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Objective assessment of bradykinesia in Parkinson’s disease using evolutionary algorithms:clinical validation

Translational Neurodegeneration 2018年第1期7卷 167-174页

作者： Chao Gao Stephen Smith Michael Lones Stuart Jamieson Jane Alty Jeremy Cosgrove Pingchen Zhang Jin Liu Yimeng Chen Juanjuan Du Shishuang Cui Haiyan Zhou Shengdi Chen Department of Neurology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of Electronic Engineering University of YorkYorkUK Department of Computer Science Heriot-Watt UniversityEdinburghUK Department of Neurology Leeds General InfirmaryLeeds Teaching Hospitals NHS TrustLeedsUK

Background:There is an urgent need for developing objective,effective and convenient measurements to help clinicians accurately identify *** 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 *** performed a standard FT task with two electromagnetic tracking sensors attached to the thumb and index *** from the sensors were transmitted to a tablet computer and subsequently analyzed by using *** 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 ***:With an increasing MDS-UPDRS FT score,the PD-Monitor score from the same hand side increased ***-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 *** 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 ***,PD-Monitor scores could discriminate early stage PD from NC,with area under the ROC curve greater than or equal to ***,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 ***:Our study demonstrated that a simple to use devic

关键词： Parkinson’s disease bradykinesia Evolutionary algorithms Objective assessment Clinical validation

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Role of the globus pallidus in motor and non-motor symptoms of Parkinson's disease

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Neural Regeneration Research 2025年第6期20卷 1628-1643页

作者： Yimiao Jiang Zengxin Qi Huixian Zhu Kangli Shen Ruiqi Liu Chenxin Fang Weiwei Lou Yifan Jiang Wangrui Yuan Xin Cao Liang Chen Qianxing Zhuang Department of Physiology School of MedicineNantong UniversityNantongJiangsu ProvinceChina Department of Neurosurgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghaiChina National Center for Neurological Disorders ShanghaiChina Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration ShanghaiChina State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science Institute of Brain ScienceFudan UniversityShanghaiChina

The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore,bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico–striato–pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease,particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremordominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia–thalamus network. Therefore, the comp

关键词： anxiety basal ganglia bradykinesia deep brain stimulation depression globus pallidus externus globus pallidus internus lateral globus pallidus medial globus pallidus neural circuit Parkinson's disease

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Voltage adjustment improves rigidity and tremor in Parkinson's disease patients receiving deep brain stimulation

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Neural Regeneration Research 2018年第2期13卷 347-352页

作者： Shao-hua Xu Chao Yang Wen-biao Xian Jing Gu Jin-long Liu Lu-lu Jiang Jing Ye Yan-mei Liu Qi-yu Guo Yi-fan Zheng Lei Wu Wan-ru Chen Zhong pei Ling Chen Department of Neurology National Key Clinical Department and Key Discipline of NeuroloryThe First Affiliated HospitalSun Yat-senUniversityGuangzhouGuangdong ProvinceChina Department of Neurosurgery First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Department of Medical Statistics and Epidemiology School of Public HealthSun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Department of Neurology Tangshan Worker's HospitalTangshanHebei ProvinceChina

Deep brain stimulation of the subthalamic nucleus is recognized as the most effective treatment for moderate and advanced Parkinson＇s disease. Programming of the stimulation parameters is important for maintaining the efficacy of deep brain stimulation. Voltage is consid- ered to be the most effective programming parameter. The present study is a retrospective analysis of six patients with Parkinson＇s disease （four men and two women, aged 37-65 years）, who underwent bilateral deep brain stimulation of the subthalamic nucleus at the First Affiliated Hospital of Sun Yat-sen University, China, and who subsequently adjusted only the stimulation voltage. We evaluated motor symptom severity using the Unified Parkinson＇s Disease Rating Scale Part III, symptom progression using the Hoehn and Yahr scale, and the levodopa equivalent daily dose, before surgery and 1 and 2 years after surgery. The 2-year follow-up results show that rigidity and tremor improved, and clinical symptoms were reduced, while pulse width was maintained at 60 ps and frequency at 130 Hz. Voltage adjust- ment alone is particularly suitable for patients who cannot tolerate multiparameter program adjustment. Levodopa equivalent daily dose was markedly reduced 1 and 2 years after surgery compared with baseline. Our results confirm that rigidity, tremor and bradykinesia can be best alleviated by voltage adjustment. The trial was registered at *** （identifier： NCT01934881）.

关键词： nerve regeneration deep brain stimulation Parkinson's disease subthalamic nucleus voltage pulse width frequency tremor rigidity bradykinesia axial symptoms neural regeneration

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Epalrestat improves motor symptoms by reducing oxidative stress and inflammation in the reserpine induced mouse model of Parkinson’s disease

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Animal Models and Experimental Medicine 2020年第1期3卷 9-21页

作者： Md.Mahbubur Rahman Rupali Rani Chakraborti Md.Abdullah Potol Ariful Haque Abir Ozayra Sharmin Mahabub Alam Md.Fazlur Rahman Khan Rownock Afrin Humayra Jannat Rasiqh Wadud Zaki Farhad Habib Laboratory of Pharmacology Department of Pharmaceutical SciencesSchool of Health&Life SciencesNorth South UniversityDhakaBangladesh

Background:Parkinson's disease(PD)is a progressive neurodegenerative disorder affecting a large number of elderly people *** current therapies for PD are symptom-based;they do not provide a cure but improve the quality of *** dysfunction is the hallmark clinical feature of PD and oxidative stress and inflammation play a critical role in its *** is used for the treatment of diabetic neuropathy and is known to improve antioxidative defense mechanisms in the ***,in this study,we investigated the role of Epalrestat in the reserpine induced mouse model of ***:We used Swiss Albino mice for the PD model and tested for akinesia/bradykinesia,muscular rigidity,palpebral ptosis,and tremor,as well as conducting swim and open field *** samples were used to determine oxidative stress parameters and infiltration of immune ***:Epalrestat treatment significantly improved akinesia and bradykinesia,muscular dysfunctions,tremor level,and gait functions compared to the reserpine *** also improved the latency in the swim *** significantly reduced lipid peroxidation and NO concentration in different brain tissues and increased the activity of antioxidative enzymes,glutathione,catalase,and superoxide ***,Epalrestat reduced neuroinflammation by reducing the number of infiltrating immune ***:Eplarestat improves muscular dysfunction in PD by reducing oxidative stress and inflammation.

关键词： bradykinesia Epalrestat glutathione oxidative-stress Parkinson's disease

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Multidimensional assessment of neuro-psychiatric symptoms in patients with low-grade hepatic encephalopathy: A clinical rating scale

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World Journal of Gastroenterology 2005年第37期11卷 5893-5898页

作者： Sergei Mechtcheriakov Ivo W Graziadei André Kugener Julia Wiedemann Chantal Galbavy Hartmann Hinterhuber Josef Marksteiner Wolfgang Vogel Department of General Psychiatry Medical University Innsbruck Austria Department of Gastroenterology and Hepatology Medical University Innsbruck Anichstrasse 35 AT-6020 Innsbruck Austria

AIM： To evaluate the feasibility of a new clinical rating scale for a standardized assessment of cirrhosis-associated neuro-psychiatric symptoms. METHODS： Forty patients with liver cirrhosis （LC, with or without low-grade hepatic encephalopathy） were investigated using a clinical neuro-psychiatric rating scale based on a comprehensive list of neurological, psychomotor, cognitive, affective, behavioral symptoms, and symptoms of disturbed bioregulation. RESULTS： The analysis revealed that the majodty of cirrhotic patients showed, besides characteristic neurological symptoms of hepatic encephalopathy, various psychomotor, affective and bioregulatory symptoms （disturbed sleep and sexual dysfunction）. Patients were impaired in the following subscales： sleep and biorhythm disorder （75.0% of patients）, Parkinsonoid symptoms （25.0%）, affective symptoms （17.5%）, and psychomotor retardation （12.5%）. The increase of total neuro-psychiatric clinical score was significantly associated with the degree of hepatic encephalopathy. CONCLUSION： This study suggests that a substantial number of patients with LC and low-grade hepatic encephalopathy manifest various clinical neuro-psychiatric symptoms. The use of a rating scale, which explores clinical dimensions of hepatic encephalopathy, would improve the management of patients with LC.

关键词： Liver cirrhosis Hepatic encephalopathy Neuropsychiatric symptoms Clinical neuro-psychiatric rating bradykinesia

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Parkinson Kinetic Graph: Are Motor Fluctuations in Parkinson Disease Related with Disease Duration?

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Advances in Parkinson's Disease 2018年第1期7卷 1-6页

作者： Esther Berghuis Barbera Van Harten Mirjam Van Kesteren-Biegstraaten Wijnand Rutgers Nicolaas Verwey Department of Neurology Medisch Centrum Leeuwarden Leeuwarden The Netherlands Department of Neurology Isala Zwolle Zwolle The Netherlands Department of Neurology Martini Ziekenhuis Groningen Groningen The Netherlands

Introduction: The Parkinson’s KinetiGraph (PKG) is a digital measurement system for motor fluctuations (FS). The aim of this study is to investigate whether FS, measured by the PKG, are associated with disease duration of Parkinson’s Disease (PD) patients. Material and Methods: 172 PD were included. PKG measurements, clinical data and disease duration were collected. Patients were categorized in four disease duration categories (0 - 5 years, 6 - 7 years, 8 - 11 years and ≥12 years). Kruskal-Wallis and Mann-Whitney U tests were used for statistical analysis. Results: The mean age of the patients is 69.2 years (SD ± 8.13). Disease duration varies between 1 and 28 years. Significant difference was found between the four disease categories in FS (p = 0.050);between group 1 - 3, p = 0.005. Conclusions: As expected, FS measured by PKG increase during disease progression in PD. In advanced disease stages, FS stabilise, indicating that PKG is the most useful in early and moderate stages of PD.

关键词： Late Stage Parkinson Disease Levodopa Disease Duration Fluctuations Dyskinesia bradykinesia

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