Moving Forward from the COVID-19 Pandemic: Needed Changes in Movement Disorders Care and Research

Abstract

Purpose of Review The COVID-19 pandemic has dramatically affected the health and well-being of individuals with movement disorders. This manuscript reviews these effects, discusses pandemic-related changes in clinical care and research, and suggests improvements to care and research models. Recent Findings During the on-going COVID-19 pandemic, individuals with movement disorders have experienced worsening of symptoms, likely due to decreased access to care, loss of social connection, and decreased physical activity. Through telemedicine, care has moved out of the clinic and into the home. Clinical research has also been significantly disrupted, and there has been a shift to decentralized approaches. The pandemic has highlighted disparities in access to care and representation in research. Summary We must now translate these experiences into better care and research models with a focus on equitable integration of telemedicine, better support of patients and caregivers, the development of meaningful digital endpoints, and optimization of decentralized research designs.

Telemedicine in the Management of Parkinson’s Disease: Achievements, Challenges, and Future Perspectives

“…Studies from different countries have demonstrated that individuals with PD experienced worsening motor and nonmotor symptoms during the pandemic [ 8 , 9 , 10 , 11 , 12 , 13 ]. Similarly, the pandemic has negatively affected individuals with other movement disorders such as multiple system atrophy, dystonia, and tic disorders [ 14 , 15 , 16 ].…”

“…Overall, telemedicine applied to PD patients increased from 9.7% prior to the pandemic to 63.5% during the pandemic [ 17 ]. In fact, we learned from the pandemic that many aspects of healthcare for patients with movement disorders could be provided remotely [ 8 ].…”

“…On the other hand, barriers to participation in trials are numerous and include troublesome financial, travel, and caregiver requirements that may be particularly problematic for individuals with mobility difficulties and cognitive impairment [ 67 ]. However, acknowledging the restrictions posed by the pandemic regarding the conduction of clinical trials, telemedicine offers the opportunity to recenter the patient in clinical research and improve the clinical research process [ 8 ]. Decentralized studies might change the old-style research structure, moving it from the clinic to the patient’s home.…”

Handwriting Declines With Human Aging: A Machine Learning Study

“…All results shown in the experimental section were computed on the test set, by training over 50 different initializations and using the concatenation of the previously defined training and validation sets as training data. The final hyper-parameters of the model used in the experimental section were the following: the size of the crops (128; 256; RGB), number of views (Valdovinos et al, 2022), backbone model (ResNet-50-pre-trained), loss function (cross-entropy-multiclass). For the implementation, we used TensorFlow for the design of the model, with the pre-trained ResNet-50 weights taken from the official Google implementation in TensorFlow Hub, while the pre-trained CRNN weights were taken from the Keras-ocr repository.…”

“…Neurodegenerative disorders, including Parkinson's disease (PD) and Alzheimer's disease (AD), represent a relevant global health issue, and the number of cases is going to increase steeply in prevalence in the next few decades (Armstrong and Okun, 2020;Feigin et al, 2020). Currently, the lockdown restrictions due to the COVID-19 global pandemic have challenged the clinical management of patients affected by neurodegenerative diseases, thus requiring innovative telemedicine approaches (Valdovinos et al, 2022). To this aim, it would be relevant to identify novel telemedicine tools allowing early and objective diagnosis, tracking the severity of the disease and thus improving the overall remote clinical management of patients with neurodegenerative diseases (Chirra et al, 2019).…”