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A multiple motion sensors index for motor state quantification in Parkinson's disease

Journal article
Authors S. Aghanavesi
J. Westin
Filip Bergquist
D. Nyholm
H. Askmark
S. M. Aquilonius
Radu Constantinescu
A. Medvedev
J. Spira
F. Ohlsson
I. Thomas
A. Ericsson
Dongni Johansson Buvarp
M. Memedi
Published in Computer Methods and Programs in Biomedicine
Volume 189
ISSN 0169-2607
Publication year 2020
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Institute of Neuroscience and Physiology, Department of Pharmacology
Language en
Keywords Drug products, Neurodegenerative diseases, Neuromuscular rehabilitation, Patient treatment, Regression analysis, Support vector machines, 10-fold cross-validation, Highly-correlated, Inertial measurement unit, Parkinson's disease, Stepwise regression method, Test-retest reliability, Treatment effects, Treatment response, Sensor data fusion, carbidopa plus levodopa, aged, Article, body height, body weight, clinical article, clinical outcome, controlled study, diagnostic procedure, disease duration, dyskinesia scale, feature extraction, female, human, male, neurologic disease assessment, Parkinson disease, pronation, supination, support vector machine, test retest reliability, treatment response index from multiple sensor, treatment response scale, Unified Parkinson Disease Rating Scale, walking
Subject categories Neurosciences


Aim: To construct a Treatment Response Index from Multiple Sensors (TRIMS) for quantification of motor state in patients with Parkinson's disease (PD) during a single levodopa dose. Another aim was to compare TRIMS to sensor indexes derived from individual motor tasks. Method: Nineteen PD patients performed three motor tests including leg agility, pronation-supination movement of hands, and walking in a clinic while wearing inertial measurement unit sensors on their wrists and ankles. They performed the tests repeatedly before and after taking 150% of their individual oral levodopa-carbidopa equivalent morning dose.Three neurologists blinded to treatment status, viewed patients’ videos and rated their motor symptoms, dyskinesia, overall motor state based on selected items of Unified PD Rating Scale (UPDRS) part III, Dyskinesia scale, and Treatment Response Scale (TRS). To build TRIMS, out of initially 178 extracted features from upper- and lower-limbs data, 39 features were selected by stepwise regression method and were used as input to support vector machines to be mapped to mean reference TRS scores using 10-fold cross-validation method. Test-retest reliability, responsiveness to medication, and correlation to TRS as well as other UPDRS items were evaluated for TRIMS. Results: The correlation of TRIMS with TRS was 0.93. TRIMS had good test-retest reliability (ICC = 0.83). Responsiveness of the TRIMS to medication was good compared to TRS indicating its power in capturing the treatment effects. TRIMS was highly correlated to dyskinesia (R = 0.85), bradykinesia (R = 0.84) and gait (R = 0.79) UPDRS items. Correlation of sensor index from the upper-limb to TRS was 0.89. Conclusion: Using the fusion of upper- and lower-limbs sensor data to construct TRIMS provided accurate PD motor states estimation and responsive to treatment. In addition, quantification of upper-limb sensor data during walking test provided strong results. © 2019

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