A Comparative Evaluation of Clinical Rating Scales and Quantitative Measurements in Assessment pre and post Striatal Implantation of Human Foetal Mesencephalon in Parkinson’s Disease

IntroductionThe impact of disease-modifying agents on disease progression in Parkinson’s disease is largely assessed in clinical trials using clinical rating scales. These scales have drawbacks in terms of their ability to capture the fluctuating nature of symptoms while living in a naturalistic environment. The SPHERE (Sensor Platform for HEalthcare in a Residential Environment) project has designed a multi-sensor platform with multimodal devices designed to allow continuous, relatively inexpensive, unobtrusive sensing of motor, non-motor and activities of daily living metrics in a home or a home-like environment. The aim of this study is to evaluate how the SPHERE technology can measure aspects of Parkinson’s disease.Methods and analysisThis is a small-scale feasibility and acceptability study during which 12 pairs of participants (comprising a person with Parkinson’s and a healthy control participant) will stay and live freely for 5 days in a home-like environment embedded with SPHERE technology including environmental, appliance monitoring, wrist-worn accelerometry and camera sensors. These data will be collected alongside clinical rating scales, participant diary entries and expert clinician annotations of colour video images. Machine learning will be used to look for a signal to discriminate between Parkinson’s disease and control, and between Parkinson’s disease symptoms ‘on’ and ‘off’ medications. Additional outcome measures including bradykinesia, activity level, sleep parameters and some activities of daily living will be explored. Acceptability of the technology will be evaluated qualitatively using semi-structured interviews.Ethics and disseminationEthical approval has been given to commence this study; the results will be disseminated as widely as appropriate.

Download Full-text

Gait quantitation in Parkinson's disease ? locomotor disability and correlation to clinical rating scales

Journal of Neural Transmission ◽

10.1007/bf01273184 ◽

1997 ◽

Vol 104 (2-3) ◽

pp. 237-248 ◽

Cited By ~ 49

Author(s):

P. Vieregge ◽

H. Stolze ◽

C. Klein ◽

I. Heberlein

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Locomotor Disability ◽

Clinical Rating

Download Full-text

Depression rating scales in Parkinson's disease: Critique and recommendations

Movement Disorders ◽

10.1002/mds.21333 ◽

2007 ◽

Vol 22 (8) ◽

pp. 1077-1092 ◽

Cited By ~ 373

Author(s):

Anette Schrag ◽

Paolo Barone ◽

Richard G. Brown ◽

Albert F.G. Leentjens ◽

William M. McDonald ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales

Download Full-text

Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation-Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease

Movement Disorders ◽

10.1002/mds.22260 ◽

2009 ◽

Vol 24 (5) ◽

pp. 635-646 ◽

Cited By ~ 102

Author(s):

Marian L. Evatt ◽

K. Ray Chaudhuri ◽

Kelvin L. Chou ◽

Ester Cubo ◽

Vanessa Hinson ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Movement Disorders ◽

Rating Scales ◽

Task Force

Download Full-text

Slow Motion Analysis of Repetitive Tapping (SMART) Test: Measuring Bradykinesia in Recently Diagnosed Parkinson’s Disease and Idiopathic Anosmia

Journal of Parkinson s Disease ◽

10.3233/jpd-212683 ◽

2021 ◽

pp. 1-15

Author(s):

Cristina Simonet ◽

Miquel A. Galmes ◽

Christian Lambert ◽

Richard N. Rees ◽

Tahrina Haque ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Early Stage ◽

Slow Motion ◽

Motor Dysfunction ◽

Prodromal Phase ◽

Floor Effect ◽

Cross Sectional ◽

Early Stages

Background: Bradykinesia is the defining motor feature of Parkinson’s disease (PD). There are limitations to its assessment using standard clinical rating scales, especially in the early stages of PD when a floor effect may be observed. Objective: To develop a quantitative method to track repetitive tapping movements and to compare people in the early stages of PD, healthy controls, and individuals with idiopathic anosmia. Methods: This was a cross-sectional study of 99 participants (early-stage PD = 26, controls = 64, idiopathic anosmia = 9). For each participant, repetitive finger tapping was recorded over 20 seconds using a smartphone at 240 frames per second. From each video, amplitude between fingers, frequency (number of taps per second), and velocity (distance travelled per second) was extracted. Clinical assessment was based on the motor section of the MDS-UPDRS. Results: People in the early stage of PD performed the task with slower velocity (p < 0.001) and with greater frequency slope than controls (p = 0.003). The combination of reduced velocity and greater frequency slope obtained the best accuracy to separate early-stage PD from controls based on metric thresholds alone (AUC = 0.88). Individuals with anosmia exhibited slower velocity (p = 0.001) and smaller amplitude (p < 0.001) compared with controls. Conclusion: We present a simple, proof-of-concept method to detect early motor dysfunction in PD. Mean tap velocity appeared to be the best parameter to differentiate patients with PD from controls. Patients with anosmia also showed detectable differences in motor performance compared with controls which may suggest that some are in the prodromal phase of PD.

Download Full-text

Parkinson’s Disease Progression and Statins: Hydrophobicity Matters

Journal of Parkinson s Disease ◽

10.3233/jpd-212819 ◽

2021 ◽

pp. 1-10

Author(s):

Mechelle M. Lewis ◽

Richard M. Albertson ◽

Guangwei Du ◽

Lan Kong ◽

Andrew Foy ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scales ◽

Motor Symptoms ◽

Clinical Progression ◽

Mixed Effect ◽

Lipophilic Statin ◽

Hydrophilic Statin ◽

Non Motor Symptoms ◽

Statin Use

Background: Recent randomized clinical trials using hydrophobic statins reported no influence on Parkinson’s disease (PD) clinical progression. Hydrophobicity is a key determinant for blood-brain barrier penetrance. Objective: Investigate a potential effect of statins on PD progression. Methods: Statin use was determined at baseline and subtyped according to hydrophobicity in 125 PD patients participated PD Biomarker Program (PDBP, 2012–2015) at our site. Clinical (N = 125) and susceptibility MRI (N = 86) data were obtained at baseline and 18-months. Movement Disorders Society-Unified PD Rating Scales were used to track progression of non-motor (MDS-UPDRS-I) and motor (MDS-UPDRS-II) symptoms, and rater-based scores (MDS-UPDRS-III) of patients in the “on” drug state. R2 * values were used to capture pathological progression in the substantia nigra. Associations between statin use, its subtypes, and PD progression were evaluated with linear mixed effect regressions. Results: Compared to statin non-users, overall statin or lipophilic statin use did not significantly influence PD clinical or imaging progression. Hydrophilic statin users, however, demonstrated faster clinical progression of non-motor symptoms [MDS-UPDRS-I (β= 4.8, p = 0.010)] and nigral R2 * (β= 3.7, p = 0.043). A similar trend was found for MDS-UPDRS-II (β= 3.9, p = 0.10), but an opposite trend was observed for rater-based MDS-UPDRS-III (β= –7.3, p = 0.10). Compared to lipophilic statin users, hydrophilic statin users also showed significantly faster clinical progression of non-motor symptoms [MDS-UPDRS-I (β= 5.0, p = 0.020)], but R2 * did not reach statistical significance (β= 2.5, p = 0.24). Conclusion: This study suggests that hydrophilic, but not lipophilic, statins may be associated with faster PD progression. Future studies may have clinical and scientific implications.

Download Full-text