scholarly journals Prediction of the Levodopa Challenge Test in Parkinson’s Disease Using Data from a Wrist-Worn Sensor

Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5153 ◽  
Author(s):  
Hamid Khodakarami ◽  
Lucia Ricciardi ◽  
Maria Contarino ◽  
Rajesh Pahwa ◽  
Kelly Lyons ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Challenge Test ◽  
Classification Problem ◽  
Clinical Scales ◽  
Clinically Significant ◽  
Class Labels ◽  
Using Data ◽  
Multi Class Classification ◽  
Operator Curve

The response to levodopa (LR) is important for managing Parkinson’s Disease and is measured with clinical scales prior to (OFF) and after (ON) levodopa. The aim of this study was to ascertain whether an ambulatory wearable device could predict the LR from the response to the first morning dose. The ON and OFF scores were sorted into six categories of severity so that separating Parkinson’s Kinetigraph (PKG) features corresponding to the ON and OFF scores became a multi-class classification problem according to whether they fell below or above the threshold for each class. Candidate features were extracted from the PKG data and matched to the class labels. Several linear and non-linear candidate statistical models were examined and compared to classify the six categories of severity. The resulting model predicted a clinically significant LR with an area under the receiver operator curve of 0.92. This study shows that ambulatory data could be used to identify a clinically significant response to levodopa. This study has also identified practical steps that would enhance the reliability of this test in future studies.

scholarly journals Khodakarami, H., et al., Prediction of the Levodopa Challenge Test in Parkinson’s Disease Using Data from a Wrist-Worn Sensor. Sensors 2019, 19, 5153

Sensors ◽  
2020 ◽  
Vol 20 (15) ◽  
pp. 4167
Author(s):  
Hamid Khodakarami ◽  
Lucia Ricciardi ◽  
Maria Fiorella Contarino ◽  
Rajesh Pahwa ◽  
Kelly E. Lyons ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Challenge Test ◽  
Using Data

The authors wish to make the following erratum to this paper [...]

scholarly journals Deep feature learning for FoG episodes prediction In patients with PD

2020 ◽  
Vol 5 (2) ◽  
pp. 79-95
Author(s):  
Hadeer Elziaat ◽  
◽  
Nashwa El-Bendary ◽  
Ramdan Mowad ◽  
◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Feature Learning ◽  
Classification Problem ◽  
Common Symptom ◽  
Suggested Approach ◽  
Time Frequency ◽  
Deep Feature ◽  
Multi Class Classification

A common symptom of Parkinson's Disease is Freezing of Gait (FoG) that causes an interrupt of the forward progression of the patient’s feet while walking. Therefore, Freezing of Gait episodes is always engaged to the patient's falls. This paper proposes a model for Freezing of Gait episodes detection and prediction in patients with Parkinson's disease. Predicting Freezing of Gait in this paper considers as a multi-class classification problem with 3 classes namely, FoG, pre-FoG, and walking episodes. In this paper, the extracted feature scheme applied for the detection and the prediction of FoG is Convolutional Neural Network (CNN) spectrogram time-frequency features. The dataset is collected from three tri-axial accelerometer sensors for PD patients with FoG. The performance of the suggested approach has been distinguished by different machine learning classifiers and accelerometer axes.

scholarly journals Temporal trajectory of biofluid markers in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Min Seok Baek ◽  
Myung Jun Lee ◽  
Han-Kyeol Kim ◽  
Chul Hyoung Lyoo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Amyloid Β ◽  
Rapid Progression ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Using Data ◽  
Negative Exponential ◽  
T Tau

AbstractFull dynamics of biofluid biomarkers have been unknown in patients with Parkinson’s disease (PD). Using data from 396 PD patients and 182 controls in the Parkinson's Progression Markers Initiative (PPMI) database, we estimated long-term temporal trajectories of CSF α-synuclein (α-syn), amyloid-β (Aβ), total tau (t-tau), phosphorylated tau (p-tau) and serum neurofilament light chain (NfL) by integrating function between the baseline levels and annual changes. At baseline, PD patients showed lower CSF α-syn, Aβ, t-tau and p-tau levels than those of the controls. In all PD patients, CSF α-syn and Aβ decreased in a negative exponential pattern before the onset of motor symptoms, whereas CSF t-tau and p-tau, and serum NfL increased. Patients with cognitive impairment exhibited faster decline of Aβ and α-syn and faster rise of t-tau, p-tau and NfL, when compared to those without. Similarly, low Aβ group showed earlier decline of α-syn, faster rise of t-tau, p-tau and NfL, and faster decline of cognitive performances, when compared to high Aβ group. Our results suggest that longitudinal changes in biomarkers can be influenced by cognitive impairment and Aβ burden at baseline. PD patients with Aβ pathology may be associated with early appearance of α-synuclein pathology, rapid progression of axonal degeneration and neurodegeneration, and consequently greater cognitive decline.

Apomorphine therapy: alternative initiation for patients with complex Parkinson's disease presentation

2019 ◽  
Vol 15 (6) ◽  
pp. 264-271 ◽  
Author(s):  
Jane Mills
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Infusion Pump ◽  
Challenge Test ◽  
Patient Specific ◽  
Drug Induced ◽  
Subcutaneous Infusion ◽  
Alternative Approach ◽  
User Friendly ◽  
Dose Injection

The apomorphine challenge test can be a distressing experience for some patients and, if they are not experienced, a discouraging option for some healthcare professionals (HCPs). The test is repeated exposure to bolus-dose injection of the medication to assess response and patient-specific dose before embarking on apomorphine therapy. Recent changes in prescribing of the anti-emetic domperidone (limited use because of QT prolongation), a drug which is a prerequisite for most patients embarking on therapy, has also added a possible complication. While recognising the value of the apomorphine challenge test, the author suggests an alternative approach of establishing apomorphine by subcutaneous infusion pump (SCAI) without the challenge test. This approach makes it more ‘user friendly’ for people with complex Parkinson's disease (PwPd) and their HCPs, and can eliminate the need for preloading with domperidone or other anti-emetic (if one is available in the country of practice). It is a viable option in acute situations, such as nil by mouth, surgery and oral dopamine agonist withdrawal, because of the associated harmful impulsive behaviour. Starting immediately with SCAI without the challenge test has proven both helpful and beneficial in clinical practice, especially in PwPd who have potential to abuse the intermittent injection, have complicated regimens and are vulnerable to drug-induced adverse effects. Some patients only need nocturnal infusions; injections during the night are difficult to administer and miss the objective of better sleep. Facilitating the process of initiation with the SCAI could improve uptake of this underused treatment through easier use and positive experience, and overcome the need for short- and longer-term domperidone use.

scholarly journals Deep Brain Stimulation Selection Criteria for Parkinson’s Disease: Time to Go beyond CAPSIT-PD

2020 ◽  
Vol 9 (12) ◽  
pp. 3931
Author(s):  
Carlo Alberto Artusi ◽  
Leonardo Lopiano ◽  
Francesca Morgante
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Selection Criteria ◽  
Challenge Test ◽  
Phenotypic Characterization ◽  
Motor Symptoms ◽  
Non Motor Symptoms ◽  
Deep Brain

Despite being introduced in clinical practice more than 20 years ago, selection criteria for deep brain stimulation (DBS) in Parkinson’s disease (PD) rely on a document published in 1999 called ‘Core Assessment Program for Surgical Interventional Therapies in Parkinson’s Disease’. These criteria are useful in supporting the selection of candidates. However, they are both restrictive and out-of-date, because the knowledge on PD progression and phenotyping has massively evolved. Advances in understanding the heterogeneity of PD presentation, courses, phenotypes, and genotypes, render a better identification of good DBS outcome predictors a research priority. Additionally, DBS invasiveness, cost, and the possibility of serious adverse events make it mandatory to predict as accurately as possible the clinical outcome when informing the patients about their suitability for surgery. In this viewpoint, we analyzed the pre-surgical assessment according to the following topics: early versus delayed DBS; the evolution of the levodopa challenge test; and the relevance of axial symptoms; patient-centered outcome measures; non-motor symptoms; and genetics. Based on the literature, we encourage rethinking of the selection process for DBS in PD, which should move toward a broad clinical and instrumental assessment of non-motor symptoms, quantitative measurement of gait, posture, and balance, and in-depth genotypic and phenotypic characterization.

scholarly journals Positive association of Parkinson’s disease with ankylosing spondylitis: a nationwide population-based study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Fu-Chiang Yeh ◽  
Hsiang-Cheng Chen ◽  
Yu-Ching Chou ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Ankylosing Spondylitis ◽  
Cox Model ◽  
Positive Association ◽  
Underlying Mechanism ◽  
Population Based ◽  
Neurodegenerative Process ◽  
Increased Risk ◽  
Using Data

Abstract Background Ankylosing spondylitis (AS) is characterized by excessive production of inflammatory cytokines. Recent evidence suggests that inflammation underlies the neurodegenerative process of Parkinson’s disease (PD). Whether AS has an influence on the development of PD is unclear. We aimed to examine a relationship, if any exists between AS and PD. Methods A population-based matched cohort study was performed using data from the 2000–2010 Taiwan National Health Insurance database. 6440 patients with AS and 25,760 randomly selected, age- and sex-matched controls were included in this study. The risk of PD in the AS cohort was evaluated by using a Cox model. Results This study revealed a positive association between AS and the risk of PD regardless of sex and age (aHR 1.75, p < .001). Particularly, AS cohort to non-AS cohort relative risk of PD significantly increased for the patients aged below 49 and above 65 years (aHR 4.70, p < .001; aHR 1.69, p < .001, respectively) and the patients with and without comorbidities (aHR 1.61, p < .001; aHR 2.71, p < .001, respectively). Furthermore, NSAID use was associated with lower risk of PD (aHR 0.69, p < .05). However, the risk of PD was higher (aHR 2.40, p < .01) in patients with AS receiving immunosuppressants than in those not receiving (aHR 1.70, p < .001). Conclusions Patients with AS had an increased risk of PD which might be related to underlying chronic inflammation. Further research is required to elucidate the underlying mechanism.

scholarly journals Changes in Phonation and Their Relations with Progress of Parkinson’s Disease

2018 ◽  
Vol 8 (12) ◽  
pp. 2339 ◽  
Author(s):  
Zoltan Galaz ◽  
Jiri Mekyska ◽  
Vojtech Zvoncak ◽  
Jan Mucha ◽  
Tomas Kiska ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Scientific Community ◽  
Partial Correlation ◽  
Acoustic Analysis ◽  
Partial Correlation Analysis ◽  
Clinical Scales ◽  
Clinical Scores ◽  
The Relationship

Hypokinetic dysarthria, which is associated with Parkinson’s disease (PD), affects several speech dimensions, including phonation. Although the scientific community has dealt with a quantitative analysis of phonation in PD patients, a complex research revealing probable relations between phonatory features and progress of PD is missing. Therefore, the aim of this study is to explore these relations and model them mathematically to be able to estimate progress of PD during a two-year follow-up. We enrolled 51 PD patients who were assessed by three commonly used clinical scales. In addition, we quantified eight possible phonatory disorders in five vowels. To identify the relationship between baseline phonatory features and changes in clinical scores, we performed a partial correlation analysis. Finally, we trained XGBoost models to predict the changes in clinical scores during a two-year follow-up. For two years, the patients’ voices became more aperiodic with increased microperturbations of frequency and amplitude. Next, the XGBoost models were able to predict changes in clinical scores with an error in range 11–26%. Although we identified some significant correlations between changes in phonatory features and clinical scores, they are less interpretable. This study suggests that it is possible to predict the progress of PD based on the acoustic analysis of phonation. Moreover, it recommends utilizing the sustained vowel /i/ instead of /a/.

Flash Electroretinography Parameters and Parkinson’s Disease

2020 ◽  
pp. 1-9
Author(s):  
Roni Netser ◽  
Docia L. Demmin ◽  
Roseanne Dobkin ◽  
Ariel Goldstein ◽  
Matthew Roché ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Photoreceptor Cell ◽  
Implicit Time ◽  
Diagnostic Tools ◽  
Strongly Correlated ◽  
Clinical Scales ◽  
Retinal Structure ◽  
Non Motor Symptoms ◽  
Structure And Activity

Background: Parkinson’s disease (PD) is known to affect retinal structure and activity. As such, retinal evaluations may be used to develop objective and possibly early PD diagnostic tools. Objective: The aim of this study was to investigate the effects of Parkinson’s disease (PD) manifestation and treatment on retinal activity. Methods: Data were collected on 21 participants diagnosed with PD, including the number of medications taken, clinical scales and flash electroretinography (fERG) measurements, under light-adapted and dark-adapted conditions. The fERG parameters measured included a-wave and b-wave amplitude and implicit time (i.e., latency). First, we investigated correlations between symptom measure scores and the fERG parameters. Next, we divided participants into two groups based on their antiparkinsonian medication load and analyzed differences between these groups’ fERG parameters. Results: fERG parameters were strongly correlated with a number of clinical variables, including motor and non-motor symptoms and age at PD onset. Photoreceptor cell implicit time was longer among participants taking one or less antiparkinsonian medication as compared to those taking two or more. However, overall there was not strong evidence of a relationship between the number of antiparkinsonian medications taken and the fERG parameters. Conclusion: Findings suggest that fERG may be a useful, non-intrusive measure of retinal, and, perhaps overall CNS function, in PD. However, additional studies in larger samples are needed to clarify this association.

Sleep Disorders Associated with Parkinson's Disease: Role of Dopamine, Epidemiology, and Clinical Scales of Assessment

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S4) ◽  
pp. 6-11 ◽  
Author(s):  
Shyamal H. Mehta ◽  
John C. Morgan ◽  
Kapil D. Sethi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sleep Problems ◽  
Behavior Disorder ◽  
Sleep Behavior ◽  
Dopaminergic Therapy ◽  
Clinical Scales ◽  
And Control

ABSTRACTSleep dysfunction is common among patients with Parkinson's disease and occurs in approximately two thirds of patients. The problems range from nocturnal issues such as difficulty with sleep initiation, sleep fragmentation, disturbance of circadian rhythm, and rapid eye movement sleep behavior disorder, to daytime problems such as excessive daytime sleepiness. Frequent nighttime awakening and sleep disruption are the most common sleep problems in Parkinson's disease. Dopamine plays an important role in maintaining wakefulness. To improve sleep in Parkinson's disease, it is important to achieve the critical balance of adequate dopaminergic therapy and control of symptoms. Increased dopaminergic agents can cause dyskinesias and painful dystonia, and undertreatment can cause nighttime akinesia, rigidity, and worse quality of sleep. Other nondopaminergic drugs commonly used in Parkinson's disease can also affect sleep. In patients with advanced Parkinson's disease, deep brain stimulation of the subthalamic nucleus has a favorable impact on sleep quality and sleep architecture.

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