Accuracy and Reliability of Onset Detection Algorithms in Gait Initiation for Healthy Controls and Participants With Parkinson’s Disease

Accurate and reliable detection of the onset of gait initiation is essential for the correct assessment of gait. Thus, this study was aimed at evaluation of the reliability and accuracy of 3 different center of pressure–based gait onset detection algorithms: A displacement baseline–based algorithm (method 1), a velocity baseline–based algorithm (method 2), and a velocity extrema–based algorithm (method 3). The center of pressure signal was obtained during 10 gait initiation trials from 16 healthy participants and 3 participants with Parkinson’s disease. Intrasession and absolute reliability of each algorithm was assessed using the intraclass correlation coefficient and the coefficient of variation of center of pressure displacement during the postural phase of gait initiation. The accuracy was evaluated using the time error of the detected onset by each algorithm relative to that of visual inspection. The authors’ results revealed that although all 3 algorithms had high to very high intrasession reliabilities in both healthy subjects and subjects with Parkinson’s disease, methods 2 and 3 showed significantly better absolute reliability than method 1 in healthy controls (P = .001). Furthermore, method 2 outperformed the other 2 algorithms in both healthy subjects and subjects with Parkinson’s disease with an overall accuracy of 0.80. Based on these results, the authors recommend using method 2 for accurate and reliable gait onset detection.

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Abnormalities of the First Three Steps of Gait Initiation in Patients with Parkinson's Disease with Freezing of Gait

Parkinson s Disease ◽

10.4061/2011/202937 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Yohei Okada ◽

Takahiko Fukumoto ◽

Katsuhiko Takatori ◽

Koji Nagino ◽

Koichi Hiraoka

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Center Of Pressure ◽

Freezing Of Gait ◽

Gait Initiation ◽

Healthy Controls ◽

Heel Contact ◽

Spatiotemporal Parameters ◽

Contact Position ◽

Weight Shifting

The purpose of this study was to investigate abnormalities of the first three steps of gait initiation in patients with Parkinson's disease (PD) with freezing of gait (FOG). Ten PD patients with FOG and 10 age-matched healthy controls performed self-generated gait initiation. The center of pressure (COP), heel contact positions, and spatiotemporal parameters were estimated from the vertical pressures on the surface of the force platform. The initial swing side of gait initiation was consistent among the trials in healthy controls but not among the trials in PD patients. The COP and the heel contact position deviated to the initial swing side during the first step, and the COP passed medial to each heel contact position during the first two steps in PD patients. Medial deviation of the COP from the first heel contact position had significant correlation with FOG questionnaire item 5. These findings indicate that weight shifting between the legs is abnormal and that medial deviation of the COP from the first heel contact position sensitively reflects the severity of FOG during the first three steps of gait initiation in PD patients with FOG.

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α-Synuclein oligomers in skin biopsy of idiopathic and monozygotic twin patients with Parkinson’s disease

Brain ◽

10.1093/brain/awaa008 ◽

2020 ◽

Vol 143 (3) ◽

pp. 920-931 ◽

Cited By ~ 5

Author(s):

Samanta Mazzetti ◽

Milo J Basellini ◽

Valentina Ferri ◽

Erica Cassani ◽

Emanuele Cereda ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Nervous System ◽

Peripheral Nervous System ◽

Genetic Predisposition ◽

Healthy Subjects ◽

Proximity Ligation Assay ◽

Healthy Controls ◽

Proximity Ligation ◽

Synaptic Terminals

Abstract A variety of cellular processes, including vesicle clustering in the presynaptic compartment, are impaired in Parkinson’s disease and have been closely associated with α-synuclein oligomerization. Emerging evidence proves the existence of α-synuclein-related pathology in the peripheral nervous system, even though the presence of α-synuclein oligomers in situ in living patients remains poorly investigated. In this case-control study, we show previously undetected α-synuclein oligomers within synaptic terminals of autonomic fibres in skin biopsies by means of the proximity ligation assay and propose a procedure for their quantification (proximity ligation assay score). Our study revealed a significant increase in α-synuclein oligomers in consecutive patients with Parkinson’s disease compared to consecutive healthy controls (P < 0.001). Proximity ligation assay score (threshold value > 96 using receiver operating characteristic) was found to have good sensitivity, specificity and positive predictive value (82%, 86% and 89%, respectively). Furthermore, to disclose the role of putative genetic predisposition in Parkinson’s disease aetiology, we evaluated the differential accumulation of oligomers in a unique cohort of 19 monozygotic twins discordant for Parkinson’s disease. The significant difference between patients and healthy subjects was confirmed in twins. Intriguingly, although no difference in median values was detected between consecutive healthy controls and healthy twins, the prevalence of healthy subjects positive for proximity ligation assay score was significantly greater in twins than in the consecutive cohort (47% versus 14%, P = 0.019). This suggests that genetic predisposition is important, but not sufficient, in the aetiology of the disease and strengthens the contribution of environmental factors. In conclusion, our data provide evidence that α-synuclein oligomers accumulate within synaptic terminals of autonomic fibres of the skin in Parkinson’s disease for the first time. This finding endorses the hypothesis that α-synuclein oligomers could be used as a reliable diagnostic biomarker for Parkinson’s disease. It also offers novel insights into the physiological and pathological roles of α-synuclein in the peripheral nervous system.

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Separated center-of-pressure measurements reveal new characteristics of reduced anticipatory postural adjustments during gait initiation in patients with Parkinson’s disease

Physiotherapy Theory and Practice ◽

10.1080/09593985.2021.1946873 ◽

2021 ◽

pp. 1-10

Author(s):

Ryo Onuma ◽

Tadashi Masuda ◽

Fumihiko Hoshi ◽

Tadamitsu Matsuda ◽

Tomoko Sakai ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Center Of Pressure ◽

Anticipatory Postural Adjustments ◽

Gait Initiation ◽

Pressure Measurements ◽

Postural Adjustments

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In Patients With Parkinson’s Disease in an OFF-Medication State, Does Bilateral Electrostimulation of Tibialis Anterior Improve Anticipatory Postural Adjustments During Gait Initiation?

Frontiers in Human Neuroscience ◽

10.3389/fnhum.2021.692651 ◽

2021 ◽

Vol 15 ◽

Author(s):

Arnaud Delafontaine ◽

Paul Fourcade ◽

Ahmed Zemouri ◽

D. G. Diakhaté ◽

Gabriel Saiydoun ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Tibialis Anterior ◽

Center Of Pressure ◽

Anticipatory Postural Adjustments ◽

Gait Initiation ◽

Control Group ◽

Postural Adjustments ◽

Locomotor Function ◽

40 Hz

A complete lack of bilateral activation of tibialis anterior (TA) during gait initiation (GI), along with bradykinetic anticipatory postural adjustments (APAs), often occurs in patients with Parkinson’s disease (PD) in their OFF-medication state. Functional electrical stimulation (FES) is a non-pharmacological method frequently used in neurorehabilitation to optimize the effect of L-DOPA on locomotor function in this population. The present study tested the potential of bilateral application of FES on TA to improve GI in PD patients. Fourteen PD patients (OFF-medication state, Hoehn and Yahr state 2-3) participated in this study. They performed series of 10 GI trials on a force-plate under the following experimental conditions: (1) GI without FES (control group), (2) GI with 2Hz-FES (considered as a very low FES frequency condition without biomechanical effect; placebo group) and (3) GI with 40Hz-FES (test group). In (2) and (3), FES was applied bilaterally to the TA during APAs (300 mA intensity/300 μs pulse width). Main results showed that the peak of anticipatory backward center of pressure shift, the forward center of mass (COM) velocity and shift at foot off were significantly larger in the 40 Hz FES condition than in the control condition, while the duration of step execution was significantly shorter. In contrast, the capacity of participants to brake the fall of their COM remained unchanged across conditions. Globally taken, these results suggest that acute application of 40-Hz FES to the TA may improve the capacity of PD patients to generate APAs during GI, without altering their balance capacity. Future studies are required before considering that TA FES application might be a valuable tool to improve GI in PD patients and be relevant to optimize the effects of L-DOPA medication on locomotor function.

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Expression Profiling of Blood microRNAs 885, 361, and 17 in the Patients with the Parkinson’s disease: Integrating Interaction Data to Uncover the Possible Triggering Age-Related Mechanisms

Scientific Reports ◽

10.1038/s41598-019-50256-3 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Molood Behbahanipour ◽

Maryam Peymani ◽

Mehri Salari ◽

Motahare-Sadat Hashemi ◽

Mohammad Hossein Nasr-Esfahani ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Cellular Senescence ◽

Healthy Subjects ◽

Target Genes ◽

Healthy Controls ◽

Early Stages ◽

Age Related ◽

Advanced Stages

Abstract MicroRNAs (miRNAs) have been reported to contribute to the pathophysiology of the Parkinson’s disease (PD), an age related-neurodegenerative disorder. The aim of present study was to compare the expression profiles of a new set of candidate miRNAs related to aging and cellular senescence in peripheral blood mononuclear cells (PBMCs) obtained from the PD patients with healthy controls and then in the early and advanced stages of the PD patients with their controls to clarify whether their expression was correlated with the disease severity. We have also proposed a consensus-based strategy to interpret the miRNAs expression data to gain a better insight into the molecular regulatory alterations during the incidence of PD. We evaluated the miRNA expression levels in the PBMCs obtained from 36 patients with PD and 16 healthy controls by the reverse transcription-quantitative real-time PCR and their performance to discriminate the PD patients from the healthy subjects assessed using the receiver operating characteristic curve analysis. Also, we applied our consensus and integration approach to construct a deregulated miRNA-based network in PD with the respective targets and transcription factors, and the enriched gene ontology and pathways using the enrichment analysis approach were obtained. There was a significant overexpression of miR-885 and miR-17 and the downregulation of miR-361 in the PD patients compared to the controls. The blood expression of miR-885 and miR-17 tended to increase along with the disease severity. On the other hand, the lower levels of miR-361 in the early stages of the PD patients, as compared to controls, and its higher levels in the advanced stages of PD patients, as compared to the early stages of the PD patients, were observed. Combination of all three miRNAs showed an appropriate value of AUC (0.985) to discriminate the PD patients from the healthy subjects. Also, the deregulated miRNAs were linked to the known PD pathways and the candidate related target genes were presented. We revealed 3 candidate biomarkers related to aging and cellular senescence for the first time in the patients with PD. Our in-silico analysis identified candidate target genes and TFs, including those related to neurodegeneration and PD. Overall, our findings provided novel insights into the probable age-regulatory mechanisms underlying PD and a rationale to further clarify the role of the identified miRNAs in the PD pathogenesis.

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Initial center of pressure position prior to anticipatory postural adjustments during gait initiation in people with Parkinson's disease with freezing of gait

Parkinsonism & Related Disorders ◽

10.1016/j.parkreldis.2021.01.012 ◽

2021 ◽

Vol 84 ◽

pp. 8-14

Author(s):

Madli Bayot ◽

Arnaud Delval ◽

Caroline Moreau ◽

Luc Defebvre ◽

Clint Hansen ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Center Of Pressure ◽

Freezing Of Gait ◽

Anticipatory Postural Adjustments ◽

Gait Initiation ◽

Postural Adjustments

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Influence of Thoracoabdominal Movement on Pulmonary Function in Patients with Parkinson's Disease: Comparison with Healthy Subjects

Neurorehabilitation and Neural Repair ◽

10.1177/154596830001400105 ◽

2000 ◽

Vol 14 (1) ◽

pp. 43-47 ◽

Cited By ~ 10

Author(s):

Akira Tamaki ◽

Yoshimi Matsuo ◽

Takehiko Yanagihara ◽

Kazuo Abe

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pulmonary Function ◽

Forced Vital Capacity ◽

Healthy Subjects ◽

Vital Capacity ◽

Healthy Controls ◽

Pulmonary Dysfunction ◽

Average Volume ◽

Abdominal Movement

Patients with Parkinson's disease (PD) may develop pulmonary dysfunction, but the pathogenesis remains unclear. We investigated a correlation between thoracoab dominal movements and pulmonary function in seven patients with PD and 14 healthy controls. We measured vital capacity (VC) and forced vital capacity (FVC) using an autospirometer, and measured chest and abdominal movements using a respiraory in ductance plethysmography by fixing transducers on the rib cage and umbilicus. Pa tients with PD had significantly decreased % VC (90.3 ± 17.1 vs 105.8 ± 13.9%), chest movement (271.3 ± 79.6 vs. 375.2 ± 126.7% VT) and abdominal movement (217.6 ± 93.5 vs. 247.4 ± 100.2% VT) with 100% VT being an average volume of chest and abdomen at rest during measurement of VC. Patients with PD also had sig nificantly decreased % FVC (74.4 ± 20.6 vs. 97.6 ± 14.1%), chest movement (246.2 ± 115.2 vs. 344.5 ± 126.4% VT) and abdominal movement (160.3 ± 105.6 vs 207.6 ± 104.7% VT) with 100% VT being an average volume of chest and abdomen at rest during forced maximal inspiration. Based on the results, we conclude that a reduction of % VC in patients with PD correlated with chest movements, while a reduction of % FVC correlated with ab dominal movement in patients with PD.

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Reliability of Two Methods for Identifying the Postural Phase of Gait Initiation in Healthy and Poststroke Subjects

Journal of Applied Biomechanics ◽

10.1123/jab.2014-0222 ◽

2015 ◽

Vol 31 (5) ◽

pp. 349-356 ◽

Cited By ~ 7

Author(s):

Andreia S.P. Sousa ◽

Augusta Silva ◽

Rubim Santos

Keyword(s):

Correlation Coefficient ◽

Coefficient Of Variation ◽

Center Of Pressure ◽

Intraclass Correlation ◽

Gait Initiation ◽

Healthy Controls ◽

Phase Duration ◽

Lateral Direction ◽

Maximal Displacement ◽

Displacement Based

This study aims to compare 2 methods of assessing the postural phase of gait initiation, in regard to intrasession reliability, in healthy and poststroke subjects. As a secondary aim, this study aims to analyze anticipatory postural adjustments during gait initiation based on the center of pressure (CoP) displacements in poststroke participants. The CoP signal was acquired during gait initiation in 15 poststroke subjects and 23 healthy controls. Postural phase was identified through a baseline-based method and a maximal displacement-based method. In both healthy and poststroke participants, higher intraclass correlation coefficient and lower coefficient of variation values were obtained with the baseline-based method when compared with the maximal displacement-based method. Poststroke participants presented decreased CoP displacement backward and toward the first swing limb compared with controls when the baseline-based method was used. With the maximal displacement based method, there were differences between groups only regarding backward CoP displacement. Postural phase duration in medial-lateral direction was also increased in poststroke participants when using the maximal displacement based method. The findings obtained indicate that the baseline-based method is more reliable detecting the onset of gait initiation in both groups, while the maximal displacement-based method presents greater sensitivity for poststroke participants.

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