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A Tool for Evaluating Facial Expression for Early Diagnosis of Parkinson's Disease

Study Rationale:
The hypomimia -- decreased facial expression with reduced blinking -- is a major motor sign of Parkinson's disease (PD). This clinical sign indicates movement dysfunction early in the course of PD, thus representing an extremely sensitive biomarker (disease indicator). The goal of FACE-PD project, which stands for Facial expressivity Automatic Classifier for Early detection of Parkinson's Disease, is to develop a tool for automatic detection of hypomimia. We am to develop an essential tool for detecting Parkinson's before or immediately after the onset of symptoms.

Hypothesis:
We hypothesize that hypomimia is a sensitive biomarker of PD and that its automated detection will allow us to objectively measure this disease sign.

Study Design:
This study will include three steps. Firstly, we will develop an automatic tool for detection of facial expressivity (FACE-PD classifier). Next, we will use this tool in a group of 50 people with Parkinson's and 50 healthy people. During this step, the FACE-PD classifier will be tested to confirm its usefulness in clinics and to obtain a score for facial expression in order to correctly distinguish between people with and without Parkinson's. Finally, this tested version of FACE-PD classifier will be used in another group of people consisting of individuals at high risk of PD, such as people with Rapid Eye Movement (REM) sleep behavior disorder.

Impact on Diagnosis/Treatment of Parkinson's Disease:
FACE-PD may have a remarkable clinical impact because it is non-invasive, inexpensive, easy to use and scalable. It is also capable of performing recordings remotely, even by smartphone. It can be used in clinical trials for stratification -- dividing participants into groups based on their symptoms -- and in clinical practice for disease monitoring, as well as in rehabilitation.

Next Steps for Development:
FACE-PD may serve as a simple, non-invasive tool for screening people at high risk of developing Parkinson's, such as people with REM sleep behavior disorder. If decreased facial expression is a strong biomarker of PD, hypomimia screening with FACE-PD may improve the diagnosis of early-stage Parkinson's disease.


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