A holistic approach to evaluating Parkinson’s disease, using the Delphi method: a linear evaluation index

ABSTRACT Background: Parkinson’s disease (PD) is a chronic disease that presents a multitude of symptoms, with symptoms of both motor and nonmotor nature. The Delphi method is widely used to create consensuses among experts in a field of knowledge. Objective: In order to reach a consensus on the values that should be assigned to the different motor and nonmotor manifestations of Parkinson’s disease, a linear evaluation index (LEI) was created. Subsequently, the metric properties of this index were studied. Methods: 120 consecutive patients with a Parkinson’s diagnosis were chosen in accordance with the UKPDSBB criteria. The Delphi method was used to reach a consensus among experts regarding the values of each of the manifestations included. Subsequently, the following attributes were analyzed: quality and acceptability of the data; reliability, in terms of internal consistency, reliability index, Cronbach’s alpha and standard error of measurement; and validity, in terms of convergent validity and validity for known groups. Results: Twenty-five experts participated. The importance factor did not differ between the first round and the second round (chi-square test). We analyzed the responses that assigned percentage values to the 10 dimensions of the LEI. Both in the first and in the second round, the values of the scattering coefficient Vr were always close to 0. The homogeneity index was 0.36; the corrected-item total correlation values ranged from 0.02 to 0.7; Cronbach’s α was 0.69; and the SEM was 4.23 (55.1%). Conclusions: The LEI was obtained through rigorous recommended methodology. The results showed adequate metric properties.

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Selection of Effective Herbal Medicines for Parkinson’s Disease Based on the Text Mining of the Classical Korean Medical Literature Donguibogam

Journal of Korean Medicine ◽

10.13048/jkm.21041 ◽

2021 ◽

Vol 42 (4) ◽

pp. 130-142

Author(s):

Hyo Won Bae ◽

Tae Wook Lee ◽

Byung Tae Choi ◽

Hwa Kyoung Shin ◽

Young Ju Yun

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Medical Literature ◽

Statistical Tests ◽

Herbal Medicines ◽

Symptomatic Treatment ◽

Mean Value ◽

Wilcoxon Test ◽

Chi Square ◽

Chi Square Test

Objectives: The prevalence of Parkinson’s disease is on an upward trend along with an increase in the aging population but there is no available treatment that halts the progression of neurodegeneration. This study reports a numerical analysis on Donguibogam and suggests novel herbal drugs, which have never been researched before but found to be deemed effective in this study.Methods: Referring to 71 Korean medicine symptom terms that represent the symptoms of Parkinson’s disease, 4170 prescriptions described in Donguibogam were classified into two groups based on whether their main effects were effective for Parkinson’s disease or not. Comparing the two groups, the chi-square test was performed to select statistically significant herbs, while the t-test, Wilcoxon test, and descriptive statistics were performed to determine the appropriate dose.Results: One hundred and twenty-seven prescriptions effective for Parkinson’s disease were identified. The chi-square test determined 17 herbs that are effective for symptomatic treatment. Among the medicinal herbs, the authors suggest Osterici seu Notopterygii Radix et Rhizoma, Ephedrae Herba, Aconiti Tuber, Myrrha, Sinomeni Caulis et Rhizoma, and Aconiti Kusnezoffii Tuber as herbal candidates that have never been studied for Parkinson’s disease. Through the statistical tests, it was judged that the mean value of the dose of the entire prescription was the appropriate dose for each herb.Conclusions: Seventeen herbs were selected for Parkinson’s disease and the appropriate daily dose were calculated. Furthermore, this study presented a new process that applies a statistical method to traditional medical literature and preselecting herbs deemed effective for specific diseases.

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Prevalence and Relationship of Rest Tremor and Action Tremor in Parkinson’s Disease

10.1101/2020.11.09.20227850 ◽

2020 ◽

Author(s):

Deepak K. Gupta ◽

Massimo Marano ◽

Cole Zweber ◽

James T. Boyd ◽

Sheng-Han Kuo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Action Tremor ◽

Chi Square ◽

Rest Tremor ◽

Progression Marker ◽

Chi Square Test ◽

Disease Rating ◽

Relationship Of

AbstractBackgroundDespite the significance of tremor in Parkinson’s disease (PD) diagnosis, classification, and patient’s quality of life, there is a relative lack of data on prevalence and relationship of different tremor types in PD.MethodsThe presence of rest tremor (RT) and action tremor (AT; defined as combination of both postural and kinetic tremor) was determined and RT severity was defined using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) at baseline in the Progression Marker Initiative (PPMI, n=423), the Fox Investigation for New Discovery of Biomarkers (BioFIND, n=118) and the Parkinson’s Disease Biomarkers Program (PDBP, n=873) cohorts.ResultsAcross baseline data of all three cohorts, RT prevalence (58.2%) was higher than AT prevalence (39.0%). Patients with RT had significantly higher (Chi-square test, p<0.05) prevalence of AT compared to patients without RT in the PPMI (40.0% versus 30.1%), BioFIND (48.0% versus 40.0%) and PDBP (49.9% versus 21.0%) cohorts. Furthermore, patients with AT had significantly (Student t-test, p<0.05) higher RT severity that those without AT in PPMI (5.7 ± 5.4 versus 3.9 ± 3.3), BioFIND, 6.4 ± 6.3 versus 3.8 ± 4.4) and PDBP (6.4 ± 6.6 versus 3.7 ± 4.4) cohorts.DiscussionThe RT is the most frequent tremor type and present in more than half of the PD patients. However, AT is also present in nearly one-third of the PD patients. Our results also indicate that RT and AT may have cross-interactions in PD.

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Olfactory Deficits in the Freezing of Gait Phenotype of Parkinson's Disease

Frontiers in Neurology ◽

10.3389/fneur.2021.656379 ◽

2021 ◽

Vol 12 ◽

Author(s):

Aliyah Glover ◽

Lakshmi Pillai ◽

Rohit Dhall ◽

Tuhin Virmani

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Freezing Of Gait ◽

Brain Structures ◽

Specific Pattern ◽

University Of Pennsylvania ◽

Normative Values ◽

Correct Identification ◽

Chi Square ◽

Chi Square Test

Background: Olfactory dysfunction often occurs before motor onset in Parkinson's disease (PD) and can be detected with the University of Pennsylvania Smell Identification Test (UPSIT). Based on the Braak hypothesis, the olfactory bulb is one of two sites where disease pathology may start and spread to deeper brain structures.Objective: To evaluate whether a specific pattern of odorant identification on the UPSIT discriminated Parkinson's disease patients with and without freezing of gait.Methods: One hundred and twenty four consecutive participants (33 controls, 31 non-freezers, and 60 freezers) were administered the UPSIT. Using the chi-square test, each odorant on the UPSIT was ranked based on the differential ability of freezers and non-freezers to identify them correctly. Using predictive statistics and confusion matrices, the best combination of odorants and a cut-off score was determined.Results: Freezers had a shift toward a more severe hyposmia classification based on age and sex based normative values. The correct identification of nine odors (bubblegum, chocolate, smoke, wintergreen, paint thinner, orange, strawberry, grass, and peanut) was significantly worse in freezers compared to non-freezers. Correctly identifying ≤ 2 out of 3-odorants (bubblegum, chocolate, and smoke) had a 77% sensitivity and 61% specificity for categorizing freezers. The 3-odorant score was not correlated with disease duration, motor or total UPDRS scores, MoCA scores or age at testing. The predictive statistics were similar when sexes were separately categorized.Conclusions: A 3-odorant score helped categorize freezers and non-freezers with similar sensitivity and specificity to short odorant Parkinson's disease identification batteries.

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Correlates of the discrepancy between objective and subjective cognitive functioning in non-demented patients with Parkinson’s disease

Journal of Neurology ◽

10.1007/s00415-021-10519-4 ◽

2021 ◽

Author(s):

Mattia Siciliano ◽

Lugi Trojano ◽

Rosa De Micco ◽

Valeria Sant’Elia ◽

Alfonso Giordano ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Linear Regression ◽

Cognitive Functioning ◽

Rating Scale ◽

Regression Analyses ◽

Chi Square ◽

Cognitive Measure ◽

Objective Evidence ◽

Cognitive Discrepancy

Abstract Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p < 0.01). Logistic regression confirmed that FSS and BDI scores distinguished the “Underestimators” group from the others (p < 0.05). Linear regression analyses also indicated that FSS and BDI scores positively related to objective-subjective cognitive discrepancy (p < 0.01). “Overestimators” scored lower than other groups on the MoCA’s total score and attention and working memory subscores (p < 0.01). Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting.

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The metric properties of a novel non-motor symptoms scale for Parkinson's disease: Results from an international pilot study

Movement Disorders ◽

10.1002/mds.21596 ◽

2007 ◽

Vol 22 (13) ◽

pp. 1901-1911 ◽

Cited By ~ 482

Author(s):

Kallol Ray Chaudhuri ◽

Pablo Martinez-Martin ◽

Richard G. Brown ◽

Kapil Sethi ◽

Fabrizio Stocchi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Pilot Study ◽

Motor Symptoms ◽

Metric Properties ◽

Non Motor Symptoms

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A holistic approach to assess the feasability of telehealth for Parkinson's disease management

10.20868/upm.thesis.43010 ◽

2016 ◽

Author(s):

Jorge Cancela González

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Management ◽

Holistic Approach

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An ensemble feature selection framework for early detection of Parkinson's disease based on feature correlation analysis

10.22541/au.161526195.51192977/v1 ◽

2021 ◽

Author(s):

Sarfaraz Masood ◽

Khwaja Wisal ◽

Om Pal ◽

Chanchal Kumar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Feature Selection ◽

Large Population ◽

Feature Selection Method ◽

Sampling Strategy ◽

Chi Square ◽

Accurate Identification ◽

Initial Symptoms ◽

Selection Framework

Parkinson’s disease (PD) is a highly common neurological disease affecting a large population worldwide. Several studies revealed that the degradation of voice is one of its initial symptoms, which is also known as dysarthria. In this work, we attempt to explore and harness the correlation between various features in the voice samples observed in PD subjects. To do so, a novel two-level ensemble-based feature selection method has been proposed, whose results were combined with an MLP based classifier using K-fold cross-validation as the re-sampling strategy. Three separate benchmark datasets of voice samples were used for the experimentation work. Results strongly suggest that the proposed feature selection framework helps in identifying an optimal set of features which further helps in highly accurate identification of PD patients using a Multi-Layer Perceptron from their voice samples. The proposed model achieves an overall accuracy of 98.3%, 95.1% and 100% on the three selected datasets respectively. These results are significantly better than those achieved by a non-feature selection based option, and even the recently proposed chi-square based feature selection option.

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Psychometric investigation of the affiliate stigma scale in Mexican Parkinson’s disease caregivers: Development of a short form

Neurorehabilitation ◽

10.3233/nre-210105 ◽

2021 ◽

pp. 1-11

Author(s):

Mickeal Pugh ◽

Paul B. Perrin ◽

Jack D. Watson ◽

Duygu Kuzu ◽

Carmen Tyler ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Factor Structure ◽

Convergent Validity ◽

Short Form ◽

Factor Analyses ◽

Confirmatory Factor Analyses ◽

Stigma Scale ◽

Affiliate Stigma ◽

Exploratory Factor Analyses

BACKGROUND: Parkinson’s disease (PD) caregivers, particularly in Latin America, may experience high levels of affiliate stigma due to their association with a person having a disability. The most common measure used of this construct in the literature, the Affiliate Stigma Scale, was validated using non-standard and questionable methods. OBJECTIVE: The purpose of this study was to investigate the factor structure and psychometric properties of the Spanish version of the Affiliate Stigma Scale with PD caregivers in Mexico using more widely accepted psychometric approaches including confirmatory and exploratory factor analyses (confirmatory factor analyses (CFAs) and exploratory factor analyses (EFAs)). METHODS: A sample of 148 PD caregivers from Mexico completed this measure, as well as indices of caregiver burden and anxiety. RESULTS: Initial CFAs revealed that the data did not fit either the originally proposed one-factor or three-factor structures. An EFA was then conducted which was unable to discern any factor structure. Upon instituting a stepwise removal alpha-if-item-deleted process, a 5-item Affiliate Stigma Scale Spanish Short Form was retained with an adequate Cronbach’s alpha, good convergent validity, and a Short Form CFA generally indicating adequate fit. CONCLUSIONS: The new Spanish Affiliate Stigma Scale Short Form holds promise for more appropriately measuring affiliate stigma likely in general but particularly in Spanish and among PD caregivers. The Short Form can assist not only in assessing levels of caregiver affiliate stigma, but in creating novel interventions to help support caregivers and decrease stigma.

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