Quantification characteristics of digital spiral analysis for understanding the relationship among tremor and clinical measures in persons with multiple sclerosis

DelMastro, Heather M.; Ruiz, Jennifer A.; Gromisch, Elizabeth S.; Garbalosa, Juan C.; Triche, Elizabeth W.; Olson, Kayla M.; Lo, Albert

doi:10.1016/j.jneumeth.2018.06.016

Cited by 8 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The difficulty in assessing MS tremor resides in the variability of tremor types the clinician is confronted with. Several clinical and neurophysiological methods have been implied in the assessment of MS tremor ranging from common tasks employed in the neurological exam (e.g., finger-to-nose task, spiral drawing, handwriting) [ 34 ] to visual tracking [ 35 , 36 , 37 ], accelerometric techniques, accelerometry–EMG coupling [ 10 ], Stewart–Holmes maneuver [ 38 ], and digitized spirography [ 39 , 40 ]. In addition, some tremor rating scales have been studied in MS. Alusi et al validated the Bain Score for Tremor Severity (BSTS) in this population [ 34 ].…”

Section: Assessment Modalitiesmentioning

confidence: 99%

Tremor in Multiple Sclerosis—An Overview and Future Perspectives

et al. 2020

View full text Add to dashboard Cite

Tremor is an important and common symptom in patients with multiple sclerosis (MS). It constituted one of the three core features of MS triad described by Charcot in the last century. Tremor could have a drastic impact on patients’ quality of life. This paper provides an overview of tremor in MS and future perspectives with a particular emphasis on its epidemiology (prevalence: 25–58%), clinical characteristics (i.e., large amplitude 2.5–7 Hz predominantly postural or intention tremor vs. exaggerated physiological tremor vs. pseudo-rhythmic activity arising from cerebellar dysfunction vs. psychogenic tremor), pathophysiological mechanisms (potential implication of cerebellum, cerebello-thalamo-cortical pathways, basal ganglia, and brainstem), assessment modalities (e.g., tremor rating scales, Stewart–Holmes maneuver, visual tracking, digitized spirography and accelerometric techniques, accelerometry–electromyography coupling), and therapeutic options (i.e., including pharmacological agents, botulinum toxin A injections; deep brain stimulation or thalamotomy reserved for severe, disabling, or pharmaco-resistant tremors). Some suggestions are provided to help overcome the unmet needs and guide future therapeutic and diagnostic studies in this complex disorder.

show abstract

Section: Assessment Modalitiesmentioning

confidence: 99%

Tremor in Multiple Sclerosis—An Overview and Future Perspectives

et al. 2020

View full text Add to dashboard Cite

show abstract

“…They successfully differentiate pwMS with intention tremor from pwMS with no tremor and healthy subjects (HS) by comparing the radial and tangential velocity PSD in the 3–5 Hz frequencies with FTMRS scores. Archimedes spirals drawings have also proven to be a good measure to identify the presence of intention tremor in pwMS by comparing it with FTN, 9HPT, and BBT [ 66 ]. Measuring the segment rate, i.e., the number of times the pen changes from the upward to the downward direction, is the feature that correlates more to visually inspected intention tremor.…”

Section: Technologies For Tremor Assessmentmentioning

confidence: 99%

Upper limb intention tremor assessment: opportunities and challenges in wearable technology

Paredes-Acuna,

Utpadel-Fischler,

Ding

et al. 2024

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

Background Tremors are involuntary rhythmic movements commonly present in neurological diseases such as Parkinson's disease, essential tremor, and multiple sclerosis. Intention tremor is a subtype associated with lesions in the cerebellum and its connected pathways, and it is a common symptom in diseases associated with cerebellar pathology. While clinicians traditionally use tests to identify tremor type and severity, recent advancements in wearable technology have provided quantifiable ways to measure movement and tremor using motion capture systems, app-based tasks and tools, and physiology-based measurements. However, quantifying intention tremor remains challenging due to its changing nature. Methodology & Results This review examines the current state of upper limb tremor assessment technology and discusses potential directions to further develop new and existing algorithms and sensors to better quantify tremor, specifically intention tremor. A comprehensive search using PubMed and Scopus was performed using keywords related to technologies for tremor assessment. Afterward, screened results were filtered for relevance and eligibility and further classified into technology type. A total of 243 publications were selected for this review and classified according to their type: body function level: movement-based, activity level: task and tool-based, and physiology-based. Furthermore, each publication's methods, purpose, and technology are summarized in the appendix table. Conclusions Our survey suggests a need for more targeted tasks to evaluate intention tremors, including digitized tasks related to intentional movements, neurological and physiological measurements targeting the cerebellum and its pathways, and signal processing techniques that differentiate voluntary from involuntary movement in motion capture systems.

show abstract

“…Developing accessible, objective measures that capture upper extremity dysfunction and progression in MS is an unmet need. Early evidence has shown the potential of novel, smartphone sensor-based, visually guided tasks to objectively assess upper extremity function with high granularity in MS, 3,[14][15][16][17] Parkinson's disease, 18,19 Huntington's disease, 20 and essential tremor. 21 The study "Monitoring of Multiple Sclerosis Participants With the Use of Digital Technology (Smartphones and Smartwatches) -A Feasibility Study" was the first clinical trial to implement the Draw a Shape (DaS) Test from the Floodlight Proof-of-Concept (PoC) app.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preliminary validity of the Draw a Shape Test for upper extremity assessment in multiple sclerosis

Graves

Ganzetti

Dondelinger

et al. 2022

Ann Clin Transl Neurol

View full text Add to dashboard Cite

Objective To validate the smartphone sensor‐based Draw a Shape Test – a part of the Floodlight Proof‐of‐Concept app for remotely assessing multiple sclerosis‐related upper extremity impairment by tracing six different shapes. Methods People with multiple sclerosis, classified functionally normal/abnormal via their Nine‐Hole Peg Test time, and healthy controls participated in a 24‐week, nonrandomized study. Spatial (trace accuracy), temporal (mean and variability in linear, angular, and radial drawing velocities, and dwell time ratio), and spatiotemporal features (trace celerity) were cross‐sectionally analyzed for correlation with standard clinical and brain magnetic resonance imaging (normalized brain volume and total lesion volume) disease burden measures, and for capacity to differentiate people with multiple sclerosis from healthy controls. Results Data from 69 people with multiple sclerosis and 18 healthy controls were analyzed. Trace accuracy (all shapes), linear velocity variability (circle, figure‐of‐8, spiral shapes), and radial velocity variability (spiral shape) had a mostly fair/moderate‐to‐good correlation (|r| = 0.14–0.66) with all disease burden measures. Trace celerity also had mostly fair/moderate‐to‐good correlation (|r| = 0.18–0.41) with Nine‐Hole Peg Test performance, cerebellar functional system score, and brain magnetic resonance imaging. Furthermore, partial correlation analysis related these results to motor impairment. People with multiple sclerosis showed greater drawing velocity variability, though slower mean velocity, than healthy controls. Linear velocity (spiral shape) and angular velocity (circle shape) potentially differentiate functionally normal people with multiple sclerosis from healthy controls. Interpretation The Draw a Shape Test objectively assesses upper extremity impairment and correlates with all disease burden measures, thus aiding multiple sclerosis‐related upper extremity impairment characterization.

show abstract

Quantification characteristics of digital spiral analysis for understanding the relationship among tremor and clinical measures in persons with multiple sclerosis

Cited by 8 publications

References 30 publications

Tremor in Multiple Sclerosis—An Overview and Future Perspectives

Tremor in Multiple Sclerosis—An Overview and Future Perspectives

Upper limb intention tremor assessment: opportunities and challenges in wearable technology

Preliminary validity of the Draw a Shape Test for upper extremity assessment in multiple sclerosis

Contact Info

Product

Resources

About