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  • 1.
    Memedi, Mevludin
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Westin, Jerker
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Nyholm, Dag
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Groth, Torgny
    A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients2010In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331Article in journal (Refereed)
    Abstract [en]

    Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting.

    Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown.

    Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients.

    Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

  • 2.
    Skoglund, Lena
    et al.
    Uppsala universitet.
    Viitanen, M
    Kalimo, H
    Lannfelt, L
    Jönhagen, M E
    Ingelsson, M
    Glaser, A
    Herva, R
    The tau S305S mutation causes frontotemporal dementia with parkinsonism.2008In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 15, no 2Article in journal (Refereed)
    Abstract [en]

    Members of families with mutations in the tau gene are known to be heterogeneous in their clinical presentation, ranging from frontotemporal dementia to a clinical picture more resembling corticobasal degeneration or progressive supranuclear palsy. In this report, we describe a new phenotype for the tau S305S mutation, previously described as progressive supranuclear palsy. Clinically, the three affected family members showed alterations in personality and behaviour as well as cognitive decline and late levodopa-resistant parkinsonian symptoms, consistent with the diagnosis of frontotemporal dementia with parkinsonism linked to chromosome 17. One autopsied case displayed degeneration of the frontal and temporal lobes together with extensive tau pathology in both neurones and glial cells. Sarkosyl-soluble and -insoluble tau extracted from frontal cortex revealed a ratio shift with decreased levels of tau with three microtubule-binding repeats and increased levels of tau with four microtubule-binding repeats (4R tau). These findings provide further evidence for the clinical and pathological variation both within and between families with mutations in the tau gene. In addition, they support previous studies which demonstrate that the S305S mutation influences the splicing of tau exon 10 and results in an overproduction of 4R tau.

  • 3.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Ahmed, M. U.
    Nyholm, D.
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Groth, T.
    A fuzzy rule-based decision support system for Duodopa treatment in Parkinson's disease2006In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 13, no s2, p. 214-214Article in journal (Other academic)
  • 4.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Nyholm, D.
    Groth, T.
    A home environment test battery for status assessment in patients with motor fluctuations2006In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 13, no s2, p. 213-214Article in journal (Other academic)
  • 5.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Ghiamati Yazdi, Samira
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Memedi, Mevludin
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Nyholm, D.
    Johansson, A.
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Groth, T.
    A successful computer method for assessing drawing impairment in Parkinson's disease2009In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 16, p. 559-559Article in journal (Other academic)
  • 6.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Nyholm, Dag
    Johansson, Anders
    Memedi, Mevludin
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Groth, Torgny
    Pålhagen, Sven
    12-month results from a novel test battery used in a duodenal levodopa infusion trial2010In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 17, no s3, p. 21-21Article in journal (Refereed)
    Abstract [en]

    A novel test battery consisting of self-assessments and motor tests (tapping and spiral drawing) for patients with Parkinson’s disease (PD) was developed for a hand computer with touch screen in a telemedicine setting. Tests are performed four times per day in the home environment during weeklong test periods. Results are processed into scores for different dimensions of the symptom state and an ‘overall score’ reflecting the global condition of a patient during a test period. The test battery was validated in a separate study recently submitted to Mov Disord. This test battery is currently being used in an open longitudinal trial (DAPHNE, EudraCT No. 2005- 002654-21) by sixty-five patients with advanced PD at nine clinics around Sweden. On inclusion, the patients were either receiving treatment with duodenal levodopa/carbidopa infusion (Duodopa®) (n=36), or they were candidates for receiving this treatment (n=29). We now present interim results for the first twelve months. Test periods were performed in three-month intervals. During most of the periods, UPDRS ratings were performed in afternoons at the start of the week. In twenty of the patients, scores were available during individually optimized oral polypharamacy, before receiving infusion and at least one test period after having started infusion treatment. Usability and compliance with performing tests, this far are good, both with patients and clinical staff. Correlations between test periods 2 and 3 during infusion treatment (three months apart) are stronger for overall test score than for total UPDRS, indicating good reliability. The correlation between overall test score and UPDRS for all test periods is adequate (r=-0.6). In an exact Wilcoxon signed rank test, where the endpoint is the change from the first to the twelve month test period (n=25), there was no change in test results in any of the test battery dimensions for the patients already receiving infusion when included. However, in the patients entering the study before receiving infusion, there was a significant change (improvement) from the baseline to the twelve month test period in dimensions; ‘off’, ‘dyskinesia’ and ‘satisfied’ and in the ‘overall score’ (n=15). The mean improvement in overall score after infusion was 29% (p=0.015). We conclude that the test battery is able to measure a functional improvement with infusion that is sustained over at least twelve months.

  • 7.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Stenberg, Georg
    Psychology, Kristianstad univ.
    Development of a test for spatial working memory in Parkinson's disease: sensitivity to medication induced periodic performance changes2012In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 19, no s1, p. 551-551Article in journal (Refereed)
  • 8.
    Westin, Jerker
    et al.
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Willows, T.
    Groth, T.
    Dougherty, Mark
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Palhagen, S.
    Pedal: Identification of models for duodenal administration of levodopa2006In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 13, no s2, p. 220-221Article in journal (Other academic)
  • 9.
    Wåhlin-Larsson, Britta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Kadi, Fawzi
    Ulfberg, Jan
    Peihl Aulin, Karin
    Skeletal muscle morphology in patients with Restless legs syndrome (RLS)2007In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 58, no 3, p. 133-137Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to assess the cellular and structural properties of skeletal muscle in Restless legs Syndrome (RLS).

    Method: Twenty patients and 16 controls were included. Aerobic performance was assessed using a sub maximal test. On muscle biopsies taken from the tiabialis anterior, fibre distribution and fibre area were analysed together with parameters surveying the microvascularisation, especially the tortuosity which is expressed as a percent of muscle fibre perimeter in contact with the wall of the microvessel, LC/PF-index (length of capillary / perimeter of fibre).

    Result: RLS group had significantly lower predicted maximal oxygen uptake (p = 0.01) and significantly higher LC/PF index (P=0.01) compared to the controls. In conclusion, the higher capillary tortuosity in RLS patients indicates the occurrence of significant remodelling in capillary geometry in RLS.

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