A "HOLTER" for Parkinson's disease: Validation of the ability to detect on-off states using the REMPARK system
A "HOLTER" for Parkinson's disease: Validation of the ability to detect on-off states using the REMPARK system
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DOI：
10.1016/j.gaitpost.2017.09.031
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发表时间：
2018-01-01
期刊：
影响因子：
2.4
通讯作者：
Cabestany, Joan
中科院分区：
文献类型：
--
作者：
Bayes, Angels;Samba, Albert;Cabestany, Joan
用左旋多巴治疗帕金森病（PD）非常有效。然而，随着时间的推移，运动并发症（MC）出现，限制患者正常生活。最严重的 MC 之一是开关波动。收集有关患者临床状况的准确信息对于规划治疗和评估其效果至关重要。 REMPARK 系统等能够准确可靠地监测 ON-OFF 波动的系统引起了人们的极大兴趣。 目的：分析 REMPARK 系统检测 ON-OFF 波动的能力。 方法：根据英国帕金森病协会脑库标准招募 41 名中重度特发性 PD 患者。该研究包括患有运动波动、步态冻结和/或运动障碍以及在关闭阶段能够独立行走的患者。患者佩戴 REMPARK 系统 3 天，每小时完成一次运动状态日记。结果：REMPARK 系统获得的记录与患者完成的日记相比，检测 OFF 状态的灵敏度为 97%，特异性为 88%（即检测 ON 状态的准确性）。结论：REMPARK 系统可以准确评估 PD 的 ON-OFF 波动；该技术为优化 PD 运动症状的症状控制以及准确评估药物疗效铺平了道路。
The treatment of Parkinson's disease (PD) with levodopa is very effective. However, over time, motor complications (MCs) appear, restricting the patient from leading a normal life. One of the most disabling MCs is ON-OFF fluctuations. Gathering accurate information about the clinical status of the patient is essential for planning treatment and assessing its effect. Systems such as the REMPARK system, capable of accurately and reliably monitoring ON-OFF fluctuations, are of great interest.Objective: To analyze the ability of the REMPARK System to detect ON-OFF fluctuations.Methods: Forty-one patients with moderate to severe idiopathic PD were recruited according to the UK Parkinson's Disease Society Brain Bank criteria. Patients with motor fluctuations, freezing of gait and/or dyskinesia and who were able to walk unassisted in the OFF phase, were included in the study. Patients wore the REMPARK System for 3 days and completed a diary of their motor state once every hour.Results: The record obtained by the REMPARK System, compared with patient-completed diaries, demonstrated 97% sensitivity in detecting OFF states and 88% specificity (i.e., accuracy in detecting ON states).Conclusion: The REMPARK System detects an accurate evaluation of ON-OFF fluctuations in PD; this technology paves the way for an optimisation of the symptomatic control of PD motor symptoms as well as an accurate assessment of medication efficacy.