Parkinson's disease (PD) presents several motor signs, including tremor and bradykinesia. However, these signs can also be found in other motor disorders and in neurologically healthy older adults. The incidence of bradykinesia in PD is relatively high in all stages of the disorder, even when compared to tremor. Thus, this research proposes an objective assessment of bradykinesia in patients with PD (G : 15 older adults with Parkinson's disease, 65.3 ± 9.1 years) and older adults (G: 12 healthy older adults, 60.1 ± 6.1 years). The severity of bradykinesia in the participants of G was assessed using the Unified Parkinson's Disease Rating Scale. Movement and muscular activity were detected by means of inertial (accelerometer, gyroscope, magnetometer) and electromyographic sensors while the participants performed wrist extension against gravity with the forearm on pronation. Mean and standard error of inertial and electromyographic signal parameters could discriminate PD patients from healthy older adults (p value<0.05). In discriminating patients with PD from healthy older adults, the mean sensitivity and specificity were respectively 86.67 and 83.33%. The discrimination between the groups, based on the objective evaluation of bradykinesia, may contribute to the accurate diagnosis of PD and to the monitoring of therapies to control parkinsonian bradykinesia, and opens the possibility for further comparative studies considering individuals suffering from other motor disorders.

BackgroundOver the years, a number of distinct treatments have been adopted for the management of the motor symptoms of Parkinson’s disease (PD), including pharmacologic therapies and deep brain stimulation (DBS). Efficacy is most often evaluated by subjective assessments, which are prone to error and dependent on the experience of the examiner. Our goal was to identify an objective means of assessing response to therapy.MethodsIn this study, we employed objective analyses in order to visualize and identify differences between three groups: healthy control (N = 10), subjects with PD treated with DBS (N = 12), and subjects with PD treated with levodopa (N = 16). Subjects were assessed during execution of three dynamic tasks (finger taps, finger to nose, supination and pronation) and a static task (extended arm with no active movement). Measurements were acquired with two pairs of inertial and electromyographic sensors. Feature extraction was applied to estimate the relevant information from the data after which the high-dimensional feature space was reduced to a two-dimensional space using the nonlinear Sammon’s map. Non-parametric analysis of variance was employed for the verification of relevant statistical differences among the groups (p < 0.05). In addition, K-fold cross-validation for discriminant analysis based on Gaussian Finite Mixture Modeling was employed for data classification.ResultsThe results showed visual and statistical differences for all groups and conditions (i.e., static and dynamic tasks). The employed methods were successful for the discrimination of the groups. Classification accuracy was 81 ± 6% (mean ± standard deviation) and 71 ± 8%, for training and test groups respectively.ConclusionsThis research showed the discrimination between healthy and diseased groups conditions. The methods were also able to discriminate individuals with PD treated with DBS and levodopa. These methods enable objective characterization and visualization of features extracted from inertial and electromyographic sensors for different groups.

Parkinson's disease (PD) is a neurodegenerative disorder that remains incurable. The available treatments for the disorder include pharmacologic therapies and deep brain stimulation (DBS). These approaches may cause distinct side effects and motor responses. This work presents the application of t-distributed stochastic neighbor embedding (t-SNE), which is a machine learning algorithm for nonlinear dimensionality reduction and data visualization, for the problem of discriminating neurologically healthy individuals from those suffering from PD (treated with levodopa and DBS). Furthermore, the assessment of classification methods is presented. Inertial and electromyographic data were collected while the subjects executed a sequence of four motor tasks. The results were focused on the comparison of the classification performance of a support vector machine (SVM) while discriminating two-dimensional feature sets estimated from Principal Component Analysis (PCA), Sammon's mapping, and t-SNE. The results showed visual and statistical differences for all three investigated groups. Classification accuracy for PCA, Sammon's mapping, and t-SNE was, respectively, 73.5%, 78.6%, and 96.9% for the training set and 67.8%, 74.1%, and 76.6% for the test set. The possibility of discriminating healthy individuals from those with PD treated with levodopa and DBS highlights the fact that each treatment method produces distinct motor behavior. The scatter plots resulting from t-SNE could be used in the clinical practice as an objective tool for measuring the discrepancy between normal and abnormal motor behaviors, being thus useful for the adjustment of treatments and the follow-up of the disorder.

Previous studies have reported that visceral disturbances can lead to increased musculoskeletal tension and pain in structures innervated from the corresponding spinal level through viscerosomatic reflexes. We designed a pilot randomised placebo-controlled study using placebo visceral manipulation as the control to evaluate the effect of osteopathic visceral manipulation (OVM) of the stomach and liver on pain, cervical mobility, and electromyographic activity of the upper trapezius (UT) muscle in individuals with nonspecific neck pain (NS-NP) and functional dyspepsia. Twenty-eight NS-NP patients were randomly assigned into two groups: treated with OVM (OVMG; n = 14) and treated with placebo visceral manipulation (PVMG; n = 14). The effects were evaluated immediately and 7 days after treatment through pain, cervical range, and electromyographic activity of the UT muscle. Significant effects were confirmed immediately after treatment (OVMG and PVMG) for numeric rating scale scores (p < 0.001) and pain area (p < 0.001). Significant increases in EMG amplitude were identified immediately and 7 days after treatment for the OVMG (p < 0.001). No differences were identified between the OVMG and the PVMG for cervical range of motion (p > 0.05). This study demonstrated that a single visceral mobilisation session for the stomach and liver reduces cervical pain and increases the amplitude of the EMG signal of the UT muscle immediately and 7 days after treatment in patients with nonspecific neck pain and functional dyspepsia.

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