scholarly journals Effectiveness of BoNT A in Parkinson's Disease Upper Limb Tremor Management

2013 ◽  
Vol 40 (5) ◽  
pp. 663-669 ◽  
Author(s):  
Fariborz Rahimi ◽  
Carina Bee ◽  
Derek Debicki ◽  
Angela C. Roberts ◽  
Priya Bapat ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Clinical Judgment ◽  
Degrees Of Freedom ◽  
Focal Therapy ◽  
Open Label ◽  
Line Drawings ◽  
Clinical Scales ◽  
Flexion Extension

Abstract:Objective:One the greatest challenges of BoNT A therapy for tremor lies in the complexity and variation of components involved in tremor movement, and the lack of objective measures to determine these components. This 3 month open-label single injection study aims to couple clinician best judgment with kinematics to improve effect of BoNT A (incobotulinumtoxinA) injection in 7 patients with upper limb Parkinson's disease (PD) tremor.Methods:Injection was guided with clinical and kinematic assessment of tremor using angular wrist position in 3 degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. Overall tremor severity and change were measured by linear finger acceleration.Results:Kinematic data from static and functional tasks demonstrate no improvement at one month post-injection, but significant improvement at two and three months. Clinical scales across UPDRS Items 20 (1, 2, 3 months post) and 21 (2 months), and spiral drawings (3 months) showed significant improvement from baseline, while line drawings did not.Conclusions:This study suggests injection of BoNT A as a viable focal management option for upper limb PD tremor. In addition to clinical judgment, objective quantification of tremor dynamics by kinematics may be a feasible assessment and guidance tool which can be used to optimize injection conditions for focal tremor therapy. Kinematic analysis of tremor across a variety of joints in all degrees of movement may provide important insight into tremor dynamics, allowing optimized, targeted focal therapy.

scholarly journals Remote Evaluation of Parkinson's Disease Using a Conventional Webcam and Artificial Intelligence

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariana H. G. Monje ◽  
Sergio Domínguez ◽  
Javier Vera-Olmos ◽  
Angelo Antonini ◽  
Tiago A. Mestre ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Rating Scale ◽  
Hand Movement ◽  
Movement Speed ◽  
Clinical Scales ◽  
Video Frames ◽  
Disease Rating

Objective: This study aimed to prove the concept of a new optical video-based system to measure Parkinson's disease (PD) remotely using an accessible standard webcam.Methods: We consecutively enrolled a cohort of 42 patients with PD and healthy subjects (HSs). The participants were recorded performing MDS-UPDRS III bradykinesia upper limb tasks with a computer webcam. The video frames were processed using the artificial intelligence algorithms tracking the movements of the hands. The video extracted features were correlated with clinical rating using the Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale and inertial measurement units (IMUs). The developed classifiers were validated on an independent dataset.Results: We found significant differences in the motor performance of the patients with PD and HSs in all the bradykinesia upper limb motor tasks. The best performing classifiers were unilateral finger tapping and hand movement speed. The model correlated both with the IMUs for quantitative assessment of motor function and the clinical scales, hence demonstrating concurrent validity with the existing methods.Conclusions: We present here the proof-of-concept of a novel webcam-based technology to remotely detect the parkinsonian features using artificial intelligence. This method has preliminarily achieved a very high diagnostic accuracy and could be easily expanded to other disease manifestations to support PD management.

Anxiety and cognitive load affect upper limb motor control in Parkinson's disease during medication phases

2021 ◽  
Author(s):  
Zahra Nodehi ◽  
Hajar Mehdizadeh ◽  
Akram Azad ◽  
Maryam Mehdizadeh ◽  
Elham Reyhanian ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Control ◽  
Cognitive Load ◽  
Upper Limb

scholarly journals Foetal Cell Transplantation for Parkinson’s Disease: Focus on Graft-Induced Dyskinesia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Elisabetta Tronci ◽  
Camino Fidalgo ◽  
Manolo Carta
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cell Transplantation ◽  
Open Label ◽  
Double Blind ◽  
Clinical Investigations ◽  
Serotonin Neurons ◽  
Ventral Mesencephalic ◽  
Preclinical And Clinical Studies ◽  
Foetal Cell

Transplantation of dopamine- (DA-) rich foetal ventral mesencephalic cells emerged as a promising therapy for Parkinson’s disease (PD), as it allowed significant improvement of motor symptoms in several PD patients in open-label studies. However, double-blind clinical trials have been largely disappointing. The general agreement in the field is that the lack of standardization of tissue collection and preparation, together with the absence of postsurgical immunosuppression, played a key role in the failure of these studies. Moreover, a further complication that emerged in previous studies is the appearance of the so-called graft-induced dyskinesia (GID), in a subset of grafted patients, which resembles dyskinesia induced by L-DOPA but in the absence of medication. Preclinical evidence pointed to the serotonin neurons as possible players in the appearance of GID. In agreement, clinical investigations have shown that grafted tissue may contain a large number of serotonin neurons, in the order of half of the DA cells; moreover, the serotonin 5-HT1A receptor agonist buspirone has been found to produce significant dampening of GID in grafted patients. In this paper, we will review the recent preclinical and clinical studies focusing on cell transplantation for PD and on the mechanisms underlying GID.

On the use of information theory for detecting upper limb motor dysfunction: An application to Parkinson’s disease

2011 ◽  
Vol 390 (23-24) ◽  
pp. 4451-4458 ◽  
Author(s):  
M. Elias de Oliveira ◽  
L.L. Menegaldo ◽  
P. Lucarelli ◽  
B.L.B. Andrade ◽  
P. Büchler
Keyword(s):  
Parkinson’S Disease ◽  
Information Theory ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Motor Dysfunction

The oasis (opicapone in sleep disorder) study in Parkinson's disease: Design and rationale of an open-label, single-arm, pilot trial

2021 ◽  
Vol 429 ◽  
pp. 119430
Author(s):  
Raquel Costa ◽  
Claudia Trenkwalder ◽  
Joaquim Ferreira ◽  
Diogo Magalhães ◽  
José Rocha ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Disorder ◽  
Pilot Trial ◽  
Open Label

scholarly journals Association between Objectively Measured Physical Activity and Gait Patterns in People with Parkinson’s Disease: Results from a 3-Month Monitoring

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Micaela Porta ◽  
Giuseppina Pilloni ◽  
Roberta Pili ◽  
Carlo Casula ◽  
Mauro Murgia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Gait Analysis ◽  
Time Slot ◽  
Moderate Intensity ◽  
Kinematic Parameters ◽  
Gait Patterns ◽  
Flexion Extension ◽  
Vigorous Intensity

Background. Although physical activity (PA) is known to be beneficial in improving motor symptoms of people with Parkinson’s disease (pwPD), little is known about the relationship between gait patterns and features of PA performed during daily life. Objective. To verify the existence of possible relationships between spatiotemporal and kinematic parameters of gait and amount/intensity of PA, both instrumentally assessed. Methods. Eighteen individuals affected by PD (10F and 8M, age 68.0 ± 10.8 years, 1.5 ≤ Hoehn and Yahr (H&Y) < 3) were required to wear a triaxial accelerometer 24 h/day for 3 consecutive months. They also underwent a 3D computerized gait analysis at the beginning and end of the PA assessment period. The number of daily steps and PA intensity were calculated on the whole day, and the period from 6:00 to 24:00 was grouped into 3 time slots, using 3 different cut-point sets previously validated in the case of both pwPD and healthy older adults. 3D gait analysis provided spatiotemporal and kinematic parameters of gait, including summary indexes of quality (Gait Profile Score (GPS) and Gait Variable Score (GVS)). Results. The analysis of hourly trends of PA revealed the existence of two peaks located in the morning (approximately at 10) and in the early evening (between 18 and 19). However, during the morning time slot (06:00–12:00), pwPD performed significantly higher amounts of steps (4313 vs. 3437 in the 12:00–18:00 time slot, p<0.001, and vs. 2889 in the 18:00–24:00 time slot, p=0.021) and of moderate-to-vigorous PA (43.2% vs. 36.3% in the 12:00–18:00 time slot, p=0.002, and vs. 31.4% in the 18:00–24:00 time slot, p=0.049). The correlation analysis shows that several PA intensity parameters are significantly associated with swing-phase duration (rho = −0.675 for sedentary intensity, rho = 0.717 for moderate-to-vigorous intensity, p<0.001), cadence (rho = 0.509 for sedentary intensity, rho = −0.575 for moderate-to-vigorous intensity, p<0.05), and overall gait pattern quality as expressed by GPS (rho = −0.498 to −0.606 for moderate intensity, p<0.05) and GVS of knee flexion-extension (rho = −0.536 for moderate intensity, p<0.05). Conclusions. Long-term monitoring of PA integrated by the quantitative assessment of spatiotemporal and kinematic parameters of gait may represent a useful tool in supporting a better-targeted prescription of PA and rehabilitative treatments in pwPD.

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