{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T13:39:26Z","timestamp":1792503566917,"version":"4.5.0"},"reference-count":292,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Motivation: Parkinson\u2019s disease (PD) is one of the most serious, non-curable, and expensive to treat. Recently, machine learning (ML) has shown to be able to predict cardiovascular\/stroke risk in PD patients. The presence of COVID-19 causes the ML systems to become severely non-linear and poses challenges in cardiovascular\/stroke risk stratification. Further, due to comorbidity, sample size constraints, and poor scientific and clinical validation techniques, there have been no well-explained ML paradigms. Deep neural networks are powerful learning machines that generalize non-linear conditions. This study presents a novel investigation of deep learning (DL) solutions for CVD\/stroke risk prediction in PD patients affected by the COVID-19 framework. Method: The PRISMA search strategy was used for the selection of 292 studies closely associated with the effect of PD on CVD risk in the COVID-19 framework. We study the hypothesis that PD in the presence of COVID-19 can cause more harm to the heart and brain than in non-COVID-19 conditions. COVID-19 lung damage severity can be used as a covariate during DL training model designs. We, therefore, propose a DL model for the estimation of, (i) COVID-19 lesions in computed tomography (CT) scans and (ii) combining the covariates of PD, COVID-19 lesions, office and laboratory arterial atherosclerotic image-based biomarkers, and medicine usage for the PD patients for the design of DL point-based models for CVD\/stroke risk stratification. Results: We validated the feasibility of CVD\/stroke risk stratification in PD patients in the presence of a COVID-19 environment and this was also verified. DL architectures like long short-term memory (LSTM), and recurrent neural network (RNN) were studied for CVD\/stroke risk stratification showing powerful designs. Lastly, we examined the artificial intelligence bias and provided recommendations for early detection of CVD\/stroke in PD patients in the presence of COVID-19. Conclusion: The DL is a very powerful tool for predicting CVD\/stroke risk in PD patients affected by COVID-19.<\/jats:p>","DOI":"10.3390\/diagnostics12071543","type":"journal-article","created":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T10:39:13Z","timestamp":1656153553000},"page":"1543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Deep Learning Paradigm for Cardiovascular Disease\/Stroke Risk Stratification in Parkinson\u2019s Disease Affected by COVID-19: A Narrative Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Jasjit S.","family":"Suri","sequence":"first","affiliation":[{"name":"Stroke Monitoring and Diagnostic Division, AtheroPoint\u2122, Roseville, CA 95661, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0813-4906","authenticated-orcid":false,"given":"Mahesh A.","family":"Maindarkar","sequence":"additional","affiliation":[{"name":"Stroke Monitoring and Diagnostic Division, AtheroPoint\u2122, Roseville, CA 95661, USA"},{"name":"Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9856-539X","authenticated-orcid":false,"given":"Sudip","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puneet","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Max Institute of Cancer Care, Max Super Specialty Hospital, New Delhi 110017, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinalini","family":"Bhagawati","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, North Eastern Hill University, Shillong 793022, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Saba","sequence":"additional","affiliation":[{"name":"Department of Radiology, and Pathology, Azienda Ospedaliero Universitaria, 09123 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-8612","authenticated-orcid":false,"given":"Gavino","family":"Faa","sequence":"additional","affiliation":[{"name":"Department of Radiology, and Pathology, Azienda Ospedaliero Universitaria, 09123 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8288-1010","authenticated-orcid":false,"given":"Sanjay","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of CSE, International Institute of Information Technology, Bhuneshwar 751029, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inder M.","family":"Singh","sequence":"additional","affiliation":[{"name":"Stroke Monitoring and Diagnostic Division, AtheroPoint\u2122, Roseville, CA 95661, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramjit S.","family":"Chadha","sequence":"additional","affiliation":[{"name":"Stroke Monitoring and Diagnostic Division, AtheroPoint\u2122, Roseville, CA 95661, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Turk","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Johri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Queen\u2019s University, Kingston, ON K7L 3N6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narendra N.","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110076, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5927-3201","authenticated-orcid":false,"given":"Klaudija","family":"Viskovic","sequence":"additional","affiliation":[{"name":"Department of Radiology and Ultrasound, University Hospital for Infectious Diseases, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1089-7766","authenticated-orcid":false,"given":"Sofia","family":"Mavrogeni","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, Onassis Cardiac Surgery Centre, 176 74 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Laird","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Adventist Health St. Helena, St. Helena, CA 94574, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Miner","sequence":"additional","affiliation":[{"name":"Men\u2019s Health Centre, Miriam Hospital, Providence, RI 02906, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0448-4765","authenticated-orcid":false,"given":"David W.","family":"Sobel","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, National Kapodistrian University of Athens, 157 72 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Balestrieri","sequence":"additional","affiliation":[{"name":"Docs Eye Care Research Lab, Dunedin 9013, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros P.","family":"Sfikakis","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, National Kapodistrian University of Athens, 157 72 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5043-7962","authenticated-orcid":false,"given":"George","family":"Tsoulfas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Aristoteleion University of Thessaloniki, 541 24 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3825-532X","authenticated-orcid":false,"given":"Athanase D.","family":"Protogerou","sequence":"additional","affiliation":[{"name":"Cardiovascular Prevention and Research Unit, Department of Pathophysiology, National & Kapodistrian University of Athens, 157 72 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durga Prasanna","family":"Misra","sequence":"additional","affiliation":[{"name":"Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, 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Lurie Children\u2019s Hospital of Chicago, Chicago, IL 60611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Al-Maini","sequence":"additional","affiliation":[{"name":"Allergy, Clinical Immunology, and Rheumatology Institute, Toronto, ON M5G 1N8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surinder K.","family":"Dhanjil","sequence":"additional","affiliation":[{"name":"Stroke Monitoring and Diagnostic Division, AtheroPoint\u2122, Roseville, CA 95661, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meyypan","family":"Sockalingam","sequence":"additional","affiliation":[{"name":"MV Centre of Diabetes, Chennai 600013, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajit","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110076, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Rathore","sequence":"additional","affiliation":[{"name":"Nephrology Department, Kaiser Permanente, Sacramento, CA 95823, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6603-9077","authenticated-orcid":false,"given":"Mostafa","family":"Fatemi","sequence":"additional","affiliation":[{"name":"Department of Physiology & Biomedical Engineering, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azra","family":"Alizad","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padukode R.","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Neurology Department, Fortis Hospital, Bangalore 560076, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomaz","family":"Omerzu","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8544-8397","authenticated-orcid":false,"given":"Subbaram","family":"Naidu","sequence":"additional","affiliation":[{"name":"Electrical Engineering Department, University of Minnesota, Duluth, MN 55812, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Vascular Screening and Diagnostic Centre, University of Nicosia Medical School, Engomi 2408, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6865-2919","authenticated-orcid":false,"given":"Kosmas I.","family":"Paraskevas","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Central Clinic of Athens, 106 80 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mannudeep","family":"Kalra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2474-5723","authenticated-orcid":false,"given":"Zolt\u00e1n","family":"Ruzsa","sequence":"additional","affiliation":[{"name":"Invasive Cardiology Division, Faculty of Medicine, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1790-8640","authenticated-orcid":false,"given":"Mostafa M.","family":"Fouda","sequence":"additional","affiliation":[{"name":"Department of Electrical and Computer Engineering, Idaho State University, Pocatello, ID 83209, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.compbiomed.2018.09.008","article-title":"Parkinson\u2019s disease: Cause factors, measurable indicators, and early diagnosis","volume":"102","author":"Bhat","year":"2018","journal-title":"Comput. 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