How resistant are levodopa‐resistant axial symptoms? Response of freezing, posture, and voice to increasing levodopa intestinal infusion rates in Parkinson disease

Imbalzano, Gabriele; Rinaldi, Domiziana; Calandra‐Buonaura, Giovanna; Contin, Manuela; Amato, Federica; Giannini, Giulia; Sambati, Luisa; Ledda, Claudia; Romagnolo, Alberto; Olmo, Gabriella; Cortelli, Pietro; Zibetti, Maurizio; Lopiano, Leonardo; Artusi, Carlo Alberto

doi:10.1111/ene.15558

Cited by 8 publications

(13 citation statements)

References 50 publications

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“…Five [ 57 – 59 , 62 , 77 ] of the included studies were interventional studies. The other studies were observational.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies out of 21 investigated solely one subjects' group [ 57 , 59 , 64 , 69 , 70 , 77 ]. Other studies included two [ 58 , 61 , 62 , 66 , 71 , 72 ] or three subjects’ groups [ 60 , 63 , 65 , 67 , 68 , 73 – 76 ].…”

Section: Resultsmentioning

confidence: 99%

“…All studies (i.e. 13 studies) involving turning limited by the number of turns utilised a single turn in the turning task [ 58 , 59 , 65 , 67 , 69 – 77 ]. Eight studies limited turning by the total time of 1 min [ 61 – 63 , 66 , 68 ], 2 min [ 60 , 64 ], or 80 s [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

“…Out of all of the studies, 16 acquired data via inertial measurement units [ 57 , 59 – 66 , 68 – 70 , 72 – 75 ], three solely via camera motion system, and two employed camera motion system along with force platforms [ 71 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

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Beyond timing and step counting in 360° turning-in-place assessment: a scoping review

Netukova,

Horakova,

Szabo

et al. 2024

BioMed Eng OnLine

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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.

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“…Five [ 57 – 59 , 62 , 77 ] of the included studies were interventional studies. The other studies were observational.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Beyond timing and step counting in 360° turning-in-place assessment: a scoping review

Netukova,

Horakova,

Szabo

et al. 2024

BioMed Eng OnLine

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“…Many studies have analyzed axial symptoms in PD patients with an instrumental approach focusing separately on gait alterations or speech disturbances. However, very few studies have assessed instrumentally the whole spectrum of axial symptoms in PD and suggested the presence of a relationship between spatial-temporal gait and speech parameters [11,12]. Subthalamic nucleus deep brain stimulation (STN-DBS) represents a short-and long-term effective treatment in advanced PD patients.…”

Section: Introductionmentioning

confidence: 99%

Interplay between speech and gait variables in Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: A long‐term instrumental assessment

Cavallieri

Gessani

Merlo

et al. 2023

Euro J of Neurology

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Objective: To evaluate correlations between speech and gait parameters in the long term and under different medication and subthalamic nucleus deep brain stimulation (STN-DBS) conditions in a cohort of advanced Parkinson's disease (PD) patients. Methods: This observational study included consecutive PD patients treated with bilateral STN-DBS. Axial symptoms were evaluated using a standardized clinical-instrumental approach. Speech and gait were assessed by perceptual and acoustic analyses and by the instrumented Timed Up and Go (iTUG) test, respectively. Disease motor severity was evaluated with the total score and subscores of the Unified Parkinson's Disease Rating Scale (UPDRS) Part III. Different stimulation and drug treatment conditions were assessed:

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Unraveling the stride: exploring the influence of neurogenic orthostatic hypotension on gait and balance in Parkinson’s disease

Imbalzano,

Ledda,

Tangari

et al. 2024

Clin Auton Res

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Purpose Neurogenic orthostatic hypotension (nOH) and gait impairment are frequent sources of disability in Parkinson’s disease (PD). However, the impact of nOH on balance and gait features remains unclear. This cross-sectional study aimed to assess the influence of nOH on postural and gait parameters in a cohort of patients with PD by means of wearable inertial sensors. Methods Gait and balance were assessed using Opal inertial sensors. nOH was defined as sustained systolic blood pressure (BP) drop ≥ 20 mmHg or diastolic BP drop ≥ 10 mmHg within 3 min of standing, with a ΔHR/ΔSBP ratio ≤ 0.5 bpm/mmHg. Analysis of covariance was performed to evaluate differences in gait/balance features between patients with and without nOH, adjusting for age, cognitive status, and motor disability. Moreover, we performed the same analysis considering the presence of hemodynamically relevant nOH (orthostatic mean BP ≤ 75 mmHg). Results A total of 82 patients were enrolled, 26 with nOH (31.7%), of which 13 presented with hemodynamically relevant nOH. After correcting for confounders, nOH was independently associated with lower gait speed (p = 0.027), shorter stride length (p = 0.033), longer time for postural transitions (p = 0.004), and increased postural sway (p = 0.019). These differences were even more pronounced in patients with hemodynamically relevant nOH. Higher postural sway was associated with a 7.9-fold higher odds of falls (p = 0.040). Conclusions Our study presents an objective demonstration of the independent negative impact of nOH on gait and balance in PD, emphasizing the need for careful detection and management of nOH to mitigate gait and balance disturbances in PD.

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How resistant are levodopa‐resistant axial symptoms? Response of freezing, posture, and voice to increasing levodopa intestinal infusion rates in Parkinson disease

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 8 publications

References 50 publications

Beyond timing and step counting in 360° turning-in-place assessment: a scoping review

Beyond timing and step counting in 360° turning-in-place assessment: a scoping review

Interplay between speech and gait variables in Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: A long‐term instrumental assessment

Unraveling the stride: exploring the influence of neurogenic orthostatic hypotension on gait and balance in Parkinson’s disease

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