Automated Stage Discrimination of Parkinson’s Disease

Abstract

Background: Treatment plans for Parkinson’s disease (PD) are based on a disease stage scale, which is generally determined using a manual, observational procedure. Automated, sensor-based discrimination saves labor and costs in clinical settings and may offer augmented stage determination accuracy. Previous automated devices were either cumbersome or costly and were not suitable for individuals who cannot walk without support.Methods: Since 2017, a device has been available that successfully detects PD and operates for people who cannot walk without support. In the present study, the suitability of this device for automated discrimination of PD stages was tested. The device consists of a walking frame fitted with sensors to simultaneously support walking and monitor patient gait. Sixty-five PD patients in Hoehn and Yahr (HY) stages 1 to 4 and 24 heathy controls were subjected to supported Timed Up and Go (TUG) tests, while using the walking frame. The walking trajectory, velocity, acceleration and force were recorded by the device throughout the tests. These physical parameters were converted into symptomatic spatiotemporal quantities that are conventionally used in PD gait assessment.Results: An analysis of variance (ANOVA) test extended by a confidence interval (CI) analysis indicated statistically significant separability between HY stages for the following spatiotemporal quantities: TUG time (p < 0.001), straight line walking time (p < 0.001), turning time (p < 0.001), and step count (p < 0.001). A negative correlation was obtained for mean step velocity (p < 0.001) and mean step length (p < 0.001). Moreover, correlations were established between these, as well as additional spatiotemporal quantities, and disease duration, L-dihydroxyphenylalanine-(L-DOPA) dose, motor fluctuation, dyskinesia and the mobile part of the Unified Parkinson Disease Rating Scale (UPDRS).Conclusions: We have proven that stage discrimination of PD can be automated, even to patients who cannot support themselves. A similar method might be successfully applied to other gait disorders.

Clinical Review of Smartphone Applications in Parkinson’s Disease

“…Several studies utilized proprietary or commercially available smartphone applications (Table 2). Among these apps, 23 were disease monitoring tools,6–13,15–19,21–24,26,27,30–34,36,37,41,42 4 were medication adherence trackers,9,18,24 and 6 were MMA 13,14,26,27. Thirteen studies reported data on feasibility, acceptability, and adherence 10,11,18,22,25,27,29,33,38,43–46…”

“…All studies demonstrated statistically significant correlations between abnormal smartphone app data and PD patients versus controls. Overall, we reviewed 7 smartphone apps which utilized passive monitoring12,13,22,24,28–31 and 19 apps which used active testing 6–13,15–19,21–24,26,27,30–34,36,37,41,42. Among these, 3 utilized a combination of passive and active testing 13,22,24…”

“…This review examined 35 studies evaluating smartphone apps targeting disease monitoring, medication management, and remote movement modulation and treatment. Among PD apps, 23 were for disease monitoring,6–13,15–19,21–24,26,27,30–34,36,37,41,42 4 for medication adherence,9,18,24 and 6 for movement-modulation-aides 13,14,26,27. PD apps more frequently required sophisticated, proprietary algorithms for parsing usable data gathered using smartphone sensors 6,8,12,21–24.…”

18F-ASEM Imaging for Evaluating Atherosclerotic Plaques Linked to α7-Nicotinic Acetylcholine Receptor

“…The biological distribution shows excellent advantage, as is shown in our results. 18 F-ASEM has been carried out in human studies and are proven to be the only α7nAChR PET radioligand available to humans with promising pharmacokinetic and imaging characteristics ( Wong et al, 2014 ; Aharonson et al, 2020 ). However, 18 F-ASEM has thus far been studied for only its use in neuroimaging but not in the imaging of vasculature, mainly because the ideal conditions required for radioligand imaging of α7nAChR in the nervous system are different from those of the receptors in blood vessels.…”

The Availability of the α7-Nicotinic Acetylcholine Receptor in Early Identification of Vulnerable Atherosclerotic Plaques: A Study Using a Novel 18F-Label Radioligand PET

“…Nicotinic acetylcholine receptors (nAChRs) are pentameric ligand-gated cation channels, which are mainly expressed in the central and peripheral nervous systems diseases (Picciotto et al, 2000;Aharonson et al, 2020). Recently, it become evident that nAChRs are also extensively expressed on nonneuronal cells, such as lung epithelial, endothelial, and immune cells (Wessler et al, 1999;Conti-Fine et al, 2000;Brüggmann et al, 2002;Heeschen et al, 2002;Moccia et al, 2004).…”