Goalkeeper Game: A New Assessment Tool for Prediction of Gait Performance Under Complex Condition in People With Parkinson's Disease

Response times are affected by mispredictions in a stochastic game

Acting as a goalkeeper in a video-game, a participant is asked to predict the successive choices of the penalty taker. The sequence of choices of the penalty taker is generated by a stochastic chain with memory of variable length. It has been conjectured that the probability distribution of the response times is a function of the specific sequence of past choices governing the algorithm used by the penalty taker to make his choice at each step. We found empirical evidence that besides this dependence, the distribution of the response times depends also on the success or failure of the previous prediction made by the participant. Moreover, we found statistical evidence that this dependence propagates up to two steps forward after the prediction failure.

Development and implementation of the frog-in-maze game to study upper limb movement in people with Parkinson's disease

Upper-limb bradykinesia occurs early in Parkinson's disease (PD) and bradykinesia is required for diagnosis. Our goal was to develop, implement and validate a game "walking" a frog through a maze using bimanual, alternating finger-tapping movements to provide a salient, objective, and remotely monitorable method of tracking disease progression and response to therapy in PD. Twenty-five people with PD and 16 people without PD participated. Responses on 5 different mazes were quantified and compared to spatiotemporal gait parameters and standard disease metrics in these participants. Intertap interval (ITI) on maze 2 & 3, which included turns, was strongly inversely related to stride-length and stride-velocity and directly related to motor UPDRS scores. Levodopa decreased ITI, except in maze 4. PD participants with freezing of gait had longer ITI on all mazes. The responses quantified on maze 2 & 3 were related to disease severity and gait stride-length, were levodopa responsive, and were worse in people with freezing of gait, suggesting that these mazes could be used to quantify motor dysfunction in PD. Programming our frog-in-maze game onto a remotely distributable platform could provide a tool to monitor disease progression and therapeutic response in people with PD, including during clinical trials.