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Main Authors: Bertram, David, Ophey, Anja, Röttgen, Sinah, Kufer, Konstantin, Fink, Gereon R., Kalbe, Elke, Hansen, Clint, Maetzler, Walter, Kapsecker, Maximilian, Reimer, Lara M., Jonas, Stephan, Damgaard, Andreas T., Bertelsen, Natasha B., Skjaerbaek, Casper, Borghammer, Per, Groenewald, Karolien, Ratti, Pietro-Luca, Hu, Michele T., Moreau, Noémie, Sommerauer, Michael, Bozek, Katarzyna
Format: Preprint
Published: 2025
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Online Access:https://arxiv.org/abs/2511.05221
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author Bertram, David
Ophey, Anja
Röttgen, Sinah
Kufer, Konstantin
Fink, Gereon R.
Kalbe, Elke
Hansen, Clint
Maetzler, Walter
Kapsecker, Maximilian
Reimer, Lara M.
Jonas, Stephan
Damgaard, Andreas T.
Bertelsen, Natasha B.
Skjaerbaek, Casper
Borghammer, Per
Groenewald, Karolien
Ratti, Pietro-Luca
Hu, Michele T.
Moreau, Noémie
Sommerauer, Michael
Bozek, Katarzyna
author_facet Bertram, David
Ophey, Anja
Röttgen, Sinah
Kufer, Konstantin
Fink, Gereon R.
Kalbe, Elke
Hansen, Clint
Maetzler, Walter
Kapsecker, Maximilian
Reimer, Lara M.
Jonas, Stephan
Damgaard, Andreas T.
Bertelsen, Natasha B.
Skjaerbaek, Casper
Borghammer, Per
Groenewald, Karolien
Ratti, Pietro-Luca
Hu, Michele T.
Moreau, Noémie
Sommerauer, Michael
Bozek, Katarzyna
contents Isolated rapid eye movement sleep behavior disorder (iRBD) is a major prodromal marker of $α$-synucleinopathies, often preceding the clinical onset of Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy. While wrist-worn actimeters hold significant potential for detecting RBD in large-scale screening efforts by capturing abnormal nocturnal movements, they become inoperable without a reliable and efficient analysis pipeline. This study presents ActiTect, a fully automated, open-source machine learning tool to identify RBD from actigraphy recordings. To ensure generalizability across heterogeneous acquisition settings, our pipeline includes robust preprocessing and automated sleep-wake detection to harmonize multi-device data and extract physiologically interpretable motion features characterizing activity patterns. Model development was conducted on a cohort of 78 individuals, yielding strong discrimination under nested cross-validation (AUROC = 0.95). Generalization was confirmed on a blinded local test set (n = 31, AUROC = 0.86) and on two independent external cohorts (n = 113, AUROC = 0.84; n = 57, AUROC = 0.94). To assess real-world robustness, leave-one-dataset-out cross-validation across the internal and external cohorts demonstrated consistent performance (AUROC range = 0.84-0.89). A complementary stability analysis showed that key predictive features remained reproducible across datasets, supporting the final pooled multi-center model as a robust pre-trained resource for broader deployment. By being open-source and easy to use, our tool promotes widespread adoption and facilitates independent validation and collaborative improvements, thereby advancing the field toward a unified and generalizable RBD detection model using wearable devices.
format Preprint
id arxiv_https___arxiv_org_abs_2511_05221
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle ActiTect: A Generalizable Machine Learning Pipeline for REM Sleep Behavior Disorder Screening through Standardized Actigraphy
Bertram, David
Ophey, Anja
Röttgen, Sinah
Kufer, Konstantin
Fink, Gereon R.
Kalbe, Elke
Hansen, Clint
Maetzler, Walter
Kapsecker, Maximilian
Reimer, Lara M.
Jonas, Stephan
Damgaard, Andreas T.
Bertelsen, Natasha B.
Skjaerbaek, Casper
Borghammer, Per
Groenewald, Karolien
Ratti, Pietro-Luca
Hu, Michele T.
Moreau, Noémie
Sommerauer, Michael
Bozek, Katarzyna
Machine Learning
Neurons and Cognition
Isolated rapid eye movement sleep behavior disorder (iRBD) is a major prodromal marker of $α$-synucleinopathies, often preceding the clinical onset of Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy. While wrist-worn actimeters hold significant potential for detecting RBD in large-scale screening efforts by capturing abnormal nocturnal movements, they become inoperable without a reliable and efficient analysis pipeline. This study presents ActiTect, a fully automated, open-source machine learning tool to identify RBD from actigraphy recordings. To ensure generalizability across heterogeneous acquisition settings, our pipeline includes robust preprocessing and automated sleep-wake detection to harmonize multi-device data and extract physiologically interpretable motion features characterizing activity patterns. Model development was conducted on a cohort of 78 individuals, yielding strong discrimination under nested cross-validation (AUROC = 0.95). Generalization was confirmed on a blinded local test set (n = 31, AUROC = 0.86) and on two independent external cohorts (n = 113, AUROC = 0.84; n = 57, AUROC = 0.94). To assess real-world robustness, leave-one-dataset-out cross-validation across the internal and external cohorts demonstrated consistent performance (AUROC range = 0.84-0.89). A complementary stability analysis showed that key predictive features remained reproducible across datasets, supporting the final pooled multi-center model as a robust pre-trained resource for broader deployment. By being open-source and easy to use, our tool promotes widespread adoption and facilitates independent validation and collaborative improvements, thereby advancing the field toward a unified and generalizable RBD detection model using wearable devices.
title ActiTect: A Generalizable Machine Learning Pipeline for REM Sleep Behavior Disorder Screening through Standardized Actigraphy
topic Machine Learning
Neurons and Cognition
url https://arxiv.org/abs/2511.05221