Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Micro-data Analysis, Dalarna University, Falun, Sweden.
Parkinsonism Relat Disord. 2019 Jul;64:112-117. doi: 10.1016/j.parkreldis.2019.03.022. Epub 2019 Mar 26.
A treatment response objective index (TRIS) was previously developed based on sensor data from pronation-supination tests. This study aimed to examine the performance of TRIS for medication effects in a new population sample with Parkinson's disease (PD) and its usefulness for constructing individual dose-response models.
Twenty-five patients with PD performed a series of tasks throughout a levodopa challenge while wearing sensors. TRIS was used to determine motor changes in pronation-supination tests following a single levodopa dose, and was compared to clinical ratings including the Treatment Response Scale (TRS) and six sub-items of the UPDRS part III.
As expected, correlations between TRIS and clinical ratings were lower in the new population than in the initial study. TRIS was still significantly correlated to TRS (r = 0.23, P < 0.001) with a root mean square error (RMSE) of 1.33. For the patients (n = 17) with a good levodopa response and clear motor fluctuations, a stronger correlation was found (r = 0.38, RMSE = 1.29, P < 0.001). The mean TRIS increased significantly when patients went from the practically defined off to their best on state (P = 0.024). Individual dose-response models could be fitted for more participants when TRIS was used for modelling than when TRS ratings were used.
The objective sensor index shows promise for constructing individual dose-response models, but further evaluations and retraining of the TRIS algorithm are desirable to improve its performance and to ensure its clinical effectiveness.
先前基于旋前-旋后测试中的传感器数据开发了一种治疗反应客观指标(TRIS)。本研究旨在检验 TRIS 在新的帕金森病(PD)患者人群中对药物疗效的表现及其在构建个体剂量反应模型中的有用性。
25 名 PD 患者在穿戴传感器的情况下进行一系列左旋多巴挑战任务。TRIS 用于确定单次左旋多巴剂量后旋前-旋后测试中的运动变化,并与临床评分进行比较,包括治疗反应量表(TRS)和 UPDRS 第三部分的六个分项。
正如预期的那样,新人群中 TRIS 与临床评分之间的相关性低于初始研究。TRIS 仍然与 TRS 显著相关(r=0.23,P<0.001),均方根误差(RMSE)为 1.33。对于具有良好左旋多巴反应和明显运动波动的患者(n=17),相关性更强(r=0.38,RMSE=1.29,P<0.001)。当患者从实际定义的关闭状态转变为最佳开启状态时,TRIS 均值显著增加(P=0.024)。当使用 TRIS 进行建模而不是使用 TRS 评分进行建模时,可以为更多参与者拟合个体剂量反应模型。
客观传感器指标在构建个体剂量反应模型方面具有潜力,但需要进一步评估和重新训练 TRIS 算法,以提高其性能并确保其临床效果。