3D Kinematics Quantifies Gait Response to Levodopa earlier and to a more Comprehensive Extent than the MDS-Unified Parkinson's Disease Rating Scale in Patients with Motor Complications.

Autor: Barbosa R; Neurology Deparment, Centre Hospitalier Universitaire Toulouse, Toulouse, France.; Nova Medical School, Faculdade de Ciências Medicas, Universidade Nova de Lisboa, Lisbon, Portugal., Mendonça M; Nova Medical School, Faculdade de Ciências Medicas, Universidade Nova de Lisboa, Lisbon, Portugal.; Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal., Bastos P; Neurology Deparment, Centre Hospitalier Universitaire Toulouse, Toulouse, France.; Nova Medical School, Faculdade de Ciências Medicas, Universidade Nova de Lisboa, Lisbon, Portugal., Pita Lobo P; Department of Neurosciences and Mental Health, Neurology Hospital Santa Maria, CHLUN, Lisbon, Portugal.; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal., Valadas A; Department of Neurosciences and Mental Health, Neurology Hospital Santa Maria, CHLUN, Lisbon, Portugal.; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal., Correia Guedes L; Department of Neurosciences and Mental Health, Neurology Hospital Santa Maria, CHLUN, Lisbon, Portugal.; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal., Ferreira JJ; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.; CNS- Campus Neurológico Senior, Torres Vedras, Portugal., Rosa MM; Department of Neurosciences and Mental Health, Neurology Hospital Santa Maria, CHLUN, Lisbon, Portugal.; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.; Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal., Matias R; Physics Department & Institute of Biophysics and Biomedical Engineering (IBEB), Faculty of Sciences, University of Lisbon, Lisbon, Portugal.; Kinetikos, Coimbra, Portugal., Coelho M; Department of Neurosciences and Mental Health, Neurology Hospital Santa Maria, CHLUN, Lisbon, Portugal.; Instituto de Medicina Molecular João Lobo Antunes, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2024 Jul; Vol. 11 (7), pp. 795-807. Date of Electronic Publication: 2024 Apr 12.
DOI: 10.1002/mdc3.14016
Abstrakt: Background: Quantitative 3D movement analysis using inertial measurement units (IMUs) allows for a more detailed characterization of motor patterns than clinical assessment alone. It is essential to discriminate between gait features that are responsive or unresponsive to current therapies to better understand the underlying pathophysiological basis and identify potential therapeutic strategies.
Objectives: This study aims to characterize the responsiveness and temporal evolution of different gait subcomponents in Parkinson's disease (PD) patients in their OFF and various ON states following levodopa administration, utilizing both wearable sensors and the gold-standard MDS-UPDRS motor part III.
Methods: Seventeen PD patients were assessed while wearing a full-body set of 15 IMUs in their OFF state and at 20-minute intervals following the administration of a supra-threshold levodopa dose. Gait was reconstructed using a biomechanical model of the human body to quantify how each feature was modulated. Comparisons with non-PD control subjects were conducted in parallel.
Results: Significant motor changes were observed in both the upper and lower limbs according to the MDS-UPDRS III, 40 minutes after levodopa intake. IMU-assisted 3D kinematics detected significant motor alterations as early as 20 minutes after levodopa administration, particularly in upper limbs metrics. Although all "pace-domain" gait features showed significant improvement in the Best-ON state, most rhythmicity, asymmetry, and variability features did not.
Conclusion: IMUs are capable of detecting motor alterations earlier and in a more comprehensive manner than the MDS-UPDRS III. The upper limbs respond more rapidly to levodopa, possibly reflecting distinct thresholds to levodopa across striatal regions.
(© 2024 International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
Externí odkaz: