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1-1-2022

Classification of parkinson disease based on patient’s voice

signal using machine learning
Imran Ahmed
Riphah International University

Sultan Aljahdali
Taif University

Muhammad Shakeel Khan

Riphah International University

Sanaa Kaddoura
Zayed University

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Intelligent Automation & Soft Computing Tech Science Press
DOI:10.32604/iasc.2022.022037
Article

Classification of Parkinson Disease Based on Patient’s Voice Signal Using

Machine Learning
Imran Ahmed1, Sultan Aljahdali2, Muhammad Shakeel Khan1 and Sanaa Kaddoura3,*

1
Riphah International University, Lahore, 54000, Pakistan
2
Department of Computer Science, Taif University, Taif, KSA
3
College of Technological Innovation, Zayed University, Abu Dhabi, UAE
*Corresponding Author: Sanaa Kaddoura. Email: [email protected]
Received: 26 July 2021; Accepted: 13 September 2021

Abstract: Parkinson’s disease (PD) is a nervous system disorder first described as

a neurological condition in 1817. It is one of the more prevalent diseases in the
elderly, and Alzheimer’s is the second most common neurodegenerative illness.
It impacts the patient’s movement. Symptoms start gradually with tremors, stiff-
ness in movement, and speech and voice disorders. Researches proved that 89%
of patients with Parkinson’s has speech disorder including uncertain articulation,
hoarse and breathy voice and monotone pitch. The cause behind this voice change
is the reduction of dopamine due to damage of neurons in the substantia nigra
responsible for dopamine production. In this work, Parkinson’s disease is classi-
fied with the help of human voice signals. Six different machine learning (ML)
algorithms are used in the classification: Stochastic Gradient Descent (SGD) Clas-
sifier, Extreme Gradient Boosting (XGB) Classifier, Logistic Regression Classi-
fier, Random Forest Classifier, K-Nearest Neighbour (KNN) Classifier, and
Decision Tree (DT) Classifier. This research aims to classify Parkinson’s disease
using human voice signals and extract essential features to reduce the complexity
of the dataset. Then, human voice signals are analyzed to check the voice intensity
and spectrum for PD patients. Then, machine learning classifiers are applied to
classify the PD patients based on the extracted features. The results show that
SGD-Classifier has 91% accuracy, XGB-Classifier has 95% accuracy, Logistic
Regression has 91% accuracy, Random Forest shows 97% accuracy, KNN shows
95% accuracy, and Decision Tree has 95% accuracy. Hence, Random Forest has
the highest accuracy. The disease can be studied more by looking for more
characteristics of PD patients to enhance its proper use in the medical field.

Keywords: SGD-classifier; XGB-classifier; logistic regression; random forest;

KNN-classifier; parkinson disease; decision tree classifier

1 Introduction
Substania nigra is an essential part of the brain which is considered the direct cause of Parkinson’s
disease. Substania nigra releases dopamine that acts as a messenger between portions of the nervous

This work is licensed under a Creative Commons Attribution 4.0 International License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.
706 IASC, 2022, vol.32, no.2

system and the brain to coordinate the body’s actions. The amount of dopamine in the brain is lowered if
these nerve cells die. This indicates that the brain region that controls movement is not working as well
as it should, resulting in slow and irregular movements.
Nerve cell death is a gradual process. When roughly 80% of the nerve cells in the substantia nigra have
been destroyed, the symptoms of Parkinson’s disease begin to appear. Parkinson’s disease affects the voices
of men, affecting them in mating or perhaps in conversations. PD is only second to Alzheimer’s disease in
neurological disorders [1]. Expansion is expected in the coming years, and appropriate testing and
frameworks are needed along these lines to identify logical remedies. More studies should be done in this
area since appropriate measures are essential for detecting and treating the disease [2]. The ideal
characteristics of data sets are transferred as a commitment to models, and forecast results are generated.
The expected exhibition of substantia nigra (see Fig. 1) is a group in the middle of the brain responsible
for producing dopamine.

Figure 1: Substantia nigra neurons in Parkinson's disease

The six different machine learning models give better results than previous work in literature. The
algorithms used in this work are:
▪ SGD-Classifier
▪ XGB-Classifier
▪ Logistic Regression Classifier
▪ Random Forest Classifier
▪ KNN-Classifier
▪ Decision Tree Classifier
Gradient Descent is the most used machine learning optimization approach. It’s a first-order
optimization procedure. It means that while updating the parameters, it only takes into consideration the
first derivative. The parameters are in the opposite direction of the objective function J(w) gradient with
IASC, 2022, vol.32, no.2 707

respect to the parameters on each iteration, where the gradient indicates the steepest ascent direction. The
learning rate determines the amount of the step we take each iteration to reach the local minimum. As a
result, we descend in the direction of the slope until we hit a local minimum [3,4]. XGBoost is part of a
family of boosting algorithms that help weak learners improve their performance. Random guessing is
marginally better than a slow learner. Boosting is a sequential process in which trees are grown one after
the other, using information from a previously developed tree. This method slowly learns from the data in
successive cycles and improves its forecast [5]. A random forest comprises a vast number of individual
decision trees that work together as an ensemble.
Each tree in the random forest produces a class prediction, and the class with the most votes becomes the
prediction of our model. The KNN is a non-parametric technique proposed by the Thomas cover used in
assembly and relapse in the confirmation design. In both applications, the information consists of the
nearest K setting forms in the component space. The yield depends on whether KNN is used for
regulation or relapse. The component space is grouped by the majority of the votes, indicated by the
nearest-distance-neighbor [5]. A Decision Tree is a non-parametric learning strategy used in
characterization and regression. The aim is to develop a model that predicts objective variable points by
introducing the essential criteria for the selection collected from the information covered [6].

2 Related Works
2.1 Classification of Parkinson Disease
The project in [6] aims to classify PD patients by analyzing their gait results. The data used was derived
from the database of Physio net Gait Analysis. The database includes data on 93 idiopathic PD patients and
73 stable control subjects. It consists of the subjects’ Vertical Ground Reaction Force as they walk for about
two minutes. Each subject has 16 sensors. Eight sensors were placed on the bottom of each foot, which
measures Newton’s force as a function of time. Some mathematical functions were used to improve data
accuracy and decrease the necessary computing capacity. This reduced data in the range of [−1, 1] while
maintaining the data singularity unchanged. The new data reduction was then used to create machine
learning models using machine learning algorithms. The highest accuracy of KNN is 93.08%.
As compared to previous research, PD was established differently.MATLAB graphical user interface
was used to incorporate the machine learning method in the application. Also, a new program called
ParkDet 2.0 was developed. Then, to increase the accuracy of the classifier, different combinations of ML
were applied using ParkDet. The goal is to enable clinician technicians to use the ParkDet software to
diagnose PD patients and not force them to use advanced engineering systems such as MATLAB and
automated detection methods.
Several variations of ML processes, such as PCA and factor analysis (FA), were introduced via the
ParkDet software. Additionally, seven classifiers were established: Support Vector Machine (SVM),
Boosting, KNN, Naive Bayes (NB), Decision Tree, Linear Discriminant Analysis (LDA), and Quadratic
Discriminant Analysis (QDA) with 2–, 5– and 10-fold cross-validations and an additional blind
examination. Since the classification accuracy hits 90.1%, the findings are promising [2].

2.2 Symptoms of Parkinson Disease

The neuropathological condition of PD or other types of Parkinsonism may result in Parkinson’s disease.
About 90% of the cases are intermittent with no specific etiology for neuropathologic PD; a further 10% have
a hereditary cause, and at least 11 separate lineages have been reported with six gene mutations. Genetic
variants of PD in young-onset PD are observed. Medicines, sequelae to central nervous system
inflammation, toxins, or vascular/metabolic conditions may be responsible for secondary forms of
Parkinsonism [7–9]. This paper’s participants underwent baseline in-clinic assessments, including the
708 IASC, 2022, vol.32, no.2

Unified Parkinson’s Disease Rating Scale (UPDRS). They were provided smartphones with an Android
operating system that contained a smartphone application to assess voice, posture, gait, finger tapping,
and response time. Twenty participants performed an average of 2.7 tests per day (68.9% adherence) for
the study duration (average of 34.4 days) in a home and community setting. The analyses of the five
tasks differed between those with Parkinson’s disease and those without it. In discriminating participants
with PD from controls, the mean sensitivity was 96.2% (standard deviation 2%), and mean specificity
was 96.9% (standard deviation 1.9%).

2.3 Voice Frequencies of Parkinson Disease Affected Patients with Parkinson Disease
Some research focuses on the tonal level, i.e., the fundamental frequency (F0) variations produced by the
laryngeal activity. The significant improvements in F0 phonation in subjects with sensorineural hearing loss
(SNHL) and PD using power spectral analysis of F0 have been studied in [8–10]. For the two disorders, F0’s
rhythm was distinct in frequency and amplitude. This research also revealed that the F0 analysis could
become a valuable instrument for the two neurological disorders to be tested. By using the
autocorrelation function algorithm, fundamental frequencies of voice signals were obtained. They were
then transformed to a series of cents after linear interpolation and re-sampling to a 50 Hz scale [8–10].
The hypothesis states that the Parkinsonian dysprosody has often been described as a mere neuro-motor
disturbance. To verify the hypothesis, both the comprehension and the production of pitch parameters in a
group of Parkinsonian patients were tested. The influence of traditional anti-parkinsonian treatments, L-
DOPA which is an amino acid precursor of dopamine and is the most effective and commonly used drug
in the treatment of PD, was also studied to determine whether improved performance occur [11].
Deep learning is used in [12] to evaluate the patient’s voice data and divide it into “severe” or “not
severe” classes. The two Unified Parkinson’s Disease Ranking Scale (UPDRS) scores are the assessment
measures used in this analysis. On a scale of 0–108, the motor UPDRS tests the patient’s motor capacity,
while total UPDRS offers a wider variety of scores from 0–1766. The 16 biomedical voice functions are
the input dataset, and the output vector is the Motor UPDRS score. The classification accuracy achieved
for train and test datasets is 83.367% and 81.6667%, respectively. Since they tested their model on the
same set of UCI Parkinson’s Telemonitoring Voice Results, they contrasted their result with that of
Nilashi et al. in forecasting the progression of Parkinson’s disease, and they used adaptive neuro-fuzzy
interference system and support vector regression. Their work provided an average accuracy of
47.2 percent for the overall UPDRS ranking [7–12].

2.4 Causes of Parkinson Disease

This research demonstrated that pesticides affect PD production. Priyadarshi et al. [13] conducted a
meta-analysis to analyze multiple studies examining environmental risk factors to produce PD. Findings
show a greater risk of PD for individuals living in rural areas using wells as their water source. However,
the environmental hazards causing PD could not be identified. Indeed, as applied to rural and urban areas,
the findings yielded an insignificant association between risk factors. Due to the differences between the
results of different trials, improved data collection techniques tend to be required to understand better
possible causes of PD [13,14]. Tab. 1 summarizes the literature review.

3 Proposed Work
Previous research stated that Parkinson’s disease had been spread all over the world. Doctors use the
most extensive equipment for physical diagnosis, which is a very time-consuming and non-accurate
process. So, we will classify Parkinson’s disease using human voice signal frequencies and explore it in
three phases, as shown in Fig. 2. Firstly, we are extracting some essential features to classify for
IASC, 2022, vol.32, no.2 709

understanding. Secondly, we apply data mining techniques to classify the healthy/affected patients based on
some voice features to generate the results in graphs and tables, accuracy-score. Thirdly, we are going to
make a comparison of all machine learning algorithms to find out the best accuracy result algorithm.

Table 1: Tabulated literature review

Reference Features/Factors Contribution
[7] Self-selected speed-walking Artificial Neural Network and SVM showed perfect ability
to distinguish gait patterns using three parameters:
spatiotemporal, kinematic, and kinetic.
[2] Variations of dysphonia, gait, or Using ML methods on vocal features, clinicians use a blind
motor skills test interface for PD detection.
[10] Smartphone monitoring voice, Analyzing tests results for participants with/without PD
posture, gait, finger tapping shows the feasibility of diagnosing PD.
[11] Gait patterns, gait initiation, and Using behavioral factors, detecting and classifying tremors
freezing of gait shows high efficiency in distinguishing healthy people from
PD using voice data.
[12] Rapid Eye Movement and Using non-motor features, automated diagnosis models
olfactory loss from ML techniques show efficiency in the early prediction
of PD.
[15] Tele-monitoring voice data Using “TensorFlow” deep neural networks, prediction of
PD severity shows high accuracy values.

Figure 2: Proposed workflow

710 IASC, 2022, vol.32, no.2

3.1 Place of Work and Facility

Our research is based on qualitative analysis rather than quantitative. We will use the qualitative data
analysis online tool. All research will be done at the university and in our personal space.

3.2 Feature Extraction

Feature extraction increases the accuracy of learned models by extracting features from input data. This
phase reduces the dimensionality of data by removing the redundant records. Of course, it enhances the
classification speed. Feature extraction helps get the best feature from those big data sets by selecting and
combining variables into features, thus, effectively reducing the amount of data. These features are easy
to process but still able to describe the actual data set with accuracy and originality.

3.3 Feature Selection

Feature selection is an essential approach for reducing the dimension of high-dimensional data. In recent
years, many feature selection algorithms have been proposed. However, most of them only exploit
information from the data space. They often neglect helpful information contained in the feature space
and typically do not exploit information about the underlying geometry of the data. To overcome these
problems, we introduce new unsupervised feature selection methods based on feature selection.

3.4 Univariate Selection

Statistical tests can select those features with the most robust relationship with the output variable. The
scikit-learn library provides the SelectKBest class for this purpose.

3.5 Voice Segmentation

In this phase, we classify the voice in segments and find out the relationship of features so used in which
seven extract features for classification of the human voice. Based on these seven features, we identify the
ranges of frequencies and compare them with patients’ health status.

3.6 Visualization
According to the voice segments classes, we classify frequencies with visualization. Data visualization
helps to analyze the measurement reports. Visualization is a method for transmitting a message by generating
pictures or animations. Visualization is any technique for creating images, diagram plots, charts, and
animations. In these analyses, we analyzed the human voice frequencies into the graph box plot and
tabular form and compared these all frequencies one by one with patients’ health status and identified the
ranges of all frequencies, and measured it with health status.

4 Findings and Results

4.1 Input Dataset
The voice signal dataset [15] display some rows and columns of data in Fig. 3, showing head (5) of the
dataset, which displayed all attributes of the data and values in float. This dataset comprises a range of
biomedical tone of voice estimations from 31 individuals, of which 23 have PD. Every section in the
table is a specific voice measure, and each line compares to one of the voice chronicles from these people
(“name” segment). The “status” segment is set to 0 for non-patient and 1 for PD [16].

4.2 Average Local Fundemental Frequencies (fo)

In this condition, most people with Parkinson’s disease will change vocabulary, voice, and swallowing.
The exact effects of Parkinson’s disease that appear in the human body’s muscles, tremor, stiffness, slow
IASC, 2022, vol.32, no.2 711

motion, and slow speech, can occur in the muscles used to speak and swallow. In the medical treatment of
reading the human voice with a machine those machines, read in different frequencies in which one of the
most critical frequencies of fundamental vocal frequencies.

Figure 3: Head of 5 elements of the dataset

Fig. 4 shows the fundamental vocal frequencies (Fo) of the human voice. The ranges of frequencies 100–
250 define the human voice. This range increases when the person is affected with PD. Fig. 5 shows the
maximum vocal fundamental frequency (Fhi(Hz)). The ranges are higher than the frequencies shown in
Fig. 4 because these frequencies measure the vocal voice length. Fig. 6 shows the minimum vocal
fundamental frequency (Flo). It visualizes the ranges of frequencies signal of human voices.

Figure 4: MDVP: Fo(Hz) Average Vocal fundamental frequencies of the human voice

Figure 5: MDVP: Fhi(Hz) in these vocal frequencies

712 IASC, 2022, vol.32, no.2

Figure 6: MDVP: Flo(Hz) the minimum vocal fundamentalfrequency of vocal frequencies

The fundamental vocal frequencies are classified to check the patient health status and interpret the
frequency. Fig. 7 shows the results of all vocal frequencies. Patient health status in 0 represents a non-
Parkinson, whereas 1 is the Parkinson’s patient. The vocal frequencies of non-patient is 0.006, which is
considered low compared to the affected patient which highest vocal frequencies range is 0.0010.

Figure 7: Results of all focal frequencies

IASC, 2022, vol.32, no.2 713

4.3 Harmonic Parameter Frequencies

In these frequencies in which harmonic-noise ratio and harmonic noise ratio of two types of frequencies
are available Kinematic changes in PD gait are well documented; however, there is less comprehension of
upper body dynamics. The rhythm of trunk accelerations is measured by harmonic ratios (HRs) and can
be studied in longitudinal, anterior-posterior, and mediolateral planes, providing an indicator of global
walking stability (lower HR indicates poorer stability) (see Figs. 8 and 9).

Figure 8: NHR—NHR (Noise Harmonic ratio)

Figure 9: HNR—The HNR (Harmonic-noise ratio)

Now here is the comparison of the harmonic parameter ratio of the human voice. The affected patients
and non-affected patients are classified with these two frequencies of ratio. Fig. 10 displays these frequencies
ratio. The blue color is healthy person whereas orange color is for patients.
The Harmonic ratio of PD was compared with the patient health status, clearly showing 0 is non-patient,
and 1 is positively affected with Parkinson’s person. Hence, in the first figure, the Harmonic noise ratio of the
non-affected person is high because the non-Parkinson person can quickly speak, and the noise ratio is high,
so there is no gap in this voice. In non-patient, the harmonic ratio is low because its speaking ratio is low,
creating gaps in the voice. Thus, the ratio goes down in the second figure.
714 IASC, 2022, vol.32, no.2

Figure 10: Harmonic parameter ratio with patient health status

4.4 Non-linear Dynamic Complexity Measure

DFA (Detrended fluctuation analysis) (shown in Fig. 11) and PPE (pitch period of entropy) (shown in
Fig. 12) show the Parkinson’s effect on the human voice. The frequencies are break down because of the slow
speaking flow of the human and sibling in the voice when speaking.

Figure 11: DFA

Figure 12: PPE

IASC, 2022, vol.32, no.2 715

Fig. 13 shows the results representing the human voice signal. The first chart is DFA in which 0 is non-
affected patients. The voice is higher than the affected patient of Parkinson’s disease.

Figure 13: Classified the non-linear dynamical complexity measure with patient health

4.5 Classification of PD with ML Classifier

In this process, we are going to classify Parkinson’s disease with a machine learning classifier. First, we
set the target of patient health status and count how many patients are available in this report. After checking
the patient’s health status, we visualize the results graphically. The dataset was split into 80% for the training
phase whereas 20% for the testing phase. In Fig. 14, 0 represents the healthy people who are 48 in the dataset,
whereas 1 represents the patients who are 147 in the dataset.
▪ Number of Parkinson people in the dataset 147 (75.39%)
▪ Number of Healthy people in the dataset 48 (24.61%)

Figure 14: PD patient health status

716 IASC, 2022, vol.32, no.2

4.6 Models Building

The machine learning classifiers were implemented. First, we set the target variable, which is a
Parkinson’s patient health status. After setting up the target, we transform the dataset columns extracted
from the dataset to take as input. After setting up the input variables of the dataset, we standardize the
dataset columns and transform the dataset with Min and Max Scalar to use in our codes.
4.6.1 SGD-Classifier
The Scikit-learn algorithm provides the SGD-Classifier module for the implementation of the SGD
classification. The results are shown in Tab. 2.

Table 2: SGD classifier results

Name Results
SGD-classifier 91.666667%
Cross-validation score 66.6667% (+/−24.6581%)
Execution time 0.02922 s

4.6.2 XGB-Classifier Model

XGB-classifier prediction results are shown in Fig. 15.

Figure 15: XGB-Classifier results in prediction tables

IASC, 2022, vol.32, no.2 717

Fig. 15 and Tab. 3 show the best results of the XGB-classifier producing the precision, recall, F1-score,
support, accuracy score. The results show that the testing score is 0.84 and the train score is 1.0.

Table 3: XGB classifier results

Name Results
Score of XGB-classifier Test Data 0.8461538461538461
Score of XGB-classifier Train Data 1.0
AUC of XGB-classifier score 0.8504464285714286
F1-score of XGB-classifier 0.8999999999999999
Total accuracy score of XGB-classifier 95.08196721311475

4.6.3 Logistic Regression Classifier

Fig. 16 and Tab. 4 show the results of the logistic regression classifier.

Figure 16: Logistic regression-classifier results

4.6.4 Random Forest Classifier

The results of Random forest are shown below (see Fig. 17).
Tab. 5 shows the maximum precision score those get and recall, support in the middle of the predicted
classes of the Parkinson disease which produces the training data score is 0.94 and testing score is 1.0, AUC
score of 0.91, and F1-score is 0.96. In the end, we generate the total accuracy score of the classifier, as shown
in Tab. 5.
718 IASC, 2022, vol.32, no.2

Table 4: Logistic regression classifier results

Name of score Results
Score of the training data 0.8260869565217391
Score of the testing data 0.8717948717948718
AUC score 0.7544642857142856
F1-score 0.923076923076923
Total accuracy score 0.9166666666666666

Figure 17: Resulting diagram of random forest classifier

Table 5: Random forest classifier results

Name of score Results
Training data score 1.0
Test data score 0.9487179487179487
AUC score 0.9129464285714287
F1-score 0.96875
Total accuracy score 0.9710144927536232
IASC, 2022, vol.32, no.2 719

4.6.5 KNN Classifier

Fig. 18 shows the line chart of the KNN classifier. This classifier reaches the range of 95%.

Figure 18: KNN classifier ranges lines chart

Fig. 19 shows the confusion matrix of the KNN classifier, which generates the precision, recall, and
shows the best accuracy score of the test data.

Figure 19: KNN-classifier of resulting figure and scores

The resulting scores are also arranged in Tab. 6.

720 IASC, 2022, vol.32, no.2

Table 6: KNN classifier results

Name of score Results
Training data score 1.0
Test data score 0.9230769230769231
AUC score 0.953125
F1-score 0.9508196721311475
Total accuracy score 0.9545454545454546

4.6.6 Decision Tree Classifier

In this classifier, we generate the decision tree classifier’s training and testing score to reduce the feature
of the dataset. The results are shown in Tab. 7.

Table 7: Decision tree classifier results

Name of score Results
Training data score 0.8173913043478261
Test data score 0.7948717948717948
Total accuracy score 0.9583333333333334

4.7 Comparison of the ML Classifiers

The comparison results between the different algorithms studied in this paper are shown in Tab. 8.
Moreover, Fig. 20 clearly shows all classifiers of the result graphically. The results show that random
forest outperforms other classifiers with a 97% accuracy score.

Table 8: Comparison results of all algorithms

Classifier Test data score Train data score Total accuracy score
SGD 0.20 0.80 91.666667%
XGB 0.8461538461538461 1.0 95.081967213114
Logistic regression 0.87179487179487 0.82608695 0.91666666666
Random forest 0.9487179487179487 1.0 0.9710144927536232
KNN 0.9230769230769231 1.0 0.9545454545454546
Decision tree 0.7948717948717948 0.8173913043478261 0.9583333333333334
IASC, 2022, vol.32, no.2 721

Figure 20: Comparison between all the machine learning classifiers

5 Conclusions and Future Work

Parkinson’s disease diagnosis is challenging to manage daily. Thus, an effective screening process will
be helpful, especially for cases that do not require a visit to a clinic. Symptoms like vocal characteristics,
voice recording, speech, and slow movement are valuable and non-invasive diagnostic tools. This paper
used machine learning algorithms to diagnose the disease through the patient’s voice patient. This is a
practical step to check before meeting with a clinician. A dataset of voices was used as an input to
several machine learning models. The results show that the random forest classifier performs with high
accuracy. In future work, more datasets of PD patients can be used in order to measure the accuracy of
the random forest if the new data was added.
Funding Statement: This work was supported by Taif University Researchers Supporting Project (TURSP)
under number (TURSP-2020/73, Taif University, Taif, Saudi Arabia, and by the Data Science Research
Program, Riphah International University, Lahore, Pakistan.

Conflicts of Interest: The authors declare that they have no conflict of interest to report regarding the present
study.

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