Accelerometric assessment of levodopa-induced dyskinesias in Parkinson's disease

Abstract

Our objective was to develop parameters for objective ambulatory measurements of levodopa‐induced dyskinesias (LID) in patients with Parkinson's disease (PD). Twenty‐three PD patients with mild to severe LID were submitted to a standardized protocol of 1‐minute recordings during rest, talking, stress, and four activities of daily life (ADL). Patients were simultaneously monitored with portable multi‐channel accelerometry (four pairs of bi‐axial sensors mounted onto the most affected arm, leg, and at the trunk) and recorded by video. LID severity was assessed with a modified Abnormal Involuntary Movement Scale (m‐AIMS). The signals were analyzed, and every 1/8‐second interval the amplitude was obtained of the dominant frequency within 1–4 Hz and 4–8 Hz frequency bands (Amp1–4 and Amp4–8). For both measures, convergent validity, reproducibility, and responsiveness were determined. In absence of voluntary movements, a significant relation was found between Amp1–4 and Amp4–8 and m‐AIMS. Repeated measurements during rest showed a high reproducibility (intraclass correlation coefficient = 0.90 [Amp1–4] and 0.86[Amp4–8]). The extent to which LID increased with talking and stress correlated significantly (p = 0.02) between the objective and clinical measures (intraclass correlation for differences = 0.67). During ADL, LID occurred in a similar frequency band as voluntary movements and only Amp1–4 and Amp4–8 of the trunk and leg sensor remained highly correlated with m‐AIMS. Although objective measures of LID are reliable and responsive, they fail to distinguish LID from voluntary movements. These measures are of value only when obtained during rest (all sensor sites) or during ADL when derived from those body segments that are normally not involved in these ADL tasks (trunk and leg). Mov. Disord. 16:58–61, 2001. © 2001 Movement Disorder Society.

24-Hour Recording of Parkinsonian Gait Using a Portable Gait Rhythmogram

“…Wrist-or belt-mounted accelerometers (5)(6)(7)(8) or six tri-axial accelerometers (9) have been used to monitor the degree of akinesia. Although the measurements of acceleration can provide a rough estimate of the quantity of movements, the nature of the executed movements remains unclear.…”

Dopaminergic-induced dyskinesia assessment based on a single belt-worn accelerometer

“…In addition, it is unknown if these studies analysed any of the usability restrictions previously described in this article, since the great majority of them use some sensors distributed on the body [12][13][14]17,18,20,22]. As far as authors know, the only paper, apart from the previously submitted by authors [16], that uses a single sensor for dyskinesia assessment is operating from the shoulder [15], which is a position contrary to the restrictions that have been presented so far.…”

“…[16,17]. Power spectrum analysis was also used in [13,21], however, this time on a larger bandwidth that reached 8 Hz. In another recent paper [14], the signal energy within 2-5 and 5-10 Hz frequency bands and entropy of the frequency spectrum were employed.…”

“…Given that walking has the 99% of its power spectral density below 20 Hz [32], 20 Hz is considered as the upper limit of the non-dyskinetic band. The lower limit of the band is provided by the maximum frequencies obtained in some dyskinesia research works [13]. In this way, harmonics in this non-dyskinetic band are used to determine the presence of gait or similar activities as the input of a machine learning classifier, as detailed below.…”

Sensor Fusion for Effective Hand Motion Detection

“…Hoff [39] used four pairs of accelerometer sensors on the leg, arm and trunk of patients with Parkinsons disease to identify accelerometric characteristics of Levodopa-induced dyskinesias.…”