背景:迫切需要制定目标,有效和方便的测量,以帮助临床医生准确识别运动迟缓。这项研究的目的是评估使用进化算法(EA)评估手指敲击运动迟缓(FT)的客观方法的准确性,并探讨其是否可用于识别早期帕金森病(PD)。
方法:一百零七个PD,收集41例特发性震颤(ET)患者和49例正常对照(NC)。参与者执行了标准的FT任务,将两个电磁跟踪传感器连接到拇指和食指。来自传感器的读数被传输到平板电脑,随后使用EA进行分析。装置的输出(称为“PD-Monitor”)从-1至+1(其中较高的分数表明运动迟缓的严重程度更大)。同时,使用运动障碍协会赞助的帕金森病统一评定量表(MDS-UPDRS)FT项目的修订对运动迟缓进行临床评估.
结果:随着MDS-UPDRSFT得分的增加,来自同一手侧的PD-Monitor评分相应增加。PD-Monitor评分与MDS-UPDRSFT评分相关性良好(右侧:r=0.819,P=0.000;左侧:r=0.783,P=0.000)。此外,97名患有MDS-UPDRSFT运动迟缓的PD患者和每个PD亚组(FT运动迟缓得分为1至3)的PD-Monitor评分均高于NC。受试者工作特征(ROC)曲线显示,PD-MonitorFT评分可以在右手中以高精度(≥89.7%)检测不同程度的运动迟缓。此外,PD-Monitor评分可以区分早期PD和NC,ROC曲线下面积大于或等于0.899。此外,没有运动迟缓的ET可以通过PD监测评分与PD区分开。在左侧发现PD-Monitor评分与改良的Hoehn和Yahr分期呈正相关。
结论:我们的研究表明,使用来自EA的分类器的简单使用设备不仅可以用于准确测量PD中运动迟缓的不同严重程度,但也有可能区分早期PD和正常性。
BACKGROUND: There is an urgent need for developing objective, effective and convenient measurements to help clinicians accurately identify bradykinesia. The purpose of this study is to evaluate the accuracy of an objective approach assessing bradykinesia in finger tapping (FT) that uses evolutionary algorithms (EAs) and explore whether it can be used to identify early stage Parkinson\'s disease (PD).
METHODS: One hundred and seven PD, 41 essential tremor (ET) patients and 49 normal controls (NC) were recruited. Participants performed a standard FT task with two electromagnetic tracking sensors attached to the thumb and index finger. Readings from the sensors were transmitted to a tablet computer and subsequently analyzed by using EAs. The output from the device (referred to as \"PD-Monitor\") scaled from - 1 to + 1 (where higher scores indicate greater severity of bradykinesia). Meanwhile, the bradykinesia was rated clinically using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson\'s Disease Rating Scale (MDS-UPDRS) FT item.
RESULTS: With an increasing MDS-UPDRS FT score, the PD-Monitor score from the same hand side increased correspondingly. PD-Monitor score correlated well with MDS-UPDRS FT score (right side: r = 0.819, P = 0.000; left side: r = 0.783, P = 0.000). Moreover, PD-Monitor scores in 97 PD patients with MDS-UPDRS FT bradykinesia and each PD subgroup (FT bradykinesia scored from 1 to 3) were all higher than that in NC. Receiver operating characteristic (ROC) curves revealed that PD-Monitor FT scores could detect different severity of bradykinesia with high accuracy (≥89.7%) in the right dominant hand. Furthermore, PD-Monitor scores could discriminate early stage PD from NC, with area under the ROC curve greater than or equal to 0.899. Additionally, ET without bradykinesia could be differentiated from PD by PD-Monitor scores. A positive correlation of PD-Monitor scores with modified Hoehn and Yahr stage was found in the left hand sides.
CONCLUSIONS: Our study demonstrated that a simple to use device employing classifiers derived from EAs could not only be used to accurately measure different severity of bradykinesia in PD, but also had the potential to differentiate early stage PD from normality.