The motor prodromes of parkinson’s disease: from bedside observation to large-scale application

Simonet, Cristina; Schrag, Anette; Lees, Andrew J.; Noyce, Alastair J.

doi:10.1007/s00415-019-09642-0

Cited by 36 publications

(37 citation statements)

References 87 publications

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“…Although several decades earlier in 22q11.2DS, there are parallels with the emergence of age-dependent parkinsonism in the general population, 9,18 where reported MDS-UPDRS part III median (interquartile range; IQR) total scores were 3 (1.0-5.5) for 74 persons aged 72.2 (69.0-75.5) years in a higher-risk subset and 1 (0.0-3.0) for a lower-risk subset (n = 111) aged 64.9 (62.8-66.6) years. 18 The findings are also consistent with those for other patient groups at increased risk of PD 19,20 and previous smaller studies of 22q11.2DS and healthy controls. [5][6][7] Furthermore, the results indicate that vigilance for parkinsonian signs should not be restricted to adults with 22q11.2DS who take antipsychotic medication.…”

Section: Discussionsupporting

confidence: 88%

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Age‐Related Parkinsonian Signs in Microdeletion 22q11.2

et al. 2020

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Background The recurrent hemizygous 22q11.2 deletion associated with 22q11.2 deletion syndrome has been identified as a genetic risk factor for early‐onset PD. However, little is known about early motor signs in this condition. Objectives We examined the presence, severity and possible factors associated with parkinsonism in adults with 22q11.2 deletion syndrome and without PD. Methods We compared motor signs between 82 adults with 22q11.2 deletion syndrome and 25 healthy controls, using the MDS‐UPDRS part III, and three‐dimensional motion‐tracker technology to quantify components of bradykinesia. Results Median MDS‐UPDRS part III total and bradykinesia subscores were significantly higher in 22q11.2 deletion syndrome (median age: 26 years; range, 17–65) than in controls ( P = 0.000; P = 0.000, respectively). Age was a significant contributor to bradykinesia subscore ( B = 0.06; P = 0.01) and to the electronic bradykinesia component, velocity ( B = –0.02; P = 0.000); psychotic illness did not significantly impact these analyses. In 22q11.2 deletion syndrome, MDS‐UPDRS–defined bradykinesia was present in 18.3%, rigidity in 14.6%, and rest tremor in 12.2%. Conclusions Parkinsonian motor signs appear to be common and age related in 22q11.2 deletion syndrome. Longitudinal studies are needed to investigate possible symptom progression to PD. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionsupporting

confidence: 88%

“…Furthermore, not all adults with "parkinsonian signs" necessarily have true parkinsonism or PD. 20,27 Although causal inferences cannot be made, the results provide important input for future studies estimating causality.…”

Section: Discussionmentioning

confidence: 99%

Age‐Related Parkinsonian Signs in Microdeletion 22q11.2

et al. 2020

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“…Pathological changes are present in other neuronal populations as well, explaining the development of various non-motor impairments in PD [2] . Most diagnoses are based on clinical detection of motor signs—the presence of two or more of tremor, rigidity, bradykinesia, or postural impairment [3] . Confirmatory evidence can be provided by dopamine transporter scanning, though this test is not widely available across the world.…”

Section: Introductionmentioning

confidence: 99%

Detecting Effect of Levodopa in Parkinson’s Disease Patients Using Sustained Phonemes

Pah

Motin

Kempster

et al. 2021

IEEE J. Transl. Eng. Health Med.

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Background: Parkinson’s disease (PD) is a multi-symptom neurodegenerative disease generally managed with medications, of which levodopa is the most effective. Determining the dosage of levodopa requires regular meetings where motor function can be observed. Speech impairment is an early symptom in PD and has been proposed for early detection and monitoring of the disease. However, findings from previous research on the effect of levodopa on speech have not shown a consistent picture. Method: This study has investigated the effect of medication on PD patients for three sustained phonemes; /a/, /o/, and /m/, which were recorded from 24 PD patients during medication off and on stages, and from 22 healthy participants. The differences were statistically investigated, and the features were classified using Support Vector Machine (SVM). Results: The results show that medication has a significant effect on the change of time and amplitude perturbation (jitter and shimmer) and harmonics of /m/, which was the most sensitive individual phoneme to the levodopa response. /m/ and /o/ performed at a comparable level in discriminating PD- off from control recordings. However, SVM classifications based on the combined use of the three phonemes /a/, /o/, and /m/ showed the best classifications, both for medication effect and for separating PD from control voice. The SVM classification for PD- off versus PD- on achieved an AUC of 0.81. Conclusion: Studies of phonation by computerized voice analysis in PD should employ recordings of multiple phonemes. Our findings are potentially relevant in research to identify early parkinsonian dysarthria, and to tele-monitoring of the levodopa response in patients with established PD.

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“…The three key elements characteristic of motor impairment in PD are bradykinesia, rigidity, and tremor [15]. Blinking is a spontaneous movement of the palpebrae due to an automatic, cyclic interplay between the elevator palpebrae superioris muscle the palpebral portion of the orbicularis oculi muscle, the reduction of blinking may be an early sign of PD [16]. Other types of movement disorders, like tremor of the eyes or of the head, can be observed in patients affected by PD sometimes early in the disease development [17].…”

Section: The Alzheimer's and Parkinson's Diseasesmentioning

confidence: 99%

Early Detection of External Neurological Symptoms through a Wearable Smart-Glasses Prototype

Sciarrone

Bisio

Garibotto

et al. 2021

JCOMSS

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The Internet of Things (IoT) framework is moving the research community to provide smart systems and solutions aimed at revolutionizing medical sciences and healthcare. Given the extreme diffusion of Alzheimer's disease (AD) and Parkinson's disease (PD), the demand for a solution to early detect neurological symptoms of such diseases strongly arose. According to the medical literature, such early detection can be obtained through the correlation between PD and AD and some external symptoms: the Essential Tremor (ET) and the number of Eye Blinks (EBs). In this paper, which can be considered as an extended version of [1], we present a prototype of wearable smart glasses able to detect the presence of ET of the head and to count the number of EBs at the same time, in a transparent way with respect to the final user. Numerical results demonstrate the reliability of the proposed approach: the proposed algorithms are able to i) correctly recognize the ET with an overall accuracy above 97% and ii) count the number of EBs with an overall error around 9%.

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The motor prodromes of parkinson’s disease: from bedside observation to large-scale application

Cited by 36 publications

References 87 publications

Age‐Related Parkinsonian Signs in Microdeletion 22q11.2

Age‐Related Parkinsonian Signs in Microdeletion 22q11.2

Detecting Effect of Levodopa in Parkinson’s Disease Patients Using Sustained Phonemes

Early Detection of External Neurological Symptoms through a Wearable Smart-Glasses Prototype

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