scholarly journals A Self-Managed System for Automated Assessment of UPDRS Upper Limb Tasks in Parkinson’s Disease

Sensors ◽  
2018 ◽  
Vol 18 (10) ◽  
pp. 3523 ◽  
Author(s):  
Claudia Ferraris ◽  
Roberto Nerino ◽  
Antonio Chimienti ◽  
Giuseppe Pettiti ◽  
Nicola Cau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Rating Scale ◽  
Home Monitoring ◽  
Hand Tracking ◽  
Optoelectronic System ◽  
Automated Assessment ◽  
Home Based ◽  
Supervised Classifiers

A home-based, reliable, objective and automated assessment of motor performance of patients affected by Parkinson’s Disease (PD) is important in disease management, both to monitor therapy efficacy and to reduce costs and discomforts. In this context, we have developed a self-managed system for the automated assessment of the PD upper limb motor tasks as specified by the Unified Parkinson’s Disease Rating Scale (UPDRS). The system is built around a Human Computer Interface (HCI) based on an optical RGB-Depth device and a replicable software. The HCI accuracy and reliability of the hand tracking compares favorably against consumer hand tracking devices as verified by an optoelectronic system as reference. The interface allows gestural interactions with visual feedback, providing a system management suitable for motor impaired users. The system software characterizes hand movements by kinematic parameters of their trajectories. The correlation between selected parameters and clinical UPDRS scores of patient performance is used to assess new task instances by a machine learning approach based on supervised classifiers. The classifiers have been trained by an experimental campaign on cohorts of PD patients. Experimental results show that automated assessments of the system replicate clinical ones, demonstrating its effectiveness in home monitoring of PD.

scholarly journals Feasibility of Home-Based Automated Assessment of Postural Instability and Lower Limb Impairments in Parkinson’s Disease

Sensors ◽  
2019 ◽  
Vol 19 (5) ◽  
pp. 1129 ◽  
Author(s):  
Claudia Ferraris ◽  
Roberto Nerino ◽  
Antonio Chimienti ◽  
Giuseppe Pettiti ◽  
Nicola Cau ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Limb ◽  
Rating Scale ◽  
Postural Instability ◽  
Motor Tasks ◽  
Automated Assessment ◽  
Home Based ◽  
Supervised Classifiers ◽  
Disease Rating

A self-managed, home-based system for the automated assessment of a selected set of Parkinson’s disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson’s Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson’s disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects’ performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson’s disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework.

scholarly journals Remote Evaluation of Parkinson's Disease Using a Conventional Webcam and Artificial Intelligence

2021 ◽  
Vol 12 ◽  
Author(s):  
Mariana H. G. Monje ◽  
Sergio Domínguez ◽  
Javier Vera-Olmos ◽  
Angelo Antonini ◽  
Tiago A. Mestre ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Rating Scale ◽  
Hand Movement ◽  
Movement Speed ◽  
Clinical Scales ◽  
Video Frames ◽  
Disease Rating

Objective: This study aimed to prove the concept of a new optical video-based system to measure Parkinson's disease (PD) remotely using an accessible standard webcam.Methods: We consecutively enrolled a cohort of 42 patients with PD and healthy subjects (HSs). The participants were recorded performing MDS-UPDRS III bradykinesia upper limb tasks with a computer webcam. The video frames were processed using the artificial intelligence algorithms tracking the movements of the hands. The video extracted features were correlated with clinical rating using the Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale and inertial measurement units (IMUs). The developed classifiers were validated on an independent dataset.Results: We found significant differences in the motor performance of the patients with PD and HSs in all the bradykinesia upper limb motor tasks. The best performing classifiers were unilateral finger tapping and hand movement speed. The model correlated both with the IMUs for quantitative assessment of motor function and the clinical scales, hence demonstrating concurrent validity with the existing methods.Conclusions: We present here the proof-of-concept of a novel webcam-based technology to remotely detect the parkinsonian features using artificial intelligence. This method has preliminarily achieved a very high diagnostic accuracy and could be easily expanded to other disease manifestations to support PD management.

scholarly journals The Effects of a 10-Week Home-Based Exercise Programme in Individuals with Parkinson’s Disease during the COVID-19 Pandemic: A Pilot Study

2021 ◽  
Vol 11 (10) ◽  
pp. 4518
Author(s):  
Fuengfa Khobkhun ◽  
Jinjuta Suwannarat ◽  
Anuchai Pheungphrarattanatrai ◽  
Kanjana Niemrungruang ◽  
Sakaowrat Techataweesub ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Exercise Program ◽  
Exercise Group ◽  
Gait Velocity ◽  
Control Group ◽  
Global Rating ◽  
Home Based ◽  
Functional Reach Test

Current restrictions on clinical visits as a consequence of the COVID-19 pandemic has increased the need for home-based exercise regimes to facilitate useful, long term patterns of behaviour in individuals with Parkinson’s disease (PD). This study aimed to evaluate the effectiveness of a 10-week home-based exercise program designed to target improvements in axial rigidity and gait. The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), motor scale and rigidity items, Functional axial rotation–physical (FAR-p), functional reach test (FRT), and time up and go (TUG) test were recorded. In addition, the 10-metre walk test, the fall efficacy scale international (FES-I) and the global rating of change score (GROC) were also recorded. Eighteen individuals were divided randomly into two groups: a home-based exercise group (n = 10) and a traditional physiotherapy control group (n = 8). Participants in the 10-week home-based exercise group showed significant improvements (p < 0.05) in the MDS-UPDRS rigidity item, FAR-p, step length, gait velocity, FRT and FES-I when compared with the control group. This study supports the use of home-based exercises in individuals with PD. These preliminary results also support the hypothesis that targeting axial deficits may be an effective approach for improving gait and reducing falls.

scholarly journals Transitioning from Unilateral to Bilateral Upper Limb Tremor Therapy for Parkinson’s Disease and Essential Tremor Using Botulinum Toxin: Case Series

Toxins ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 394 ◽  
Author(s):  
Olivia Samotus ◽  
Jack Lee ◽  
Mandar Jog
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Botulinum Toxin ◽  
Essential Tremor ◽  
Upper Limb ◽  
Kinematic Analysis ◽  
Rating Scale ◽  
Pilot Trial ◽  
Case Series ◽  
Preliminary Finding

Botulinum toxin type A (BoNT-A) injections guided by kinematic analysis for unilateral upper limb essential tremor (ET) and Parkinson’s disease (PD) tremor therapy has demonstrated efficacy, improvements in quality of life (QoL) and arm functionality. In this open-label pilot trial, 5 ET and 2 PD participants decided to switch from receiving long-term unilateral arm treatment to now bilateral BoNT-A arm therapy in their other tremulous arm which worsened over time. Injection patterns were based on kinematic analysis. Efficacy endpoints including kinematic analysis, Fahn-Tolosa-Marin tremor rating scale, QoL questionnaire, and maximal grip strength were collected over 2 treatments and 2 follow-up visits totaling 18-weeks. BoNT-A decreased wrist tremor amplitude by 84.6% and 89.6% 6-weeks following the 1st injection in the newly-treated limb in ET and PD participants, respectively. PD participants started with worse QoL but demonstrated an additional improvement in QoL by 29.9% for switching to bilateral treatment, whereas ET participants did not. Left and right arm tremor also did not share commonalities in severity or dose. This preliminary finding suggests trends for transitioning to bilateral therapy and warrants further studies to evaluate efficacy of bilateral tremor BoNT-A therapy in a larger cohort of PD and ET patients.

Prospective study on cost-effectiveness of home-based motor assessment in Parkinson’s disease

2016 ◽  
Vol 23 (2) ◽  
pp. 328-338 ◽  
Author(s):  
E Cubo ◽  
N Mariscal ◽  
B Solano ◽  
V Becerra ◽  
D Armesto ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cost Effectiveness ◽  
Functional Status ◽  
Rating Scale ◽  
Cost Effective ◽  
Office Visits ◽  
Home Based ◽  
Life Years

Introduction Treatment adjustments in Parkinson’s disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. Methods The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits. Motor and non-motor symptom severities, quality of life, neuropsychiatric symptoms, and comorbidities were assessed every four months. Direct costs were assessed using a standardized questionnaire. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). Results Both groups of PD patients were largely comparable in their clinical and demographic variables at baseline; however, there were more participants using levodopa-carbidopa intestinal gel in the home-based motor monitoring group. There was a trend for lower Unified Parkinson’s Disease Rating Scale functional status (UPDRS II) scores in the patients monitored at home compared to the standard clinical follow-up ( p = 0.06). However, UPDRS parts I, III, IV and quality-adjusted life-years scores were similar between both groups. Home-based motor monitoring was cost-effective in terms of improvement of functional status, motor severity, and motor complications (UPDRS II, III; IV subscales), with an ICER/UPDRS ranging from €126.72 to €701.31, respectively. Discussion Home-based motor monitoring is a tool which collects cost-effective clinical information and helps augment health care for patients with advanced PD.

Parkinson's Disease Cognitive Functional Rating Scale

2012 ◽  
Author(s):  
Jaime Kulisevsky ◽  
Ramón Fernández de Bobadilla ◽  
Javier Pagonabarraga
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale

Anxiety and cognitive load affect upper limb motor control in Parkinson's disease during medication phases

2021 ◽  
Author(s):  
Zahra Nodehi ◽  
Hajar Mehdizadeh ◽  
Akram Azad ◽  
Maryam Mehdizadeh ◽  
Elham Reyhanian ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Control ◽  
Cognitive Load ◽  
Upper Limb

scholarly journals Azathioprine immunosuppression and disease modification in Parkinson’s disease (AZA-PD): a randomised double-blind placebo-controlled phase II trial protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040527
Author(s):  
Julia C Greenland ◽  
Emma Cutting ◽  
Sonakshi Kadyan ◽  
Simon Bond ◽  
Anita Chhabra ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Immune System ◽  
Phase Ii ◽  
Rating Scale ◽  
Positron Emission Tomography Imaging ◽  
Clinical Markers ◽  
Double Blind ◽  
Positron Emission ◽  
Immunosuppressant Medication

IntroductionThe immune system is implicated in the aetiology and progression of Parkinson’s disease (PD). Inflammation and immune activation occur both in the brain and in the periphery, and a proinflammatory cytokine profile is associated with more rapid clinical progression. Furthermore, the risk of developing PD is related to genetic variation in immune-related genes and reduced by the use of immunosuppressant medication. We are therefore conducting a ‘proof of concept’ trial of azathioprine, an immunosuppressant medication, to investigate whether suppressing the peripheral immune system has a disease-modifying effect in PD.Methods and analysisAZA-PD is a phase II randomised placebo-controlled double-blind trial in early PD. Sixty participants, with clinical markers indicating an elevated risk of disease progression and no inflammatory or immune comorbidity, will be treated (azathioprine:placebo, 1:1) for 12 months, with a further 6-month follow-up. The primary outcome is the change in the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale gait/axial score in the OFF state over the 12-month treatment period. Exploratory outcomes include additional measures of motor and cognitive function, non-motor symptoms and quality of life. In addition, peripheral and central immune markers will be investigated through analysis of blood, cerebrospinal fluid and PK-11195 positron emission tomography imaging.Ethics and disseminationThe study was approved by the London-Westminster research ethics committee (reference 19/LO/1705) and has been accepted by the Medicines and Healthcare products Regulatory Agency (MHRA) for a clinical trials authorisation (reference CTA 12854/0248/001–0001). In addition, approval has been granted from the Administration of Radioactive Substances Advisory Committee. The results of this trial will be disseminated through publication in scientific journals and presentation at national and international conferences, and a lay summary will be available on our website.Trial registration numbersISRCTN14616801 and EudraCT- 2018-003089-14.

scholarly journals Glucocerebrosidase Activity is Reduced in Cryopreserved Parkinson’s Disease Patient Monocytes and Inversely Correlates with Motor Severity

2021 ◽  
pp. 1-9
Author(s):  
Laura P. Hughes ◽  
Marilia M.M. Pereira ◽  
Deborah A. Hammond ◽  
John B. Kwok ◽  
Glenda M. Halliday ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Rating Scale ◽  
Disease Patient ◽  
Motor Symptom ◽  
Blood Monocytes ◽  
Peripheral Blood Monocytes ◽  
Classical Monocytes

Background: Reduced activity of lysosomal glucocerebrosidase is found in brain tissue from Parkinson’s disease patients. Glucocerebrosidase is also highly expressed in peripheral blood monocytes where its activity is decreased in Parkinson’s disease patients, even in the absence of GBA mutation. Objective: To measure glucocerebrosidase activity in cryopreserved peripheral blood monocytes from 30 Parkinson’s disease patients and 30 matched controls and identify any clinical correlation with disease severity. Methods: Flow cytometry was used to measure lysosomal glucocerebrosidase activity in total, classical, intermediate, and non-classical monocytes. All participants underwent neurological examination and motor severity was assessed by the Movement Disorders Society Unified Parkinson’s Disease Rating Scale. Results: Glucocerebrosidase activity was significantly reduced in the total and classical monocyte populations from the Parkinson’s disease patients compared to controls. GCase activity in classical monocytes was inversely correlated to motor symptom severity. Conclusion: Significant differences in monocyte glucocerebrosidase activity can be detected in Parkinson’s disease patients using cryopreserved mononuclear cells and monocyte GCase activity correlated with motor features of disease. Being able to use cryopreserved cells will facilitate the larger multi-site trials needed to validate monocyte GCase activity as a Parkinson’s disease biomarker.

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