# Can Semantics Uncover Hidden Relations between Neurodegenerative Diseases and Artistic Behaviors?
## 5 Discussing Open Issues and Challenges  
This review presents state-of-the-art research on technologies in the intersection of fields related to CDSSs, NDs and artistic behavior. What makes it a challenging research topic is the research question of how to combine and analyze the personal health data and artistic behavior of patients to predict and diagnose the early onset of NDs. From \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Ontology** & **Domain** & **Language** & **Fuzzy Logic** & **Availability** & **Status** \\ \hline DO & Human Disease & OWL, OBO, RDF & Yes & Open Source & Up to date \\ HPO & Human Disease & OWL, OBO, In2 RDF, JSON & No & Open Source & Up to date \\ GMA & Elderly Motor Symptoms & OWL & Yes & Free & Last update 2018 \\ OntoNeuroLOG & NDs & OWL, RDF, JSON & No & Free & Last update 2017 \\ BIRNLex & Neuroscience & OWL, OBO, RDF & Yes & Open Source & Last update 2021 \\ NIO & Neuroscience & OWL, RDF & Yes & Free & Last update 2018 \\ PDON & PD & OWL & No & Free & Up to date \\ PMDO & PD & OWL & No & Free & Up to date \\ PDKO & PD & OWL & No & - & Dead \\ ADO & AD & OWL & No & Free & Last update 2021 \\ ADMO & AD & OWL, RDF & No & Free & Up to date \\ ADIO & AD & OWL & No & Open Source & Last update 2020 \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Comparative table of reviewed ontologies. this study, it can be concluded that there is limited data and technology available in this research area. We conducted our review in three categories with a small degree of overlap between them. The first category reviews work that examine the symptomatology of NDs and creative expression. The second category reviews work related to the development of fuzzy logic-based expert systems and decision support systems for medical purposes. The third category reviews the ontologies for NDs, such as ontologies for PD or AD. As presented in Table 2, currently, an expert system that combines technology from the three categories does not exist. Based on this survey, it was found that NDs can damage brain cells, neural connections, and the ability to perform mental tasks, indicating that further study is necessary to understand their mechanisms more accurately. Although changes in a person's creative style may not always indicate a decline in health, neuroplasticity can occur. Unfortunately, there is a lack of artistic behavior ontologies, which creates a significant gap that needs to be filled. On the other hand, medical ontologies have not been updated with new knowledge gained from recent years, such as the increasing use of neuroimaging technology, specific biological and cognitive tests, and the high progression of the AI sector. Moreover, there is a vast amount of biological and non-biological data in the medical sector that needs to be expanded to provide relevant information to both physicians and patients. However, there is no available data in open-source distribution about brain scans of individuals performing creative activities. What are easily discovered are descriptive observations of the art created, such as color intensity, lines, curves, shape delineation, mind capture, movement precision, and abstract awareness of the surrounding world. Another data stream that is more easily collected and stored is personal health and daily activity data collected from the ND patients through wearable sensors. These data can be integrated in an expert system that takes advantage of sensor-related ontologies. The Semantic Sensor Network ontology (SSN) [104] and the Sensor, Observation, Sample, and Actuator (SOSA) ontology [104] were introduced mainly for the representation of sensors and observations they facilitate. The Smart Applications Reference (SAREF) ontology [105] was introduced as a result of ETSI standardization, and its extension, SAREF4 WEAR [106], was developed for modeling using different wearables available in the market.