scholarly journals Accuracy, Sensitivity, and Specificity of Different Tests to Detect Impaired Hand Function in Parkinson’s disease

2020 ◽  
Author(s):  
Cintia C. G. Alonso ◽  
Paulo Barbosa de Freitas ◽  
Raquel Pires ◽  
Dalton Lustosa de Oliveira ◽  
Sandra M. S. Ferreira de Freitas
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Roc Analysis ◽  
Hand Function ◽  
Area Under The Curve ◽  
Maximum Power ◽  
Pinch Grip ◽  
Nine Hole Peg Test

AbstractIntroductionParkinson’s Disease (PD) can affect hand function. To examine the diagnostic accuracy, sensitivity, and specificity of four traditionally used hand function tests in individuals with PD by using the receiver operator characteristic (ROC) analysis.MethodsEighty individuals (24 with PD and 56 healthy controls) performed the Jebsen-Taylor Hand Function Test (JTHF, with seven subtests), Nine-Hole Peg Test, and maximum power and pinch grip strength tests. The outcomes of the tests were compared between groups. The values of the area under the curve from the ROC analysis assessed the diagnostic accuracy, sensitivity, and specificity of the tests.ResultsIndividuals with PD presented worst performance than controls in all tests, except the writing subtest of the JTHF and maximum power strength. Two subtests of the JTHF, the turning cards and moving large, heavy objects, showed the highest area under the curve in the ROC analysis. The Nine-Hole Peg Test was able to distinguish the PD stage and progression, while the simulated feeding of the JTHFT subtest showed a high area under the curve only for PD stage analysis.ConclusionTwo dexterity tasks (turning cards and moving large, heavy objects) were highly discriminative of the hand function impairments in individuals with PD. The Nine-Hole Peg Test provides the most accurate identification of the PD stage and progression based on hand function impairment. Different dexterity tasks should be used depending on the aims of the evaluation, whether for diagnosis, monitoring, or classification of the PD.

scholarly journals FPL tendon thickness, tremor and hand functions in Parkinson’s disease

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Hasan Toktas ◽  
Umit Dundar ◽  
Özge Yilmaz Kusbeci ◽  
Alper Murat Ulasli ◽  
Ozgur Toy ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Functional Performance ◽  
Hand Function ◽  
Hand Functions ◽  
Hand Grip ◽  
Function Test ◽  
Tendon Thickness ◽  
The Relationship ◽  
Nine Hole Peg Test

AbstractIntroductionIn Parkinson’s disease (PD), a resting tremor of the thumb may affect the flexor pollicis longus (FPL) and influence hand functions. We investigated the relationship between FPL tendon thickness and hand function in PD patients and compared these characteristics with those in healthy controls.MethodsThe hand grip and pinch strengths were measured. The participants completed the Duruöz hand index, the Sollerman’s hand function test, and the Nine Hole Peg Test. The thickness of the FPL tendon was measured using ultrasonographyResultsThe FPL tendon was thicker in PD patients but was not associated with tremor severity. In PD patients, despite functional performance of the hands are impaired and grip strength is decreased, pinch strengths are preserved. FPL thickness was not correlated with grip and pinch strengths.ConclusionThe thicker FPL tendon may be associated with greater pinch and grip strengths and manual dexterity in healthy individuals. The presence of tremor is associated with a thicker FPL tendon.

Using the Internet to assess activities of daily living and hand function in people with Parkinson's disease

2008 ◽  
Vol 23 (3) ◽  
pp. 253-261 ◽  
Author(s):  
Tammy Hoffmann ◽  
Trevor Russell ◽  
Leah Thompson ◽  
Amy Vincent ◽  
Mark Nelson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Hand Function ◽  
The Internet

The potential value of a pictorial atlas for aid in the visual diagnosis of 123I FP-CIT SPECT scans

2009 ◽  
Vol 48 (04) ◽  
pp. 173-178 ◽  
Author(s):  
H. Ham ◽  
A. Dobbeleir ◽  
P. Santens ◽  
Y. D'Asseler ◽  
I. Goethals
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Interobserver Variability ◽  
Area Under The Curve ◽  
Visual Assessment ◽  
Added Value ◽  
Related Disorder ◽  
Visual Diagnosis ◽  
Spect Images

SummaryThe aim of our study was to evaluate the value of a pictorial atlas of 123I FP-CIT SPECT images for aid in the visual diagnosis. Patients, materials, methods: Sixty patients, of whom 20 were clinically diagnosed as ‘non-parkinsonian’ and 40 as having Parkinson's disease or any related disorder, were included in the study. An atlas consisting of 12 123I FP-CIT SPECT images was constructed first. Validity of the atlas was investigated by performing a receiver operating characteristic (ROC) analysis with the clinical diagnosis as the gold standard. The remaining 48 SPECT images were visually assessed twice by 5 observers, first with and secondly without consulting the atlas, or vice versa. The added value of the atlas was investigated by comparing the diagnostic accuracy and the interobserver variability for both methods. Results: ROC analysis performed on the atlas yielded an area under the curve of 1 for a threshold discriminating between clinically non-parkinsonian and parkinsonian patients that was situated between image 4 and 5 of the atlas. For the diagnostic accuracy, we found that the area under the ROC curve was systematically higher if observers had access to the atlas compared to when they had not (Wilcoxon's test, p<0.05). Also, the interobserver variability was significantly lower when observers used the atlas when compared to when they did not (p = 0.05). Conclusion: Diagnostic accuracy was significantly higher and interobserver variability significantly lower if observers had access to the atlas compared to when they had not. Hence, having a pictorial atlas available may facilitate the visual assessment of 123I FP-CIT SPECT scans.

scholarly journals Stability of MDS-UPDRS Motor Subtypes Over Three Years in Early Parkinson's Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Abhijeet K. Kohat ◽  
Samuel Y. E. Ng ◽  
Aidan S. Y. Wong ◽  
Nicole S. Y. Chia ◽  
Xinyi Choi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Baseline Factors ◽  
Prospective Cohorts ◽  
The Mean ◽  
The Stability ◽  
Early Parkinson’S Disease ◽  
Levodopa Equivalent Daily Dose

Background: Various classifications have been proposed to subtype Parkinson's disease (PD) based on their motor phenotypes. However, the stability of these subtypes has not been properly evaluated.Objective: The goal of this study was to understand the distribution of PD motor subtypes, their stability over time, and baseline factors that predicted subtype stability.Methods: Participants (n = 170) from two prospective cohorts were included: the Early PD Longitudinal Singapore (PALS) study and the National Neuroscience Institute Movement Disorders Database. Early PD patients were classified into tremor-dominant (TD), postural instability and gait difficulty (PIGD), and indeterminate subtypes according to the Movement Disorder Society's Unified PD Rating Scale (MDS-UPDRS) criteria and clinically evaluated for three consecutive years.Results: At baseline, 60.6% patients were TD, 12.4% patients were indeterminate, and 27.1% patients were PIGD subtypes (p &lt; 0.05). After 3 years, only 62% of patients in TD and 50% of patients in PIGD subtypes remained stable. The mean levodopa equivalent daily dose (LEDD) was higher in the PIGD subtype (276.92 ± 232.91 mg; p = 0.01). Lower LEDD [p &lt; 0.05, odds ratio (OR) 0.99, 95% confidence interval (CI): 0.98–0.99] and higher TD/PIGD ratios (p &lt; 0.05, OR 1.77, 95% CI: 1.29–2.43) were independent predictors of stability of TD subtype with an area under the curve (AUC) of 0.787 (95%CI: 0.669–0.876), sensitivity = 57.8%, and specificity = 89.7%.Conclusion: Only 50–62% of PD motor subtypes as defined by MDS-UPDRS remained stable over 3 years. TD/PIGD ratio and baseline LEDD were independent predictors for TD subtype stability over 3 years.

scholarly journals Determining Postoperative Thrombocyte Reduction Cut Off to Predict 30-Day Mortality in Patients Undergo Coronary Artery Bypass Graft Surgery

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4914-4914
Author(s):  
Ikhwan Rinaldi ◽  
Arif Mansjoer
Keyword(s):  
Sensitivity And Specificity ◽  
Roc Analysis ◽  
Conflicts Of Interest ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Area Under The Curve ◽  
Early Mortality ◽  
Receiver Operating Curve ◽  
Thrombocyte Count ◽  
Cabg Surgery

Background There are many factors associated with early mortality after CABG, including postoperative thrombocytopenia (Kertai, 2016). Many factors during CABG surgery, such as administration of heparin or cardio pulmonary bypass during surgery are related to thrombocyte count reduction (Hamid, Akhtar, Naqvi, & Ahsan, 2017; Arepally, 2017). However, it is possible for a post-CABG patient to suffer a significant thrombocyte reduction without reaching the thrombocytopenic state (thrombocyte count <150000/µL). Up to this time, there is still lack of study about association between thrombocyte reduction after surgery and 30-day mortality in patients undergo CABG. This study aim to determine cut off point for postoperative thrombocyte reduction as a predictor of 30-day mortality after CABG surgery. Method This is a retrospective cohort study using medical record of 263 adult patients who underwent CABG surgery in dr. Ciptomangunkusumo National Hospital on 2012-2015. Thrombocyte reduction was determined by substracting preoperative thrombocyte count from postoperative thrombocyte count. Receiver operating curve (ROC) analysis between percentage of thrombocyte reduction and 30-day mortality after surgery was done to obtain the sensitivity and specificity value of a particular degree of thrombocyte reduction. Cut off point was obtained from intersection between sensitivity and specificity value. Result Thirty-day mortality rate after CABG surgery in this study was 11.9%. Cut off point obtained from ROC analysis was 30% with area under the curve (AUC) 0.671. The sensitivity of this cut off point to predict early mortality after CABG surgery was 64.5%, while the specificity was 64.7% Conclusion Thrombocyte reduction more than or equal to 30% can be used as a predictor of 30-day mortality after CABG surgery. Figure Disclosures No relevant conflicts of interest to declare.

scholarly journals Comparing Sensitivity and Specificity of Addenbrooke’s Cognitive Examination-I, III and Mini-Addenbrooke’s Cognitive Examination in Parkinson’s Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Tivadar Lucza ◽  
Zsuzsanna Ascherman ◽  
Márton Kovács ◽  
Attila Makkos ◽  
Márk Harmat ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sensitivity And Specificity ◽  
Neurodegenerative Disorder ◽  
Education Level ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Receiver Operation Characteristic ◽  
Education Levels ◽  
Addenbrooke’S Cognitive Examination

Background. Parkinson’s disease (PD) is the second most common neurodegenerative disorder characterized by numerous motor and nonmotor symptoms. Neurocognitive disorders (NCD) are one of the most troublesome problems and their diagnosis is often challenging. Methods. We compared the sensitivity and specificity of several versions of Addenbrooke Cognitive Examination (ACE, ACE-III, and Mini-ACE) on 552 subjects with PD. Normal cognition, mild and major NCD were judged in accordance with the respective criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition. Subsequently, we applied the receiver operation characteristic (ROC) analysis in comparison of different education levels. Results. For subjects with education level 0–8 and 9–12 years, the ACE-III had the best discriminating capabilities for mild NCD (cut-off scores: 83.5 and 85.5 points, respectively), while Mini-ACE was the best for subjects having education > 12 years (cut-off score: 25.5 points). For detecting major NCD, ACE-III had the best diagnostic accuracy in all levels of education (cut-off scores: 70.5, 77.5, and 78.5 points for subjects having education level 0–8, 9–12, and >12 years, respectively). Conclusion. ACE-III and its nested version, the Mini-ACE, had the best screening abilities for detecting mild and major NCD in PD.

scholarly journals Laboratory versus daily life gait characteristics in patients with multiple sclerosis, Parkinson’s disease, and matched controls

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Vrutangkumar V. Shah ◽  
James McNames ◽  
Martina Mancini ◽  
Patricia Carlson-Kuhta ◽  
Rebecca I. Spain ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Neurological Disease ◽  
Inertial Sensors ◽  
Daily Life ◽  
Area Under The Curve ◽  
Gait Characteristics ◽  
Discrete Moment ◽  
Healthy Control

Abstract Background and purpose  Recent findings suggest that a gait assessment at a discrete moment in a clinic or laboratory setting may not reflect functional, everyday mobility. As a step towards better understanding gait during daily life in neurological populations, we compared gait measures that best discriminated people with multiple sclerosis (MS) and people with Parkinson’s Disease (PD) from their respective, age-matched, healthy control subjects (MS-Ctl, PD-Ctl) in laboratory tests versus a week of daily life monitoring. Methods  We recruited 15 people with MS (age mean ± SD: 49 ± 10 years), 16 MS-Ctl (45 ± 11 years), 16 people with idiopathic PD (71 ± 5 years), and 15 PD-Ctl (69 ± 7 years). Subjects wore 3 inertial sensors (one each foot and lower back) in the laboratory followed by 7 days during daily life. Mann–Whitney U test and area under the curve (AUC) compared differences between PD and PD-Ctl, and between MS and MS-Ctl in the laboratory and in daily life. Results  Participants wore sensors for 60–68 h in daily life. Measures that best discriminated gait characteristics in people with MS and PD from their respective control groups were different between the laboratory gait test and a week of daily life. Specifically, the toe-off angle best discriminated MS versus MS-Ctl in the laboratory (AUC [95% CI] = 0.80 [0.63–0.96]) whereas gait speed in daily life (AUC = 0.84 [0.69–1.00]). In contrast, the lumbar coronal range of motion best discriminated PD versus PD-Ctl in the laboratory (AUC = 0.78 [0.59–0.96]) whereas foot-strike angle in daily life (AUC = 0.84 [0.70–0.98]). AUCs were larger in daily life compared to the laboratory. Conclusions Larger AUC for daily life gait measures compared to the laboratory gait measures suggest that daily life monitoring may be more sensitive to impairments from neurological disease, but each neurological disease may require different gait outcome measures.

scholarly journals Alpha-Synuclein Protofibrils in Cerebrospinal Fluid: A Potential Biomarker for Parkinson's Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1429-1442
Author(s):  
Marianne von Euler Chelpin ◽  
Linda Söderberg ◽  
Johanna Fälting ◽  
Christer Möller ◽  
Marco Giorgetti ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cerebrospinal Fluid ◽  
Single Molecule ◽  
Area Under The Curve ◽  
Corticobasal Degeneration ◽  
Alpha Synuclein ◽  
Cross Reactivity ◽  
Potential Biomarker ◽  
Csf Levels

Background: Currently, there is no established biomarker for Parkinson's disease (PD) and easily accessible biomarkers are crucial for developing disease-modifying treatments. Objective: To develop a novel method to quantify cerebrospinal fluid (CSF) levels of α-synuclein protofibrils (α-syn PF) and apply it to clinical cohorts of patients with PD and atypical parkinsonian disorders. Methods: A cohort composed of 49 patients with PD, 12 with corticobasal degeneration (CBD), 22 with progressive supranuclear palsy, and 33 controls, that visited the memory clinic but had no biomarker signs of Alzheimer’s disease (AD, tau<350 pg/mL, amyloid-beta 42 (Aβ42)>530 pg/mL, and phosphorylated tau (p-tau)<60 pg/mL) was used in this study. The CSF samples were analyzed with the Single molecule array (Simoa) technology. Total α-synuclein (α-syn) levels were analyzed with a commercial ELISA-kit. Results: The assay is specific to α-syn PF, with no cross-reactivity to monomeric α-syn, or the β- and γ-synuclein variants. CSF α-syn PF levels were increased in PD compared with controls (62.1 and 40.4 pg/mL, respectively, p = 0.03), and CBD (62.1 and 34.2 pg/mL, respectively, p = 0.02). The accuracy of predicting PD using α-syn PF is significantly different from controls (area under the curve 0.68, p = 0.0097) with a sensitivity of 62.8% and specificity of 67.7%. Levels of total α-syn were significantly different between the PD and CBD groups (p = 0.04). Conclusion: The developed method specifically quantifies α-syn PF in human CSF with increased concentrations in PD, but with an overlap with asymptomatic elderly controls.

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