Postural sway as a marker of progression in Parkinson's disease: a pilot longitudinal study.
Postural sway as a marker of progression in Parkinson's disease: a pilot longitudinal study.
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DOI：
10.1016/j.gaitpost.2012.04.010
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发表时间：
2012-07
期刊：
影响因子：
2.4
通讯作者：
Horak FB
中科院分区：
文献类型：
--
作者：
Mancini M;Carlson-Kuhta P;Zampieri C;Nutt JG;Chiari L;Horak FB
对帕金森病（PD）进展敏感的姿势控制的客观措施将改善患者护理并加速临床试验。虽然未治疗的PD患者在安静站立时的姿势摇摆测量结果与年龄匹配的对照受试者不同，但尚不清楚摇摆测量结果是否随早期PD的疾病进展而变化。在这项初步研究中，我们询问了基于加速度计的摇摆指标是否可以提供一个实用的工具，用于监测未经治疗或新治疗的PD患者的姿势控制障碍的进展。我们检查了13例PD受试者和12例年龄匹配的健康对照受试者。PD受试者最近被诊断为PD，并且在基线阶段未开始任何抗帕金森病药物治疗。所有受试者在基线期后3至6个月和12个月进行测试。受试者被要求安静地站两分钟，同时在他们的后躯干上佩戴惯性传感器，测量躯干线性加速度。我们的研究结果表明，客观的摇摆措施恶化超过一年，尽管最小的变化，在WISTRRS运动评分。内侧（ML）摇摆措施比前后摇摆措施在检测进展更敏感。在所有三个测试阶段中，PD组的ML JERK大于对照组。在12个月评估时，PD患者的ML摇摆离散度和ML摇摆速度也显著高于对照组受试者。使用基于加速度计的安静站立测量方法在治疗开始前测量PD进展是可行的。
Objective measures of postural control that are sensitive to Parkinson's Disease (PD) progression would improve patient care and accelerate clinical trials. Although measures of postural sway during quiet stance in untreated PD have been shown to differ from age-matched control subjects, it is not known if sway measures change with disease progression in early PD. In this pilot study, we asked whether accelerometer-based metrics of sway could provide a practical tool for monitoring progression of postural dyscontrol in people with untreated or newly treated PD. We examined 13 subjects with PD and 12 healthy, age-matched control subjects. The PD subjects had been recently diagnosed and had not started any antiparkinsonian medications at the baseline session. All subjects were tested 3-to-6 months and 12 months after the baseline session. Subjects were asked to stand quietly for two minutes while wearing an inertial sensor on their posterior trunk that measured trunk linear acceleration. Our results suggested that objective sway measures deteriorated over one year despite minimal changes in UPDRS motor scores. Medio-lateral (ML) sway measures were more sensitive than antero-posterior sway measures in detecting progression. The ML JERK was larger in the PD group than the control group across all three testing sessions. The ML sway dispersion and ML sway velocity were also significantly higher in PD compared to control subjects by the 12-month evaluation. It is feasible to measure progression of PD prior to onset of treatment using accelerometer-based measures of quiet standing.
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