Future Opportunities for IoT to Support People with Parkinson’s

Recent years have seen an explosion of internet of things (IoT) technologies being released to the market. There has also been an emerging interest in the potentials of IoT devices to support people with chronic health conditions. In this paper, we describe the results of engagements to scope the future potentials of IoT for supporting people with Parkinson’s. We ran a 2-day multi-disciplinary event with professionals with expertise in Parkinson’s and IoT, to explore the opportunities, challenges and benefits. We then ran 4 workshops, engaging 13 people with Parkinson’s and caregivers, to scope out the needs, values and desires that the community has for utilizing IoT to monitor their symptoms. This work contributes a set of considerations for future IoT solutions that might support people with Parkinson’s in better understanding their condition, through the provision of objective measurements that correspond to their, currently unmeasured, subjective experiences

Acute Neuromuscular Adaptations in the Postural Control of Patients with Parkinson’s Disease after Perturbed Walking

Patients suffering from Parkinson’s disease (PD) present motor impairments reflected in the dynamics of the center of pressure (CoP) adjustments during quiet standing. One method to study the dynamics of CoP adjustments is the entropic half-life (EnHL), which measures the short-term correlations of a time series at different time scales. Changes in the EnHL of CoP time series suggest neuromuscular adaptations in the control of posture. In this study, we sought to investigate the immediate changes in the EnHL of CoP adjustments of patients with PD during one session of perturbed (experimental group) and unperturbed treadmill walking (control group). A total of 39 patients with PD participated in this study. The experimental group (n = 19) walked on a treadmill providing small tilting of the treadmill platform. The control group (n = 20) walked without perturbations. Each participant performed 5-min practice followed by three 5-min training blocks of walking with or without perturbation (with 3-min resting in between). Quiet standing CoP data was collected for 30 s at pre-training, after each training block, immediately post-training, and after 10 min retention. The EnHL was computed on the original and surrogates (phase-randomized) CoP signals in the medio-lateral (ML) and anterior–posterior (AP) directions. Data was analyzed using four-way mixed ANOVA. Increased EnHL values were observed for both groups (Time effect, p < 0.001) as the intervention progressed, suggesting neuromuscular adaptations in the control of posture. The EnHL of surrogate signals were significantly lower than for original signals (p < 0.001), confirming that these adaptations come from non-random control processes. There was no Group effect (p = 0.622), however by analyzing the significant Group by Direction by Time interaction (p < 0.05), a more pronounced effect in the ML direction of the perturbed group was observed. Altogether, our findings show that treadmill walking decreases the complexity of CoP adjustments, suggesting neuromuscular adaptations in balance control during a short training period. Further investigations are required to assess these adaptations during longer training intervals

Fabrication and validation of reference structures for the localization of subdural standard- and micro-electrodes in MRI

Objective.Report simple reference structure fabrication and validate the precise localization of subdural micro- and standard electrodes in magnetic resonance imaging (MRI) in phantom experiments.Approach. Electrode contacts with diameters of 0.3 mm and 4 mm are localized in 1.5 T MRI using reference structures made of silicone and iron oxide nanoparticle doping. The precision of the localization procedure was assessed for several standard MRI sequences and implant orientations in phantom experiments and compared to common clinical localization procedures.Main results.A localization precision of 0.41 +/- 0.20 mm could be achieved for both electrode diameters compared to 1.46 +/- 0.69 mm that was achieved for 4 mm standard electrode contacts localized using a common clinical standard method. The new reference structures are intrinsically bio-compatible, and they can be detected with currently available feature detection software so that a clinical implementation of this technology should be feasible.Significance.Neuropathologies are increasingly diagnosed and treated with subdural electrodes, where the exact localization of the electrode contacts with respect to the patient's cortical anatomy is a prerequisite for the procedure. Post-implantation electrode localization using MRI may be advantageous compared to the common alternative of CT-MRI image co-registration, as it avoids systematic localization errors associated with the co-registration itself, as well as brain shift and implant movement. Additionally, MRI provides superior soft tissue contrast for the identification of brain lesions without exposing the patient to ionizing radiation. Recent studies show that smaller electrodes and high-density electrode grids are ideal for clinical and research purposes, but the localization of these devices in MRI has not been demonstrated