An Jian, Xie Zhiying, Jia Fan, Wang Zhaoxia, Yuan Yun, Zhang Jue, Fang Jing
Academy of Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
Department of Neurology, Peking University First Hospital, Beijing 100034, China.
Chaos. 2020 Feb;30(2):023116. doi: 10.1063/1.5126116.
As the potential for a treatment of Duchenne muscular dystrophy (DMD) grows, the need for methods for the early diagnosis of DMD becomes more and more important. Clinical experiences suggest that children with DMD will show some lack of motor ability in the early stage when compared with children at the same age, especially in balance and coordination abilities. Is it possible to quantify the coordination differences between DMD and typically developing (TD) children to achieve the goal of screening for DMD diseases? In this study, we introduced a Local Manifold Structure Mapping approach in phase space and extracted a novel index, relative coupling coefficient (RCC), from gait pattern signals, which were acquired by wearable accelerometers to evaluate the coordination of children with DMD during a walking task. Furthermore, we compared the RCC of 100 children with DMD and 100 TD children in four different age groups and verified the feasibility and reliability of the proposed indices to distinguish children with TD from DMD. T-test results show that, for all age groups, children of the same age with DMD and TD show significant differences in RCC (p < 0.001). Moreover, RCC comprehensively reflects that the coordination ability of DMD patients under walking tasks gradually decreases with age, which is consistent with clinical experience. As a functional biomarker extracted in the phase space of the gait data, the proposed coupling degree index RCC could sensitively distinguish between DMD and TD children at the same age and provide alternative insights and potentially valuable tools for the screening of DMD.
随着杜氏肌营养不良症（DMD）治疗潜力的增长，早期诊断DMD的方法需求变得越来越重要。临床经验表明，与同龄儿童相比，DMD患儿在早期会表现出一些运动能力的不足，尤其是在平衡和协调能力方面。是否有可能量化DMD患儿与正常发育（TD）儿童之间的协调差异，以实现DMD疾病筛查的目标？在本研究中，我们在相空间中引入了局部流形结构映射方法，并从步态模式信号中提取了一个新的指标，即相对耦合系数（RCC），该信号由可穿戴加速度计获取，用于评估DMD患儿在步行任务中的协调性。此外，我们比较了四个不同年龄组中100名DMD患儿和100名TD儿童的RCC，并验证了所提出指标区分TD儿童和DMD患儿的可行性和可靠性。t检验结果表明，对于所有年龄组，同龄的DMD患儿和TD儿童在RCC方面存在显著差异（p < 0.001）。此外，RCC全面反映了DMD患者在步行任务中的协调能力随年龄逐渐下降，这与临床经验一致。作为在步态数据相空间中提取的功能生物标志物，所提出的耦合度指标RCC能够敏感地区分同龄的DMD患儿和TD儿童，并为DMD的筛查提供新的见解和潜在有价值的工具。
