OBJECTIVE: To date, very few studies have focused on structural changes and their association with cognitive performance in isolated REM sleep behaviour disorder (iRBD). Moreover, the results of these studies are inconclusive. This study aims to evaluate differences in the associations between brain morphology and cognitive tests in iRBD and healthy controls. METHODS: Sixty-three patients with iRBD and thirty-six controls underwent MRI with a 3 T scanner. The cognitive performance was assessed by a comprehensive neuropsychological battery. Based on performance, the iRBD group was divided into two subgroups with (iRBD-MCI) and without mild cognitive impairment (iRBD-NC). The high-resolution T1-weighted images were analysed using an automated atlas segmentation tool, voxel-based (VBM) and deformation-based (DBM) morphometry to identify between-group differences and correlations with cognitive performance. RESULTS: VBM, DBM and the comparison of ROI volumes yielded no significant differences between iRBD and controls. In the iRBD group, significant correlations in VBM were found between several cortical and subcortical structures primarily located in the temporal, parietal, occipital lobe, cerebellum, and basal ganglia and three cognitive tests assessing psychomotor speed and one memory test. Between-group analysis of cognition revealed a significant difference between iRBD-MCI and iRBD-NC in tests including a processing speed component. CONCLUSIONS: iRBD shows deficits in several cognitive tests that correlate with morphological changes, the most prominent of which is in psychomotor speed and visual attention as measured by the TMT-A and associated with the volume of striatum, insula, cerebellum, temporal lobe, pallidum and amygdala.
BACKGROUND: Turning in place is a challenging motor task and is used as a brief assessment test of lower limb function and dynamic balance. This review aims to examine how research of instrumented analysis of turning in place is implemented. In addition to reporting the studied population, we covered acquisition systems, turn detection methods, quantitative parameters, and how these parameters are computed. METHODS: Following the development of a rigorous search strategy, the Web of Science and Scopus were systematically searched for studies involving the use of turning-in-place. From the selected articles, the study population, types of instruments used, turn detection method, and how the turning-in-place characteristics were calculated. RESULTS: Twenty-one papers met the inclusion criteria. The subject groups involved in the reviewed studies included young, middle-aged, and older adults, stroke, multiple sclerosis and Parkinson's disease patients. Inertial measurement units (16 studies) and motion camera systems (5 studies) were employed for gathering measurement data, force platforms were rarely used (2 studies). Two studies used commercial software for turn detection, six studies referenced previously published algorithms, two studies developed a custom detector, and eight studies did not provide any details about the turn detection method. The most frequently used parameters were mean angular velocity (14 cases, 7 studies), turn duration (13 cases, 13 studies), peak angular velocity (8 cases, 8 studies), jerkiness (6 cases, 5 studies) and freezing-of-gait ratios (5 cases, 5 studies). Angular velocities were derived from sensors placed on the lower back (7 cases, 4 studies), trunk (4 cases, 2 studies), and shank (2 cases, 1 study). The rest (9 cases, 8 studies) did not report sensor placement. Calculation of the freezing-of-gait ratio was based on the acceleration of the lower limbs in all cases. Jerkiness computation employed acceleration in the medio-lateral (4 cases) and antero-posterior (1 case) direction. One study did not reported any details about jerkiness computation. CONCLUSION: This review identified the capabilities of turning-in-place assessment in identifying movement differences between the various subject groups. The results, based on data acquired by inertial measurement units across studies, are comparable. A more in-depth analysis of tests developed for gait, which has been adopted in turning-in-place, is needed to examine their validity and accuracy.
BACKGROUND: Local dynamic stability (LDS) has become accepted as a gait stability indicator. The deterioration of gait stability is magnified in older adults. RESEARCH QUESTION: What is the current state in the field regarding rthe relationship between LDS and cognitive and/or physical function in older adults? METHODS: A scoping review design was used to search for peer-reviewed literature or conference proceedings published through May 2023 for an association between LDS and cognitive (e.g., Montreal Cognitive Assessment) or physical performance (e.g., Timed Up & Go Test) in older adults. Only studies investigating gait stability via LDS during controlled walking, when dealing with a subject group consisting of healthy older adults, and quantifying LDS relationship to cognitive and/or physical measure were included. We analysed data from the studies in a descriptive manner. RESULTS: In total, 814 potentially relevant articles were selected, of which 15 met the inclusion criteria. We identified 37 LDS quantifiers employed in LDS-cognition and/or LDS-physical performance relationship assessment. Nine measures of cognitive and 20 measures of physical performance were analysed. Most studies estimated LDS quantities using triaxial acceleration data. However, there was a variance in sensor placement and signal direction. Out of the 56 studied relationships of LDS to physical performance measures, sixteen were found to be relevant. Out of 22 studied relationships between LDS and cognitive measures, only two were worthwhile. SIGNIFICANCE: Considering the heterogeneity of the utilized LDS (caused by different sensors locations, signals, and signal directions as well as variety of computational approaches to estimate LDS) and cognitive/physical measures, the results of this scoping review does not indicate a current need for a systematic review with meta-analysis. To assess the overall utility of LDS to reveal a relationship between LDS to cognitive and physical performance measures, an analysis of other subject groups would be appropriate.
- MeSH
- chůze (způsob) * MeSH
- chůze * MeSH
- kognice MeSH
- lidé MeSH
- senioři MeSH
- tělesná a funkční výkonnost MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- přehledy MeSH
- systematický přehled MeSH
AIM: To investigate the presence and relationship of temporal speech and gait parameters in patients with postural instability/gait disorder (PIGD) and tremor-dominant (TD) motor subtypes of Parkinson's disease (PD). METHODS: Speech samples and instrumented walkway system assessments were acquired from a total of 60 de-novo PD patients (40 in TD and 20 in PIGD subtype) and 40 matched healthy controls. Objective acoustic vocal assessment of seven distinct speech timing dimensions was related to instrumental gait measures including velocity, cadence, and stride length. RESULTS: Compared to controls, PIGD subtype showed greater consonant timing abnormalities by prolonged voice onset time (VOT) while also shorter stride length during both normal walking and dual task, while decreased velocity and cadence only during dual task. Speaking rate was faster in PIGD than TD subtype. In PIGD subtype, prolonged VOT correlated with slower gait velocity (r = -0.56, p = 0.01) and shorter stride length (r = -0.59, p = 0.008) during normal walking, whereas relationships were also found between decreased cadence in dual task and irregular alternating motion rates (r = -0.48, p = 0.04) and prolonged pauses (r = -0.50, p = 0.03). No correlation between speech and gait was detected in TD subtype. CONCLUSION: Our findings suggest that speech and gait rhythm disorder share similar underlying pathomechanisms specific for PIGD subtype.
- MeSH
- chůze (způsob) MeSH
- chůze MeSH
- lidé MeSH
- neurologické poruchy chůze * etiologie MeSH
- Parkinsonova nemoc * komplikace MeSH
- posturální rovnováha MeSH
- řeč MeSH
- tremor MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Due to the ever-increasing proportion of older people in the total population and the growing awareness of the importance of protecting workers against physical overload during long-time hard work, the idea of supporting exoskeletons progressed from high-tech fiction to almost commercialized products within the last six decades. Sensors, as part of the perception layer, play a crucial role in enhancing the functionality of exoskeletons by providing as accurate real-time data as possible to generate reliable input data for the control layer. The result of the processed sensor data is the information about current limb position, movement intension, and needed support. With the help of this review article, we want to clarify which criteria for sensors used in exoskeletons are important and how standard sensor types, such as kinematic and kinetic sensors, are used in lower limb exoskeletons. We also want to outline the possibilities and limitations of special medical signal sensors detecting, e.g., brain or muscle signals to improve data perception at the human-machine interface. A topic-based literature and product research was done to gain the best possible overview of the newest developments, research results, and products in the field. The paper provides an extensive overview of sensor criteria that need to be considered for the use of sensors in exoskeletons, as well as a collection of sensors and their placement used in current exoskeleton products. Additionally, the article points out several types of sensors detecting physiological or environmental signals that might be beneficial for future exoskeleton developments.
- MeSH
- biomechanika MeSH
- dolní končetina fyziologie MeSH
- exoskeleton * MeSH
- lidé MeSH
- pohyb fyziologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Cíl: Cílem práce bylo ozřejmit využitelnost vyšetření prahu pro somatosenzorickou časovou diskriminaci (somatosensory temporal discrimination threshold; STDT) u pacientů s třesem hlavy k rozlišení pacientů s esenciálním (ET) a dystonickým třesem hlavy při cervikální dystonii (CD). Soubor a metodika: Bylo vyšetřeno 42 pacientů s třesem hlavy (21 ET a 21 CD) a 20 zdravých kontrol (healthy controls; HC). Byla odebrána anamnéza (začátek příznaků, rodinná anamnéza, efekt alkoholu) a byly hodnoceny škály tíže třesu hlavy a horních končetin, tíže CD a tíže ataxie. Poté byl vyšetřen STDT. Jde o metodu založenou na stanovení nejkratšího intervalu, v němž jedinec rozpozná dva taktilní podněty jako časově oddělené. Výsledky: V anamnestických datech nebyly mezi pacienty s ET a CD nalezeny významné rozdíly. Ve škálách se obě skupiny pacientů signifikantně lišily – pacienti s ET měli vyšší tíži třesu horních končetin, pacienti s CD zase vyšší míru dystonie (p < 0,0001). Obě skupiny měly vyšší míru ataxie, více pacienti s ET (p = 0,0008). Hodnoty STDT byly vyšší u pacientů s ET vs. u HC (p = 0,0067). Nenašli jsme významnější rozdíly při srovnání skupin pacientů s ET vs. CD. Závěr: U pacientů s třesem hlavy byly pozorovány abnormálně zvýšené hodnoty STDT u ET, ale ne u CD, pravděpodobně v důsledku narušených mechanizmů zpracování somatosenzorických podnětů a vnímání času, které se připisují postižení mozečku. Nicméně při srovnání vyšetřovaných skupin pacientů jsme nenašli signifikantní rozdíl v hodnotě STDT.
Aim: The aim of this study was to evaluate the utility of the somatosensory temporal discrimination threshold (STDT) examination in patients with head tremor to differentiate between patients with essential tremor (ET) and dystonic head tremor in cervical dystonia (CD). Patients and methods: 42 patients with head tremor (21 ET and 21 CD patients) and 20 healthy controls (HC) were examined. Patient examination consisted of medical history (onset of symptoms, family history, and effect of alcohol) and scales that objectively assessed head and upper limb tremor, severity of CD and severity of ataxia. All subjects were examined by STDT. This is a method based on determining the shortest interval in which an individual recognizes two tactile stimuli as temporally separated. Results: No significant differences were found between ET and CD patients in medical history data. On rating scales, the two groups of patients differed significantly, with ET patients having a higher severity of upper limb tremor and CD patients having a higher degree of dystonia (P < 0.0001). Both groups of patients had a higher degree of ataxia, significantly more in patients with ET (P = 0.0008). STDT values were significantly higher in patients with ET vs. HC (P = 0.0067). We did not find major differences when comparing groups of patients with ET and CD. Conclusion: In patients with head tremor, abnormally elevated STDT values were observed in patients with ET but not in CD, probably due to impaired somatosensory stimulus processing mechanisms and time perception attributed to cerebellar involvement. However, we did not find a significant difference in the STDT values when comparing the examined groups of patients.
- Klíčová slova
- práh pro somatosenzorickou časovou diskriminaci, dystonický třes, třes hlavy,
- MeSH
- esenciální tremor * MeSH
- klinická studie jako téma MeSH
- lidé středního věku MeSH
- lidé MeSH
- mozeček MeSH
- senioři MeSH
- somatosenzorické korové centrum MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- chůze (způsob) MeSH
- lidé MeSH
- Parkinsonova nemoc * MeSH
- polysomnografie MeSH
- porucha chování v REM spánku * komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- komentáře MeSH
- práce podpořená grantem MeSH
BACKGROUND: The Timed Up and Go test is a well-known clinical test for assessing of mobility and fall risk. It has been shown that the IMU which use an accelerometer and gyroscope are capable of analysing the quantitative parameters of the sit-to-stand transition. RESEARCH QUESTION: Which signals obtained by the inertial sensors are suitable for continuous Timed Up & Go test sit-to-stand transition analysis? METHODS: In the study we included 29 older adult volunteers and 31 de-novo Parkinson disease (PD) patients. All subjects performed an instrumented extended TUG wearing a gyro-accelerometer. The sit-to-stand transition was detected from an angular velocity signal. The sit-to-stand signal pattern within the subject group was analyzed via an intra-class correlation between curves. Inter-subjects' variability was visualized using prediction bands. RESULTS: The angular velocity about the pitch axis exhibited the best signal match across subjects in both groups (0.50 < ICC < 0.75). When analysing acceleration, the acceleration along the antero-posterior axis showed moderate inter-subjects signal pattern match (0.50 < ICC < 0.75) in the reference group. The analysis of other signals revealed a poor signal pattern in both subject groups. SIGNIFICANCE: For optimal interpretation of the analysis of continuous curves, the signal pattern must be considered. Also, the inter-subject variability along this pattern can be informative and useful.
- MeSH
- lidé MeSH
- posturální rovnováha fyziologie MeSH
- pozice sedu MeSH
- stoj MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
Nestr.
Advanced methods for image analysis may allow noninvasive objectification of movement disorders. We want to expand and validate the methods of image analysis BradykAn and TremAn that we developed for monitoring movements of the upper limbs and for measuring the amplitude and frequency of resting and action tremor. The methods will be used for detailed analysis of movement patterns and to study the mechanisms of bradykinesia and tremor in Parkinson's disease (PD) and other neurodegenerations. We also want to demonstrate functional changes in the cerebral cortex using the NIRS method, based on detection of changes in infrared light emissions, which occur due to the actual concentrations of oxygenated and deoxygenated hemoglobin reflecting neuronal activity in the cortex. The aim will be to demonstrate changes in the activation of the motor cortex related to kinematic parameters recorded using BradykAn and TremAn.
Pokročilé metody kvantitativní analýzy obrazových dat umožňují neinvazivní objektivizaci pohybových poruch. Námi vyvinuté metodiky obrazové analýzy BradykAn a TremAn chceme rozšířit a validovat pro sledování pohybů horní končetiny a pro měření amplitudy a frekvence klidového a akčního třesu. Metody budou použity k detailní analýze pohybových vzorců a k výzkumu mechanismů bradykineze a třesu u Parkinsonovy nemoci (PN) a dalších neurodegenerativních onemocnění. Zároveň chceme prokázat funkční změny mozkové kůry v obraze metody NIRS, založené na detekci změn zpětné emise infračerveného světla, ke kterým dochází podle aktuální koncentrace oxygenovaného a deoxygenovaného hemoglobinu v závislosti na neuronální aktivitě kortexu. Cílem bude prokázat změny aktivace motorického kortexu související s kinematickými parametry pohybu zaznamenanými systémy BradykAn a TremAn.
- MeSH
- blízká infračervená spektroskopie MeSH
- horní končetina MeSH
- hypokineze diagnóza MeSH
- lidé MeSH
- nemoci bazálních ganglií MeSH
- pohybové poruchy diagnóza MeSH
- snímání pohybu MeSH
- tremor diagnóza MeSH
- Check Tag
- lidé MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- neurologie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu AZV MZ ČR
BACKGROUND: Idiopathic rapid eye movement sleep behaviour (iRBD) is considered as a risk factor for Parkinson's disease (PD) development. Evaluation of repetitive movements with finger tapping, which serves as a principal task to measure the extent of bradykinesia in PD, may undercover potential PD patients. The aim of this study was to explore whether finger tapping abnormalities, evaluated with a 3D motion capture system, are already present in RBD patients. METHODS: Finger tapping data was acquired using a contactless 3D motion capture system from 40 RBD subjects and compared to 25 de-novo PD patients and 25 healthy controls. Objective assessment of amplitude decrement, maximum opening velocity and their combination representing finger tapping decrement was performed in the sequence of the first ten tapping movements. The association between instrumental finger tapping data and semi-quantitative clinical evaluation was analyzed. RESULTS: While significant differences between PD and controls were found for all investigated finger tapping measures (p < 0.002), RBD differed from controls in finger tapping amplitude (p = 0.004) and velocity (p = 0.007) decrement but not in maximal opening velocity. A significant relationship between the motor score from the Movement Disorders Society - Unified Parkinson's Disease Rating Scale and finger tapping decrement was shown for both patient groups, ie RBD (r = 0.36, p = 0.02) and PD (r = 0.60, p = 0.002). CONCLUSIONS: In our group of RBD patients we demonstrated amplitude decrement of repetitive movements, which may correspond with prodromal bradykinesia. Our findings suggest instrumental analysis of finger tapping abnormalities as a potential novel clinical marker reflecting subclinical motor disturbances in RBD.
