Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2025
Perioperative quantification of clinical bradykinesia measurements in patients with Parkinson's disease using accelerometry.
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Smid Annemarie, van Laar Teus, Pinkster Amber E, Ten Kate Jolien M, Kremer Naomi I, Oterdoom D L Marinus, Tamasi Katalin, van Dijk J Marc C, Drost Gea
Аннотация
OBJECTIVE: The gold standard for assessing bradykinesia in Parkinson's disease (PD) is the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), although it is inherently subjective and relies on experienced raters. Therefore, we translated MDS-UPDRS upper limb bradykinesia assessments into an objective scoring method with 3D-accelerometry.
METHODS: In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen's kappa-coefficient (κ).
RESULTS: The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test-retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).
CONCLUSIONS: This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test-retest reliability.
SIGNIFICANCE: Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.
METHODS: In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen's kappa-coefficient (κ).
RESULTS: The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test-retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).
CONCLUSIONS: This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test-retest reliability.
SIGNIFICANCE: Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.