Automated Affect Detection in Deep Brain Stimulation for ...

1 Automated Affect Detection in Deep Brain Stimulation forObsessive-Compulsive Disorder: A Pilot StudyJeffrey F. CohnUniversity of PittsburghPittsburgh, A. Jeni,Itir Onal ErtugrulCarnegie Mellon UniversityPittsburgh, MaloneCleveland ClinicCleveland , S. OkunUniversity of FloridaGainesville, BortonBrown UniversityProvidence, Rhode K. GoodmanBaylor College of MedicineHouston, measurement of affective behavior in psychopathologyhas been limited primarily to screening and diagnosis. While useful,clinicians more often are concerned with whether patients are im-proving in response to treatment.

2 Are symptoms abating, is affectbecoming more positive, are unanticipated side effects emerging?When treatment includes neural implants, need for objective, re-peatable biometrics tied to neurophysiology becomes especiallypressing. We used Automated face analysis to assess treatmentresponse to deep Brain Stimulation (DBS) in two patients with in-tractable obsessive-compulsive disorder (OCD). One was assessedintraoperatively following implantation and activation of the DBSdevice. The other was assessed three months were assessed during DBS on and off conditions.

3 Positive andnegative valence were quantified using a CNN trained on norma-tive data of 160 non-OCD participants. Thus, a secondary goal wasdomain transfer of the classifiers. In both contexts, DBS-on resultedin marked positive Affect . In response to DBS-off, Affect flattenedin both contexts and alternated with increased negative Affect inthe outpatient setting. Mean AUC for domain transfer was findings suggest that parametric variation of DBS is stronglyrelated to affective behavior and may introduce vulnerability fornegative Affect in the event that DBS is CONCEPTS Applied computing Psychology.

4 KEYWORDSO bsessive compulsive disorder, Deep Brain Stimulation , Facial ex-pression, Body expression, Action units, Behavioral dynamics, So-cial signal processingPermission to make digital or hard copies of all or part of this work for personal orclassroom use is granted without fee provided that copies are not made or distributedfor profit or commercial advantage and that copies bear this notice and the full citationon the first page. Copyrights for components of this work owned by others than ACMmust be honored. Abstracting with credit is permitted.

5 To copy otherwise, or republish,to post on servers or to redistribute to lists, requires prior specific permission and/or afee. Request permissions from 18, October 16 20, 2018, Boulder, CO, USA 2018 Association for Computing ISBN 978-1-4503-5692-3/18/10.. $ Reference Format:Jeffrey F. Cohn, Laszlo A. Jeni, Itir Onal Ertugrul, Donald Malone, MichaelS. Okun, David Borton, and Wayne K. Goodman. 2018. Automated AffectDetection in Deep Brain Stimulation for Obsessive-Compulsive Disorder:A Pilot Study . In2018 International Conference on Multimodal Interaction(ICMI 18), October 16 20, 2018, Boulder, CO, , New York, NY, USA,5 pages.

6 INTRODUCTIONO bsessive compulsive disorder (OCD) is a persistent, oftentimesdisabling psychiatric disorder that is characterized by obsessivethoughts and compulsive behavior. Obsessive thoughts are intru-sive and unwanted and can be highly disturbing. Compulsions arerepetitive behaviors that an individual feels driven to perform. Theobsessive thoughts are recognized as irrational, yet they remainhighly troubling and are relieved if only temporarily by compulsiverituals, such as repetitive hand washing or repeatedcheckingto seewhether a particular event ( , shutting a door) was performed [1].

7 When severe, individuals may be home-bound and highly impairedpersonally and in their ability to function in family or work set-tings. While cognitive behavioral therapy or medication often aresuccessful in providing relief, about25%of patients fail to respondto them. Their OCD is treatment resistant, Stimulation of the ventral striatum (VS) has proveneffective in about60%of otherwise treatment resistant ( , in-tractable) cases [16]. DBS entails implanting electrodes into theVS for continuous deep Brain Stimulation (DBS). The VS is part ofareward circuitthat is involved in appetitive behavior and emo-tion processes more generally.

8 A potential side effect of DBS fortreatment of OCD is hypomania or mania, which can have seri-ous consequences that can necessitate hospitalization. To avoidthis potential side effect and maximize treatment efficacy, optimalprogramming of DBS is of intense positive Affect frequently occursduring initial DBS and signals good prognosis. The mirth responseis related to the affective circuitry of VS. Programing DBS adjust-ments for OCD are made largely on the basis of subjective reportedemotion over a period of several months. While useful, subjectivejudgments are idiosyncratic and difficult to standardize.

9 To max-imize treatment efficacy while minimizing potential side effects,objective, quantifiable, repeatable, and efficient biomarkers of treat-ment response to DBS are promising option is Automated measurement of facial expres-sion. Automated emotion recognition from facial expression is anactive area of research [26,29]. In clinical contexts, investigatorshave detected occurrence of depression, autism, conflict, and PTSD from visual features ( , face and body expression or movement)[7,10,18,22,25,27]. In the current pilot study, we explored thefeasibility of detecting changes in Affect in response to time-lockedchanges in neurophysiological challenge.

10 We evaluated intraop-erative variation in DBS in relation to discrete facial actions andemotion valence in response to previous work in relation to psychological disorders hasfocused on detecting presence or absence of a clinical diagnosis( , depression). In contrast, our focus is synchronized variationbetween deep Brain Stimulation and affective behavior in a clinicaldisorder, OCD. We ask how closely Affect varies with parametricchanges in DBS of the ventral striatum in clinical patients. The goalis to evaluate a new measure of DBS, objective measurement offacial expression, in relation to Brain Stimulation .