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Verification of a method for measuring Parkinson’s disease related temporal irregularity in spiral drawings
Dalarna University, School of Technology and Business Studies, Microdata Analysis.ORCID iD: 0000-0002-1548-5077
Dalarna University, School of Technology and Business Studies, Computer Engineering.ORCID iD: 0000-0002-2372-4226
Dalarna University, School of Technology and Business Studies, Microdata Analysis.
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2017 (English)In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 17, no 10, article id 2341Article in journal (Refereed) Published
Abstract [en]

Parkinson's disease (PD) is a progressive movement disorder caused by the death of dopamine-producing cells in the midbrain. There is a need for frequent symptom assessment, since the treatment needs to be individualized as the disease progresses. The aim of this paper was to verify and further investigate the clinimetric properties of an entropy-based method for measuring PD-related upper limb temporal irregularities during spiral drawing tasks. More specifically, properties of a temporal irregularity score (TIS) for patients at different stages of PD, and medication time points were investigated. Nineteen PD patients and 22 healthy controls performed repeated spiral drawing tasks on a smartphone. Patients performed the tests before a single levodopa dose and at specific time intervals after the dose was given. Three movement disorder specialists rated videos of the patients based on the unified PD rating scale (UPDRS) and the Dyskinesia scale. Differences in mean TIS between the groups of patients and healthy subjects were assessed. Test-retest reliability of the TIS was measured. The ability of TIS to detect changes from baseline (before medication) to later time points was investigated. Correlations between TIS and clinical rating scores were assessed. The mean TIS was significantly different between healthy subjects and patients in advanced groups (p-value = 0.02). Test-retest reliability of TIS was good with Intra-class Correlation Coefficient of 0.81. When assessing changes in relation to treatment, TIS contained some information to capture changes from Off to On and wearing off effects. However, the correlations between TIS and clinical scores (UPDRS and Dyskinesia) were weak. TIS was able to differentiate spiral drawings drawn by patients in an advanced stage from those drawn by healthy subjects, and TIS had good test-retest reliability. TIS was somewhat responsive to single-dose levodopa treatment. Since TIS is an upper limb high-frequency-based measure, it cannot be detected during clinical assessment.

Place, publisher, year, edition, pages
2017. Vol. 17, no 10, article id 2341
Keywords [en]
Parkinson's disease; smartphone; spiral tests; temporal irregularity; timing variability; motor assessment; approximate entropy; complexity
National Category
Other Medical Engineering Probability Theory and Statistics
Research subject
Complex Systems – Microdata Analysis
Identifiers
URN: urn:nbn:se:du-29318DOI: 10.3390/s17102341PubMedID: 29027941Scopus ID: 2-s2.0-85032855199OAI: oai:DiVA.org:du-29318DiVA, id: diva2:1280955
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-02-27Bibliographically approved
In thesis
1. Multisensor data-driven methods for automated quantification of motor symptoms in Parkinson’s disease
Open this publication in new window or tab >>Multisensor data-driven methods for automated quantification of motor symptoms in Parkinson’s disease
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to develop and evaluate new data-driven methods for supporting treatment and providing information for better management of Parkinson’s disease (PD).

This disease is complex and progressive. There is a large amount of inter- and intra-variability in motor symptoms of patients with PD (PwPD). Current evaluation of motor symptoms which is done at clinics by using clinical rating scales provides limited and only part of the health status of PwPD. PD requires an accurate assessment that is approved by clinics. Therefore frequent evaluation of symptoms at micro-level is required.

Sensor systems including smartphone and motion sensors were employed to collect data from PwPD and the recruited healthy controls. Repeated measures consisting of subjective assessment of symptoms and objective assessment of motor functions were collected.

First, the smartphone-based data-driven methods were developed to quantify the dexterity presented in fine motor tests of spiral drawing and alternate tapping. The upper extremities temporal irregularity measure presented in spiral drawing tests of PwPD was further analyzed by the approximate entropy (ApEn) method. Second, tri-axial motion sensor data were collected from various tests like leg agility, walking, and rapid alternating movements of hands of PwPD during a full cycled levodopa challenge. Data driven methods for quantification of leg agility tests and a combination of multiple motor tests were developed. The clinimetric properties of the methods such as reliability, validity, and responsiveness were evaluated. In addition, the feasibility of using smartphone inertial measurement unit (IMU) sensors in comparison to motion sensors for quantifying the motor states in PD during rapid alternating movements of hands tests was investigated.

Results of the developed methods for quantification of PD motor symptoms via dexterity tests in a smartphone can be used for measuring treatment related changes in PwPD. Investigation of the ApEn method showed good sensitivity and test-retest reliability indicating that this method is useful in measuring upper limb temporal irregularity at micro-level. High convergence validity resulted from using motion sensors during leg agility tests which led to valid and reliable objective measures of PD motor symptoms. The results of fusion of sensor data gathered during standardized motor tests were promising and led to highly valid, reliable and sensitive objective measures of PD motor symptoms. The results of the analyzing acceleration IMU data showed that smartphone IMU is capable of capturing symptom information from hand rotation tests. It can provide sufficient data for quantification of the motor states.

The findings from the data-driven methodology in this thesis can be used in development of systems for follow up of the effects of treatment and individualizing treatments in PD.

Place, publisher, year, edition, pages
Borlänge: Dalarna University, 2019
Series
Dalarna Doctoral Dissertations ; 10
Keywords
Parkinson’s disease, motor symptoms, motion sensors, smartphone, microdata, multivariate analysis, data-driven, support vector machine, stepwise regression, predictive models
National Category
Medical Laboratory and Measurements Technologies Biomedical Laboratory Science/Technology Computer Sciences
Research subject
Complex Systems – Microdata Analysis
Identifiers
urn:nbn:se:du-29583 (URN)978-91-88679-00-0 (ISBN)
Public defence
2019-04-26, Clas Ohlson, Borlänge, 13:00 (English)
Opponent
Supervisors
Available from: 2019-03-28 Created: 2019-02-27 Last updated: 2019-03-28Bibliographically approved

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Aghanavesi, SomayehMemedi, MevludinDougherty, MarkWestin, Jerker

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