Time measurement characterization of stand-to-sit and sit-to-stand transitions by using a smartphone

The aim of this study is to analyze a common method to measure the acceleration of a daily activity pattern by using a smartphone. In this sense, a numerical approach is proposed to transform the relative acceleration signal, recorded by a triaxial accelerometer, into an acceleration referred to an inertial reference. The integration of this acceleration allows to determine the velocity and position with respect to an inertial reference. Two different kinematic parameters are suggested to characterize the profile of the velocity during the sit-to-stand and stand-to-sit transitions for Parkinson and control subjects. The results show that a dimensionless kinematic parameter, which is linked to the time of sit-to-stand and stand-to-sit transitions, has the potential to differentiate between Parkinson and control subjects.Peer ReviewedPreprin

Caracterización del ángulo de inclinación en los planos sagital y frontal de pacientes enfermos de Parkinson utilizando un acelerómetero triaxial

Una de las enfermedades que con frecuencia se presenta en la actualidad en personas adultas es la enfermedad de Parkinson (EP). En el proceso de diagnóstico clínico de la misma se utilizan diferentes exámenes clínicos siendo uno de ellos el examen Levantarse-Sentarse. La determinación precisa del estado de una persona para saber si padece Parkinson o no y el grado de avance de la enfermedad de un paciente se realiza básicamente mediante diagnósticos clínicos y utilizando las escalas Hoehn & Yarh y la UPDRS de progresión y severidad de la enfermedad. En estas escalas el diagnóstico se hace a través de una valoración visual de los médicos especialistas del comportamiento del paciente. El presente trabajo expone un estudio del movimiento de un grupo de diez pacientes enfermos de Parkinson y de cinco controles −personas sanas− utilizando un acelerómetro triaxial colocado en la espalda del paciente, durante la realización del examen antes citado. El objetivo del estudio es obtener información del proceso de movimiento e identificar variables que permitan diferenciar el grupo de controles y el de pacientes.Postprint (published version

Analysis of four scales for global severity evaluation in Parkinson’s disease

Global evaluations of Parkinson?s disease (PD) severity are available, but their concordance and accuracy have not been previously tested. The present international, cross-sectional study was aimed at determining the agreement level among four global scales for PD (Hoehn and Yahr, HY; Clinical Global Impression of Severity, CGIS; Clinical Impression of Severity Index, CISI-PD; and Patient Global Impression of Severity, PGIS) and identifying which of them better correlates with itemized PD assessments. Assessments included additional scales for evaluation of the movement impairment, disability, affective disorders, and quality of life. Spearman correlation coefficients, weighted and generalized kappa, and Kendall?s concordance coefficient were used. Four hundred thirty three PD patients, 66% in HY stages 2 or 3, mean disease duration 8.8 years, were analyzed. Correlation between the global scales ranged from 0.60 (HY with PGIS) to 0.91 (CGIS with CISI-PD). Kendall?s coefficient of concordance resulted 0.76 (P<0.0001). HY and CISI-PD showed the highest association with age, disease duration, and levodopa-equivalent daily dose, and CISI-PD with measures of PD manifestations, disability, and quality of life. PGIS and CISI-PD correlated similarly with anxiety and depression scores. The lowest agreement in classifying patients as mild, moderate, or severe was observed between PGIS and HY or CISI-PD (58%) and the highest between CGIS and CISI-PD (84.3%). The four PD global severity scales agree moderately to strongly among them; clinician-based ratings estimate PD severity, as established by other measures, better than PGIS; and the CISI-PD showed the highest association with measures of impairment, disability, and quality of life.Fil: Martinez Martin, Pablo. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Rojo Abuin, José Manuel. Consejo Superior de Investigaciones Cientificas. Centro de Ciencias Humanas y Sociales. Instituto de Historia.; EspañaFil: Rodríguez Violante, Mayela. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Serrano Dueñas, Marcos. Pontificia Universidad Católica del Ecuador; EcuadorFil: Garreto, Nélida Susana. Universidad de Buenos Aires. Facultad de Medicina. Centro Universitario de Neurologia "dr. Jose Maria Ramos Mejia".; ArgentinaFil: Martínez Castrillo, Juan Carlos. Instituto Ramón y Cajal de Investigación Sanitaria; EspañaFil: Campos Arillo, Víctor. Hospital Xanit International; EspañaFil: Fernández, William. Universidad Nacional de Colombia; ColombiaFil: Chaná Cuevas, Pedro. Universidad de Santiago de Chile. Facultad de Humanidades. Instituto de Ciencias Biomédicas.; ChileFil: Arakaki, Tomoko. Universidad de Buenos Aires. Facultad de Medicina. Centro Universitario de Neurologia "dr. Jose Maria Ramos Mejia".; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Alvarez, Mario Gustavo. Centro Internacional de Restauración Neurológica ; CubaFil: Pedroso Ibañez, Ivonne. Centro Internacional de Restauración Neurológica ; CubaFil: Rodríguez Blázquez , Carmen. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Ray Chaudhuri , Kallol. National Parkinson Foundation International Centre of Excellence; Reino UnidoFil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Burden among caregivers of patients with Parkinson disease

Los resultados de este estudio nos muestran que los pacientes con enfermedad de Parkinson experimentan altos índices de depresión, lo que es un importante factor de riesgo para la sobrecarga de los cuidadores. Otros factores como el deterioro cognitivo y el compromiso motor, especialmente la marcha y el equilibrio, también sobrecargan al cuidador, lo que concuerda con los trabajos de otros autores. El manejo del cuadro depresivo sería un factor relevante para mejorar la calidad de vida, tanto de los cuidadores como de los pacientes

Caracterización del ángulo de inclinación en los planos sagital y frontal de pacientes enfermos de Parkinson utilizando un acelerómetero triaxial

Una de las enfermedades que con frecuencia se presenta en la actualidad en personas adultas es la enfermedad de Parkinson (EP). En el proceso de diagnóstico clínico de la misma se utilizan diferentes exámenes clínicos siendo uno de ellos el examen Levantarse-Sentarse. La determinación precisa del estado de una persona para saber si padece Parkinson o no y el grado de avance de la enfermedad de un paciente se realiza básicamente mediante diagnósticos clínicos y utilizando las escalas Hoehn & Yarh y la UPDRS de progresión y severidad de la enfermedad. En estas escalas el diagnóstico se hace a través de una valoración visual de los médicos especialistas del comportamiento del paciente. El presente trabajo expone un estudio del movimiento de un grupo de diez pacientes enfermos de Parkinson y de cinco controles −personas sanas− utilizando un acelerómetro triaxial colocado en la espalda del paciente, durante la realización del examen antes citado. El objetivo del estudio es obtener información del proceso de movimiento e identificar variables que permitan diferenciar el grupo de controles y el de pacientes

Recognizing Atypical Dopa-Responsive Dystonia and Its Mimics

Purpose of review: Dopa-responsive dystonia (DRD) encompasses a group of phenotypically and genetically heterogeneous neurochemical disorders. Classic GTP cyclohydrolase 1 (GCH-1)-associated DRD consists of early-onset lower limb asymmetrical dystonia, with sleep benefit, diurnal variation, and excellent and sustained response to low l-dopa doses.Recent findings: Unlike the classic phenotype, GCH-1-associated DRD may include features inconsistent with the original phenotype. We describe a GCH-1-associated late-onset DRD case with a family history of parkinsonism and cervical dystonia whose response to levodopa was poor and complicated with dyskinesia, blepharospasm, and severe nonmotor symptoms. We use this case as a springboard to review the spectrum of atypical DRD, DRD-plus, and DRD mimics.Summary: GCH-1-related dystonia may exhibit wide intrafamilial phenotypic variability, no diurnal fluctuation, poor response to l-dopa, and such complications as dyskinesia, epilepsy, sleep disorders, autonomic dysfunction, oculogyric crisis, myoclonus, or tics. More recently, rare GCH-1 variants have been found to be associated with Parkinson disease. Clinicians should be aware of atypical DRD, DRD-plus, and DRD mimics.Fil: Salles, Philippe A.. University of Cincinnati; Estados UnidosFil: Terán Jimenez, Mérida. University of Cincinnati; Estados UnidosFil: Vidal Santoro, Alvaro. University of Cincinnati; Estados UnidosFil: Chaná Cuevas, Pedro. University of Cincinnati; Estados UnidosFil: Kauffman, Marcelo Andres. Universidad Austral. Facultad de Ciencias Biomédicas. Instituto de Investigaciones en Medicina Traslacional. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones en Medicina Traslacional; ArgentinaFil: Espay, Alberto J.. University of Cincinnati; Estados Unido

Time measurement characterization of stand-to-sit and sit-to-stand transitions by using a smartphone

The aim of this study is to analyze a common method to measure the acceleration of a daily activity pattern by using a smartphone. In this sense, a numerical approach is proposed to transform the relative acceleration signal, recorded by a triaxial accelerometer, into an acceleration referred to an inertial reference. The integration of this acceleration allows to determine the velocity and position with respect to an inertial reference. Two different kinematic parameters are suggested to characterize the profile of the velocity during the sit-to-stand and stand-to-sit transitions for Parkinson and control subjects. The results show that a dimensionless kinematic parameter, which is linked to the time of sit-to-stand and stand-to-sit transitions, has the potential to differentiate between Parkinson and control subjects.Peer Reviewe

TremorSoft: An decision support application for differential diagnosis between Parkinson’s disease and essential tremor

A cost-effective, non-invasive, and easy-to-use tool is presented that uses the 6-axis inertial sensor of the smartphone or a specific wearable sensor, boosted by machine learning, to support early differential diagnosis of Parkinson’s disease and Essential Tremor. A dedicated web server helps extract the kinematic indexes from the recorded signals, implement the machine learning models and return the resulting classification to the App. Thus, clinicians can use this App as a support tool in the clinic, contributing to performing motor evaluations in the uncertain and undecided stages of the diseases and promoting appropriate, fast, and timely therapeutic responses

Care of patients with Huntington's disease in South America: a survey Cuidado de pacientes com doença de Huntington na América do Sul: um inquérito

Huntington's disease (HD) is a rare neurodegenerative disease with a multitude of symptoms, which requires access to specialized multidisciplinary care for adequate management. The aim of this study was to survey the characteristics of care in various HD centers in South America (SA). Methods A questionnaire was sent to 24 centers involved in the care for HD patients in SA. Results Of the total 24 centers, 19 (79.2%) are academic units. The majority of centers (62.5%) are general movement disorders clinics. Multidisciplinary care is available in 19 (79.2%) centers and in 20 (83.3%) care is provided free of charge. Genetic testing and counseling are available in 25 and 66.6% of centers, respectively. The majority of centers (83.3%) have no institutional support for end-stage care. Conclusions Although HD centers in SA are committed to providing multidisciplinary care, access to genetic counseling and end-stage care are lacking in most centers. A doen&#231;a de Huntington (DH) &#233; uma doen&#231;a neurodegenerativa rara que requer tratamento multidisciplinar especializado para manejo adequado. O objetivo do presente trabalho foi pesquisar as caracter&#237;sticas da assist&#234;ncia &#224; sa&#250;de em centros de DH na Am&#233;rica do Sul (AS). M&#233;todos Um question&#225;rio foi enviado para 24 centros envolvidos no cuidado de pacientes com DH na AS. Resultados Dos 24 centros, 19 (79,2%) s&#227;o unidades acad&#234;micas. A maioria (62,5%) s&#227;o cl&#237;nicas de dist&#250;rbios dos movimentos. Cuidado multidisciplinar &#233; dispon&#237;vel em 19 (79,2%) dos centros e em 20 (83,3%), o tratamento &#233; gratuito. O teste e o aconselhamento gen&#233;tico est&#227;o dispon&#237;veis em 25 e 66,6% dos centros, respectivamente. N&#227;o h&#225; suporte institucional para cuidado terminal em 83,3% dos centros. Conclus&#245;es Apesar dos centros de DH na AS terem compromisso com o provimento de cuidados multidisciplinares, o acesso a aconselhamento gen&#233;tico e a tratamento na fase terminal s&#227;o falhos na maioria dos centros. </sec