Tossing and Turning in Bed: A Wearable Sensor Documents Abnormal Nocturnal Movements in Parkinson's Disease

2019 ◽  
Author(s):  
Anat Mirelman ◽  
Inbar Hillel ◽  
Lynn Rochester ◽  
Silvia Del Din ◽  
Bastiaan R. Bloem ◽  
...  
Sensors ◽  
2020 ◽  
Vol 20 (20) ◽  
pp. 5963 ◽  
Author(s):  
Elke Warmerdam ◽  
Robbin Romijnders ◽  
Julius Welzel ◽  
Clint Hansen ◽  
Gerhard Schmidt ◽  
...  

Neurological pathologies can alter the swinging movement of the arms during walking. The quantification of arm swings has therefore a high clinical relevance. This study developed and validated a wearable sensor-based arm swing algorithm for healthy adults and patients with Parkinson’s disease (PwP). Arm swings of 15 healthy adults and 13 PwP were evaluated (i) with wearable sensors on each wrist while walking on a treadmill, and (ii) with reflective markers for optical motion capture fixed on top of the respective sensor for validation purposes. The gyroscope data from the wearable sensors were used to calculate several arm swing parameters, including amplitude and peak angular velocity. Arm swing amplitude and peak angular velocity were extracted with systematic errors ranging from 0.1 to 0.5° and from −0.3 to 0.3°/s, respectively. These extracted parameters were significantly different between healthy adults and PwP as expected based on the literature. An accurate algorithm was developed that can be used in both clinical and daily-living situations. This algorithm provides the basis for the use of wearable sensor-extracted arm swing parameters in healthy adults and patients with movement disorders such as Parkinson’s disease.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jamie L. Adams ◽  
Karthik Dinesh ◽  
Christopher W. Snyder ◽  
Mulin Xiong ◽  
Christopher G. Tarolli ◽  
...  

AbstractMost wearable sensor studies in Parkinson’s disease have been conducted in the clinic and thus may not be a true representation of everyday symptoms and symptom variation. Our goal was to measure activity, gait, and tremor using wearable sensors inside and outside the clinic. In this observational study, we assessed motor features using wearable sensors developed by MC10, Inc. Participants wore five sensors, one on each limb and on the trunk, during an in-person clinic visit and for two days thereafter. Using the accelerometer data from the sensors, activity states (lying, sitting, standing, walking) were determined and steps per day were also computed by aggregating over 2 s walking intervals. For non-walking periods, tremor durations were identified that had a characteristic frequency between 3 and 10 Hz. We analyzed data from 17 individuals with Parkinson’s disease and 17 age-matched controls over an average 45.4 h of sensor wear. Individuals with Parkinson’s walked significantly less (median [inter-quartile range]: 4980 [2835–7163] steps/day) than controls (7367 [5106–8928] steps/day; P = 0.04). Tremor was present for 1.6 [0.4–5.9] hours (median [range]) per day in most-affected hands (MDS-UPDRS 3.17a or 3.17b = 1–4) of individuals with Parkinson’s, which was significantly higher than the 0.5 [0.3–2.3] hours per day in less-affected hands (MDS-UPDRS 3.17a or 3.17b = 0). These results, which require replication in larger cohorts, advance our understanding of the manifestations of Parkinson’s in real-world settings.


2021 ◽  
pp. 1-8
Author(s):  
Daniel J. van Wamelen ◽  
Daniele Urso ◽  
Kallol Ray Chaudhuri

Background: Several smaller-scale studies have shown that motor performance in Parkinson’s disease (PD) fluctuates throughout the day. Studies focusing on de novo patients are, however, lacking. Objective: To evaluate the effect of clock time on motor performance in de novo drug-naïve patients with PD. Methods: We retrieved MDS-UPDRS III scores for 421 de novo PD patients from the PPMI cohort and stratified them into three groups based on time of assessment: group 1) 7:00–10:00; group 2) 10:00–13:00, and group 3) 13:00–18:00. Groups were compared using Kruskal-Wallis test and results corrected for multiple testing. In addition, we obtained 27 wearable sensor reports, objectively capturing bradykinesia scores in a home setting over a 6-day continuous period, in 12 drug-naïve patients from the Parkinson’s Kinetigraph Registry held at King’s College Hospital London. Time spent in severe bradykinesia scores were broken down into five daytime (06:00–21:00) three-hourly epochs and scores compared using the Friedman test. Results: There were no group differences in demographic or other clinical variables for the cross-sectional analysis. MDS-UPDRS III total scores worsened significantly during the course of the day (median 18 (group 1); 20 (group 2); and 23 (group 3); p = 0.001). In the longitudinal wearable sensor cohort, diurnal variations were present in percentage of time spent in severe bradykinesia (p <  0.001) with the lowest percentage during the 09:00–12:00 epoch (69.56±16.68%), when most patients are awake and start daily activity, and the highest percentage during the 18:00–21:00 epoch (73.58±16.35%). Conclusion: This exploratory study shows the existence of a diurnal pattern of motor function in patients with de novo PD. The results obtained were corroborated by objective measurements in a small longitudinal cohort confirming a similar diurnal motor score variation.


2019 ◽  
Author(s):  
Maarten De Vos ◽  
John Prince ◽  
Tim Buchanan ◽  
James J. FitzGerald ◽  
Chrystalina A. Antoniades

AbstractBackgroundProgressive supranuclear palsy (PSP), a neurodegenerative conditions may be difficult to discriminate clinically from idiopathic Parkinson’s disease (PD). It is critical that we are able to do this accurately and as early as possible in order that future disease modifying therapies for PSP may be deployed at a stage when they are likely to have maximal benefit. Analysis of gait and related tasks is one possible means of discrimination.Research QuestionHere we investigate a wearable sensor array coupled with machine learning approaches as a means of disease classification.Methods21 participants with PSP, 20 with PD, and 39 healthy control (HC) subjects performed a two minute walk, static sway test, and timed up-and-go task, while wearing an array of six inertial measurement units. The data were analysed to determine what features discriminated PSP from PD and PSP from HC. Two machine learning algorithms were applied, Logistic Regression (LR) and Random Forest (RF).Results17 features were identified in the combined dataset that contained independent information. The RF classifier outperformed the LR classifier, and allowed discrimination of PSP from PD with 86% sensitivity and 90% specificity, and PSP from HC with 90% sensitivity and 97% specificity. Using data from the single lumbar sensor only resulted in only a modest reduction in classification accuracy, which could be restored using 3 sensors (lumbar, right arm and foot). However for maximum specificity the full six sensor array was needed.SignificanceA wearable sensor array coupled with machine learning methods can accurately discriminate PSP from PD. Choice of array complexity depends on context; for diagnostic purposes a high specificity is needed suggesting the more complete array is advantageous, while for subsequent disease tracking a simpler system may suffice.


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