scholarly journals Age Matters: Objective Gait Assessment in Early Parkinson’s Disease Using an RGB-D Camera

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Beatriz Muñoz Ospina ◽  
Jaime Andrés Valderrama Chaparro ◽  
Juan David Arango Paredes ◽  
Yor Jaggy Castaño Pino ◽  
Andrés Navarro ◽  
...  

Background. Gait alterations are hallmarks for the diagnosis and follow-up of patients with Parkinson’s disease (PD). In normal conditions, age could affect gait dynamics. Although it is known that objective assessment of gait is a valuable tool for diagnosis and follow-up of patients with PD, only few studies evaluate the effect of aging on the gait pattern of patients with PD. Objective. The purpose of this study was to assess differences in gait dynamics between PD patients and healthy subjects and to investigate the effects of aging on these differences using a low-cost RGB-D depth-sensing camera. Methods. 30 PD patients and 30 age-matched controls were recruited. Descriptive analysis was used for clinical variables, and Spearman’s rank correlation was used to correlate age and gait variables. The sample was distributed in age groups; then, Mann–Whitney U test was used for comparison of gait variables between groups. Results. PD patients exhibited prolonged swing (p=0.002) and stance times (p<0.001) and lower speed values (p<0.001) compared to controls. This was consistent in all age groups, except for the one between 76 and 88 years old, in which the controls were slower and had longer swing and stance times. These results were statically significant for the group from 60 to 66 years. Conclusion. Gait speed, swing, and stance times are useful for differentiating PD patients from controls. Quantitative gait parameters measured by an RGB-D camera can complement clinical assessment of PD patients. The analysis of these spatiotemporal variables should consider the age of the subject.

2020 ◽  
Author(s):  
Yuan-Pin Lin ◽  
Hsing-Yi Liang ◽  
Yueh-Sheng Chen ◽  
Cheng-Hsien Lu ◽  
Yih-Ru Wu ◽  
...  

Abstract BackgroundPatients with Parkinson’s disease (PD) can develop the cognitive adverse effect of impulse control disorders (ICDs) while undergoing a pharmacological treatment for motor control dysfunctions with a dopamine agonist (DA). Conventional clinical interviews or questionnaires can be biased and may not provide an accurate diagnosis in the early stage. A wearable electroencephalogram (EEG)-sensing headset paired with an examination procedure can be a potential user-friendly method to explore ICD-related biomarkers that can reflect brain activity abnormalities and detect its early signs and progression.MethodsA stereotypical Go/NoGo test that targets impulse inhibition was performed with 59 individuals, including heathy controls, patients with PD, and patients with PD diagnosed with ICD. A low-cost LEGO-like EEG headset was used to record concurrent EEG signals. The event-related potential (ERP) analytical framework was then used to explore ICD-related EEG abnormalities after DA treatment.ResultsOnly PD patients with ICD exhibited a tendency for N2 and P3 amplitude deterioration at the fronto-central regions (i.e., Fz, FCz, and Cz); in particular, the P3 counterpart reached statistical significance (p<0.05). Neither PD patients nor healthy controls (without DA) replicated such findings. Furthermore, N2 amplitude deterioration was found to be related to ICD severity at Fz (r=-0.28, p=0.04).ConclusionsA low-cost LEGO-like EEG headset successfully captured ERP neuromarkers for the objective assessment of ICD in PD patients undergoing DA treatment. The present objective neuro-evidence could provide complementary information to conventional clinical scales used to diagnose the ICD adverse effect.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Naeimehossadat Asmarian ◽  
Ahmad Ruzitalab ◽  
Gholamhossien Erjaee ◽  
Mohammad Hadi Farahi ◽  
Seyyed Mojtaba Asmarian

Analysis of gait dynamics is a noninvasive and totally painless test, and it can be an ideal method for the diagnosis of neurodegenerative diseases. In this study, based on the strength of synchronization between dynamics of strides, we have suggested a rating scale method for Parkinson’s disease (PD). Methods. The sample included 15 persons with PD (age: 66.8 ± 10.9 years) and 16 healthy persons (age: 39.3 ± 18.5   years) which were recruited from the Neurology Outpatient Clinic at Massachusetts General Hospital and were instructed to walk a 77 m long, straight hallway. The time interval of strides and subphases of strides were measured. Using the Hilbert transformation method, we obtained the data phase and used mean absolute error (MAE) to calculate the synchronization strength of the data phase. Results. In order to check the accuracy of our method, we measured the correlation between our numerical results (MAE) and values of the Hoehn-Yahr scale. Spearman’s rank correlation coefficients ( r ) and the P values were calculated. MAE of left and right stride intervals (LRSI) significantly correlates with the Hoehn-Yahr scale for the subjects with PD (with r = 0.60 and P = 0.025 < 0.05 ). Conclusion. We have revealed that the synchronization weakness of LRSI shows the severity of PD. This method seems to be well suited as a rating scale for people with PD.


2021 ◽  
pp. 1-10
Author(s):  
Olaitan Okunoye ◽  
Laura Horsfall ◽  
Louise Marston ◽  
Kate Walters ◽  
Anette Schrag

Background: Hospitalization in Parkinson’s disease (PD) is associated with reduced quality of life, caregiver burden and high costs. However, no large-scale studies of rate and causes of hospitalizations in patients with PD have been published. Objective: To investigate the rate and reasons for hospitalization and factors associated with hospitalization among people with PD compared to the general population. Methods: We examined rate and causes of admission in PD patients and matched controls in The Health Improvement Network from 2006 to 2016. Multivariable Poisson regression was used to explore the effects of age, gender, social deprivation, urbanicity and practice geographic location on hospitalization. Results: In longitudinal data from 9,998 newly diagnosed individuals with PD and 55,554 controls without PD aged≥50years, 39%of PD patients and 28%of controls were hospitalised over a median follow-up 5.1years. The adjusted incidence rate ratio(IRR) of hospitalization in PD compared to controls was 1.33(95%CI:1.29–1.37) and rose with increased follow-up duration. Hospitalization rate was overall higher in the older age groups, but the adjusted IRR of hospitalization compared to controls was highest in the youngest age group. PD patients were more often admitted with falls/fractures, infections, gastrointestinal complications, PD, dementia, psychosis/hallucinations, postural hypotension, electrolyte disturbances, stroke and surgical procedures and slightly less often due to hypertension. Conclusion: People with PD have an increased hospitalization rate compared to controls, particularly in the younger age groups, and it increases with longer disease duration. The complications of motor and non-motor features of PD are amongst the main reasons for admission, some of which could be managed preventatively to avoid admissions.


2016 ◽  
Vol 46 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Mark R. Keezer ◽  
Christina Wolfson ◽  
Ronald B. Postuma

Background: Understanding sources of variation in International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores is essential for planning clinical trials in Parkinson's disease and interpreting studies of mild parkinsonian signs. Methods: We describe the characteristics of the MDS-UPDRS in a population-based sample of individuals without parkinsonism. Multiple linear regression and Spearman's rank correlation coefficients were used to examine potential associations. Results: Among 194 consecutive individuals without parkinsonism, the mean total MDS-UPDRS score was 12.5 (SD 9.8). Sixty-nine percent (134/193) had motor examination (Part III) scores of 2 or more, 16% (30/194) had scores of 10 or more. Female sex, arthritis or spondylosis, diabetes mellitus, and essential tremor were found to be associated with statistically significant increases in MDS-UPDRS Part III scores. For every 10-year increase in age, the Part III score was greater on average by 2.2 (1.5-2.8). Conclusions: Elevated MDS-UPDRS scores are common in the general population. The overall burden of motor signs of parkinsonism is especially high in older age groups, in women, and in those with particular comorbidities. Whether this represents evidence of a subclinical neurodegenerative process or the effect of comorbid conditions requires further examination.


2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.


2021 ◽  
Vol 11 (8) ◽  
pp. 1027
Author(s):  
Diego Santos García ◽  
Marta Blázquez-Estrada ◽  
Matilde Calopa ◽  
Francisco Escamilla-Sevilla ◽  
Eric Freire ◽  
...  

Parkinson’s disease (PD) is a chronic progressive and irreversible disease and the second most common neurodegenerative disease worldwide. In Spain, it affects around 120.000–150.000 individuals, and its prevalence is estimated to increase in the future. PD has a great impact on patients’ and caregivers’ lives and also entails a substantial socioeconomic burden. The aim of the present study was to examine the current situation and the 10-year PD forecast for Spain in order to optimize and design future management strategies. This study was performed using the modified Delphi method to try to obtain a consensus among a panel of movement disorders experts. According to the panel, future PD management will improve diagnostic capacity and follow-up, it will include multidisciplinary teams, and innovative treatments will be developed. The expansion of new technologies and studies on biomarkers will have an impact on future PD management, leading to more accurate diagnoses, prognoses, and individualized therapies. However, the socio-economic impact of the disease will continue to be significant by 2030, especially for patients in advanced stages. This study highlighted the unmet needs in diagnosis and treatment and how crucial it is to establish recommendations for future diagnostic and therapeutic management of PD.


2021 ◽  
pp. 1-20
Author(s):  
Diego Santos García ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores ◽  
Ester Suárez Castro ◽  
Jorge Hernández Vara ◽  
...  

Background: There is a need for identifying risk factors for hospitalization in Parkinson’s disease (PD) and also interventions to reduce acute hospital admission. Objective: To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort. Methods: PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit. Results: Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065–5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319–6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757–8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124–4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080–8.322; p = 0.035) was an independent predictor of AH. Conclusion: Falls is an independent predictor of AH in PD patients.


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