Clinician versus machine: reliability and responsiveness of motor endpoints in Parkinson's disease.
Clinician versus machine: reliability and responsiveness of motor endpoints in Parkinson's disease.
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DOI：
10.1016/j.parkreldis.2014.02.022
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发表时间：
2014-06
影响因子：
4.1
通讯作者：
Giuffrida JP
中科院分区：
文献类型：
--
作者：
Heldman DA;Espay AJ;LeWitt PA;Giuffrida JP
提高证明治疗效果所需的运动评估的可靠性和反应性是帕金森病 (PD) 临床试验的首要任务。本研究的目的是确定便携式运动系统的可靠性和响应能力，用于与临床评级相比量化 PD 运动缺陷。 18 名接受丘脑底核深部脑刺激 (DBS) 的 PD 患者执行了三项任务，以评估静息性震颤、姿势性震颤以及手指敲击速度、幅度和节律，同时在受影响较严重的食指上佩戴无线运动传感器单元 (Kinesia)。这些任务在 DBS 关闭的情况下重复 3 次，每次选择 10 个不同的刺激幅度，以产生治疗反应的微小变化。每项任务的表现都会被录像，以便临床医生以盲法、随机的顺序进行评分。重测可靠性计算为组内相关性 (ICC)，敏感性计算为每个 DBS 幅度的最小可检测变化 (MDC)。运动的 ICC 显着高于临床医生对手指敲击速度 (p<0.0001)、振幅 (p<0.0001) 和节律 (p<0.05) 的评分，但对于静息或姿势性震颤的评估没有显着差异。同样，与所有手指敲击子分数的临床医生分数相比，Kinesia 分数产生的 MDC 较低 (p<0.0001)，但在静息和姿势性震颤方面没有显着差异。与传统的临床评级相比，Kinesia 便携式运动系统可以提供更高的重测可靠性和变化敏感性，用于测量 PD 患者的运动迟缓、运动功能减退和节律失常。
Enhancing the reliability and responsiveness of motor assessments required to demonstrate therapeutic efficacy is a priority for Parkinson's disease (PD) clinical trials. The objective of this study is to determine the reliability and responsiveness of a portable kinematic system for quantifying PD motor deficits as compared to clinical ratings. Eighteen PD patients with subthalamic nucleus deep brain stimulation (DBS) performed three tasks for evaluating of resting tremor, postural tremor, and finger-tapping speed, amplitude, and rhythm while wearing a wireless motion-sensor unit (Kinesia) on the more-affected index finger. These tasks were repeated three times with DBS turned off and at each of 10 different stimulation amplitudes chosen to yield small changes in treatment response. Each task performance was video-recorded for subsequent clinician rating in blinded, randomized order. Test-retest reliability was calculated as intraclass correlation (ICC) and sensitivity was calculated as minimal detectable change (MDC) for each DBS amplitude. ICCs for Kinesia were significantly higher than those for clinician ratings of finger-tapping speed (p<0.0001), amplitude (p<0.0001), and rhythm (p<0.05), but were not significantly different for evaluations of resting or postural tremor. Similarly, Kinesia scores yielded a lower MDC as compared with clinician scores across all finger-tapping subscores (p<0.0001), but did not differ significantly for resting and postural tremor. The Kinesia portable kinematic system can provide greater test-retest reliability and sensitivity to change than conventional clinical ratings for measuring bradykinesia, hypokinesia, and dysrhythmia in PD patients.
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影响因子：
8.6
作者：
Heldman, Dustin A.;Giuffrida, Joseph P.;Chen, Robert;Payne, Megan;Mazzella, Filomena;Duker, Andrew P.;Sahay, Alok;Kim, Sang Jin;Revilla, Fredy J.;Espay, Alberto J.
通讯作者：
Espay, Alberto J.
影响因子：
4.1
作者：
Nanhoe-Mahabier, W.;Allum, J. H.;Bloem, B. R.
通讯作者：
Bloem, B. R.
影响因子：
3.2
作者：
Haley, SM;Fragala-Pinkham, MA
通讯作者：
Fragala-Pinkham, MA
DOI：
10.2307/2987937
发表时间：
1983-01-01
期刊：
JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES D-THE STATISTICIAN
影响因子：
--
作者：
ALTMAN, DG;BLAND, JM
通讯作者：
BLAND, JM
影响因子：
8.6
作者：
Giuffrida, Joseph P.;Riley, David E.;Heldman, Dustin A.
通讯作者：
Heldman, Dustin A.