AI Video Analysis in Parkinson's Disease: A Systematic Review of the Most Accurate Computer Vision Tools for Diagnosis, Symptom Monitoring, and Therapy Management.

Abstract

<b>Background.</b> Clinical assessment of Parkinson's disease (PD) is limited by high subjectivity and inter-rater variability. Markerless video analysis, namely Computer Vision (CV), offers objective and scalable characterization of motor signs. We systematically reviewed CV technologies suited for PD diagnosis, symptom monitoring, and treatment management. <b>Methods.</b> Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed for articles published between 1 January 1984 and 9 May 2025. We used the following search strategy: ("Parkinson Disease" [MeSH Terms] OR "parkinson's disease" OR "parkinson disease") AND ("computer vision" OR "video analysis" OR "pose estimation" OR "OpenPose" OR "DeepLabCut" OR "OpenFace" OR "YOLO" OR "MediaPipe" OR "markerless motion capture" OR "skeleton tracking"). <b>Results.</b> Out of 154 identified studies, 45 met eligibility criteria and were synthesized. Gait was assessed in 42% of studies, followed by bradykinesia items (17.7%). OpenPose and custom CV solutions were each used in 36% of studies, followed by MediaPipe (16%), DeepLabCut (9%), YOLO (4%). Across aims, CV pipelines consistently showed diagnostic discrimination and severity tracking aligned with expert ratings. <b>Conclusions.</b> CV non-invasively quantifies PD motor impairment, holding potential for objective diagnosis, longitudinal monitoring, and therapy response. Guidelines for standardized video-recording protocols and software usage are needed for real-world applications.