frequency cannot be
estimated. After this time period the frequency is calculated
each time when the sensors receive a new value. Thus, the
frequency is calculated 20 times per second. The acceleration
values of the last 2s are taken into account for the peak
detection and calculation of the frequency each time.
B. Pattern recognition:
In this technique the tremor signals are compared with
periodical sample signals with a known frequency. These
signals are sinusoidal signals with time span of two seconds
and frequencies from 0 to 7Hz with a step of 0.1Hz. Each time
when the sensors receive a new value the relative accelerations
of the last two seconds are correlated with the sinusoidal
signals. The frequency of the signal equates with the
frequency of the sinusoidal signal with the maximal
correlation.

Figure 2. Tremor signal and the most suitable sinus signal

V.

EVALUATION OF PEAK DETECTION AND PATTERN


RECOGNITION METHODS

A. Materials and Methods:


The smart glove, described in [18], was used for our
experiments as a test instrument. The glove includes inter alia
two integrated triaxial acceleration sensors fixed on the middle
finger and on the dorsal wrist. The data of the 3D acceleration
sensors were recorded with a sampling rate of 20 Hz.
B. Peak Detection Experiment:
1) Setup:
To assess the reliability of the two techniques of peak
detection, 3 patients with PD executed the two tasks according
to UPDRS. First, hands and arms were kept at rest, afterwards
stretched out (fig. 3). During the first task the rest tremor
can be assessed, while during the second task the postural
tremor of the hand is obtained.
Using the first technique the system calculated the
frequency over a time of 15s for each executed task. The
frequencies were compared with the estimated frequencies.
The estimated frequencies were calculated using an optical
measurement of the signal. We detected visually the duration
between the peaks and estimated the frequency from this.
To assess the reliability of the second technique, we
calculated the frequencies with the second technique and
determined the average of the frequency every 5 seconds
during the execution of the tasks for rest and postural tremor.

In fig. 2 we can see a tremor signal (red line) and the most
suitable sinusoidal signal (blue dashed line) from 71 sample
signals. The signal has a frequency of 6Hz. The tremor signal
is not a periodical signal. Using this method we will try to find
repetitions in the tremor signal and its frequency.
Figure 3. Two tasks according to UPDRS [18]

695

At the end we compared the average meaasured frequency


of the system with the estimated average freqquency during the
same period.
2) Results:
The average deviation of measured freqquency from the
estimated frequency according to the offline method is 0.31
0.34Hz. The average deviation of meassured frequency
according to online method from the estimaated frequency is
0.440.51Hz. The large deviation comes intoo because of the
non-repeatable processes.
C. Pattern recognition Experiment:
1) Setup:
For the evaluation of this method we ttook acceleration
data from a patient with PD for 30s andd calculated the
frequency of the signal for intervals of 2ss. After that we
estimated the frequency of signal repetitions aas above. In fig.4
a low frequency (a) and a high frequencyy (b) signal are
displayed.
2) Results:
The average deviation of measured frequeency according to
pattern recognition from the estimatedd frequency is
0.620.76Hz.
VI.

EVALUATION OF COMPARISON BEETWEEN THE


DIFFERENT METHODS

In order to compare the different methodss (peak detection


(PD), pattern recognition (PR), Fast Fourierr Transformation
(FFT) and power spectral density (PSD)), w
we performed the
following experiment.
A. Materials and Methods:
A measurement was performed on a subjeect (28 years old)
for 90 seconds. The subject (fig. 5.1) wore the smart glove
(fig. 5.2) during the measurement.
a)

Figure 5. Experiment setup: subject (1), smart glove (2), sensor on the
middle finger (3) and on the dorsal wrist (4),
( IR-Marker (5) and IR- stereo
camera (6).

The forearm and middle fingerr of the subject was fixed.


Only one movement around th
he forearm was allowed.
Oscillating movements with lo
ow, medium and high
frequencies each for 10 seconds are
a first low and then after
five seconds of rest with a high
h intensity movement was
simulated. We fixed additionally a marker (fig. 5.5) on the
smart glove and measured with a IRI stereo camera (fig. 5.6)
the position of the glove during
g the tremor activity. We
calculated visually the frequenciess of the position changes.
The distance to the IR-Marker is measured with the camera
and the frequency of movemeent change is calculated
manually. These frequencies are th
he target simulated tremor
frequencies. Additionally, we calcu
ulated from the acceleration
values the frequencies of the sign
nal with the four methods
during 90 seconds. The measured frequencies from the four
methods were compared with the target frequencies.
B. Results:
In table II the difference is presented for the measured
hods from the estimated
frequencies from the four meth
frequencies. We can see that thee peak detection is more
precise than the other three methods. In fig. 6 the calculated
d from 50 to 90s.
and target frequencies are displayed

b)

VII. CONCL
LUSION
Frequency analysis of tremor in patients with PD can be
p
of treatment. FFT
used to diagnose and monitor the progress
(Fast Fourier transformation), ST
TFT (short time Fourier
transform) and PSD (power spectrral density) are most often
used for spectral analysis of trem
mor. As the frequency of
motion is a stochastic signal resullting from the acceleration
values, the Fourier transformation is not reliable. In this work,
two new methods were presenteed for the calculation of
frequency.
Figure 4. A) Low frequency and b) High frequuency signal

696

TABLE II.

Method
Peak Detection
Pattern Recognition
Power Spectral Density
Fast Fourier Transformation

EVALUATION OF THE 4 METHODS

Difference from target frequency


[Hz]
10.88
2.391.92
2.972.38
2.291.94

The first method calculates the frequency based on the


number of detected peaks in the motion signal. The second
method correlates the motion signal with 71 pre-defined
pattern signals of different frequencies. The frequency of the
pattern signal with the highest correlation corresponds to the
signal frequency. These methods were compared and
evaluated with common methods of the state of art with the
help of an experiment. The activity signal is equivalent to the
body movement. The sensor that detects the movement sits on
the skin surface. With each change of movement caused
several oscillations that are dependent on the position of the
sensor and the skin elasticity. These oscillations are high
frequency and are superimposed on the signal activity. These
oscillations by a PD patient can hardly distinguished from the
actual activity and distort the analysis. The frequency change
can be detected very well by all methods but the peakdetection method has the highest correlation with the
estimated frequency of tremor with a deviation of 1 0.88Hz.
The accuracy of peak detection method can be improved
through better threshold value calculation. The methods
should be evaluated and improved in further studies in a
clinical setting. With a larger number of participants the peak
detection should be adapted and tested for various applications
(e.g. intra operative diagnosis by deep brain stimulation). In
pattern recognition the recognition should be improved by
means of adjusting the pattern signal to the shape of the tremor
signal. The effect of sampling frequency on the accuracy of
frequency calculation should also be investigated.
VIII. ACKNOWLEDGMENT
We thank the patients and physician of the Schoen Klinik
Muenchen Schwabing, especially Dr. U. M. Fietzek, for their
support and cooperation. Within the research consortium of
the Bavarian Research Foundation (BFS) FitForAge a team
of scientists and engineers works together with 25 industrial
partners on the development of products and services for the
aging society.

Eventually not only elderly people but also all social


groups should profit from these solutions.
IX.
[1]
[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]
[12]
[13]
[14]

[15]

[16]

[17]
[18]

[19]

Figure 6. Comparison between the PD, PR, FFT and PSD

697

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