Prediction of Motor Function in Stroke Patients Using Machine Learning Algorithm: Development of Practical Models

J Stroke Cerebrovasc Dis. 2021 Aug;30(8):105856. doi: 10.1016/j.jstrokecerebrovasdis.2021.105856. Epub 2021 May 19.


Background: Machine learning (ML) techniques are being increasingly adopted in the medical field.

Objective: We developed a deep neural network (DNN) model and applied 2 well-known ML algorithms, logistic regression and random forest, in predicting motor outcome at 6 months after stroke.

Methods: In the present study, by using 14 input variables which are easily measured by clinicians, we developed ML models and investigated their applicability to predicting motor outcome in hemiplegic stroke patients. We retrospectively analyzed data of 1,056 consecutive stroke patients. Favorable outcomes of the upper and lower limbs were defined as a modified Brunnstrom classification (MBC) score of ≥5 (able to perform activities of daily living with the affected upper limb) and a functional ambulation category (FAC) score of ≥4 (able to walk without guardian's assistance), respectively. Poor outcomes of the upper and lower limbs were defined as MBC and FAC scores of <5 and <4, respectively. We developed 3 ML algorithms, namely the DNN, logistic regression, and random forest.

Results: Regarding the prediction of upper limb function, for the DNN model, the area under the curve (AUC) was 0.906. For the logistic regression and random forest models, the AUC were 0.874 and 0.882, respectively. For the prediction of lower limb function, for the DNN, logistic regression, and random forest models, the AUCs were 0.822, 0.768, and 0.802, respectively.

Conclusions: We demonstrated that the ML algorithms, particularly the DNN, can be useful for predicting motor outcomes in the upper and lower limbs at 6 months after stroke.

Keywords: Deep neural network; Logistic regression; Machine learning; Motor function; Prediction; Random forest; Stroke.

MeSH terms

  • Aged
  • Decision Support Techniques*
  • Deep Learning*
  • Diagnosis, Computer-Assisted*
  • Extremities / innervation*
  • Female
  • Functional Status
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Motor Activity*
  • Predictive Value of Tests
  • Prognosis
  • Recovery of Function
  • Reproducibility of Results
  • Retrospective Studies
  • Stroke / diagnosis*
  • Stroke / physiopathology
  • Stroke / therapy
  • Time Factors