scholarly journals Integrated robotics platform with haptic control differentiates subjects with Parkinson’s disease from controls and quantifies the motor effects of levodopa

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Pauline Gaprielian ◽  
Stephen H. Scott ◽  
Catherine Lowrey ◽  
Stuart Reid ◽  
Giovanna Pari ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Rating Scale ◽  
Healthy Controls ◽  
Exoskeleton Robot ◽  
Cumulative Score ◽  
Roc Area ◽  
Motor Effects ◽  
Passive Stretch

Abstract Background The use of integrated robotic technology to quantify the spectrum of motor symptoms of Parkinson’s Disease (PD) has the potential to facilitate objective assessment that is independent of clinical ratings. The purpose of this study is to use the KINARM exoskeleton robot to (1) differentiate subjects with PD from controls and (2) quantify the motor effects of dopamine replacement therapies (DRTs). Methods Twenty-six subjects (Hoehn and Yahr mean 2.2; disease duration 0.5 to 15 years) were evaluated OFF (after > 12 h of their last dose) and ON their DRTs with the Unified Parkinson’s Disease Rating Scale (UPDRS) and the KINARM exoskeleton robot. Bilateral upper extremity bradykinesia, rigidity, and postural stability were quantified using a repetitive movement task to hit moving targets, a passive stretch task, and a torque unloading task, respectively. Performance was compared against healthy age-matched controls. Results Mean hand speed was 41% slower and 25% fewer targets were hit in subjects with PD OFF medication than in controls. Receiver operating characteristic (ROC) area for hand speed was 0.94. The torque required to stop elbow movement during the passive stretch task was 34% lower in PD subjects versus controls and resulted in an ROC area of 0.91. The torque unloading task showed a maximum displacement that was 29% shorter than controls and had an ROC area of 0.71. Laterality indices for speed and end total torque were correlated to the most affected side. Hand speed laterality index had an ROC area of 0.80 against healthy controls. DRT administration resulted in a significant reduction in a cumulative score of parameter Z-scores (a measure of global performance compared to healthy controls) in subjects with clinically effective levodopa doses. The cumulative score was also correlated to UPDRS scores for the effect of DRT. Conclusions Robotic assessment is able to objectively quantify parkinsonian symptoms of bradykinesia, rigidity and postural stability similar to the UPDRS. This integrated testing platform has the potential to aid clinicians in the management of PD and help assess the effects of novel therapies.

scholarly journals A Comparison of Pain between Parkinson’s Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
He-Yang You ◽  
Lei Wu ◽  
Hai-Ting Yang ◽  
Chen Yang ◽  
Xiao-Ling Ding
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multiple System Atrophy ◽  
Rating Scale ◽  
Depression Scale ◽  
Healthy Controls ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Disease Rating ◽  
Vas Scores

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.

scholarly journals Diffusion Kurtosis Imaging of Substantia Nigra Is a Sensitive Method for Early Diagnosis and Disease Evaluation in Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Guohua Zhang ◽  
Yuhu Zhang ◽  
Chengguo Zhang ◽  
Yukai Wang ◽  
Guixian Ma ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Substantia Nigra ◽  
Rating Scale ◽  
Diffusion Tensor ◽  
Diffusion Kurtosis Imaging ◽  
Healthy Controls ◽  
Potential Biomarker ◽  
Diffusion Kurtosis ◽  
Sensitive Method

Background.To diagnose Parkinson disease (PD) in an early stage and accurately evaluate severity, it is important to develop a sensitive method for detecting structural changes in the substantia nigra (SN).Method.Seventy-two untreated patients with early PD and 72 healthy controls underwent diffusion tensor and diffusion kurtosis imaging. Regions of interest were drawn in the rostral, middle, and caudal SN by two blinded and independent raters. Mean kurtosis (MK) and fractional anisotropy in the SN were compared between the groups. Receiver operating characteristic (ROC) and Spearman correlation analyses were used to compare the diagnostic accuracy and correlate imaging findings with Hoehn-Yahr (H-Y) staging and part III of the Unified Parkinson’s Disease Rating Scale (UPDRS-III).Result.MK in the SN was increased significantly in PD patients compared with healthy controls. The area under the ROC curve was 0.976 for MK in the SN (sensitivity, 0.944; specificity, 0.917). MK in the SN had a positive correlation with H-Y staging and UPDRS-III scores.Conclusion.Diffusion kurtosis imaging is a sensitive method for PD diagnosis and severity evaluation. MK in the SN is a potential biomarker for imaging studies of early PD that can be widely used in clinic.

scholarly journals Exploring Movement Impairments in Patients With Parkinson's Disease Using the Microsoft Kinect Sensor: A Feasibility Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Ditte Rudå ◽  
Gudmundur Einarsson ◽  
Anne Sofie Schott Andersen ◽  
Jannik Boll Matthiassen ◽  
Christoph U. Correll ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Performance ◽  
Rating Scales ◽  
Rating Scale ◽  
Motor Task ◽  
Microsoft Kinect ◽  
Healthy Controls ◽  
Kinect Sensor ◽  
Microsoft Kinect Sensor

Background: Current assessments of motor symptoms in Parkinson's disease are often limited to clinical rating scales.Objectives: To develop a computer application using the Microsoft Kinect sensor to assess performance-related bradykinesia.Methods: The developed application (Motorgame) was tested in patients with Parkinson's disease and healthy controls. Participants were assessed with the Movement Disorder Society Unified Parkinson's disease Rating Scale (MDS-UPDRS) and standardized clinical side effect rating scales, i.e., UKU Side Effect Rating Scale and Simpson-Angus Scale. Additionally, tests of information processing (Symbol Coding Task) and motor speed (Token Motor Task), together with a questionnaire, were applied.Results: Thirty patients with Parkinson's disease and 33 healthy controls were assessed. In the patient group, there was a statistically significant (p &lt; 0.05) association between prolonged time of motor performance in the Motorgame and upper body rigidity and bradykinesia (MDS-UPDRS) with the strongest effects in the right hand (p &lt; 0.001). In the entire group, prolonged time of motor performance was significantly associated with higher Simson-Angus scale rigidity score and higher UKU hypokinesia scores (p &lt; 0.05). A shortened time of motor performance was significantly associated with higher scores on information processing (p &lt; 0.05). Time of motor performance was not significantly associated with Token Motor Task, duration of illness, or hours of daily physical activity. The Motorgame was well-accepted.Conclusions: In the present feasibility study the Motorgame was able to detect common motor symptoms in Parkinson's disease in a statistically significant and clinically meaningful way, making it applicable for further testing in larger samples.

scholarly journals Validation of a Spanish Version of the Lille Apathy Rating Scale for Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Rocio García-Ramos ◽  
Clara Villanueva Iza ◽  
María José Catalán ◽  
Abilio Reig-Ferrer ◽  
Jorge Matías-Guíu
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Interrater Reliability ◽  
Rating Scales ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Spanish Version ◽  
Healthy Controls ◽  
Lars Score ◽  
Optimal Cutoff Point

Introduction. To date, no rating scales for detecting apathy in Parkinson’s disease (PD) patients have been validated in Spanish. For this reason, the aim of this study was to validate a Spanish version of Lille apathy rating scale (LARS) in a cohort of PD patients from Spain.Participants and Methods. 130 PD patients and 70 healthy controls were recruited to participate in the study. Apathy was measured using the Spanish version of LARS and the neuropsychiatric inventory (NPI). Reliability (internal consistency, test-retest, and interrater reliability) and validity (construct, content, and criterion validity) were measured.Results. Interrater reliability was 0.93. Cronbach’sαfor LARS was 0.81. The test-retest correlation coefficient was 0.97. The correlation between LARS and NPI scores was 0.61. The optimal cutoff point under the ROC curve was-14, whereas the value derived from healthy controls was-11. The prevalence of apathy in our population tested by LARS was 42%.Conclusions. The Spanish version of LARS is a reliable and useful tool for diagnosing apathy in PD patients. Total LARS score is influenced by the presence of depression and cognitive impairment. However, both disorders are independent identities with respect to apathy. The satisfactory reliability and validity of the scale make it an appropriate instrument for screening and diagnosing apathy in clinical practice or for research purposes.

scholarly journals Serum Butyrylcholinesterase Activity: A Biomarker for Parkinson’s Disease and Related Dementia

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Mei-Xue Dong ◽  
Xiao-Min Xu ◽  
Ling Hu ◽  
Yang Liu ◽  
Yuan-Jun Huang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sensitivity And Specificity ◽  
Rating Scale ◽  
Roc Curves ◽  
Healthy Controls ◽  
Bche Activity ◽  
Disease Rating ◽  
Independent Risk Factors ◽  
Butyrylcholinesterase Activity

Objective. This study aim to determine changes of serum butyrylcholinesterase (BChE) activity in PD patients and related dementia. Patients and Methods. Consecutive PD patients and healthy controls were included and clinical data were collected. Fast serum BChE activity was determined and compared between healthy controls and PD patients. Independent risk factors were performed for BChE activity, PD, and related dementia. The relationship between BChE activity and disease severity was also evaluated. Receiver operating characteristic (ROC) curves were obtained to explore serum BChE activity in distinguishing PD patients and related dementia. Results. Serum BChE activity mainly independently correlated with gender, albumin, triglyceride, body mass index, and PD. Serum BChE activity decreased in PD patients compared with healthy controls. Based on the ROC curve, the optimal cut-off point was 6864.08 IU/L for distinguishing PD patients, and the sensitivity and specificity values were 61.8% and 72.1%. It inversely correlated with Unified Parkinson’s Disease Rating Scale score. BChE activity decreased in PD-related dementia compared with those without dementia. The sensitivity and specificity values were 70.6% and 76.3%, respectively, with an optimal cut-off point of 6550.00 IU/L. Conclusions. Serum BChE activity can be regarded as a biomarker for PD and related dementia.

Levodopa Reduces the Phase lag Index of Parkinson’s Disease Patients: A Magnetoencephalographic Study

2018 ◽  
Vol 50 (2) ◽  
pp. 134-140 ◽  
Author(s):  
Chunyan Cao ◽  
Dianyou Li ◽  
Ke Zeng ◽  
Shikun Zhan ◽  
Peng Huang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Phase Lag ◽  
Healthy Controls ◽  
Levodopa Treatment ◽  
Parietal Area ◽  
Sensorimotor Area ◽  
Disease Rating ◽  
Duration Of Disease

Objectives. As a method of measuring the phase difference between 2 signals, the phase lag index (PLI) of the alpha and beta bands in patients with Parkinson’s disease (PD) was investigated by using magnetoencephalography (MEG). Methods. Eighteen PD patients were measured by MEG in the state of overnight withdrawal of levodopa and after levodopa treatment; meanwhile, Unified Parkinson’s Disease Rating Scale (UPDRS) III scale was evaluated. Results. Compared with healthy controls, alpha (8-13 Hz) PLI in the frontal and parietal areas elevated in PD patients, while the elevation was reversed by the levodopa treatment. The alterations of the UPDRS III total scale ( rs = 0.552, P = .013, n = 16) and the changes of akinesia scale ( rs = 0.622, P = .005, n = 16) were correlated to the change of beta (13-30 Hz) PLI in the left parietal area. The change of the UPDRS total scale was negatively correlated to duration of disease ( rs = 0.432, P = .047, n = 16). There was a negative correlation between the age of PD patients and the change of alpha PLI in the left frontal area ( rs = 0.519, P = .020, n = 16). Conclusions. PD patients showed a higher mu PLI in the sensorimotor area relative to the healthy controls. The improvement of motor symptoms of PD patients by levodopa was correlated to the inhibition of beta PLI in the sensorimotor area.

scholarly journals Contemporaneous bilateral pallidotomy

1997 ◽  
Vol 2 (3) ◽  
pp. E7 ◽  
Author(s):  
Robert P. Iacono ◽  
Jonathan D. Carlson ◽  
Sandra Kuniyoshi ◽  
Aymen Mohamed ◽  
Christine Meltzer ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Deficits ◽  
Postural Stability ◽  
Rating Scale ◽  
Number Of Patients ◽  
Scale Scores ◽  
Posteroventral Pallidotomy ◽  
Disease Rating ◽  
Controversial Nature

To investigate the effects of bilateral posteroventral pallidotomy (PVP) for Parkinson's disease (PD), the authors reviewed the technique and neurological outcome in a number of patients who had undergone bilateral pallidotomy. The authors have previously reported the outcome of PVP in 25 bilateral and 25 unilateral surgeries, rating the patient's postural stability, speech, and total Unified Parkinson's Disease Rating Scale scores. A second, separate group of 23 patients who underwent contemporaneous bilateral PVP were evaluated for early onset idiopathic PD, levodopa failure syndrome, and severe bilateral dyskinesia as well as akinetic “off” states. Cognitive and psychological studies were reviewed in 10 patients who demonstrated preoperative impairments in spatial recognition and memory. Following surgery there were significant improvements in these cognitive deficits and no deficits were incurred by surgery. Published reports regarding bilateral operations for PD have emphasized the risks of speech and cognitive deficits. This study shows bilateral PVP to be effective, particularly in patients with bilateral symptoms, including disabling dyskinesia. Additionally, bilateral PVP does not cause additional cognitive or speech deficits. The techniques and indications as well as outcomes and complications are presented and discussed in this report in light of their controversial nature.

scholarly journals A-WEAR Bracelet for Detection of Hand Tremor and Bradykinesia in Parkinson’s Patients

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 981
Author(s):  
Asma Channa ◽  
Rares-Cristian Ifrim ◽  
Decebal Popescu ◽  
Nirvana Popescu
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Objective Assessment ◽  
Spectral Features ◽  
Motor Symptoms ◽  
Healthy Controls ◽  
Clinical Environment ◽  
Hand Tremor

Parkinson’s disease patients face numerous motor symptoms that eventually make their life different from those of normal healthy controls. Out of these motor symptoms, tremor and bradykinesia, are relatively prevalent in all stages of this disease. The assessment of these symptoms is usually performed by traditional methods where the accuracy of results is still an open question. This research proposed a solution for an objective assessment of tremor and bradykinesia in subjects with PD (10 older adults aged greater than 60 years with tremor and 10 older adults aged greater than 60 years with bradykinesia) and 20 healthy older adults aged greater than 60 years. Physical movements were recorded by means of an AWEAR bracelet developed using inertial sensors, i.e., 3D accelerometer and gyroscope. Participants performed upper extremities motor activities as adopted by neurologists during the clinical assessment based on Unified Parkinson’s Disease Rating Scale (UPDRS). For discriminating the patients from healthy controls, temporal and spectral features were extracted, out of which non-linear temporal and spectral features show greater difference. Both supervised and unsupervised machine learning classifiers provide good results. Out of 40 individuals, neural net clustering discriminated 34 individuals in correct classes, while the KNN approach discriminated 91.7% accurately. In a clinical environment, the doctor can use the device to comprehend the tremor and bradykinesia of patients quickly and with higher accuracy.

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