Validation of Artificial Intelligence-Based Facial Paralysis Assessment in Patients With Bell's Palsy (AI-FACE)

May 1, 2026 updated by: Ali Noureldin Elsayed, Cairo University
This observational study aims to assess the concurrent validity of an artificial intelligence (AI)-based facial paralysis assessment system in patients with unilateral Bell's palsy. Currently, clinical assessment relies on subjective scales like the Sunnybrook Facial Grading System, which can vary between different observers. This study will compare AI-generated composite asymmetry scores-derived from real-time computer vision analysis of facial landmarks-with scores from the Sunnybrook system. The goal is to determine if AI can provide a valid, objective method for monitoring facial nerve recovery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Participants with unilateral Bell's palsy will be recruited for a single assessment session. The assessment involves two primary components:

Clinical Assessment: A qualified physical therapist will grade the patient's facial function using the Sunnybrook Facial Grading System, which evaluates resting symmetry, degree of voluntary movement, and synkinesis.

AI Assessment: A computer-vision-based system will utilize a standard camera to detect 468 facial landmarks in real-time. The system calculates a composite asymmetry score by comparing the movement amplitude and positioning of the affected side of the face against the healthy side during standardized facial expressions.

The study will utilize Spearman's rank correlation coefficient to analyze the relationship between the AI-derived scores and the Sunnybrook scores to establish concurrent validity. No personal images or videos will be stored; the AI performs real-time processing and immediate data deletion to ensure participant privacy.

Study Type

Observational

Enrollment (Estimated)

63

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Egypt
    • Giza Governorate
      • Giza, Giza Governorate, Egypt, 12613
        • Faculty of physical therapy, Cairo University
        • Contact:
        • Principal Investigator:
          • Ali Noureldin Hassanein, B.Sc.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Sixty-three patients of both sexes with unilateral Bell's palsy will be recruited from private clinics. Patients will be diagnosed by a neurologist based on clinical examination.

Description

Inclusion Criteria:

  • Patients with unilateral Bell's palsy.
  • Patients must be within one month of onset of Bell's palsy symptoms at the time of enrollment.
  • Body mass index (BMI) less than 30 $kg/m^2$.
  • Patients must be cooperative and able to follow simple verbal instructions during facial movement tasks.

Exclusion Criteria:

  • Bilateral facial paralysis or recurrent Bell's palsy.
  • Facial nerve palsy due to known secondary causes (e.g., trauma, neoplasm, infection, stroke, Ramsay Hunt syndrome, or otitis media).
  • Facial deformities, scars, or burns that interfere with facial motion detection.
  • Uncooperative or cognitively impaired individuals unable to follow instructions or maintain required facial postures.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Patients with Unilateral Bell's Palsy
Sixty-three patients of both sexes, aged 25-40 years, with a body mass index (BMI) less than 30 $kg/m^2$. Participants must be within one month of the onset of Bell's palsy symptoms and be able to follow verbal instructions during facial movement tasks.
Other: Sunnybrook Facial Grading System (FGS)
Clinical grading of facial muscle paralysis based on resting symmetry, symmetry of voluntary movements, and synkinesis detection.
Other: AI-Based Facial Assessment
Real-time computer vision analysis using deep-learning-based landmark detection to track 468 facial points during standardized facial expressions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Spearman's Rank Correlation Coefficient between AI-derived scores and Sunnybrook Facial Grading System scores.
Time Frame: Baseline (single assessment at the time of enrollment).
This measure evaluates the concurrent validity of the AI-based assessment system. The AI system uses 468 facial landmarks to calculate a composite asymmetry score (0-100%). These results will be correlated with the clinical scores from the Sunnybrook Facial Grading System (0-100), where higher scores indicate better facial function.
Baseline (single assessment at the time of enrollment).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
AI-Based Composite Asymmetry Score.
Time Frame: Baseline.
The specific numerical output generated by the computer-vision system. It quantifies facial symmetry by measuring the amplitude of movement (in pixels/displacement) during five standardized facial expressions: brow lift, eye closure, broad smile, snarl, and lip pucker.
Baseline.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Investigators

  • Principal Investigator: Ali Noureldin Hassanein, B.Sc., Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

October 1, 2026

Study Completion (Estimated)

December 1, 2026

Study Registration Dates

First Submitted

May 1, 2026

First Submitted That Met QC Criteria

May 1, 2026

First Posted (Actual)

May 7, 2026

Study Record Updates

Last Update Posted (Actual)

May 7, 2026

Last Update Submitted That Met QC Criteria

May 1, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/006311

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

To maintain participant confidentiality and privacy. The AI system processes facial landmarks in real-time, and no individual images or raw biometric data are stored for future distribution

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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