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Bouchard-Tremblay J, Théberge M, Ayoub T, Martel-Brosseau G, Levasseur-Ouellet MP, Tremblay M, Houde-Thibeault A, Wotto EA, Carezolli FR, Hébert LJ, da Silva RA. Age- and Parkinson-related differences in trunk and lower-limb muscle activation during four balance tasks: A case-control pilot study. Clin Biomech (Bristol, Avon) 2024; 117:106298. [PMID: 38936292 DOI: 10.1016/j.clinbiomech.2024.106298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/20/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Poor postural control has been reported in people with Parkinson's disease, which could be explained by the changes in muscular activation patterns related to antigravitational muscles. This study aims to measure the muscle activation of antigravitational muscles during balance tasks in individuals, with and without Parkinson's. METHODS Sixteen (16) participants (9 with Parkinson's), aged ≥65 yrs., performed 2 × 30-s trials of 4 balance tasks (bipodal and semi-tandem opened eyes and closed eyes) on a force platform (center of pressure measurement); while surface electromyography measurements were obtained bilaterally on the multifidus at L5, biceps femoris and medialis gastrocnemius. Electromyography amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance task, to determine each muscle's activity level. FINDINGS The Parkinson's group reported lower muscle activation than control across tasks (in mean for multifidus = 8%, biceps femoris = 16%, gastrocnemius = 7%), although not statistically significant. Parkinson's reported significantly poorer postural control than control, mainly for the center of pressure sway ellipse area (p = 0.016) from challenge balance tasks such as semi-tandem. INTERPRETATION Poor postural control was confirmed in the Parkinson's group, but not significantly associated by the changes from muscle activation of trunk and lower limbs, during balance performance.
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Affiliation(s)
- Jérôme Bouchard-Tremblay
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1; Centre Intersectoriel en Santé Durable, Laboratoire de Recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Michael Théberge
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Tamami Ayoub
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Gabrielle Martel-Brosseau
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Marie-Pier Levasseur-Ouellet
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Maxim Tremblay
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Alexandra Houde-Thibeault
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Enafa Anais Wotto
- Centre Intersectoriel en Santé Durable, Laboratoire de Recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1
| | - Fernando Rezende Carezolli
- Doctoral and Master Programs in Human Movement and Rehabilitation, University Center of Anapolis, Anapolis, GO, Brazil
| | - Luc J Hébert
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, Quebec City, Quebec, Canada, G1V 0A6
| | - Rubens A da Silva
- Programme de Maîtrise en Physiothérapie, Département des Sciences de la Santé l'Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1; Centre Intersectoriel en Santé Durable, Laboratoire de Recherche BioNR, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada, G7H 2B1; Doctoral and Master Programs in Human Movement and Rehabilitation, University Center of Anapolis, Anapolis, GO, Brazil; Centre Intégré de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Services at La Baie Hospital, Saguenay, Quebec, Canada, G7H 7K9.
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Challenges for future theories of Parkinson pathophysiology. Neurosci Res 2021; 177:1-7. [PMID: 34861293 DOI: 10.1016/j.neures.2021.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 11/24/2022]
Abstract
Current theories on the basal ganglia-thalamic-cortical circuitry address the phenomena of hypokinesia and hyperkinesia. In this Perspective, we question whether the current models can address the orchestration of the motor units which is the common final pathway of the motor system. We conclude that the current theories do not to address this orchestration in health and disease. One alternative approach worthy of consideration is nonmonotonic nonlinear dynamics that contrast with a fundamentally linear or monotonic nonlinear approach that are presumed by current theories of basal ganglia-thalamic-cortical system. The purpose here is to make the case that current theories do presuppose a linear or monotonic nonlinear perspective which will be demonstrated as failing to adequately explicate the complex orchestration of motor unit activities in normal movement and in movement disorders. The notion of nonlinear dynamics is not new to neurophysiology; however, it is argued that it is new to the concepts of the physiology and pathophysiology of the basal ganglia-thalamic-cortical system. Providing a wholesale reconceptualization of the basal ganglia-thalamic-cortical system is beyond the scope of this effort. Rather, the contribution of the essay is convincing that there is a need to reconceptualize theories as nonlinear dynamical systems and there are metaphors and analogies from nonlinear science that can be productive in the reconsideration.
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López-López L, Rodríguez-Torres JR, Cahalin LP, Cabrera-Martos I, Torres Sánchez I, Valenza MC. Ventilatory Impairments Associated with Parkinson's Disease: A Systematic Review and Meta-Analysis. Respiration 2021; 100:173-181. [PMID: 33472204 DOI: 10.1159/000506234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 01/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The peripheral and central repercussions of Parkinson's disease (PD) affect the neuromuscular system producing a loss of muscle strength that can influence the respiratory system. Although several studies have examined various respiratory aspects of PD, to the best of our knowledge no study to date has systematically reviewed the existing data. OBJECTIVES To examine the available literature related to the respiratory impairment in PD patients. METHODS We used PRISMA guidelines when reporting this review. We searched Pubmed, Cinhal, SciELO, and Cochrane Library, from inception until August 2018. Main variables assessed were forced vital capacity percent predicted (FVC%) and forced expiratory volume in 1 s percent predicted (FEV1%) for PD patients. RESULTS Six studies were included in this systematic review and meta-analysis. The obtained results concluded that PD patients present poorer pulmonary function when compared to healthy controls. When PD patients were compared between ON and OFF states, the results reviewed are in favour of the ON state. In the meta-analysis performed for FVC% and FEV1%, the results fail to find significant differences between PD patients and controls (p = 0.336 and p = 0.281, respectively), and between PD ON and OFF states (p = 0.109 and p = 0.059, respectively). CONCLUSIONS We conclude that PD patients have impaired respiratory capacities that are related to the PD severity, time since diagnosis, and OFF state. Adequate follow-up of the respiratory function and studies focused on PD phenotypes have to be considered in future studies.
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Affiliation(s)
- Laura López-López
- Department of Physical Therapy, Faculty of Health Sciences. University of Granada, Granada, Spain
| | | | - Lawrence Patrick Cahalin
- Department of Physical Therapy, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Irene Cabrera-Martos
- Department of Physical Therapy, Faculty of Health Sciences. University of Granada, Granada, Spain
| | - Irene Torres Sánchez
- Department of Physical Therapy, Faculty of Health Sciences. University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences. University of Granada, Granada, Spain,
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Valenza MC, Prados-Román E, Granados-Santiago M, Torres-Sanchez I, Lopez-Lopez L, Cabrera-Martos I. Respiratory repercussions of neurological diseases and how best to manage them. Expert Rev Respir Med 2019; 14:89-102. [PMID: 31679407 DOI: 10.1080/17476348.2020.1689124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: The high incidence of respiratory impairments in patients with neurological diseases is recognized, but the design, dosage, and effectiveness of interventions to manage them are seen as an ongoing challenge.Areas covered: This article summarizes the evidence regarding the respiratory impairments in major neurological diseases, and how to best manage them.Expert opinion: On the balance of available evidence, respiratory impairments are part of the clinical profile of neurological diseases including Multiple Sclerosis, Stroke, and Parkinson's Disease, acquiring more importance as the pathologies progress. It is recognized that knowledge gaps remain in some areas of relevance related to respiratory function and further research is required. When considering the therapeutic options, the respiratory training emerges as the approach with most evidence. However, important questions remain unsolved: what kind, how much, and how to best include respiratory interventions is uncertain. At present, respiratory programs also fail to include clinically relevant factors such as ambulation and trunk stability.
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Affiliation(s)
- Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Esther Prados-Román
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Irene Torres-Sanchez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura Lopez-Lopez
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera-Martos
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Cantú H, Nantel J, Millán M, Paquette C, Côté JN. Abnormal Muscle Activity and Variability Before, During, and After the Occurrence of Freezing in Parkinson's Disease. Front Neurol 2019; 10:951. [PMID: 31551912 PMCID: PMC6733893 DOI: 10.3389/fneur.2019.00951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022] Open
Abstract
Freezing of gait (FOG) is often experienced in advanced stages of Parkinson's disease (PD) and can lead to an increased risk of falls. Although spatiotemporal characteristics of FOG are well-described, their underlying neuromuscular mechanisms remain poorly understood. Several studies have demonstrated an abnormal activation of distal muscles of the lower limb and coordination impairments during gait in people with PD (pwPD). However, few have investigated how various characteristics of electromyograms (EMGs) change before, during and after a freezing episode (FE). Our objective was to quantify changes in proximal and distal leg muscle activity associated with FEs. In this study, 12 pwPD, confirmed as freezers, performed a repetitive stepping-in-place task used to elicit FE. Surface EMGs were collected from proximal [rectus femoris and biceps femoris (BF)] and distal [tibialis anterior (TA) and gastrocnemius medialis (GM)] muscles. Data epochs of 500 ms were extracted from EMG time series at four different periods: baseline, 2 s before a FE, during a FE, and 2 s after a FE. For each epoch, EMG amplitude [root-mean-square (RMS)], variability [coefficient of variation (CoV)], and inter-muscle functional connectivity (mutual information) were quantified. Results from the analysis of 21 FEs show a significant main effect of Period for EMG amplitude in bilateral TA and in the least affected GM (p < 0.01), with decreased activation before freezing that remained low during and after the FE. On the other hand, a main effect of Period was also found in bilateral BF muscles (p < 0.01) but with increased activation before freezing that was generally sustained during and after FE. Main effects of Period were also found for all measures of variability, except for the least affected GM, showing reduced variability during the FE that returned to baseline in all muscles except both TA. Moreover, an increase in functional connectivity between the least affected distal muscles was seen before the FE. Our findings confirm that many characteristics of EMG patterns of both distal and proximal leg muscles change throughout periods of a FE, suggesting both impairment and adaptive strategies from proximal muscles.
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Affiliation(s)
- Hiram Cantú
- Departamento de Ingeniería Biomédica, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza García, Mexico.,Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, QC, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Michelle Millán
- Departamento de Ingeniería Biomédica, Vicerrectoría de Ciencias de la Salud, Universidad de Monterrey, San Pedro Garza García, Mexico
| | - Caroline Paquette
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.,Centre for Interdisciplinary Research in Rehabilitation, Montreal, QC, Canada
| | - Julie N Côté
- Occupational Biomechanics and Ergonomics Laboratory, Michael Feil and Ted Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, QC, Canada.,Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada
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Zago M, Sforza C, Pacifici I, Cimolin V, Camerota F, Celletti C, Condoluci C, De Pandis MF, Galli M. Gait evaluation using inertial measurement units in subjects with Parkinson's disease. J Electromyogr Kinesiol 2018; 42:44-48. [PMID: 29940494 DOI: 10.1016/j.jelekin.2018.06.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 06/05/2018] [Accepted: 06/15/2018] [Indexed: 11/24/2022] Open
Abstract
We investigated whether a wearable system based on a commercial Inertial Measurement Unit (IMU) can reliably provide the main spatiotemporal gait parameters in subjects with Parkinson's disease (PD), compared to a gold-standard optoelectronic motion capture system. The gait of 22 subjects with PD (Age: 69.4 (6.1) years; UPDRS-III: 28.0 (9.2)) was recorded simultaneously with an optoelectronic system and a commercial IMU-based wearable system. Eight spatiotemporal parameters describing the step cycle (cadence, velocity, stride length, stride duration, step length, stance, swing and double support duration) were compared between the two systems. The IMU and the optical system reported comparable gait parameters, with the exception of walking velocity (optical system, 0.72 (0.27) m∙s-1 vs. IMU: 0.86 (0.26) m∙s-1, p < 0.05). Although most parameters detected by the two systems were not statistically different, some of them like stride length, double support and step duration showed notable root mean square and mean absolute errors. In conclusion, the algorithm embedded in the current release of the commercial IMU requires further improvements to be properly used with subjects with PD. Overall, the IMU system was sufficiently accurate in the assessment of fundamental gait spatiotemporal parameters. The fast and simplified data recording process allowed by wearables makes this technology appealing and represents a possible solution for the quantification of gait in the clinical context, especially when using a traditional 3D optoelectronic gait analysis is not possible, and when subjects are not fully cooperative.
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Affiliation(s)
- Matteo Zago
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, MI, Italy; Fondazione Istituto Farmacologico Filippo Serpero Viale Luigi, Majno 40, 20122 Milano, Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milan, MI, Italy; Institute of Molecular Bioimaging and Physiology, National Research Council, via Fratelli Cervi, 20090 Segrate, MI, Italy
| | - Ilaria Pacifici
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, MI, Italy; Department of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milan, MI, Italy
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, MI, Italy
| | - Filippo Camerota
- Università degli Studi di Roma "La Sapienza", Piazzale Aldo Moro 5, 00185 Rome, RM, Italy
| | - Claudia Celletti
- Università degli Studi di Roma "La Sapienza", Piazzale Aldo Moro 5, 00185 Rome, RM, Italy
| | - Claudia Condoluci
- IRCCS San Raffaele Pisana, Via della Pisana, Tosinvest Sanità, Rome, Italy
| | | | - Manuela Galli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, MI, Italy.
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Assessment of the acute effects of different PEP levels on respiratory pattern and operational volumes in patients with Parkinson's disease. Respir Physiol Neurobiol 2014; 198:42-7. [PMID: 24751473 DOI: 10.1016/j.resp.2014.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/10/2014] [Accepted: 04/11/2014] [Indexed: 11/23/2022]
Abstract
The aim of the study was to determine the acute effects of positive expiratory pressure (PEP) on breathing pattern, operational volumes and shortening velocity of respiratory muscles on patients with Parkinson's disease. It was evaluated 15 patients and healthy controls, by optoelectronic plethysmography, using PEP in three different levels (10, 15 and 20cmH2O). Breathing pattern changed in both groups. Parkinson group increased tidal volume in all PEP levels (p<0.001), but with lower values compared to control. End-inspiratory chest wall volume increased in the Parkinson group at all PEP levels (p<0.001), end-expiratory chest wall volume show a slightly increase when we compared QB to all PEP levels in Parkinson's. There was an intergroup difference in the index of shortening velocity of abdominal, diaphragm and inspiratory muscles of the rib cage at all PEP levels (p<0.01). We conclude that Parkinson's disease promotes important alterations in different breathing pattern components and PEP has significant effects on these alterations.
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Wang XY, Kang WY, Yang Q, Zhang LY, Chen SD, Liu J. Using gastrocnemius sEMG and plasma α-synuclein for the prediction of freezing of gait in Parkinson's disease patients. PLoS One 2014; 9:e89353. [PMID: 24586710 PMCID: PMC3937335 DOI: 10.1371/journal.pone.0089353] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/19/2014] [Indexed: 11/19/2022] Open
Abstract
Freezing of gait (FOG) is a complicated gait disturbance in Parkinson's disease (PD) and a relevant subclinical predictor algorithm is lacking. The main purpose of this study is to explore the potential value of surface electromyograph (sEMG) and plasma α-synuclein levels as predictors of the FOG seen in PD. 21 PD patients and 15 normal controls were recruited. Motor function was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) and Freezing of gait questionnaire (FOG-Q). Simultaneously, gait analysis was also performed using VICON capture system in PD patients and sEMG data was recorded as well. Total plasma α-synuclein was quantitatively assessed by Luminex assay in all participants. Recruited PD patients were classified into two groups: PD patients with FOG (PD+FOG) and without FOG (PD-FOG), based on clinical manifestation, the results of the FOG-Q and VICON capture system. PD+FOG patients displayed higher FOG-Q scores, decreased walking speed, smaller step length, smaller stride length and prolonged double support time compared to the PD-FOG in the gait trial. sEMG data indicated that gastrocnemius activity in PD+FOG patients was significantly reduced compared to PD-FOG patients. In addition, plasma α-synuclein levels were significantly decreased in the PD+FOG group compared to control group; however, no significant difference was found between the PD+FOG and PD-FOG groups. Our study revealed that gastrocnemius sEMG could be used to evaluate freezing gait in PD patients, while plasma α-synuclein might discriminate freezing of gait in PD patients from normal control, though no difference was found between the PD+FOG and PD-FOG groups.
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Affiliation(s)
- Xiao-Ying Wang
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Wen-Yan Kang
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qiong Yang
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lin-Yuan Zhang
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Sheng-Di Chen
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- * E-mail: (SC); (JL)
| | - Jun Liu
- Department of Neurology & Institute of Neurology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
- * E-mail: (SC); (JL)
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Torres EB. The rates of change of the stochastic trajectories of acceleration variability are a good predictor of normal aging and of the stage of Parkinson's disease. Front Integr Neurosci 2013; 7:50. [PMID: 23882193 PMCID: PMC3713394 DOI: 10.3389/fnint.2013.00050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 06/21/2013] [Indexed: 11/13/2022] Open
Abstract
The accelerometer data from mobile smart phones provide stochastic trajectories that change over time. This rate of change is unique to each person and can be well-characterized by the continuous two-parameter family of Gamma probability distributions. Accordingly, on the Gamma plane each participant can be uniquely localized by the shape and the scale parameters of the Gamma probability distribution. The scatter of such points contains information that can unambiguously separate the normal controls (NC) from those patients with Parkinson's disease (PD) that are at a later stage of the disease. In general normal aging seems conducive of more predictable patterns of variation in the accelerometer data. Yet this trend breaks down in PD where the statistical signatures seem to be a more relevant predictor of the stage of the disease. Those patients at a later stage of the disease have more random and noisier patterns than those in the earlier stages, whose statistics resemble those of the older NC. Overall the peak rates of change of the stochastic trajectories of the accelerometer are a good predictor of the stage of PD and of the age of a "normally" aging individual.
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Affiliation(s)
- Elizabeth B Torres
- Psychology Department, Computer Science, Cognitive Science, Sensory Motor Integration, Rutgers University Piscataway, NJ, USA
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