Regular and stochastic behavior of Parkinsonian pathological tremor signals

Regular and stochastic behavior in the time series of Parkinsonian pathological tremor velocity is studied on the basis of the statistical theory of discrete non-Markov stochastic processes and flicker-noise spectroscopy. We have developed a new method of analyzing and diagnosing Parkinson's disease (PD) by taking into consideration discreteness, fluctuations, long- and short-range correlations, regular and stochastic behavior, Markov and non-Markov effects and dynamic alternation of relaxation modes in the initial time signals. The spectrum of the statistical non-Markovity parameter reflects Markovity and non-Markovity in the initial time series of tremor. The relaxation and kinetic parameters used in the method allow us to estimate the relaxation scales of diverse scenarios of the time signals produced by the patient in various dynamic states. The local time behavior of the initial time correlation function and the first point of the non-Markovity parameter give detailed information about the variation of pathological tremor in the local regions of the time series. The obtained results can be used to find the most effective method of reducing or suppressing pathological tremor in each individual case of a PD patient. Generally, the method allows one to assess the efficacy of the medical treatment for a group of PD patients.Comment: 39 pages, 10 figures, 1 table Physica A, in pres

Towards the Development of a Wearable Tremor Suppression Glove

Patients diagnosed with Parkinson’s disease (PD) often associate with tremor. Among other symptoms of PD, tremor is the most aggressive symptom and it is difficult to control with traditional treatments. This thesis presents the assessment of Parkinsonian hand tremor in both the time domain and the frequency domain, the performance of a tremor estimator using different tremor models, and the development of a novel mechatronic transmission system for a wearable tremor suppression device. This transmission system functions as a mechatronic splitter that allows a single power source to support multiple independent applications. Unique features of this transmission system include low power consumption and adjustability in size and weight. Tremor assessment results showed that the hand tremor signal often presents a multi-harmonics pattern. The use of a multi-harmonics tremor model produced a better estimation result than using a monoharmonic tremor model

Pathological Tremor as a Mechanical System: Modeling and Control of Artificial Muscle-Based Tremor Suppression

Central nervous system disorders produce the undesired, approximately rhythmic movement of body parts known as pathological tremor. This undesired motion inhibits the patient\u27s ability to perform tasks of daily living and participate in society. Typical treatments are medications and deep brain stimulation surgery, both of which include risks, side effects, and varying efficacy. Since the pathophysiology of tremor is not well understood, empirical investigation drives tremor treatment development. This dissertation explores tremor from a mechanical systems perspective to work towards theory-driven treatment design. The primary negative outcome of pathological tremor is the undesired movement of body parts: mechanically suppressing this motion provides effective tremor treatment by restoring limb function. Unlike typical treatments, the mechanisms for mechanical tremor suppression are well understood: applying joint torques that oppose tremor-producing muscular torques will reduce tremor irrespective of central nervous system pathophysiology. However, a tremor suppression system must also consider voluntary movements. For example, mechanically constraining the arm in a rigid cast eliminates tremor motion, but also eliminates the ability to produce voluntary motions. Indeed, passive mechanical systems typically reduce tremor and voluntary motions equally due to the close proximity of their frequency content. Thus, mechanical tremor suppression requires active actuation to reduce tremor with minimal influence on voluntary motion. However, typical engineering actuators are rigid and bulky, preventing clinical implementations. This dissertation explores dielectric elastomers as tremor suppression actuators to improve clinical implementation potential of mechanical tremor suppression. Dielectric elastomers are often called artificial muscles due to their similar mechanical properties as human muscle; these similarities may enable relatively soft, low-profile implementations. The primary drawback of dielectric elastomers is their relatively low actuation levels compared to typical actuators. This research develops a tremor-active approach to dielectric elastomer-based tremor suppression. In a tremor-active approach, the actuators only actuate to oppose tremor, while the human motor system must overcome the passive actuator dynamics. This approach leverages the low mechanical impedance of dielectric elastomers to overcome their low actuation levels. Simulations with recorded tremor datasets demonstrate excellent and robust tremor suppression performance. Benchtop experiments validate the control approach on a scaled system. Since dielectric elastomers are not yet commercially available, this research quantifies the necessary dielectric elastomer parameters to enable clinical implementations and evaluates the potential of manufacturing approaches in the literature to achieve these parameters. Overall, tremor-active control using dielectric elastomers represents a promising alternative to medications and surgery. Such a system may achieve comparable tremor reduction as medications and deep brain stimulation with minimal risks and greater efficacy, but at the cost of increased patient effort to produce voluntary motions. Parallel advances in scaled dielectric elastomer manufacturing processes and high-voltage power electronics will enable consumer implementations. In addition to tremor suppression, this dissertation investigates the mechanisms of central nervous system tremor generation from a control systems perspective. This research investigates a delay-based model for parkinsonian tremor. Besides tremor, Parkinson\u27s disease generally inhibits movement, with typical symptoms including rigidity, bradykinesia, and increased reaction times. This fact raises the question as to how the same disease produces excessive movement (tremor) despite characteristically inhibiting movement. One possible answer is that excessive central nervous system inhibition produces unaccounted feedback delays that cause instability. This dissertation develops an optimal control model of human motor control with an unaccounted delay between the state estimator and controller. This delay represents the increased inhibition projected from the basal ganglia to the thalamus, delaying signals traveling from the cerebellum (estimator) to the primary motor cortex (controller). Model simulations show increased delays decrease tremor frequency and increase tremor amplitude, consistent with the evolution of tremor as the disease progresses. Simulations that incorporate tremor resetting and random variation in control saturation produce simulated tremor with similar characteristics as recorded tremor. Delay-induced tremor explains the effectiveness of deep brain stimulation in both the thalamus and basal ganglia since both regions contribute to the presence of feedback delay. Clinical evaluation of mechanical tremor suppression may provide clinical evidence for delay-induced tremor: unlike state-independent tremor, suppression of delay-induced tremor increases tremor frequency. Altogether, establishing the mechanisms for tremor generation will facilitate pathways towards improved treatments and cure development

Monitoring Motor Fluctuations in Patients With Parkinson’s Disease Using Wearable Sensors

This paper presents the results of a pilot study to assess the feasibility of using accelerometer data to estimate the severity of symptoms and motor complications in patients with Parkinson’s disease. A support vector machine (SVM) classifier was implemented to estimate the severity of tremor, bradykinesia and dyskinesia from accelerometer data features. SVM-based estimates were compared with clinical scores derived via visual inspection of video recordings taken while patients performed a series of standardized motor tasks. The analysis of the video recordings was performed by clinicians trained in the use of scales for the assessment of the severity of Parkinsonian symptoms and motor complications. Results derived from the accelerometer time series were analyzed to assess the effect on the estimation of clinical scores of the duration of the window utilized to derive segments (to eventually compute data features) from the accelerometer data, the use of different SVM kernels and misclassification cost values, and the use of data features derived from different motor tasks. Results were also analyzed to assess which combinations of data features carried enough information to reliably assess the severity of symptoms andmotor complications.Combinations of data features were compared taking into consideration the computational cost associated with estimating each data feature on the nodes of a body sensor network and the effect of using such data features on the reliability of SVM-based estimates of the severity of Parkinsonian symptoms and motor complications.Engineering and Applied Science

Spectral parameters for finger tapping quantification

A miniature inertial sensor placed on fingertip of index finger while performing finger tapping test can be used for an objective quantification of finger tapping motion. Temporal and spatial parameters such as cadence, tapping duration, and tapping angle can be extracted for detailed analysis. However, the mentioned parameters, although intuitive and simple to interpret, do not always provide all the necessary information regarding the subject's motor performance. Analysis of frequency content of the finger tapping movement can provide crucial information about the patient's condition. In this paper, we present parameters extracted from spectral analysis that we found to be significant for finger tapping assessment. With these parameters, tapping's intra-variability, movement smoothness and anomalies that may occur within the tapping performance can be detected and described, providing significant information for further diagnostics and monitoring progress of the disease or response to therapy

A Movement-Tremors Recorder for Patients of Neurodegenerative Diseases

Neurodegenerative diseases such as Alzheimer, Parkinson, motor neuron, and Chorea affect millions of people today. Their effect on the central nervous system causes the loss of brain functions as well as motor disturbances and sometimes cognitive deficits. In such a scenario, the monitoring and evaluation of early symptoms are mandatory for the improvement of the patient's quality of life. Here, the authors describe the development, the laboratory calibration, and the "in-field validation" under the medical supervision of a movement tremors recorder for subjects affected by neurodegenerative diseases. The developed device is based on an array of four accelerometers connected to an embedded development board. This system is able to monitor tremor/movement, accidental falls, and, moreover, it can track the Alzheimer subjects' geographical position. A remote supervisor can collect data from the system through Bluetooth, Wi-Fi, or GSM connections. A data compression algorithm was developed directly on board in order to increase the efficiency of data transmission and reduce power consumptions