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304 Computational Intelligence Algorithms
FIGURE 19.9 Model communication cost comparison.
communication. However, DenseNet requires higher data transfer of 1.1 GB per
round, and ResNet communicates at 1.2 GB. Among the four models, Inception v3
has the highest communication cost of 1.3 GB per round, as it has a complex architecture. The plot in Figure 19.9 shows that EfcientNetB2 is more advantageous to
consider for training models for deep FL for detecting AD classication.
Figure 19.10 illustrates the efciency of different optimization algorithms applied
in FL with the combination of EfcientNetB2. GWO attained good federated
FIGURE 19.10 Comparison of Federated Learning accuracies of EfcientNetB2 with different evolutionary algorithms.

305 Optimizing Digital Healthcare for Alzheimer’s Disease
FIGURE 19.11 Comparison of federated learning accuracies of ResNet with different evo-
lutionary algorithms.
accuracy at 84.5% among other algorithms with client results. These observations
show that GWO is the most efcient optimization algorithm.
The above Figure 19.11 shows the results for optimization algorithms for ResNet in
FL, where GWO has achieved the highest federated accuracy of 85.5%. Figure 19.12
shows DenseNet with various optimization algorithms and their federated accuracies.
FIGURE 19.12 Comparison of federated learning accuracies of dense net with different
evolutionary algorithms.

306 Computational Intelligence Algorithms
FIGURE 19.13 Comparison of federated learning accuracies of inception V3 with different
evolutionary algorithms.
Figure 19.13 shows the federated accuracy results for optimization algorithms for
Inception v3 in FL with various evolutionary optimization algorithms.
The bar plot depicted in Fig ure 19.14 displays the accuracy comparison of different federated DL models from various studies from previous reseach, including a proposed model. The data comprise four entries: Li et al. (2022) with CNN,
FIGURE 19.14 Comparison of existing methodologies with proposed DFLCNN.

307 Optimizing Digital Healthcare for Alzheimer’s Disease
Zhang et al. (2023) with MobileNet, Wang et al. (2024) with VGG, and the proposed
DFLCNN model. It shows that DFLCNN achieves the highest accuracy of 92.2%,
signicantly outperforming the other models. MobileNet follows with an accuracy
of 89.0%, VGG at 88.5%, and CNN at 85.0%.
19.8 CONCLUSION
In this chapter, we have explored the applications of federated DL models for classication of AD, specically applying EfcientNetB2 and optimizing the model with
the GWO algorithm. The obtained results demonstrated that this scheme yields better performance metrics, where accuracy is 92.2%, a loss is 0.29, and achieved an F1
score with value of 0.89. In addition, the cost of model communication is effectively
managed at 0.9 GB, which highlights its efciency in a deep FL environment. These
ndings specify that by optimizing advanced neural networks with dense layers, we
can achieve high accuracy and lower model communication cost, which is an encouraging solution for real-world applications in distributed environments, like cloud and
fog environments that receive data from various digital healthcare systems. Despite
these results, DFLCNNS is limited to a specic dataset. Future research can be
focused on applying evolutionary optimization algorithms to different datasets with
different parameter settings. Additionally, the research can be elaborated by validating model performance on biomarkers datasets.
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Articial Intelligence
20
A Game-Changer in
Parkinson’s Disease
Neurorehabilitation
Nabeela Rehman, Arshya Anwar, and Sahar Zaidi
20.1 INTRODUCTION
Parkinson’s disease (PD) is a neurodegenerative, extrapyramidal, progressive,
chronic disorder of movement characterized by a reduction of dopamine-producing
neurons [1, 2]. Recent epidemiological research has provided new insight into
the rising incidence and pattern of this debilitating condition around the world.
According to the Global Burden of Disease (GBD) report, the number of people
with PD increased by 118% to 6.2 million between 1990 and 2015. It is expected
that this concerning pattern will persist, with over 12 million people worldwide
estimated to have PD by 2040 [3, 4]. Notably, the disease is associated with motor
symptoms like rigidity, tremors, bradykinesia, postural instability, muscle stiffness,
and coordination issues, all of which can limit a patient’s movement and independence [5].
Articial intelligence (AI) has shown signicant potential in the diagnosis and
treatment of disease. With high accuracy rates ranging from 93.88% to 96.27%,
many AI models, including a support vector machine, random forest, and decision
tree, are used to assess PD. Early and precise prediction is essential, and these models help with that [6, 7].
Furthermore, AI methods assist in evaluating disease severity and stage, producing reliable evaluations necessary for PD patients’ appropriate treatment and monitoring [8]. Automated assessment of motor and gait impairments is one such use; this
is an important rst step toward early identication of the disorder [9]. Researchers
can now examine and compare walking patterns between PD patients and healthy
individuals owing to the development of autoregressive algorithms that can extract
information from gait signals [10].
By accurately classifying patients based on their speech and language patterns,
AI − especially deep learning − also helps develop speech biomarkers for the assessment of disorders and provides efcacy for speech rehabilitation [11–13]. Several
studies have emphasized the practical importance of AI methods, like computer
vision and machine learning algorithms, in precisely detecting PD based on small
variations in motor control in handwriting patterns [14]. These AI-driven methods
extract information from handwriting photos, such as spectral properties, pressure
DO I: 10.1201/ 97810 03520 34 4 -23
311

312 Computational Intelligence Algorithms
FIGURE 20.1 Projected global burden of Parkinson disease, 1990–2040.
data, and kinematic parameters to precisely differentiate PD patients from healthy
individuals [15]. Current machine learning techniques have demonstrated encouraging outcomes in accurately diagnosing PD, offering a useful adjunct to traditional
clinical evaluation approaches. AI allows for proactive intervention in the management of the disease and greatly improves diagnostic precision by integrating clinical
data with machine learning algorithms [6]. Additionally, AI-powered rehabilitation
programmers can be very helpful in assisting people with PD to regain and maintain
their independence and mobility. The development of specialized rehabilitation programs that are tailored to the particular needs of every individual can be provided.
This chapter will talk about AI-based evaluation and treatment strategies along
with robotic rehabilitation for gait management, machine learning models for speech
rehabilitation, and the role of virtual reality in maintaining a healthy diet and sleep
and performing an adequate amount of physical activity to improve the quality of
life of people with the disease. Figure 20.1 shows projections for the growth in the
use of these strategies.
20.2 INTRODUCTION OF INTELLIGENCE IN PARKINSON’S DISEASE
20.2.1 AI-BASED GAIT EVALUATION AND REHABILITATION
A modern instance of technological innovation is the virtualization of rehabilitation. In
the evaluation and management of PD, AI-based technologies have become increasingly
important in recent years [16, 17 ]. Furthermore, PD biomarkers for analysis of posture
during the gait cycle can be used by various devices with machine learning and deep
learning features to carry out automated detection [18]. Numerous AI models, including

313 Articial Intelligence
machine learning techniques, smartphone applications, sensory-based technology, and
data on nocturnal breathing, are utilized to study and identify PD [19]. Gait analysis
and assistive technology have been combined, allowing sensor-equipped devices to recognize and predict risks associated with falling (freezing of gait) to prevent falls or
reduce their impact [18, 20]. Excellent outcomes have been observed when using inertial measurement units (IMUs) to observe the advancement of PD and identify specic
gait anomalies in individuals (see Figure 20.2). Research has shown that IMU-based
models of gait assessment are capable of quantifying a wide variety of gait factors,
such as spatiotemporal parameters, joint kinematics, variability, asymmetry, and stability, and can accurately distinguish between healthy controls and early-stage PD [21].
Wearable IMUs have also been used to track motor characteristics of PD, identify uctuations in motor performance, dyskinesia, and freezing of gait, and evaluate treatment
responsiveness in outdoor environments, demonstrating its potential as a tool for ongoing monitoring and disease rehabilitation [22]. One well-known disorder that frequently
harms a person’s quality of life is gait festination. The pooling techniques have been
heavily utilized by convolutional neural networks (CNN) in particular for their deep
learning strategies. In fog prediction, recurrent neural networks (RNNs), CNNs, and
other distinct neural network subtypes have also been extensively used [23].
AI models like the hybrid ConvNet-Transformer architecture can accurately diagnose PD severity stages from gait data, leveraging the strengths of CNNs and transformers to capture both local features and long-term spatiotemporal dependencies in
the data [24]. Levodopa administration combined with any type of implantable pulse
generator (IPG) stimulation results in a signicant improvement on posture and also
average step height and step length on each side [25].
Also, in terms of PD gait evaluation and rehabilitation, random forest outperformed naïve Bayes, which had an accuracy of 84.6% in diagnosing the disease,
while random forest performed exceptionally well in identifying its stages [26].
FIGURE 20.2 Signicance of ML algorithms for PD diagnosis and stage identication by
analysing gait parameters.
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