Abstract:
Patients not yet receiving medication provide insight to drug-naïve early physiology of Parkinson\'s Disease (PD). Wearable sensors can measure changes in motor features before and after introduction of antiparkinsonian medication. We aimed to identify features of upper limb bradykinesia, postural stability, and gait that measurably progress in de novo PD patients prior to the start of medication, and determine whether these features remain sensitive to progression in the period after commencement of antiparkinsonian medication. Upper limb motion was measured using an inertial sensor worn on a finger, while postural stability and gait were recorded using an array of six wearable sensors. Patients were tested over nine visits at three monthly intervals. The timepoint of start of medication was noted. Three upper limb bradykinetic features (finger tapping speed, pronation supination speed, and pronation supination amplitude) and three gait features (gait speed, arm range of motion, duration of stance phase) were found to progress in unmedicated early-stage PD patients. In all features, progression was masked after the start of medication. Commencing antiparkinsonian medication is known to lead to masking of progression signals in clinical measures in de novo PD patients. In this study, we show that this effect is also observed with digital measures of bradykinetic and gait motor features.
摘要:
尚未接受药物治疗的患者提供了对帕金森病(PD)的药物初期早期生理学的见解。可穿戴传感器可以测量在引入抗帕金森病药物之前和之后的运动特征的变化。我们的目的是确定上肢运动迟缓的特征,姿势稳定性,和步态在开始用药之前可以测量的进展,并确定这些特征在开始抗帕金森病药物治疗后的时期内是否仍然对进展敏感。使用佩戴在手指上的惯性传感器测量上肢运动,同时使用六个可穿戴传感器阵列记录姿势稳定性和步态。以三个月的间隔对患者进行了九次访问。记录开始用药的时间点。三个上肢运动迟缓特征(手指敲击速度,旋前速度,和内旋旋后振幅)和三个步态特征(步态速度,手臂的运动范围,站立期的持续时间)在未用药的早期PD患者中发现进展。在所有功能中,开始用药后进展被掩盖.已知开始抗帕金森病药物治疗会导致新生PD患者临床测量中进展信号的掩蔽。在这项研究中,我们表明,这种影响也观察到与缓慢运动和步态运动特征的数字测量。