A Markerless 2D Video, Facial Feature Recognition-Based, Artificial Intelligence Model to Assist With Screening for Parkinson Disease: Development and Usability Study

Background: Masked face is a characteristic clinical manifestation of Parkinson disease (PD), but subjective evaluations from different clinicians often show low consistency owing to a lack of accurate detection technology. Hence, it is of great significance to develop methods to make monitoring easier and more accessible. Objective: The study aimed to develop a markerless 2D video, facial feature recognition-based, artificial intelligence (AI) model to assess facial features of PD patients and investigate how AI could help neurologists improve the performance of early PD diagnosis. Methods: We collected 140 videos of facial expressions from 70 PD patients and 70 matched controls from 3 hospitals using a single 2D video camera. We developed and tested an AI model that performs masked face recognition of PD patients based on the acquisition and evaluation of facial features including geometric and texture features. Random forest, support vector machines, and k-nearest neighbor were used to train the model. The diagnostic performance of the AI model was compared with that of 5 neurologists. Results: The experimental results showed that our AI models can achieve feasible and effective facial feature recognition ability to assist with PD diagnosis. The accuracy of PD diagnosis can reach 83% using geometric features. And with the model trained by random forest, the accuracy of texture features is up to 86%. When these 2 features are combined, an F1 value of 88% can be reached, where the random forest algorithm is used. Further, the facial features of patients with PD were not associated with the motor and nonmotor symptoms of PD. Conclusions: PD patients commonly exhibit masked facial features. Videos of a facial feature recognition-based AI model can provide a valuable tool to assist with PD diagnosis and the potential of realizing remote monitoring of the patient's condition, especially during the COVID-19 pandemic.