Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington’s Disease: A Cross-Sectional Multicentre Study

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington’s disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.The project leading to these results has received funding from “La Caixa” Foundation (ID100010434), under agreement FUI1-PI008

Expanded and Independent Spanish Validation of the MDS-Non Motor Rating Scale

[Background] The Movement Disorder Society-sponsored Non-motor Rating Scale (MDS-NMS) assess the severity and disability caused by non-motor symptoms (NMS) in Parkinson's disease (PD).[Objective] This article encapsulates the formal process for completing this program and the data on the first officially approved non-English version of the MDS-NMS (Spanish).[Methods] The MDS-NMS translation program involves four steps: translation and back-translation; cognitive pre-testing to ensure that raters and patients understand the scale and are comfortable with its content; field testing of the finalized version; analysis of the factor structure of the tested version against the original English language version for the nine domains that could be analyzed in a confirmatory factor analysis. To be designated an “Official MDS translation,” the confirmatory factor analysis Comparative Fit Index had to be ≥0.90.[Results] The Spanish MDS-NMS was tested in 364 native-Spanish-speaking patients with PD from seven countries. For all subjects with fully computable data with all domains of the MDS-NMS (n = 349), the Comparative Fit Index was ≥0.90 for the nine eligible domains. Missing data were negligible and moderate floor effect (42.90%) was found for the Non-Motor Fluctuations subscale. Item homogeneity coefficient was adequate, and the correlation of the MDS-NMS domains with other measures for related constructs was acceptable (rs ≥ 0.50).[Conclusions] The Spanish version of the MDS-NMS followed the IPMDS Translation Program protocol, reached the criterion to be designated as an Official Translation, and is now available on the MDS website.Grant support from the International Parkinson and Movement Disorder SocietyPeer reviewe

Adopting a multidisciplinary telemedicine intervention for fall prevention in Parkinson’s disease. Protocol for a longitudinal, randomized clinical trial

Approximately 40–70% of people with Parkinson’s disease (PD) fall each year, causing decreased activity levels and quality of life. Current fall-prevention strategies include the use of pharmacological and non-pharmacological therapies. To increase the accessibility of this vulnerable population, we developed a multidisciplinary telemedicine program using an Information and Communication Technology (ICT) platform. We hypothesized that the risk for falling in PD would decrease among participants receiving a multidisciplinary telemedicine intervention program added to standard office-based neurological care.This work was supported by the project PI19/00670 of the Ministerio de Ciencia, Innovacio´n y Universidades, Instituto de Salud Carlos II, Spain. The authors gratefully acknowledge the support of NVIDIA Corporation and its donation of the TITAN Xp GPUs used in this research

A Low-Cost System Using a Big-Data Deep-Learning Framework for Assessing Physical Telerehabilitation: A Proof-of-Concept

The consolidation of telerehabilitation for the treatment of many diseases over the last decades is a consequence of its cost-effective results and its ability to offer access to rehabilitation in remote areas. Telerehabilitation operates over a distance, so vulnerable patients are never exposed to unnecessary risks. Despite its low cost, the need for a professional to assess therapeutic exercises and proper corporal movements online should also be mentioned. The focus of this paper is on a telerehabilitation system for patients suffering from Parkinson’s disease in remote villages and other less accessible locations. A full-stack is presented using big data frameworks that facilitate communication between the patient and the occupational therapist, the recording of each session, and real-time skeleton identification using artificial intelligence techniques. Big data technologies are used to process the numerous videos that are generated during the course of treating simultaneous patients. Moreover, the skeleton of each patient can be estimated using deep neural networks for automated evaluation of corporal exercises, which is of immense help to the therapists in charge of the treatment programs.This work was supported by project PI19/00670 of the Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Spain. The authors gratefully acknowledge the support of the NVIDIA Corporation and its donation of the TITAN Xp GPU used in this research. In addition, this work was partially supported by the European Social Fund, as the authors José Miguel Ramírez-Sanz, José Luis Garrido-Labrador, and Alicia Olivares-Gil are the recipients of a pre-doctoral grant (EDU/875/2021) from the Conserjería de Educación de la Junta de Castilla y León

Assistive Devices for Personal Mobility in Parkinson's Disease: A Systematic Review of the Literature

Artículo de revisiónGait abnormalities are a hallmark of Parkinson’s disease and contribute to falling risk. As disease symptoms progress, assistive devices are often prescribed. However, there are no guidelines for choosing appropriate ambulatory devices for gait impairment.This work was supported by the project PI19/00670 of the Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III, Spain. The authors declare that there are no additional disclosures to report relevant to this work

Proyecto de gestión de calidad y mejora para la disminución de los errores en el manejo de los citostáticos

Los fármacos citostáticos están formados por diversas sustancias químicas que se utilizan como terapia única o combinada para el tratamiento de enfermedades neoplásicas (1,2). La eficacia que se ha conseguido alcanzar en el tratamiento de este tipo de patologías con este tipo de fármacos ha incrementado el empleo de estos durante los últimos años. Sin embargo, a pesar de que son altamente beneficiosos, también conllevan una serie de riesgos, que pueden ser letales (2,3). Especialmente porque tienen un estrecho margen terapéutico, por lo que un pequeño error puede generar una alta toxicidad en los pacientes (4). Las consecuencias para los pacientes pueden ser diversas. Algunos estudios han clasificado la severidad de los efectos adversos, como incidentes sin daño (50%), daños potenciales (41% )o incluso el fallecimiento (9%) (3)

Computer Vision for Parkinson’s Disease Evaluation: A Survey on Finger Tapping

Parkinson’s disease (PD) is a progressive neurodegenerative disorder whose prevalence has steadily been rising over the years. Specialist neurologists across the world assess and diagnose patients with PD, although the diagnostic process is time-consuming and various symptoms take years to appear, which means that the diagnosis is prone to human error. The partial automatization of PD assessment and diagnosis through computational processes has therefore been considered for some time. One well-known tool for PD assessment is finger tapping (FT), which can now be assessed through computer vision (CV). Artificial intelligence and related advances over recent decades, more specifically in the area of CV, have made it possible to develop computer systems that can help specialists assess and diagnose PD. The aim of this study is to review some advances related to CV techniques and FT so as to offer insight into future research lines that technological advances are now opening up

Research project. Restless legs syndrome: follow-up of an adult population cohort in Burgos

Objetivos: estudiar la evolución de la cohorte a la largo de 11 años (2007-2018). Mientras que, los objetivos específicos han sido: analizar las diferencias entre casos y controles; conocer la tasa de mortalidad de la cohorte y su relación con el síndrome de piernas inquietas; estimar el impacto del síndrome de piernas inquietas en la calidad de vida relacionada con la salud y el sueño. Métodos: el estudio ha seguido una metodología observacional, retrospectiva y longitudinal de una cohorte de casos y controles, formada por 232 pacientes. En ambas evaluaciones se recogieron datos sociodemográficos, clínicos (se administraron las siguientes escalas: EuroQol, Índice de Comorbilidad de Charlson, escala de ansiedad y depresión de Goldberg, escala de somnolencia de Epworth y el cuestionario de Calidad de Vida del síndrome de piernas inquietas) y analíticos, y en la segunda evaluación también se recolectaron datos de actigrafía (actividad física y sueño).Objective: to study the evolution of the cohort over 11 years (2007-2018). Considering that the specific objectives have been: to analyze the differences between cases and controls; know the mortality rate of the cohort and its relationship with restless legs syndrome; estimate the impact of restless legs syndrome on health and sleep- related quality of life. Methods: the study has followed an observational, retrospective and longitudinal methodology of a cohort of cases and controls, made up of 232 patients. Sociodemographic and clinical data were collected in both evaluations (the following scales were administered: EuroQol, Charlson's Comorbidity Index, Goldberg's anxiety and depression scale, Epworth's sleepiness scale and the Quality-of-Life questionnaire for restless legs syndrome) and analytical, and in the second evaluation actigraphy data (physical activity and sleep) were also collected.El proyecto fue financiado con una beca del Servicio de Salud de Castilla y León (Sacyl), GRS 1764/A/18

Time evolution of cytokine profiles associated with mortality in COVID-19 hospitalized patients

Producción CientíficaBackground: High cytokine levels have been associated with severe COVID-19 disease. Although many cytokine studies have been performed, not many of them include combinatorial analysis of cytokine profiles through time. In this study we investigate the association of certain cytokine profiles and its evolution, and mortality in SARS-CoV2 infection in hospitalized patients. Methods: Serum concentration of 45 cytokines was determined in 28 controls at day of admission and in 108 patients with COVID-19 disease at first, third and sixth day of admission. A principal component analysis (PCA) was performed to characterize cytokine profiles through time associated with mortality and survival in hospitalized patients. Results: At day of admission non-survivors present significantly higher levels of IL-1α and VEGFA (PC3) but not through follow up. However, the combination of HGF, MCP-1, IL-18, eotaxine, and SCF (PC2) are significantly higher in non-survivors at all three time-points presenting an increased trend in this group through time. On the other hand, BDNF, IL-12 and IL-15 (PC1) are significantly reduced in non-survivors at all time points with a decreasing trend through time, though a protective factor. The combined mortality prediction accuracy of PC3 at day 1 and PC1 and PC2 at day 6 is 89.00% (p<0.001). Conclusions: Hypercytokinemia is a hallmark of COVID-19 but relevant differences between survivors and non-survivors can be early observed. Combinatorial analysis of serum cytokines and chemokines can contribute to mortality risk assessment and optimize therapeutic strategies. Three clusters of cytokines have been identified as independent markers or risk factors of COVID mortality

Occupational performance in Huntington’s disease: A cross-sectional study

Introduction: Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder characterized by motor dysfunction, cognitive impairment, and psychiatric disorders. These symptoms cause functional limitations in occupational performance. This study aimed to describe the difficulties in self-care, productivity, and leisure activities and to analyze the patients’ own perception and satisfaction and the association with sex, age, disability, HD severity, and quality of life. Method: We conducted an observational, retrospective study in 38 patients with HD without cognitive impairment at the Burgos University Hospital. We assessed occupational performance, quality of life, and HD severity with the Canadian Occupational Performance Measure, Short-Form Health Survey 12, Unified Huntington’s Disease Rating Scale, Total Functional Capacity, and the Problems Behavior Assessment. Results: One hundred sixty-five occupations (median 4, range 2–7) were categorized as self-care (50.90%), leisure (30.30%), and productivity (18.79%). Patients reported a higher degree of satisfaction with the activities prioritized than with the degree of performance. Elderly HD patients reported more satisfaction in leisure and women in self-care. Self-ratings of satisfaction in productivity were associated with higher levels of mental wellbeing. Conclusions: HD patients have problems with their daily life occupations, particularly with self-care. This underlines the need for assessment tools that capture the complexity of occupations