Quantitative continuous measurement of movements in the extremities

Published: 05-10-2020| Version 2 | DOI: 10.17632/xs8nycxg9v.2
Contributors:
Timothy Harrigan,
Alveena Syed,
Brian Hwang,
Anil K Mathur,
Kelly Mills,
Alexander Pantelyat,
Jee Bang,
Chakradhar Mishra,
Pankhuri Vyas,
Samuel Martin,
Armaan Jamal,
Liran Ziegelman,
Manuel Hernandez,
Matthew Shneyderman,
Mohamed Doheim,
Rohan Panaparambil,
Alfonse Gaite,
Dean Wong,
James Brasic

Description

We hypothesized that (1) correlation of (A) the output of instrumentation to generate quantitative continuous measurements of movements and (B) the quantitative measurements of trained examiners using structured ratings of movements would generate the tools to differentiate the movements of (A) Parkinson's disease (PD), (B) parkinsonian syndromes, and health, and (2) continuous quantitative measurements of movements would improve the ratings generated by visual observations of trained raters, and provide pathognomonic signatures to identify PD and parkinsonian syndromes. A protocol for a low-cost quantitative continuous measurement of movements in the extremities of people with PD (McKay, et al., 2019) was administered to people with PD and multiple system atrophy-parkinsonian type (MSA-P) and age- and sex-matched healthy control participants. Data from instrumentation was saved as WinDaq files (Dataq Instruments, Inc., Akron, Ohio) and converted into Excel files (McKay, et al., 2019) using the WinDaq Waveform Data Browser (Dataq Instruments, Inc., Akron, Ohio). Participants were asked to sit in a straight-back chair with arms approximately six inches from the wall to minimize the risk of hitting the wall. The examiner sat in a similar chair facing the participant. The examiner asked the technologist and the videographer to begin recording immediately before instructing the participant to perform each item. Items were scored live by the examiner at the same time that the quantitative continuous measurements of movements were recorded by the instrumentation. Healthy control participants were matched for age and sex with participants with PD. The key identifies the diagnosis (PD = Parkinson's disease, MSA-P = Multiple system atrophy - parkinsonian type, HC = healthy control, 1 = male, 0 = female). Participants with PD completed a single test session (0002, 0005, 0007-0009, 0012, 0017-0018, and 0021), a test and a retest session (0001, 0003, 0006, 0010-0011, 0013, 0015, 0019, 0022-0023), or a test and two retest sessions (0014). HC participants completed test and retest sessions (0020, 0024-0030). A participant with MSA-P (0004) completed a test session. Individual files for the WinDaq, Excel, and coding forms for each testing are entered in the dataset. The Excel files for the five repetitive items were converted to fast Fourier transforms (FFTs) and continuous wavelet transforms (CWTs) (MatLab). The laterality of signals and transforms for test ratings of the upper extremity for participant 30 were reversed. No files were filtered. Findings were presented at the MDS Congress Virtual.

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Steps to reproduce

Diagnoses of participants are established by the interview and examination of neurologists trained in movement disorders. The age, sex, and diagnosis of each participant is recorded. The height and the weight of each participant is measured and recorded. The use of levodopa and deep brain stimulation (DBS) is recorded. If levodopa or DBS is used, record if the effect is on or off at the time of the protocol. Administer the protocol for a low-cost quantitative continuous measurement of movements in the extremities of people with Parkinson's disease (McKay, et al., 2019) to people with Parkinson's disease and parkinsonian syndromes and age- and sex-matched healthy control participants (Brasic, et al., 2017, 2018). Save data from instrumentation (Harrigan, et al., 2017) as WinDaq files and convert into Excel files (McKay, et al., 2019) using the WinDaq Waveform Data Browser (Dataq Instruments, Inc., Akron, Ohio). Examiners are certified by the International Parkinson's Disease and Movement Disorders Society in the administration and scoring of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) (Goetz, et al., 2008). For the protocol ask participants to sit in a straight-back chair with arms approximately six inches from the wall to minimize the risk of hitting the wall. Place the examiner in a similar chair facing the participant. Just before administering an item of the protocol, the examiner asks the technologist and the videographer to begin recording. At the end of each item the examiner instructs the technologist and the videographer to stop. The examiner scores clinical ratings live using the coding form for a low-cost quantitative continuous measurement of movements in the extremities of people with Parkinson's disease (McKay, et al., 2019). The clinical ratings occur at the same time that the quantitative continuous measurements of movements are recorded by the instrumentation. After administering each item on the protocol, the examiner scores the coding form. Additionally the examiner encircles on the coding forms the specific abnormality observed and notes the laterality by writing "L" or "R." Individual files for the WinDaq, Excel, and coding forms for each testing are entered in the dataset. The Excel files for the five repetitive items are converted to fast Fourier transforms (FFTs) and continuous wavelet transforms (CWTs) (Harrigan, et al., 2018, 2019; MatLab). None of the files are filtered. Repeat the procedure on each participant after one week to one month (Brasic, et al., 2019; Hwang, et al., 2017).