scholarly journals Developing and Validating a New Web-Based Tapping Test for Measuring Distal Bradykinesia in Parkinson’s Disease

2020 ◽  
Author(s):  
Noreen Akram ◽  
Haoxuan Li ◽  
Aaron Ben-Joseph ◽  
Caroline Budu ◽  
David Gallagher ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Characteristic Curve ◽  
Motor Impairment ◽  
Motor Fluctuation ◽  
Motor Dysfunction ◽  
Upper Limb Function ◽  
Travelling Time ◽  
User Friendly

ABSTRACTBackgroundDisability in Parkinson’s disease (PD) is measured by standardised scales including the MDS-UPDRS, which are subject to high inter and intra-rater variability and fail to capture subtle motor impairment. The BRadykinesia Akinesia INcoordination (BRAIN) test is a previously validated keyboard tapping test, evaluating proximal upper-limb motor impairment. Here, a new Distal Bradykinesia Tapping (DBT) test was developed to assess distal upper-limb function. Kinetic parameters of the test include kinesia score (KS20, key taps over 20 seconds), akinesia time (AT20, mean dwell-time on each key) and incoordination score (IS20, variance of travelling time between key taps).ObjectiveTo develop and validate a new keyboard-tapping test to assess distal motor function in PD patients.MethodsThe DBT test was validated in 45 PD patients and 24 controls, alongside the BRAIN test. Test scores were compared between groups and correlated with MDS-UPDRS-III scores. 10 additional PD patients were recruited to assess the DBT test in monitoring motor fluctuations.ResultsAll three parameters discriminated between patients and controls, with KS20 performing best, yielding 75% sensitivity for 85% specificity; area under the receiver operating characteristic curve (AUC) = 0.87. Combination of both the DBT and BRAIN tests improved discrimination (AUC=0.91). KS20 and AT20 correlated with MDS-UPDRS-III (Pearson’s r=-0.49, p<0.001 and r=0.54, p<0.001, respectively). The DBT test detected subtle changes in motor fluctuation states, which were not reflected clearly by MDS-UPDRS-III sub-scores.ConclusionThe DBT test is a user-friendly method of assessing distal motor dysfunction in PD, possibly permitting longitudinal monitoring of PD motor complications.

scholarly journals Developing and assessing a new web-based tapping test for measuring distal movement in Parkinson’s disease: a Distal Finger Tapping test

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Noreen Akram ◽  
Haoxuan Li ◽  
Aaron Ben-Joseph ◽  
Caroline Budu ◽  
David A. Gallagher ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Characteristic Curve ◽  
Motor Impairment ◽  
Motor Fluctuation ◽  
Finger Tapping ◽  
Upper Limb Function ◽  
Travelling Time ◽  
Finger Tapping Test

AbstractDisability in Parkinson’s disease (PD) is measured by standardised scales including the MDS-UPDRS, which are subject to high inter and intra-rater variability and fail to capture subtle motor impairment. The BRadykinesia Akinesia INcoordination (BRAIN) test is a validated keyboard tapping test, evaluating proximal upper-limb motor impairment. Here, a new Distal Finger Tapping (DFT) test was developed to assess distal upper-limb function. Kinetic parameters of the test include kinesia score (KS20, key taps over 20 s), akinesia time (AT20, mean dwell-time on each key) and incoordination score (IS20, variance of travelling time between key taps). To develop and evaluate a new keyboard-tapping test for objective and remote distal motor function in PD patients. The DFT and BRAIN tests were assessed in 55 PD patients and 65 controls. Test scores were compared between groups and correlated with the MDS-UPDRS-III finger tapping sub-scores. Nine additional PD patients were recruited for monitoring motor fluctuations. All three parameters discriminated effectively between PD patients and controls, with KS20 performing best, yielding 79% sensitivity for 85% specificity; area under the receiver operating characteristic curve (AUC) = 0.90. A combination of DFT and BRAIN tests improved discrimination (AUC = 0.95). Among three parameters, KS20 showed a moderate correlation with the MDS-UPDRS finger-tapping sub-score (Pearson’s r = − 0.40, p = 0.002). Further, the DFT test detected subtle changes in motor fluctuation states which were not reflected clearly by the MDS-UPDRS-III finger tapping sub-scores. The DFT test is an online tool for assessing distal movements in PD, with future scope for longitudinal monitoring of motor complications.

scholarly journals Parkinson’s Disease Motor Symptom Progression Slowed with Multisensory Dance Learning over 3-Years: A Preliminary Longitudinal Investigation

2021 ◽  
Vol 11 (7) ◽  
pp. 895
Author(s):  
Karolina A. Bearss ◽  
Joseph F. X. DeSouza
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daily Living ◽  
Rating Scale ◽  
Motor Impairment ◽  
Motor Dysfunction ◽  
Motor Symptom ◽  
Significant Group ◽  
Rate Of Decline ◽  
Symptom Progression

Parkinson’s disease (PD) is a neurodegenerative disease that has a fast progression of motor dysfunction within the first 5 years of diagnosis, showing an annual motor rate of decline of the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) between 5.2 and 8.9 points. We aimed to determine both motor and non-motor PD symptom progression while participating in dance classes once per week over a period of three years. Longitudinal data was assessed for a total of 32 people with PD using MDS-UPDRS scores. Daily motor rate of decline was zero (slope = 0.000146) in PD-Dancers, indicating no motor impairment, whereas the PD-Reference group showed the expected motor decline across three years (p < 0.01). Similarly, non-motor aspects of daily living, motor experiences of daily living, and motor complications showed no significant decline. A significant group (PD-Dancers and PD-Reference) by days interaction showed that PD who train once per week have less motor impairment (M = 18.75) than PD-References who do not train (M = 24.61) over time (p < 0.05). Training is effective at slowing both motor and non-motor PD symptoms over three years as shown in decreased scores of the MDS-UPDRS.

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

Comparative analysis of speech impairment and upper limb motor dysfunction in Parkinson’s disease

2016 ◽  
Vol 124 (4) ◽  
pp. 463-470 ◽  
Author(s):  
Jan Rusz ◽  
Tereza Tykalová ◽  
Radim Krupička ◽  
Kateřina Zárubová ◽  
Michal Novotný ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Comparative Analysis ◽  
Upper Limb ◽  
Motor Dysfunction ◽  
Speech Impairment

scholarly journals Quantifying upper limb motor impairment in people with Parkinson’s disease: a physiological profiling approach

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10735
Author(s):  
Lewis A. Ingram ◽  
Vincent K. Carroll ◽  
Annie A. Butler ◽  
Matthew A. Brodie ◽  
Simon C. Gandevia ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Strength ◽  
Upper Limb ◽  
Bimanual Coordination ◽  
Handgrip Strength ◽  
Position Sense ◽  
Healthy Controls ◽  
Limb Function ◽  
Upper Limb Function

Background Upper limb motor impairments, such as slowness of movement and difficulties executing sequential tasks, are common in people with Parkinson’s disease (PD). Objective To evaluate the validity of the upper limb Physiological Profile Assessment (PPA) as a standard clinical assessment battery in people with PD, by determining whether the tests, which encompass muscle strength, dexterity, arm stability, position sense, skin sensation and bimanual coordination can (a) distinguish people with PD from healthy controls, (b) detect differences in upper limb test domains between “off” and “on” anti-Parkinson medication states and (c) correlate with a validated measure of upper limb function. Methods Thirty-four participants with PD and 68 healthy controls completed the upper limb PPA tests within a single session. Results People with PD exhibited impaired performance across most test domains. Based on validity, reliability and feasibility, six tests (handgrip strength, finger-press reaction time, 9-hole peg test, bimanual pole test, arm stability, and shirt buttoning) were identified as key tests for the assessment of upper limb function in people with PD. Conclusions The upper limb PPA provides a valid, quick and simple means of quantifying specific upper limb impairments in people with PD. These findings indicate clinical assessments should prioritise tests of muscle strength, unilateral movement and dexterity, bimanual coordination, arm stability and functional tasks in people with PD as these domains are the most commonly and significantly impaired.

scholarly journals Sensor Network for Analyzing Upper Body Strategies in Parkinson’s Disease versus Normative Kinematic Patterns

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3823
Author(s):  
Paola Romano ◽  
Sanaz Pournajaf ◽  
Marco Ottaviani ◽  
Annalisa Gison ◽  
Francesco Infarinato ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Quantitative Measure ◽  
Upper Body ◽  
Limb Function ◽  
Mean Velocity ◽  
Upper Limb Function ◽  
Motor Strategy ◽  
Block Test

In rehabilitation, the upper limb function is generally assessed using clinical scales and functional motor tests. Although the Box and Block Test (BBT) is commonly used for its simplicity and ease of execution, it does not provide a quantitative measure of movement quality. This study proposes the integration of an ecological Inertial Measurement Units (IMUs) system for analysis of the upper body kinematics during the execution of a targeted version of BBT, by able-bodied persons with subjects with Parkinson’s disease (PD). Joint angle parameters (mean angle and range of execution) and hand trajectory kinematic indices (mean velocity, mean acceleration, and dimensionless jerk) were calculated from the data acquired by a network of seven IMUs. The sensors were applied on the trunk, head, and upper limb in order to characterize the motor strategy used during the execution of BBT. Statistics revealed significant differences (p < 0.05) between the two groups, showing compensatory strategies in subjects with PD. The proposed IMU-based targeted BBT protocol allows to assess the upper limb function during manual dexterity tasks and could be used in the future for assessing the efficacy of rehabilitative treatments.

scholarly journals Validity of a Fully-Immersive VR-Based Version of the Box and Blocks Test for Upper Limb Function Assessment in Parkinson’s Disease

Sensors ◽  
2020 ◽  
Vol 20 (10) ◽  
pp. 2773 ◽  
Author(s):  
Edwin Daniel Oña ◽  
Alberto Jardón ◽  
Alicia Cuesta-Gómez ◽  
Patricia Sánchez-Herrera-Baeza ◽  
Roberto Cano-de-la-Cuerda ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Manual Dexterity ◽  
Clinical Test ◽  
Leap Motion ◽  
Hand Motion ◽  
Upper Limb Function ◽  
Classical Procedure ◽  
Yahr Scale

In recent decades, gaming technology has been accepted as a feasible method for complementing traditional clinical practice, especially in neurorehabilitation; however, the viability of using 3D Virtual Reality (VR) for the assessment of upper limb motor function has not been fully explored. For that purpose, we developed a VR-based version of the Box and Blocks Test (BBT), a clinical test for the assessment of manual dexterity, as an automated alternative to the classical procedure. Our VR-based BBT (VR-BBT) integrates the traditional BBT mechanics into gameplay using the Leap Motion Controller (LMC) to capture the user’s hand motion and the Oculus Rift headset to provide a fully immersive experience. This paper focuses on evaluating the validity of our VR-BBT to reliably measure the manual dexterity in a sample of patients with Parkinson’s Disease (PD). For this study, a group of twenty individuals in a mild to moderate stage of PD were recruited. Participants were asked to perform the physical BBT (once) and our proposed VR-BBT (twice) system, separately. Correlation analysis of collected data was carried out. Statistical analysis proved that the performance data collected by the VR-BBT significantly correlated with the conventional assessment of the BBT. The VR-BBT scores have shown a significant association with PD severity measured by the Hoehn and Yahr scale. This fact suggests that the VR-BBT could be used as a reliable indicator for health improvements in patients with PD. Finally, the VR-BBT system presented high usability and acceptability rated by clinicians and patients.

Does Pisa syndrome affect upper limb function in patients with Parkinson’s disease? An observational cross-sectional study

2018 ◽  
Vol 42 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Mohammad Alwardat ◽  
Giulia Di Lazzaro ◽  
Tommaso Schirinzi ◽  
Paola Sinibaldi Salime ◽  
Nicola Biagio Mercuri ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Limb Function ◽  
Cross Sectional ◽  
Upper Limb Function ◽  
Pisa Syndrome

scholarly journals Graphical Tasks to Measure Upper Limb Function in Patients With Parkinson's Disease: Validity and Response to Dopaminergic Medication

2017 ◽  
Vol 21 (1) ◽  
pp. 283-289 ◽  
Author(s):  
Esther J. Smits ◽  
Antti J. Tolonen ◽  
Luc Cluitmans ◽  
Mark van Gils ◽  
Rutger C. Zietsma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Limb Function ◽  
Dopaminergic Medication ◽  
Upper Limb Function

scholarly journals Small molecule inhibitors of α-synuclein oligomers identified by targeting early dopamine-mediated motor impairment in C. elegans

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kevin S. Chen ◽  
Krystal Menezes ◽  
Jarlath B. Rodgers ◽  
Darren M. O’Hara ◽  
Nhat Tran ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dopaminergic Neuron ◽  
Motor Impairment ◽  
Motor Dysfunction ◽  
In Vivo Models ◽  
C Elegans

Abstract Background Parkinson’s disease is a disabling neurodegenerative movement disorder characterized by dopaminergic neuron loss induced by α-synuclein oligomers. There is an urgent need for disease-modifying therapies for Parkinson’s disease, but drug discovery is challenged by lack of in vivo models that recapitulate early stages of neurodegeneration. Invertebrate organisms, such as the nematode worm Caenorhabditis elegans, provide in vivo models of human disease processes that can be instrumental for initial pharmacological studies. Methods To identify early motor impairment of animals expressing α-synuclein in dopaminergic neurons, we first used a custom-built tracking microscope that captures locomotion of single C. elegans with high spatial and temporal resolution. Next, we devised a method for semi-automated and blinded quantification of motor impairment for a population of simultaneously recorded animals with multi-worm tracking and custom image processing. We then used genetic and pharmacological methods to define the features of early motor dysfunction of α-synuclein-expressing C. elegans. Finally, we applied the C. elegans model to a drug repurposing screen by combining it with an artificial intelligence platform and cell culture system to identify small molecules that inhibit α-synuclein oligomers. Screen hits were validated using in vitro and in vivo mammalian models. Results We found a previously undescribed motor phenotype in transgenic α-synuclein C. elegans that correlates with mutant or wild-type α-synuclein protein levels and results from dopaminergic neuron dysfunction, but precedes neuronal loss. Together with artificial intelligence-driven in silico and in vitro screening, this C. elegans model identified five compounds that reduced motor dysfunction induced by α-synuclein. Three of these compounds also decreased α-synuclein oligomers in mammalian neurons, including rifabutin which has not been previously investigated for Parkinson’s disease. We found that treatment with rifabutin reduced nigrostriatal dopaminergic neurodegeneration due to α-synuclein in a rat model. Conclusions We identified a C. elegans locomotor abnormality due to dopaminergic neuron dysfunction that models early α-synuclein-mediated neurodegeneration. Our innovative approach applying this in vivo model to a multi-step drug repurposing screen, with artificial intelligence-driven in silico and in vitro methods, resulted in the discovery of at least one drug that may be repurposed as a disease-modifying therapy for Parkinson’s disease.

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