Supine MDS-UPDRS-III Assessment: An Explorative Study

Kremer, Naomi I; Smid, Annemarie; Lange, Stefan; Marçal, Iara Mateus; Tamási, Katalin; Dijk, J. Marc C. van; Laar, Teus van; Drost, Gea

doi:10.3390/jcm12093108

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Lastly, approximately 10% of phenotypically healthy older adult participants may have had latent parkinsonism ( Gibb and Lees, 1988 ); however, they may not have been excluded from the present study. In future research, we would consider the addition of the UPDRS-III clinimetric scale ( Kremer et al, 2023 ) because it is similar to the UEF test and also may assist in identifying Parkinson’s disease, to assure our exclusion criteria is correctly applied. Further, we have previously developed a dual-task module for assessing cognitive impairment using the UEF test ( Toosizadeh et al, 2021b ; Eskandari et al, 2022 ; Ruberto et al, 2022 ; Toosizadeh et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Associating frailty and dynamic dysregulation between motor and cardiac autonomic systems

Arrué,

Laksari,

Russo

et al. 2024

Front. Aging

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Frailty is a geriatric syndrome associated with the lack of physiological reserve and consequent adverse outcomes (therapy complications and death) in older adults. Recent research has shown associations between heart rate (HR) dynamics (HR changes during physical activity) with frailty. The goal of the present study was to determine the effect of frailty on the interconnection between motor and cardiac systems during a localized upper-extremity function (UEF) test. Fifty-six individuals aged 65 or above were recruited and performed the previously developed UEF test consisting of 20-s rapid elbow flexion with the right arm. Frailty was assessed using the Fried phenotype. Wearable gyroscopes and electrocardiography were used to measure motor function and HR dynamics. In this study, the interconnection between motor (angular displacement) and cardiac (HR) performance was assessed, using convergent cross-mapping (CCM). A significantly weaker interconnection was observed among pre-frail and frail participants compared to non-frail individuals (p < 0.01, effect size = 0.81 ± 0.08). Using logistic models, pre-frailty and frailty were identified with sensitivity and specificity of 82%–89%, using motor, HR dynamics, and interconnection parameters. Findings suggested a strong association between cardiac-motor interconnection and frailty. Adding CCM parameters in a multimodal model may provide a promising measure of frailty.

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Section: Discussionmentioning

confidence: 99%

Associating frailty and dynamic dysregulation between motor and cardiac autonomic systems

Arrué,

Laksari,

Russo

et al. 2024

Front. Aging

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“…This research contributes to creating quantitative outcome measures in ET research and enabling physicians and other personnel to more objectively monitor patients with ET. Considering the few materials needed to perform the proposed accelerometric measurements, this technique is also suitable for monitoring tremors during awake neurosurgical procedures (e.g., deep brain stimulation surgery, MRI-guided focused ultrasound, and radioactive Gamma knife thalamotomy) [ 18 , 28 , 29 , 30 , 31 ]. As a future perspective, sensor-based measurement methods such as the one described in this article may allow patients to perform smartphone-assisted measurements at home, increasing patient self-management.…”

Section: Discussionmentioning

confidence: 99%

A Novel Accelerometry Method to Perioperatively Quantify Essential Tremor Based on Fahn–Tolosa–Marin Criteria

Smid

Pauwels

Elting

et al. 2023

JCM

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The disease status, progression, and treatment effect of essential tremor (ET) patients are currently assessed with clinical scores, such as the Fahn–Tolosa–Marin Clinical Rating Scale for Tremor (FTM). The use of objective and rater-independent monitoring of tremors may improve clinical care for patients with ET. Therefore, the focus of this study is to develop an objective accelerometry-based method to quantify ET, based on FTM criteria. Thirteen patients with ET and thirteen matched healthy participants underwent FTM tests to rate tremor severity, paired with tri-axial accelerometric measurements at the index fingers. Analogue FTM assessments were performed by four independent raters based on video recordings. Quantitative measures were derived from the accelerometric data, e.g., the area under the curve of power in the 4–8 Hz frequency band (AUCP) and maximal tremor amplitude. As such, accelerometric tremor scores were computed, using thresholds based on healthy measurements and FTM criteria. Agreement between accelerometric and clinical FTM scores was analyzed with Cohen’s kappa coefficient. It was assessed whether there was a relationship between mean FTM scores and the natural logarithm (ln) of the accelerometric outcome measures using linear regression. The agreement between accelerometric and FTM scores was substantial for resting and intention tremor tests (≥72.7%). However, the agreement between accelerometric postural tremor data and clinical FTM ratings (κ = 0.459) was low, although their logarithmic (ln) relationship was substantial (R2 ≥ 0.724). Accelerometric test–retest reliability was good to excellent (ICC ≥ 0.753). This pilot study shows that tremors can be quantified with accelerometry, using healthy thresholds and FTM criteria. The test–retest reliability of the accelerometric tremor scoring algorithm indicates that our low-cost accelerometry-based approach is a promising one. The proposed easy-to-use technology could diminish the rater dependency of FTM scores and enable physicians to monitor ET patients more objectively in clinical, intraoperative, and home settings.

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“…There are several methods to monitor tremor intensity [ 27 , 28 , 29 ]. Clinical scales (e.g., Movement Disorder Society Unified PD Rating Scale [MDS-UPDRS]) are often used to assess surgical results [ 30 , 31 ]. However, although the MDS-UPDRS is a standardized scoring system, the results can vary based on the experience of the rater [ 31 , 32 , 33 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical scales (e.g., Movement Disorder Society Unified PD Rating Scale [MDS-UPDRS]) are often used to assess surgical results [ 30 , 31 ]. However, although the MDS-UPDRS is a standardized scoring system, the results can vary based on the experience of the rater [ 31 , 32 , 33 , 34 , 35 ]. Sensor-based measurements, like tri-axial accelerometry, allow for objective and continuous quantification of tremor intensity [ 34 , 36 , 37 ].…”

Section: Introductionmentioning

confidence: 99%

The Relevance of Intraoperative Clinical and Accelerometric Measurements for Thalamotomy Outcome

Smid,

Oterdoom,

Pauwels

et al. 2023

JCM

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Thalamotomy alleviates medication-refractory tremors in patients with movement disorders such as Parkinson’s Disease (PD), Essential tremor (ET), and Holmes tremor (HT). However, limited data are available on tremor intensity during different thalamotomy stages. Also, the predictive value of the intraoperative tremor status for treatment outcomes remains unclear. Therefore, we aimed to quantify tremor status during thalamotomy and postoperatively. Data were gathered between January 2020 and June 2023 during consecutive unilateral thalamotomy procedures in patients with PD (n = 13), ET (n = 8), and HT (n = 3). MDS-UPDRS scores and tri-axial accelerometry data were obtained during rest, postural, and intention tremor tests. Measurements were performed intraoperatively (1) before lesioning-probe insertion, (2) directly after lesioning-probe insertion, (3) during coagulation, (4) directly after coagulation, and (5) 4–6 months post-surgery. Accelerometric data were recorded continuously during the coagulation process. Outcome measures included MDS-UPDRS tremor scores and accelerometric parameters (peak frequency, tremor amplitude, and area under the curve of power (AUCP)). Tremor intensity was assessed for the insertion effect (1–2), during coagulation (3), post-coagulation effect (1–4), and postoperative effect (1–5). Following insertion and coagulation, tremor intensity improved significantly compared to baseline (p < 0.001). The insertion effect clearly correlated with the postoperative effect (ρ = 0.863, p < 0.001). Both tremor amplitude and AUCP declined gradually during coagulation. Peak frequency did not change significantly intraoperatively. In conclusion, the study data show that both the intraoperative insertion effect and the post-coagulation effect are good predictors for thalamotomy outcomes.

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Supine MDS-UPDRS-III Assessment: An Explorative Study

Cited by 6 publications

References 20 publications

Associating frailty and dynamic dysregulation between motor and cardiac autonomic systems

Associating frailty and dynamic dysregulation between motor and cardiac autonomic systems

A Novel Accelerometry Method to Perioperatively Quantify Essential Tremor Based on Fahn–Tolosa–Marin Criteria

The Relevance of Intraoperative Clinical and Accelerometric Measurements for Thalamotomy Outcome

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