scholarly journals Remote monitoring of progression in early Parkinson's disease: reliability and validity of the Roche PD Mobile Application v2

2021 ◽  
Author(s):  
Florian Lipsmeier ◽  
Kirsten I Taylor ◽  
Ronald B Postuma ◽  
Ekaterina Volkova-Volkmar ◽  
Timothy Kilchenmann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mobile Application ◽  
Rating Scale ◽  
Early Stage ◽  
Digital Health ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Health Technologies ◽  
At Home

Digital health technologies (DHTs) enable remote and therefore frequent measurement of motor signs, potentially providing reliable and valid estimates of motor sign severity and progression in Parkinson's disease (PD). The Roche PD Mobile Application v1 was revised to v2 to include more measures of bradykinesia, and bradyphrenia and speech tests, to optimize suitability for early-stage PD. It was studied in 316 early-stage PD participants who performed daily active tests at home then carried a smartphone and wore a smartwatch throughout the day for passive monitoring (study NCT03100149). Adherence was excellent (96.29%). All pre-specified sensor features exhibited good-to-excellent test-retest reliability (median intraclass correlation coefficient = 0.9), and correlated with corresponding Movement Disorder Society - Unified Parkinson's Disease Rating Scale items (rho: 0.12-0.71). These findings demonstrate the preliminary reliability and validity of remote at-home quantification of motor sign severity with the Roche PD Mobile Application v2 in individuals with early PD.

scholarly journals Validation of Revised Chinese Version of PD-CRS in Parkinson’s Disease Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Yuyan Tan ◽  
Weiguo Liu ◽  
Juanjuan Du ◽  
Miaomiao Hou ◽  
Cuiyu Yu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Chinese Version ◽  
Neuropsychological Battery ◽  
Normal Cognitive Function

There is a high prevalence of mild cognitive impairment (MCI) and dementia in Parkinson’s disease (PD) patients, but a Chinese version of cognitive rating scale that is specific and sensitive to PD patients is still lacking. The aims of this study are to test the reliability and validity of a Chinese version of Parkinson’s disease-cognitive rating scale (PD-CRS), establish cutoff scores for diagnosis of Parkinson’s disease dementia (PDD) and PD with mild cognitive impairment (PD-MCI), explore cognitive profiles of PD-MCI and PDD, and find cognitive deficits suggesting a transition from PD-MCI to PDD. PD-CRS was revised based on the culture background of Chinese people. Ninety-two PD patients were recruited in three PD centers and were classified into PD with normal cognitive function (PD-NC), PD-MCI, and PDD subgroups according to the cognitive rating scale (CDR). Those PD patients underwent PD-CRS blind assessment by a separate neurologist. The PD-CRS showed a high internal consistency (Cronbach’s Alpha = 0.840). Intraclass Correlation coefficient (ICC) of test-retest reliability reached 0.906 (95% CI 0.860–0.935, p<0.001). ICC of inter-rater reliability was 0.899 (95% CI 0.848–0.933, p<0.001). PD-CRS had fair concurrent validity with MDRS (ICC = 0.731, 95% CI 0.602–0.816). All the frontal-subcortical items showed significant decrease in PD-MCI compared with the PD-NC group (p≤0.001), but the instrument cortical items did not (confrontation naming p=0.717, copying a clock p=0.620). All the frontal-subcortical and instrumental-cortical functions showed significant decline in PDD compared with the PD-NC group (p≤0.001). The cutoff value for diagnosis of PD-MCI is 80.5 with the sensitivity of 75.7% and the specificity of 75.0%, and for diagnosis of PDD is 73.5 with the sensitivity of 89.2% and the specificity of 98.9%. Revised Chinese version of PD-CRS is a reliable, acceptable, valid, and useful neuropsychological battery for assessing cognition in PD patients.

scholarly journals Translation, linguistic and cultural adaptation, reliability and validity of the Radboud Oral Motor Inventory for Parkinson's Disease – ROMP questionnaire

2018 ◽  
Vol 76 (5) ◽  
pp. 316-323 ◽  
Author(s):  
Monia Presotto ◽  
Maira Rozenfeld Olchik ◽  
Johanna G. Kalf ◽  
Carlos R.M. Rieder
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Rating Scale ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Brazilian Portuguese ◽  
Intraclass Correlation Coefficients ◽  
Oral Motor

ABSTRACT Objective: To translate and linguistically and culturally adapt to Brazilian Portuguese, and verify the reliability and validity of the Radboud Oral Motor Inventory for Parkinson's Disease (ROMP). Methods: The ROMP was translated and retranslated, and the instrument reliability was verified by analyzing the internal consistency and the reproducibility of the intra-examiner retest. The final version was applied to 27 participants with Parkinson's disease. Results: Internal consistency was 0.99 for the total ROMP and 0.96 to 0.99 for the three domains. Intraclass correlation coefficients for reproducibility were 0.99 for the total ROMP and 0.93 to 0.99 for the subscales. The ROMP and its subscales correlated substantially with the Likert-type scale, as well as with the unified Parkinson's disease rating scale II and III items. Conclusion: The linguistic and cultural equivalence of the ROMP in Brazilian Portuguese is now available, with excellent reliability and validity.

Retinal Morphological Changes during the Two Years of Follow-Up in Parkinson's Disease

2020 ◽  
Author(s):  
Mahmut Atum ◽  
Bekir Enes Demiryurek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Early Stage ◽  
Morphological Changes ◽  
Fiber Layer ◽  
Significant Difference ◽  
Yahr Scale ◽  
And Control

Abstract Background: The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. Methods: The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. Results: The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p = 0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Conclusion: Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

scholarly journals Neuroprotection of Granulocyte Colony-Stimulating Factor for Early Stage Parkinson's Disease

2017 ◽  
Vol 26 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Sheng-Tzung Tsai ◽  
Sung-Chao Chu ◽  
Shu-Hsin Liu ◽  
Cheng-Yoong Pang ◽  
Ting-Wen Hou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Early Stage ◽  
In Vivo Studies ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Elevated Liver Enzymes ◽  
Stimulating Factor

Parkinson's disease (PD) is a slowly progressive neurodegenerative disease. Both medical and surgical choices provide symptomatic treatment. Granulocyte colony-stimulating factor (G-CSF), a conventional treatment for hematological diseases, has demonstrated its effectiveness in acute and chronic neurological diseases through its anti-inflammatory and antiapoptosis mechanisms. Based on previous in vitro and in vivo studies, we administered a lower dose (3.3 μg/kg) G-CSF injection for 5 days and six courses for 1 year in early-stage PD patients as a phase I trial. The four PD patient's mean unified PD rating scale motor scores in medication off status remained stable from 23 before the first G-CSF injection to 22 during the 2-year follow-up. 3,4-Dihydroxy-6-18F-fluoro-L-phenylalanine (18F-DOPA) positron emission tomography (PET) studies also revealed an annual 3.5% decrease in radiotracer uptake over the caudate nucleus and 7% in the putamen, both slower than those of previous reports of PD. Adverse effects included transient muscular–skeletal pain, nausea, vomiting, and elevated liver enzymes. Based on this preliminary report, G-CSF seems to alleviate disease deterioration for early stage PD patients. The effectiveness of G-CSF was possibly due to its amelioration of progressive dopaminergic neuron degeneration.

scholarly journals An Automatic Gait Analysis Pipeline for Wearable Sensors: A Pilot Study in Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8286
Author(s):  
Luis R. Peraza ◽  
Kirsi M. Kinnunen ◽  
Roisin McNaney ◽  
Ian J. Craddock ◽  
Alan L. Whone ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Digital Health ◽  
Wearable Sensors ◽  
Intraclass Correlation ◽  
Initial Contact ◽  
Analysis Pipeline ◽  
Double Support ◽  
Lower Back

The use of wearable sensors allows continuous recordings of physical activity from participants in free-living or at-home clinical studies. The large amount of data collected demands automatic analysis pipelines to extract gait parameters that can be used as clinical endpoints. We introduce a deep learning-based automatic pipeline for wearables that processes tri-axial accelerometry data and extracts gait events—bout segmentation, initial contact (IC), and final contact (FC)—from a single sensor located at either the lower back (near L5), shin or wrist. The gait events detected are posteriorly used for gait parameter estimation, such as step time, length, and symmetry. We report results from a leave-one-subject-out (LOSO) validation on a pilot study dataset of five participants clinically diagnosed with Parkinson’s disease (PD) and six healthy controls (HC). Participants wore sensors at three body locations and walked on a pressure-sensing walkway to obtain reference gait data. Mean absolute errors (MAE) for the IC events ranged from 22.82 to 33.09 milliseconds (msecs) for the lower back sensor while for the shin and wrist sensors, MAE ranges were 28.56–64.66 and 40.19–72.50 msecs, respectively. For the FC-event detection, MAE ranges were 29.06–48.42, 40.19–72.70 and 36.06–60.18 msecs for the lumbar, wrist and shin sensors, respectively. Intraclass correlation coefficients, ICC(2,k), between the estimated parameters and the reference data resulted in good-to-excellent agreement (ICC ≥ 0.84) for the lumbar and shin sensors, excluding the double support time (ICC = 0.37 lumbar and 0.38 shin) and swing time (ICC = 0.55 lumbar and 0.59 shin). The wrist sensor also showed good agreements, but the ICCs were lower overall than for the other two sensors. Our proposed analysis pipeline has the potential to extract up to 100 gait-related parameters, and we expect our contribution will further support developments in the fields of wearable sensors, digital health, and remote monitoring in clinical trials.

scholarly journals CHANGES IN THE MICROSTRUCTURE AND FUNCTION OF BRAIN TISSUE IN PD BY DIFFUSION KURTOSIS IMAGING

2021 ◽  
Author(s):  
LEI WANG ◽  
XIN LIU ◽  
SHUOHUA WU ◽  
FANG CHEN ◽  
YE ZHENG ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Substantia Nigra ◽  
Rating Scale ◽  
Early Stage ◽  
Roc Curves ◽  
Diffusion Kurtosis Imaging ◽  
Diagnostic Efficacy ◽  
Brain Microstructure ◽  
Diffusion Kurtosis

This study proposed to detect changes in brain microstructure in patients with Parkinson’s disease (PD) using diffusion kurtosis imaging (DKI) to quantitatively diagnose early-stage PD. Conventional magnetic resonance imaging and DKI scanning were performed in 24 patients with PD and in 12 age- and sex-matched healthy participants. Hoehn and Yahr (H–Y) stage and Unified Parkinson’s Disease Rating Scale-III (UPDRS-III) scores were obtained from both groups. The mean kurtosis (MK), axial kurtosis, and radial kurtosis of the bilateral substantia nigra on DKI were measured and compared between the two groups. The correlations between MK, H–Y stage, and UPDRS-III scores were determined. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of MK for PD in the substantia nigra. The MK value in the PD group was 0.971. The area under the ROC curve of the substantia nigra was 0.905; the sensitivity and specificity were 0.917 and 0.875, respectively, and the cutoff value was 1.046. The MK of the substantia nigra in the PD group had no significant correlation with the H–Y stages but was negatively correlated with the UPDRS-III scores ([Formula: see text]; [Formula: see text]). Our research identified DKI as a novel tool for the qualitative diagnosis of PD. The optimal MK value for PD diagnosis could be determined with ROC analysis.

scholarly journals Effect of Acute Levodopa Up-Titration on Blood Pressure in Patients With Early Stage Parkinson’s Disease: Results of a Levodopa Challenge Test

2022 ◽  
Vol 13 ◽  
Author(s):  
Xiaoqin He ◽  
Chengjun Mo ◽  
Yi Zhang ◽  
Ying Cai ◽  
Xiaodong Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Early Stage ◽  
Challenge Test ◽  
Drug Uptake ◽  
Induced Hypotension ◽  
Before And After ◽  
Standing Up ◽  
At Home

Objective: Levodopa up-titration is the primary therapeutic strategy as the Parkinson’s disease (PD) progresses. However, the effects of levodopa up-titration on blood pressure (BP) are inconclusive. This study aimed to investigate the effect of acute levodopa up-titration simulated by levodopa challenge test (LCT) on BP in patients with early stage PD.Methods: We monitored BP in 52 patients with early stage PD using a standardized standing test. BP was assessed in supine position after 10 min of rest and at 1 and 3 min after standing up. BP was measured in the “off-state” and the best “on-state” during LCT in the morning at hospital. In another day, “off-state” and the best “on-state” BP was measured before and after anti-PD drug uptake in the morning at home. Demographic and clinical features of the patients were evaluated and analyzed.Results: In the LCT, the prevalence of OH in the “off-state” and the best “on-state” was 11.5 and 13.5%, respectively. Additionally, the OH in the best “on-state” was associated with OH in the “off-state” and monoamine oxidase B inhibitor use. Although 38 (73.1%) patients experienced levodopa-induced hypotension during the LCT, no risk factors were identified. While BP reductions were observed after taking anti-PD drugs at home, no further reduction was seen during acute levodopa up-titration simulated by the LCT.Conclusion: Our results demonstrate that acute levodopa up-titration does not exacerbate BP reduction induced by anti-PD drugs at home. BP monitoring is critical for the management of patients with PD.

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