Maetzler Walter, Ellerbrock Maren, Heger Tanja, Sass Christian, Berg Daniela, Reilmann Ralf
Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany; DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany.
Hertie Institute for Clinical Brain Research, Department of Neurodegeneration, Center of Neurology, University of Tuebingen, Tuebingen, Germany; Clinical Center Lunenburg, Clinic of Neurology, Lunenburg, Germany.
PLoS One. 2015 Apr 22;10(4):e0123914. doi: 10.1371/journal.pone.0123914. eCollection 2015.
Motor symptoms in Parkinson's disease (PD) are usually assessed with semi-quantitative tests such as the Unified PD Rating Scale (UPDRS) which are limited by subjectivity, categorical design, and low sensitivity. Particularly bradykinesia as assessed e.g. with speeded index finger tapping exhibits low validity measures. This exploratory study set out to (i) assess whether force transducer-based objective and quantitative analysis of motor coordination in index finger tapping is able to distinguish between PD patients and controls, and (ii) assess longitudinal changes. Sixteen early-stage and 17 mid-stage PD patients as well as 18 controls were included in the cross-sectional part of the study; thirteen, 16 and 16 individuals of the respective groups agreed in a reassessment 12 months later. Frequency, force, rhythmicity, regularity and laterality of speeded and metronome paced tapping were recorded by digitomotography using a quantitative motor system ("Q-Motor"). Analysis of cross-sectional data revealed most consistent differences between PD patients and controls in variability of tap performance across modalities assessed. Among PD patients, variability of taps and the ability to keep a given rhythm were associated with UPDRS motor and finger tapping scores. After 12 months, laterality parameters were reduced but no other parameters changed significantly. This data suggests that digitomotography provides quantitative and objective measures capable to differentiate PD from non-PD in a small cohort, however, the value of the assessment to track PD progression has to be further evaluated in larger cohorts of patients.
帕金森病（PD）的运动症状通常采用半定量测试进行评估，如统一帕金森病评定量表（UPDRS），但这些测试受主观性、分类设计和低敏感性的限制。特别是以快速食指敲击评估的运动迟缓，其效度指标较低。这项探索性研究旨在：（i）评估基于力传感器的食指敲击运动协调性客观定量分析是否能够区分PD患者和对照组；（ii）评估纵向变化。16名早期和17名中期PD患者以及18名对照组被纳入研究的横断面部分；12个月后，相应组中的13名、16名和16名个体同意进行重新评估。使用定量运动系统（“Q-Motor”）通过数字运动描记法记录快速和节拍器节奏敲击的频率、力量、节律性、规律性和偏侧性。横断面数据分析显示，在评估的各种模式下，PD患者和对照组在敲击表现的变异性方面差异最为一致。在PD患者中，敲击的变异性和保持特定节奏的能力与UPDRS运动和手指敲击评分相关。12个月后，偏侧性参数降低，但其他参数无显著变化。这些数据表明，数字运动描记法能够在一小群患者中提供定量和客观的测量方法以区分PD和非PD患者，然而，该评估在追踪PD进展方面的价值还需要在更大的患者队列中进一步评估。
