%0 Journal Article
%T Kinect-based objective assessment of the acute levodopa challenge test in parkinsonism: a feasibility study.
%A Hong R
%A Wu Z
%A Peng K
%A Zhang J
%A He Y
%A Zhang Z
%A Gao Y
%A Jin Y
%A Su X
%A Zhi H
%A Guan Q
%A Pan L
%A Jin L
%J Neurol Sci
%V 45
%N 6
%D 2024 Jun 6
%M 38183553
%F 3.83
%R 10.1007/s10072-023-07296-5
%X <B>BACKGROUND: </B>The acute levodopa challenge test (ALCT) is an important and valuable examination but there are still some shortcomings with it. We aimed to objectively assess ALCT based on a depth camera and filter out the best indicators.<BR><B>METHODS: </B>Fifty-nine individuals with parkinsonism completed ALCT and the improvement rate (IR, which indicates the change in value before and after levodopa administration) of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was calculated. The kinematic features of the patients' movements in both the OFF and ON states were collected with an Azure Kinect depth camera.<BR><B>RESULTS: </B>The IR of MDS-UPDRS III was significantly correlated with the IRs of many kinematic features for arising from a chair, pronation-supination movements of the hand, finger tapping, toe tapping, leg agility, and gait (rs =  - 0.277 ~  - 0.672, P < 0.05). Moderate to high discriminative values were found in the selected features in identifying a clinically significant response to levodopa with sensitivity, specificity, and area under the curve (AUC) in the range of 50-100%, 47.22%-97.22%, and 0.673-0.915, respectively. The resulting classifier combining kinematic features of toe tapping showed an excellent performance with an AUC of 0.966 (95% CI = 0.922-1.000, P < 0.001). The optimal cut-off value was 21.24% with sensitivity and specificity of 94.44% and 87.18%, respectively.<BR><B>CONCLUSIONS: </B>This study demonstrated the feasibility of measuring the effect of levodopa and objectively assessing ALCT based on kinematic data derived from an Azure Kinect-based system.