Technologies for Assessment of Motor Disorders in  Parkinson’s Disease: A Review

Oung, Q.W.; Hariharan, M.; Lee, Hoi Leong; Basah, Shafriza Nisha; Yaacob, Sazali; Sarillee, Mohamed; Lee, Chia Hau

doi:10.3390/s150921710

Cited by 63 publications

(40 citation statements)

References 113 publications

(212 reference statements)

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“…Nevertheless, there is a significant utility for wearable sensor technology in the movement disorders field. There has been an explosion of ongoing investigations in wearable sensors for the development of objective measures that can be used to record long-term changes [39]. Current clinical scales are assessed by scoring a video recording (examination by a specialist), who then assigns a categorical rating to each item.…”

Section: Development Of Closed-loop Dbs Systemsmentioning

confidence: 99%

Reengineering deep brain stimulation for movement disorders: Emerging technologies

Gündüz

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Okun

2017

Current Opinion in Biomedical Engineering

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Deep brain stimulation (DBS) is a neurosurgical technique, which consists of continuous delivery of an electrical pulse through chronically implanted electrodes connected to a neurostimulator, programmable in amplitude, pulse width, frequency, and stimulation channel. DBS is a promising treatment option for addressing severe and drug-resistant movement disorders. The success of DBS therapy is a combination of surgical implantation techniques, device technology, and clinical programming strategies. Changes in device settings require highly trained and experienced clinicians to achieve maximal therapeutic benefit for each targeted symptom, and optimization of stimulation parameters can take many visits. Thus, the development of innovative DBS technologies that can optimize the clinical implementation of DBS will lead to wider scale utilization. This review aims to present engineering approaches that have the potential to improve clinical outcomes of DBS, focusing on the development novel temporal patterns, innovative electrode designs, computational models to guide stimulation, closed-loop DBS, and remote programming.

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Section: Development Of Closed-loop Dbs Systemsmentioning

confidence: 99%

Reengineering deep brain stimulation for movement disorders: Emerging technologies

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Okun

2017

Current Opinion in Biomedical Engineering

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“…Motion tracking studies have provided guidelines to prevent sports injuries and to enhance occupational well‐being . Continuous monitoring of body movements can provide feedback on injury rehabilitation and enable early detection of disorders that affect motor control, for example, Parkinson's disease and multiple sclerosis . Furthermore, assessment of fine motor skills is one of the screening tests for conditions such as epilepsy and autism spectrum disorder (ASD) .…”

Section: Introductionmentioning

confidence: 99%

Flexible Pressure Sensors for Objective Assessment of Motor Disorders

Amit

Chukoskie

Skalsky

et al. 2019

Adv Funct Materials

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Monitoring body motion is relevant to motor control disorders as well as assessment of fine motor skills in child development. Furthermore, motion tracking is necessary for rehabilitation monitoring and injury prevention and benefits both sick and healthy individuals. Flexible pressure sensors based on resistors, capacitors, inductors, or transistors are reviewed in the context of healthcare measurements, ranging from physiological signals to body movement characteristics such as grip and gait. To demonstrate the use of flexible pressure sensors for motor assessment, a touch sensing glove that evaluates fine motor skills in autism research is developed. The results show that autistic children perform fewer taps per minute compared to typically developing children, with larger variations in tap durations. In a second example, a force and motion sensing glove is developed to assess spasticity, a neuromuscular disorder that causes muscle stiffness/resistance and jerky movement. Analyses of force versus velocity show movement-dependent muscle resistance in a patient with spasticity. Through these flexible sensor systems, the shift from subjective scores to objective measurement will promote better diagnosis and dramatically improve the accuracy in tracking patient response to therapy.patients doing certain movements, and then clinicians rank each patient's level according to qualitative descriptions in benchmark classification scales. [12,13] The subjective scores can be inconsistent between raters and do not capture finelevel changes in a patient's progress in response to therapy. Therefore, there is a critical need to tackle the issue of imprecise assessment of motor disorders.With recent advances in flexible sensors and innovations in tactile sensing, [14][15][16][17][18][19] we have new low-cost technologies that are prime to facilitate quantitative evaluation of motor control. This progress report presents current developments in wearable sensor systems applicable to motor disorders, so that consistent, objective metrics become available to accurately track whether a treatment effectively relieves symptoms. The wearable sensors are not limited to placement on patients but can also be worn by clinicians or caregivers to assist them in taking measurements during patient interactions. [20,21] The point-of-care sensor systems will allow frequent monitoring, which is highly desirable to offer a better understanding of the patient's short and long-term response to therapies, to tailor treatment and improve outcome and quality of life for patients.Other reviews [14][15][16][17][18][19] have already extensively covered the flexible materials and devices used in tracking vital signs and electronic skin applications. In light of that, this progress report focuses on the applications in monitoring motor skills, in particular to implement pressure sensor designs for wearable systems with diverse form factors, for instance, gloves, [20,22,23] epidermal tags tags, [24,25] and shoe insoles. [26,27] We will discuss the mechanis...

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“…Using wearable devices, various studies have shown that is possible to collect objective data regarding bradykinesia, tremor, dyskinesia, walking, sleep and speech that correlate to severity of disease, response to medication and track disease progression [87][88][89][90]. A recent study also showed that an intelligent closed-loop system integrating a wide range of wearable sensors, allowed physicians to remotely monitor the condition changes of the patients, adjust medication schedules, and individualize therapy in real-life conditions [91].…”

Section: Minimising Variability / Error In Assessing Endpointsmentioning

confidence: 99%

Challenges in detecting disease modification in Parkinson's disease clinical trials

Athauda

Foltynie

2016

Parkinsonism & Related Disorders

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Despite the wealth of encouraging data from numerous compounds that demonstrate "neuroprotection" in pre-clinical studies of Parkinson's disease, and despite numerous clinical trials, to date, no intervention has been demonstrated to able to modify the course of disease progression.While this "failure to translate" is likely due to numerous factors including our incomplete understanding of the pathogenic mechanisms underlying PD together with excessive reliance on data from the toxin-based animal models of PD, here we will discuss the "structural issues" pertaining to inadequate clinical trial design, selection of inappropriate endpoints and poor patient selection which are often not addressed following failed disease modification trials. Future directions to overcome these challenges such as reducing the heterogeneity of patient cohorts,

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Technologies for Assessment of Motor Disorders in Parkinson’s Disease: A Review

Cited by 63 publications

References 113 publications

Reengineering deep brain stimulation for movement disorders: Emerging technologies

Reengineering deep brain stimulation for movement disorders: Emerging technologies

Flexible Pressure Sensors for Objective Assessment of Motor Disorders

Challenges in detecting disease modification in Parkinson's disease clinical trials

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