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E, N. Shaban, and V. Abousetta S. "Online EMG signal analysis for Parkinson’s tremor determination." Thesis, Boston, USA, 2020. http://openarchive.nure.ua/handle/document/11838.
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In this paper, we introduced a general development of software for quantifying the severity of the Parkinson's tremor. The extracted features from the surface EMG of the wrist and hand muscles were the input of the designed model of the application. Using the application that can record reliably the EMG signals and quantify the levels of tremor may contribute to the early diagnosis of the disorder online.
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Shaban, N. E., and V. S. Abousetta. "Online EMG signal analysis for Parkinson’s tremor determination." Thesis, Boston, USA, 2020. http://openarchive.nure.ua/handle/document/13654.
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In this paper, we introduced a general development of software for quantifying the severity of the Parkinson's tremor. The extracted features from the surface EMG of the wrist and hand muscles were the input of the designed model of the application. Using the application that can record reliably the EMG signals and quantify the levels of tremor may contribute to the early diagnosis of the disorder online.
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Wolz, Martin, Antje Hähner, Linda Meixner, Matthias Löhle, Heinz Reichmann, Thomas Hummel, and Alexander Storch. "Accurate Detection of Parkinson’s Disease in Tremor Syndromes Using Olfactory Testing." Karger, 2014. https://tud.qucosa.de/id/qucosa%3A70557.
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Background/Aims: The diagnostic value of olfactory testing for the discrimination of tremor-dominant Parkinson’s disease (PD) from other tremor disorders remains enigmatic. We evaluated whether olfactory testing can accurately detect PD in tremor patients. Methods: A
retrospective analysis of 299 consecutive subjects referred for the differential diagnosis of a tremor disorder was done. Olfactory testing was performed using ‘Sniffin’ Sticks’, resulting in a composite TDI score of odor threshold (T), discrimination (D), and identification (I). Receiver operating curve (ROC) plots were used to calculate sensitivity/specificity for the detection of PD. Results: Of all subjects, 167 (55.9%) had PD and 85 (28.4%) had essential tremor (ET). The mean TDI score in PD was significantly reduced compared to those in ET and other tremor disorders with no differences between ET and other tremor disorders. ROC analysis revealed strong correlations of TDI scores with PD [area under the curve: 0.85 (95% CI: 0.80–0.89); p < 0.001]. The highest Youden index was observed for a TDI score <25 (Youden index: 0.58). Using this cutoff score and that generated from normative data of healthy controls, the TDI score provided high sensitivity (negative predictive value) and specificity (positive predictive value) of approximately 80% for detecting PD. Conclusion: Olfactory testing is a useful, easily applied and inexpensive diagnostic test which is helpful to detect PD among tremor patients.
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Perumal, Shyam Vignesh. "Gait and Tremor Monitoring System for Patients with Parkinson’s Disease Using Wearable Sensors." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6353.
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Typically, a Parkinson’s disease (PD) patient would display instances of tremor and bradykinesia (slowness of movement) at an early stage of the disease and later develop gait disturbances and postural instability. So, it is important to measure the tremor occurrences in subjects to detect the onset of PD. Also, it is equally essential to monitor the gait impairments that the patient displays, as the order at which the PD symptoms appear in subjects vary from one to another.
The primary goal of this thesis is to develop a monitoring system for PD patients using wearable sensors. To achieve that objective, our work focused first on identifying the most significant features that would best distinguish between PD and normal healthy subjects. Here, the various gait and tremor features were extracted from the raw data collected from the wearable sensors and further analyzed using statistical analysis and pattern classification techniques to pick the most significant features. In statistical analysis, the analysis of variance (ANOVA) test was conducted to differentiate the subjects based on the values of the mean. Further, pattern classification was carried out using the Linear Discriminant Analysis (LDA) algorithm. The analysis of our results shows that the features of heel force, step distance, stance and swing phases contributed more significantly to achieving a better classification between a PD and a normal subject, in comparison with other features. Moreover, the tremor analysis based on the frequency-domain characteristics of the signal including amplitude, power distribution, frequency dispersion, and median frequency was carried out to identify PD tremor from different types of artifacts.
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Chen, Alice. "Should Highly-Skilled Parkinson’s Disease Patients Undergo Deep Brain Stimulation or Thalamotomy?" Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/cmc_theses/2052.
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Parkinson’s disease (PD) is a neurodegenerative disorder characterized by a resting tremor combined with varying degrees of rigidity and bradykinesia. Introduced in the 1950s, thalamotomy is used as a surgical procedure to improve brain function in patients and serves as an effective treatment method for the PD tremor where connections within the thalamus are cut. In 1987, deep brain stimulation (DBS), chronic electrical stimulation of deep neural structures using electrodes, was introduced as a clinical treatment for medically refractory tremor in patients with PD. Though thalamotomy has historically been the primary treatment method for PD, an increasing number of patients have chosen to undergo DBS as it has become increasingly touted as an alternative to ablative therapies. The proposed study examines the advantages and disadvantages of both treatment methods to improve cardinal features in highly-skilled, career-oriented PD patients who actively use motor functions in their work. As an alternative to a simple finger-tapping test used for normal PD patients, a more complex strength-dexterity (S-D) test would be performed on 50 skilled patients to evaluate and compare the effectiveness of tremor suppression between both surgeries. The goal of this experiment is to determine which treatment produces the most short-term benefits for the patient to continue with his or her career with minimal future management required. The results of this study will help determine the preferred treatment method when taking into consideration other external factors such as cost, continual management, and preference for short-term vs. long-term results.
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Manohar, Jayashankar. "Detecting Parkinson Tremor Using Bluetooth." Thesis, Uppsala universitet, Institutionen för informationsteknologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-208250.
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Wearable technology is used today for many different applications such as heart rate monitoring and other clinical applications. This thesis aims at developing a Parkinson tremor monitoring application and contributes to optimizing the power consumptionof the system. The monitoring application is developed by implementing software on an embedded hardware prototype to collect accelerometer sensor data to store it in an SD card and to transfer the sensor data via Bluetooth to PC or mobile devices. Since the wearable device has to consume limited energy supplied by the battery, this project also includes reducing the energy consumption of the system by duty cycling the hardware peripherals of the system.
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Erickson-Davis, Cordelia R. "Neurofeedback training for Parkinsonian tremor and bradykinesia /." Connect to online version, 2006. http://ada.mtholyoke.edu/setr/websrc/pdfs/www/2006/153.pdf.
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Cheung, Marcus Ting Hin. "Personalized stimuli as treatment for resting tremor in Parkinson's disease." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/62554.
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Resting tremor in Parkinson’s disease (PD) affects quality of life and individuals’ ability to complete activities of daily living. Resting tremor has been shown to respond to transcranial alternating current stimulation (tACS) when delivered out of phase with the tremor. The present work aimed to further investigate potential tACS-based treatment mechanisms by designing and delivering personalized stimuli and extend our understanding of Parkinsonian resting tremor. Nine participants with tremor dominant PD received fourteen unique tACS stimuli to Primary Motor Cortex (M1) and Supplementary Motor Area (SMA). Effect on tremor was measured before and during stimulation via a 9 degree of freedom (DoF) motion sensor. The first principal component score was obtained from Principal Component Analysis (PCA) of these measures and the power of the data was compared before and during stimulation using a two-sample t-test. Four custom stimuli were designed by weighted linear combination of the data with the greatest effect on tremor; two of which were designed to be suppressive and two were designed to be augmentative towards tremor. Average power was calculated following delivery of the personalized and non-personalized stimuli. Regardless of whether tACS was delivered as a personalized or non-personalized stimuli, results indicate an increased average power during stimulation compared to no stimulation and an overall trend towards augmentation of tremor across participants. Supporting analyses, including Multivariate Empirical Mode Decomposition (MEMD) reinforce this finding, showing no clear trend towards any specific frequencies contributing to tremor suppression. The present results suggest that a broad spectrum frequency-based approach is not an effective means of suppressing tremor in people with PD and a phase-based or more targeted frequency approach may have more promise as a treatment mechanism for resting tremor in PD.Applied Science, Faculty of
Electrical and Computer Engineering, Department of
Graduate
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Burgess, Jonathan G. "Identifying tremor-related characteristics of basal ganglia nuclei in Parkinson's disease." Thesis, University of Reading, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.541954.
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Davidson, Andrew Doran. "Fundamental Principles of Tremor Propagation in the Upper Limb." BYU ScholarsArchive, 2016. https://scholarsarchive.byu.edu/etd/6509.
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Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter musculoskeletal model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom (DOF) from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices.
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Pan, Song. "On demand DBS for Parkinson's Disease : tremor prediction using artificial neural networks." Thesis, University of Reading, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.567590.
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In this thesis results are presented which relate to using artificial neural networks to predict the onset of Parkinson's disease tremors in human subjects. Data for the networks was obtained from implanted deep brain electrodes in human subjects. A tuned artificial neural network was shown to be able to identify the pattern of the onset tremor from these real time recordings. Parkinson's disease (PO) is one disease in a group of conditions called movement disorders. One of the primary symptoms of Parkinson's disease is tremor, and in the extreme case, the patient can suffer loss of physical movement. There are two major types of treatment for PO currently available, namely chemical treatment (Levodopa) and surgical implants (Deep Brain Stimulation). Deep Brain Stimulation (DBS) has been widely accepted as an efficient treatment for PO over the past decade. Despite the high cost of surgical operation, deep brain stimulation has become a widely accepted alternative choice (if not the only) to medical treatment such as Levodopa for patients. In this work, number of methods have been applied on exploring the possibility of determining PO tremor onset from patient's brain signal, in particular using combination of artificial neural networks (ANN) and advanced signal processing algorithms. The result of this work could eventually lead to design a deep brain stimulation device with the ability to react on different brain activities, for example, start stimulation just before Parkinson's disease tremor onset. The benefits of such smart device are pre-Iong DBS battery life and reduce stimulation interference on normal brain functions.
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Calveley, Louise. "Emotional experience and expression in people with Parkinson's disease and essential tremor." Thesis, University of Sheffield, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.434438.
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Meixner, Linda. "Retrospektive Analyse der olfaktorischen Testung in Bezug auf die Differentialdiagnosen von Parkinsonsyndromen und Tremorerkrankungen." Doctoral thesis, Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-203747.
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Duval, Christian 1963. "The clinical relationship between tremor and voluntary motor behavior in patients with Parkinson's disease /." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82862.
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Parkinson's disease (PD) is a neurodegenerative disease characterized by progressive loss of dopaminergic neurons of the substantia nigra pars compacta. Symptoms usually include akinesia, bradykinesia, muscle rigidity, postural imbalance and tremor. Despite numerous studies on the physiology and pathophysiology of tremor, its influence on voluntary motor behavior remains unclear. Accordingly, the main objectives of the present thesis were to (a) determine if a clinical relationship existed between tremor and performance of voluntary movements, and (b) characterize the impact of ventrolateral (VL) thalamotomy on tremor and voluntary motor behavior. Results indicate that age-related change of the supraspinal component of normal physiological tremor (NPT) has no influence on the performance of healthy elderly subjects making rapid alternating movements (RAM). Our results also show that subsets of patients presenting different tremor amplitudes and/or tremor power characteristics had similar RAM performance, hence negating any direct relationship between the supraspinal oscillator(s) generating tremor and RAM performance. Our results demonstrate that tremor can be detected during manual-tracking movements performed by patients with early PD, but this tremor has little consequence on the accuracy of these patients.As for the impact of VL thalamotomy on tremor, our results show that the thalamic lesion eliminates selectively PD tremor oscillations, in addition to preventing a resurgence of the supraspinal component of physiological tremor. The surgical procedure did not however improve or worsen RAM performance, suggesting that tremor probably plays little role in bradykinesia. Accuracy during the manual-tracking task is nonetheless greatly improved post-surgery, hence confirming the anticipated clinical benefits of the surgical procedure. In conclusion, despite previous evidence that tremor and RAM may share common neural networks and that tremor may be pathophysiologically linked with bradykinesia, the aforementioned results suggest that there is little clinical relationship between tremor and bradykinesia observed in patients with PD making RAM.
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Müller, Inga. "Periphere Beeinflussbarkeit eines zentralen Tremor-Oszillators durch Gewichtsbelastung loading bei Morbus Parkinson /." [S.l.] : [s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=969574258.
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Amer, Hani Taha Sherif Ben. "Differential diagnosis of parkinsonism and tremor disorders : basal ganglia imaging with a novel isotope." Thesis, University of Glasgow, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312132.
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Reck, Christiane. "Neuronale Oszillationen bei Patienten mit Bewegungsstörungen Charakterisierung neuronaler Oszillationen im Nucleus subthalamicus und Nucleus ventralis intermedius thalami mittels intraoperativer Ableitungen." Saarbrücken VDM Verlag Dr. Müller, 2008. http://d-nb.info/989352501/04.
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Zugl.: Düsseldorf, Univ., Diss., 2008 u.d.T.: Reck, Christiane: Charakterisierung oszillatorischer Aktivität im Nucleus subthalamicus und Nucleus ventralis intermedius thalami bei Patienten mit BewegungsstörungenHergestellt on demand
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Molnar, Gregory F. "Neuronal firing rates in motor thalamus of Parkinson's disease (PD) and essential tremor (ET) patients." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape2/PQDD_0020/MQ54142.pdf.
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Blomstedt, Patric. "Analysis of deep brain stimulation and ablative lesions in surgical treatment of movement disorders : with emphasis on safety aspects." Doctoral thesis, Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1072.
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Gillivan-Murphy, Patricia. "Voice tremor in Parkinson's disease (PD) : identification, characterisation and relationship with speech, voice and disease variables." Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/2170.
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Voice tremor is associated with Parkinson’s disease (PD), however little is known about the precise characteristics of PD voice tremor, optimum methods of evaluation or possible relationships with other speech, voice, and disease variables. The question of possible differences between voice tremor in people with PD (pwPD) and neurologically healthy ageing people has not been addressed. Thirty pwPD ‘off-medication’ and twenty eight age-sex matched neurologically healthy controls were evaluated for voice tremor features using acoustic measurement, auditory perceptual voice rating, and nasendoscopic vocal tract examination. Speech intelligibility, severity of voice impairment, voice disability and disease variables (duration, disability, motor symptom severity, phenotype) were measured and examined for relationship with acoustic voice tremor measures. Results showed that pwPD were more likely to show greater auditory perceived voice instability and a greater magnitude of frequency and amplitude tremor in comparison to controls, however without statistical significance. PwPD had a higher rate of amplitude tremor than controls (p<0.05). Judged from ‘silent’ video recordings of nasendoscopic examination, pwPD had a greater amount of tremor in the palate, tongue, and global larynx (vertical dimension) than controls during rest breathing, sustained /s/, /a/ and /i/ (p<0.05). Acoustic voice tremor did not relate significantly to other speech and voice variables. PwPD had a significantly higher voice disability than controls (p<0.05), though this was independent of voice tremor. The magnitude of frequency tremor was positively associated with disease duration (p<0.05). A lower rate of amplitude tremor was associated with an increase in motor symptoms severity (p<0.05). Acoustic voice tremor did not relate in any significant way to PD disability or phenotype. ii PD voice tremor is characterised by auditory perceived instability and tremor, a mean amplitude tremor of 4.94 Hz, and tremor in vocal tract structures. Acoustic analysis and nasendoscopy proved valuable adjunctive tools for characterising voice tremor. Voice tremor is not present in all people with PD, but does appear to increase with disease duration. However pwPD examined here represent a relatively mild group with relatively short disease duration. Further work will look at people with more severe disease symptomatology and longer duration.
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Dengler, Steffen [Verfasser]. "Essentieller Tremor und Idiopathisches Parkinson-Syndrom : Unterschiede nicht-motorischer Symptome im Verlauf / Steffen Dengler." Tübingen : Universitätsbibliothek Tübingen, 2020. http://d-nb.info/1219903752/34.
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Mertens, Christophe. "Analysis of vocal tremor in normophonic and dysphonic speakers." Doctoral thesis, Universite Libre de Bruxelles, 2015. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/218423.
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The study concerns the analysis of vocal cycle length perturbations in normophonic and dysphonic speakers.A method for tracking cycle lengths in voiced speech is proposed. The speech cycles are detected via the saliences of the speech signal samples, defined as the length of the temporal interval over which a sample is a maximum. The tracking of the cycle lengths is based on a dynamic programming algorithm that does not request that the signal is locally periodic and the average period length known a priori.The method is validated on a corpus of synthetic stimuli. The results show a good agreement between the extracted and the synthetic reference length time series. The method is able to track accurately low-frequency modulations and ast cycle-to-cycle perturbations of up to 10% and 4% respectively over the whole range of vocal frequencies. Robustness with regard to the background noise has lso been tested. The results indicate that the tracking is reliable for signal-to-noise ratios higher than 15dB.A method for analyzing the size of the cycle length perturbations as well as their frequency is proposed. The cycle length time series is decomposed into a sum of oscillating components by empirical mode decomposition the instantaneous envelopes and frequencies of which are obtained via AM-FM decomposition. Based on their average instantaneous frequencies, the empirical modes are then assigned to four categories (declination, physiological tremor, neurological tremor as well as cycle length jitter) and added within each. The within-category size of the cycle length perturbations is estimated via the standard deviation of the empirical mode sum divided by the average cycle length. The neurological tremor modulation frequency and bandwidth are obtained via the instantaneous frequencies and amplitudes of empirical modes in the neurological tremor category and summarized via a weighted instantaneous frequency probability density, compensating for the effects of mode mixing.The method is applied to two corpora of vowels comprising 123 and 74 control and 456 and 205 Parkinson speaker recordings respectively. The results indicate that the neurological tremor modulation depth is statistically significantly higher for female Parkinson speakers than for female control speakers. Neurological tremor frequency differs statistically significantly between male and female speakers and increases statistically significantly for the pooled Parkinson speakers compared to the pooled control speakers. Finally, the average vocal frequency increases for male Parkinson speakers and decreases for female Parkinson speakers, compared to the control speakers.Doctorat en Sciences de l'ingénieur et technologie
info:eu-repo/semantics/nonPublished
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Fytagoridis, Anders. "Deep brain stimulation of the posterior subthalamic area in the treatment of movement disorders." Doctoral thesis, Umeå universitet, Neurokirurgi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-51785.
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Background: The posterior subthalamic area (PSA) is essentially composed of the caudal Zona incerta and the prelemniscal radiation. Subthalamotomy in the PSA was renowned for its effectiveness in alleviating movement disorders and particularly tremor. The modern literature on DBS of this area is limited, but promising results have been presented for Parkinson’s disease (PD), essential tremor (ET) and other movement disorders. Aim: To evaluate the safety of PSA DBS with emphasis on the panorama of side effects, the distribution of stimulation-induced side effects and the effects of PSA DBS on verbal fluency. To evaluate the therapeutic effect of PSA DBS on less common forms of tremor, tremor-dominant PD, and concerning the long-term results in ET. Method: 40 patients were evaluated regarding side effects of the procedure. 28 patients with ET were analyzed for stimulation-induced side effects in a standardized manner. The locations of the contacts that caused stimulation-induced side effects were plotted on atlas slides. A 3-D model of the area was created based on these slides. Verbal fluency was analyzed in 17 patients with ET before surgery, after 3 days and finally after 1 year. Five patients with less common forms of tremor and 18 with ET were evaluated according to the ETRS at baseline and one year or 3-5 years after surgery, respectively. 14 patients with mainly unilateral tremor-dominant PD were evaluated a mean of 18 months after surgery according to the motor part of UPDRS. Results: PSA DBS was associated with few serious side-effects, but a transient and mild postoperative dysphasia was found in 22.5% of the patients. There was a slight transient decline in the performance on verbal fluency tests immediately after surgery. Visualization of the contacts causing stimulation-induced side effects showed that identical responses can be elicited from various points in the PSA and its vicinity. The effect on the less common forms of tremor was excellent except for neuropathic tremor where the effect was moderate. A pronounced and sustained microlesional effect was seen for some of the patients. After a mean of 4 years with unilateral PSA DBS the total ETRS score was improved by 52.4%, tremor by 91.8% and hand function by 78.0% in the patients with ET. There was no increase in the stimulation strength over time. In PD, the scores improved 47.7% for contralateral UPDRS III. Contralateral tremor, rigidity, and bradykinesia improved by 82.2%, 34.3%, and 26.7%, respectively. Conclusions: PSA DBS generally seem to be a safe procedure, but it may be associated with transient declines of verbal fluency. There was no clear somatotopic pattern with regard to stimulation-induced side effects in the PSA. PSA DBS can alleviate tremor regardless of the etiology. The long-term effects in ET were favorable when compared to our previous results of Vim DBS. The effect on Parkinsonian tremor was satisfying, however, the reductions of rigidity and bradykinesia were less compared to previous studies of PSA DBS for PD.
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Meshack, Rubia Parwyn. "The effects of weights on the amplitude and frequency of postural hand tremor in people with Parkinson's disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ63339.pdf.
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Hirabayashi, Hidehiro. "Stereotactic imaging in functional neurosurgery." Doctoral thesis, Umeå universitet, Klinisk neurovetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-55141.
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Background: The birth of stereotactic functional neurosurgery in 1947 was to a great extent dependent on the development of ventriculography. The last decades have witnessed a renaissance of functional stereotactic neurosurgery in the treatment of patients with movement disorders. Initially, these procedures were largely based on the same imaging technique that had been used since the birth of this technique, and that is still used in some centers. The introduction of new imaging modalities such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) provided new potentials, but also new challenges for accurate identification and visualisation of the targets in the basal ganglia and the thalamus with an urge to thoroughly evaluate and optimize the stereotactic targeting technique, as well as evaluate accurately in stereotactic space the location and extent of stereotactic Radiofrequency (RF) lesions and the position of deep brain stimulation (DBS) electrodes. Aims: To study the differences between CT and MRI regarding indirect atlas coordinates in thalamic and pallidal procedures and to evaluate and validate visualisation of the pallidum and the subthalamic nucleus in view of direct targeting irrespective of atlas-derived coordinates. Furthermore, to evaluate the contribution of RF parameters on the size of stereotactic lesions, as well as the impact of size and location on clinical outcome. Method: The coordinates in relation to the landmarks of the 3rd ventricle of the targets in the pallidum and ventrolateral thalamus were compared between CT and MRI in 34 patients. In another 48 patients direct visualization of the pallidum was evaluated and compared to indirect atlas based targeting. The possibility and versatility of visualizing the Subthalamic Nucleus (STN) on short acquisition MRI were evaluated in a multicentre study, and the use of alternative landmarks in identification of the STN was demonstrated in another study. In 46 patients CT and MRI were compared regarding the volume of the visible RF lesions. The volume was analysed with regard to coagulation parameters, and the location and size of the lesions were further evaluated concerning the clinical outcome. Results:Minor deviations were seen between MRI and CT coordinates of brain targets. The rostro-caudal direction of these deviations were such that they would be easily accounted for during surgery, why MRI can obviate the need for CT in these procedures. MRI using a proton density sequence provided detailed images of the pallidal structures, which demonstrated considerable inter-individual variations in relation to the landmarks of the 3rd ventricle. By using a direct visualization of the target, each patient will act as his or her own atlas, avoiding the uncertainties of atlas-based targeting. The STN could be visualized on various brands of MRI machines in 8 centers in 6 countries with good discrimination and with a short acquisition time, allowing direct visual targeting. The same scanning technique could be used for postoperative localization of the implanted electrodes. In cases where the lateral and inferior borders of the STN cannot be easily distinguished on MRI the Sukeroku sign and the dent internal-capsule-sign signs might be useful. The volume of a stereotactic RF lesion could be as accurately assessed by CT as by MRI. The lesion´s size was most strongly influenced by the temperature used for coagulation. The lesions´ volumes were however rather scattered and difficult to predict in the individual patient based solely on the coagulation parameters. For thalamotomy, the results on tremor was not related to the lesion´s volume. For pallidotomy, larger and more posterior-ventral lesions had better effect on akinesia while effects on tremor and dyskinesias were not related to size or location of the lesions. Conclusions: The minor deviations of MRI from CT coordinates can be accounted for during surgery, why MRI can obviate the need of CT in these procedures. Direct visualized targeting on MRI of the pallidum is superior to atlas based targeting. The targets in the pallidum and the STN, as well as the location of the electrodes, can be well visualized with short acquisition MRI. When borders of the STN are poorly defined on MRI the Sukeroku sign and the dent internal-capsule-sign signs proved to be useful. The volumes of RF lesions can be accurately assessed by both stereotactic thin slice CT and MRI. The size of these lesions is most strongly influenced by the temperature of coagulation, but difficult to predict in the individual patient based on the coagulation parameters. Within certain limits, there were no clear relationships between lesions´ volume and location and clinical effects of thalamotomies and pallidotomies.
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Markovič, Michal. "Metody analýzy dysgrafie u pacientů s Parkinsonovou nemocí pro účely diagnózy a sledování progrese onemocnění." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2017. http://www.nusl.cz/ntk/nusl-317009.
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Parkinson’s disease causes among other symptoms also writing disorder. Parkinson's dysgrafia is disease the writing of parkinsonics. The aim of the work is to show the importance of examinig the parametres of Parkinson's dysgrafia and to find writing parametres, which could distinguish healthy subjects from the pacient and also it could monitoring progress of pakinson's disease. Some of the parametrs showed marked differences and therefore could distinguish healthy people from those with Parkinson’s disease.
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Saidi, Azadeh. "Robotic Evaluation Of Rigidity In Parkinson's As A Function Of Speed-Comparison To Clinical Scales." VCU Scholars Compass, 2005. http://scholarscompass.vcu.edu/etd_retro/147.
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Rigidity is one of the cardinal symptoms in Parkinson's disease, along with Bradykinesia, tremor and postural instability. Rigidity in PD has been understudied, but its pathophysiological basis remains unclear. Various types of neurophysiological and biomechanical approach have been developed in order to investigate the neural control of muscle tone. A common approach is to observe the sensitivity of muscle resistance in response to stretch velocity or displacement [Kamper, Rea, He]. A recent study on elbow flexors in patients with spasticity and rigidity showed a velocity dependent increase in reactive torque in both groups [Lee H, et al). Even though this Study shows a correlation between elbow flexors and velocity, it doesn't discuss the role of elbow extensors. We studied the rigidity response in the elbow of both arms to different speed movements in 12 patients suffering from Parkinson's disease ON or OFF medication. The purpose of this study was to look at both elbow flexion and extension and show that quantitative measures of rigidity and movement disorders in subjects with Parkinson's disease correlate with the currently used clinical evaluations and also find the correlation between velocity and both elbow extension and flexion at the same time. Elbow was flexed and extended by means of a robotic arm,under four different speeds. The resistance to movement was recorded with a torque sensor and EMG of two elbow muscles; Biceps and Triceps; was recorded while the subjects were attempting to relax. The patients were also examined by physicians and their elbow rigidity and muscle tone and Parkinson's disease stage was evaluated and a Universal score in the categories of UPDRS, MMSE, and CAPIT was assigned for each arm of each individual. In the end we will argue that there is a very strong correlation between speed and elbow Extension and Flexion, muscle activity and the rigidity presented in each arm. We will also present the correlation between the robotic torque measurement and the clinical scores given to each subject.
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Nezzar, Hachemi. "Etude in vivo du connectome des saccades oculomotrices chez l'Homme par imagerie structurelle." Thesis, Clermont-Ferrand 1, 2016. http://www.theses.fr/2016CLF1MM15/document.
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Le système visuel humain est complexe par son organisation anatomique et par son fonctionnement incomplètement élucidé. Il est fonctionnellement divisé en deux systèmes. Le premier système est destiné à la vision consciente communément appelée voie visuelle principale ou en anglais « image forming visual pathways ». Le second, appelé système secondaire ou accessoire, n’apporte pas d’information visuelle consciente, il est dit « non image forming visual pathway ». Ce dernier apporte à notre cerveau une information sur l’environnement telle que la sensation jour/nuit. Ses fonctions sont sous-tendues par l’afflux d’informations rétiniennes non visuelles sur des structures de l’hypothalamus comme le noyau supra-chiasmatique. Les deux systèmes visuels ont un substratum anatomique complexe faisant intervenir de nombreuses structures anatomiques au sein des différents étages du cerveau cortical et sous-cortical comme les noyaux gris centraux dits « Basal Ganglias » (BG). Le système visuel secondaire intervient aussi comme une structure de contrôle des mouvements oculomoteurs tels que la poursuite ou les saccades nécessaires pour explorer notre environnement. Ainsi les saccades oculomotrices sont sous le contrôle modulateur des BG. De ce fait l’étude des saccades apparait comme un très bon modèle pour explorer le fonctionnement du système extrapyramidal au cours des maladies neuro-dégénératives. Les connaissances actuelles sur ce système de contrôle des saccades proviennent essentiellement des études sur le primate non humain et sur des observations cliniques chez l’homme au cours de pathologies dégénératives ou toxiques des BG. L’observation des structures anatomiques, en particulier du réseau de la substance blanche cérébrale qui supporte les connections axonales, n’est pas accessible à l’imagerie clinique de routine. Pour décrire et étudier ces réseaux de connections, la notion de connectomique a été introduite il y a un dizaine d’années. Dans ce travail, nous nous sommes donné l’objectif de décrire le connectome des saccades oculomotrices sur un plan structurel. Nous avons exploré les structures sous-corticales intervenant dans le contrôle des saccades comme les BG, le colliculus supérieur et le pulvinar. Pour ce faire, nous avons utilisé l’imagerie IRM structurelle en diffuseur de tension (DTI) chez deux groupes de patients présentant une maladie neuro-dégénérative : un groupe souffrant de maladie de Parkinson chez qui une atteinte des BG et une dysfonction des saccades sont reconnues, et un groupe de trembleurs essentiels reconnu pour ne pas présenter de dysfonction des saccades et chez qui les BG sont épargnés. Le résultat de ce travail a permis pour la première fois une description in vivo du connectome des saccades chez l’Homme. Il a de plus montré des différences dans la structure du connectome dans les deux groupes de patients. Une meilleure connaissance de ce connectome pourrait permettre de mieux comprendre certains troubles oculomoteurs et aussi de suivre l’évolution de certaines maladies neurodegenerativesVisual system is complex by its anatomy and its function. Neuro-anatomists have been interested in understanding the link between the visual pathways and the brain for centuries. Classical brain fixation and dissection methods were used to describe the visual pathways identifiable macroscopically. Non–image visual pathway, particularly the part involves in saccadic eye movements network in human is still not mastered. Our current knowledge in SCM is based on animal studies, anatomic dissection and brain histopathology examination of specimens from patients with clinical basal ganglia (BG) disorders. Saccadic eye movements (SCM) are under the control of the basal ganglia (BG) and SCM circuitry within the BG represents a good model for studying pathology in the extra-pyramidal system. The diagnosis of Parkinson’s disease (PD), which affects SEM and its distinction from non-dopaminergic, essential tremor (ET) where SEM are not impaired can be challenging and still relies on clinical observations. Diffusion tensor imaging and fiber tractography (DTI-FT), a new MRI technology, can be used to evaluate the presence and integrity of white matter tracts using directional diffusion patterns of water. The purpose of this study is to use DTI-FT to analyse SEM networks within BG and compare the SEM neural pathways or connectome of patients clinically diagnosed with PD and ET. To date, there are no studies, using DTI-FT for the extensive exploration of non-image visual pathways and SCM circuits, notably the deep brain connections. For this goal, we introduced the concept of SCM connectomes, derived from the general concept of connectome. Our study used structural MRI to identify nuclei and fascicles of the SCM connectome in PD and ET patients; imageries were acquired in routine clinical conditions fitted for DBS surgery. We found a reduction of the fiber number in two fascicles of the connectome in PDcompared to ET group
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Phillips, Robert Scott. "SINGLE TRIAL EFFECTS OF DYNAMIC CYCLING: HOW LONG DOES IT LAST?" Kent State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=kent1396275775.
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Engelhardt, Julien. "Optimisation du ciblage des noyaux gris centraux en neurochirurgie stéréotaxique." Thesis, Bordeaux, 2019. http://www.theses.fr/2019BORD0168.
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La stimulation cérébrale profonde (SCP) constitue un traitement chirurgical validé pour certaines formes de maladie de Parkinson, de tremblement essentiel ou de dystonies.La principale étape de cette procédure est le ciblage de la structure cérébrale dans laquelle sera délivré le courant par les électrodes implantées (cible). Les cibles de la SCP sont de l’ordre du millimètre, correspondant à des sous-parties de noyaux gris centraux (noyaux sous-thalamique – NST, globus pallidus interne – GPi, noyau ventral-intermédiaire du thalamus – VIM) ou à des régions autour de ces noyaux dans lesquelles transitent les faisceaux de fibres blanches à destination de ceux-ci. L’imagerie par résonnance magnétique (IRM) permet de visualiser certains de ces noyaux, mais avec une résolution insuffisante pour guider avec précision l’implantation des électrodes pour ce qui est du STN et du VIM, rendant pour certains auteurs l’électrophysiologie peropératoire indispensable. D’autre part, la définition anatomique des cibles est sujette à controverses et la nature même de la structure visée varie entre les différents centres. Ces éléments constituent des sources d’erreur dans le ciblage et peuvent rendre compte de l’absence d’efficacité de la procédure, ou de son efficacité partielle, chez certains patients. L’objectif de ce travail était d’optimiser le ciblage en SCP en définissant une cible non pas anatomique mais fonctionnelle : pour un patient donné, trouver la position d’une cible dont la stimulation aboutira à un excellent résultat clinique.Pour cela, nous avons résolu un problème inverse, grâce à des méthodes d’apprentissage statistique. La base d’entrainement était constituée par la position des électrodes implantées chez des patients ayant un excellent résultat clinique post-opératoire d’une part, et la position de structures anatomiques avoisinantes visibles sur une IRM à 1,5Tesla chez ces mêmes patients, d’autre part. Trois approches d’apprentissage ont été utilisées : la régression de type RKHS, puis les SVR (support vector régression) et les réseaux de neurones (apprentissage profond). 15 patients atteints d’un tremblement essentiel (29 électrodes) opérés avec un excellent résultat ont été inclus pour la définition d’une cible « VIM ». 18 points de repères par hémisphère ont été définis dans la région des noyaux gris centraux.Les modèles de prédiction ont été validés en calculant la distance euclidienne entre la cible prédite et la cible « réelle », à savoir le centre du contact actif de l’électrode implantée. Ensembles d’apprentissage et de validation étaient partitionnés de manière itérative selon la méthode de validation croisée type leave-one-out. Nous avons également normalisé la position des contacts actifs et des cibles prédites sur un cerveau moyen (MNI template) et avons calculé la distance minimale entre la cible prédite et le VIM donné par un atlas (Ewert) normalisé sur ce template, d’une part, et entre le contact actif et le VIM de cet atlas d’autre part. Nous avons ainsi pu comparer les distance cibles prédites – VIM et contact actif – VIM.En parallèle, nous avons développé un logiciel (Optim DBS), permettant de visualiser directement la cible prédite à partir des points de repères sur l’IRM de n’importe quel patient devant être opéré.Enfin, nous avons mis en place et démarré une étude prospective multicentrique permettant de valider la cible « VIM » sur le tremblement essentiel. Il est prévu d’inclure22 patients en 2 ans et de les opérer sous anesthésie générale sans électrophysiologie peropératoire en utilisant la cible développée dans ce travail pour implanter l’électrodeDeep brain stimulation (DBS) is a surgical treatment for some forms of Parkinson's disease, essential tremor and dystonia. The main step in this procedure is the targeting of the brain structure in which the current will be delivered by the implanted electrodes (target). Targets of the SCP are of the order of a millimeter, corresponding to sub-parts of basal ganglia (subthalamic nucleus - STN, globus pallidus internal - GPi, ventral intermediate nucleus of the thalamus - VIM) or regions around these nuclei in which pass the white fibers destined for these nuclei. Magnetic resonance imaging (MRI) allows viewing some of these nuclei, but with insufficient resolution to guide accurate implantation of electrodes to the STN and the VIM, making for some authors essential intraoperative electrophysiology. On the other hand, the anatomic target definition is controversial and the nature of the target structure varies between different centers. These elements are sources of error in targeting and can account for the lack of efficiency of the surgery, or its partial effectiveness in some patients. The objective of this work was to optimize targeting in DBS by setting a functional target and non-anatomically: for a given patient, to find the position of a target whose stimulation will lead to an excellent clinical outcome. For this, we resolved a reverse problem through statistical learning methods. The training base was formed by the position of the electrodes implanted in patients with an excellent postoperative clinical result on the one hand, and the position of anatomical structures nearby visible on an MRI at 1.5 Tesla in these same patients, on the other hand. We used three machine-learning approches: RKHS (Reproducing Kernel Hilbert Space), SVR (support vector regression) as well as deep neural networks. 15 patients with an essential tremor (29 electrodes) operated with an excellent result have been included to the definition of a 'VIM' target. 18 points of reference by hemisphere have been defined in the region of the basal ganglia. The prediction model has been validated by calculating the Euclidean distance between the predicted target and the 'real' target distance, which is the center of the active contact of the implanted electrode. The validation was done according to leave-one-out cross-validation approach. We also normalized the position of active contacts and targets predicted on an average brain (MNI template) and have calculated the minimum distance between the predicted target and the VIM given by an atlas (Ewert) normalized on this template, on the one hand, and between the active contact and the VIM of this atlas on the other hand. We were able to compare the distances predicted targets - VIM and active contact - VIM. In parallel, we developed a software (OptimDBS), to visualize directly the target predicted from landmarks on the MRI of any patient to be operated on. Finally, we set up and started a multi-center prospective study to validate the "VIM" target on essential tremor. It is planned to include 22 patients in 2 years who will be operated under general anesthesia without intraoperative electrophysiology using the target developed in this work to implant the electrode
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Auzou, Nicolas. "Production du verbe dans le vieillissement normal et les pathologies du mouvement : analyses quantitatives et qualitatives." Thesis, Bordeaux, 2018. http://www.theses.fr/2018BORD0304.
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L’objectif général de cette thèse est d’étudier la production quantitative (i.e., nombre de mots) et qualitative (i.e. regroupements et alternances) du verbe d’action dans le vieillissement normal et dans les pathologies du mouvement à travers la tâche de fluence d’action, comparativement aux fluences classiques (i.e., sémantique et littérale). Nous avons montré que la production lors d’une tâche de fluence d’action est altérée chez des adultes âgés (60 ans et plus) comparativement à des adultes jeunes (30 ans et moins) et qu’elle est en lien avec les fonctions exécutives (Expérience 1) et la mémoire de travail (Expérience 3) chez l’adulte âgé. L’effet de l’âge paraît être modifié par le temps de production, les adultes âgés produisant moins de verbes d’action que les adultes jeunes pour un temps de trois minutes (Expérience 1) mais pas pour des temps d’une (Expérience 2) et de deux minutes (Expérience 3). De plus, les adultes âgés prenaient davantage en considération la consigne temporelle lors des tâches de fluence verbale que les adultes jeunes (Expérience 2). Les données d’une tâche d’association verbale (Expérience 4) indiquaient que les associations entre les noms et les verbes sont modifiées par l’âge. Nous avons comparés les performances de patients atteints de pathologiesdu mouvement à celles de participants contrôles lors de la tâche de fluence d’action. Nous avons montré que la production quantitative lors cette tâche est altérée chez des patients atteints de maladie de Parkinson (Expérience 5) et d’atrophie multisystématisée (Expérience 6). Dans le tremblement essentiel (Expérience 7), nous avons montré une atteinte de la fluence d’action alors que le traitement des verbes, lors d’une tâche de décision lexicale, n’était pas altéré. De plus, la chirurgie (stimulation cérébrale profonde) modifiait qualitativement la production dans la tâche de fluence d’action. Nos données montrent un impact du vieillissement normal et des pathologies du mouvement sur la production du verbe d’action, enraison de la nature fortement exécutive de ce processusThe aim of this thesis is to investigate the production of action verbs through the action fluency task, in comparison to classical fluency tasks (i.e., semantic and letter). In first instance, production has been studied, both quantitatively and qualitatively, in aging. We have shown that action fluency is impacted by healthy aging and is related to executive functions (Experiment 1) and working memory (Experiment 3) in older adults. This effect of age appearsto be affected by production time, with older adults producing fewer action verbs than younger adults in three minutes (Experiment 1) but not in one (Experiment 2) and two minutes (Experiment 3). In addition, older adults took more into account the time instruction during verbal fluency tasks (Experiment 2). The verbal association task’s data (Experiment 4) indicated that associations between nouns and verbs are modified by age. In second instance,the production of action verbs has been studied within movement disorders. We have shown that the production in the action fluency task and the adaptation to time instruction are impacted by Parkinson's disease (Experiment 5). We have also shown that action fluency is altered within an atypical parkinsonism, multiple system atrophy (Experiment 6). In essential tremor (Experiment 7), we have shown an impairment of action fluency while verbs treatment, in a lexical decision task, was not altered. In addition, surgery (deep brain stimulation) qualitatively modified the production of verbs in action fluency. Our data highlight the impact of healthy aging and movement disorders on the production of action verb, due to the highly executive nature of this process
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MacLaggan, Linda. "The impact of Tai Chi Chuan training on the gait, balance, fear of falling, quality of life, and tremor in four women with moderate idiopathic Parkinson's disease." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ57306.pdf.
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Siegel-Fockink, Lara [Verfasser]. "Stellenwert der transkraniellen Sonographie in der Differentialdiagnostik zwischen tremordominantem idiopathischen M. Parkinson und essentiellem Tremor : eine vergleichende Analyse zur FP-CIT SPECT / Lara Siegel-Fockink." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/1030381011/34.
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Green, Heather Joyce. "Characterization of the Zona Incerta." VCU Scholars Compass, 2005. http://hdl.handle.net/10156/1829.
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Richter, Daniel [Verfasser], Christos [Gutachter] Krogias, and Jens [Gutachter] Eyding. "Diagnostischer Nutzen der koronalen Untersuchungsebene der transkraniellen Sonographie in Kombination mit der M-Mode-Tremorfrequenzbestimmung zur Unterscheidung des idiopathischen Parkinson-Syndroms vom essentiellen Tremor und gesunden Kontrollpersonen / Daniel Richter ; Gutachter: Christos Krogias, Jens Eyding ; Medizinische Fakultät." Bochum : Ruhr-Universität Bochum, 2018. http://d-nb.info/1154307891/34.
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Gitchel, George Thomas Jr. "Development of an Accurate Differential Diagnostic Tool for Neurological Movement Disorders Utilizing Eye Movements." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/4109.
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Parkinson’s disease and Essential tremor are the two most prevalent movement disorders in the world, but due to overlapping clinical symptoms, accurate differential diagnosis is difficult. As a result, approximately 60% of patients with movement disorders symptoms will have their diagnosis changed at least once before death. By their subjective nature, clinical exams are inherently imprecise, leading to the desire to create an objective, quantifiable test for movement disorders; a test that currently is elusive. Eye movements have been studied for a century, and are widely appreciated to be quantifiably affected in those with neurological disease. Through a collaborative effort between the VA hospital and VCU, over 1,000 movement disorder subjects had their eye movements recorded, utilizing an SR Research Eyelink 2. Patients with Parkinson’s disease exhibited an ocular gaze tremor during fixation, normal reflexive saccades, and reduced blink rate. Subjects with Essential tremor exhibited slowed saccadic dynamics, with increased latencies, in addition to a larger number of square wave jerk interruptions of otherwise stable fixation. After diagnostic features of each disorder were identified, prospective data collection could occur in a blinded fashion, and oculomotor features used to predict clinical diagnoses. It was determined that measures of fixation stability were capable of almost perfectly differentiating subjects with PD, and a novel, combined parameter was capable of similar results in ET. As a group, it appears as if these symptoms do not progress as the disease does, but subanalyses show that individual patients on constant pharmaceutical doses tracked over time do slightly change and progress. The near perfect separation of disease states suggest the ability of oculomotor recording to be a powerful biomarker to be used for the differential diagnosis of movement disorders. This tool could potentially impact and improve the lives of millions of people the world over.
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Alvaia, Clarissa Gomes Andrade. "Efeito da administração de cloridrato de fluoxetina em ratos submetidos a um modelo de parkinsonismo induzido por reserpina." Pós-Graduação em Ciências Fisiológicas, 2017. http://ri.ufs.br/jspui/handle/riufs/7404.
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Parkinson`s Disease is the second most common motor disorder and is also considered a progressive multisystemic disease associated to several nom motor symptoms (NMS), such as depression, with a prevalence of about 50% among PD patients. Selective serotonin reuptake inhibitors (SSIR) are the main treatment for this NMS, although researches with acutely induced parkinsonism has related fluoxetine to increased motor impairment. The aim of the present research is to evaluate the effect of the fluoxetine hydrochloride on a model of parkinsonism induced by low doses of reserpine. Sixty-four male 7-9-month-old Wistar rats were used, and were obtained from vivarium of the Department of Physiology – Federal University of Sergipe. Animals were divided into four groups: fluoxetine vehicle + reserpine vehicle (CTR); fluoxetine 10 mg/kg + reserpine vehicle (F); fluoxetine 10 mg/kg + reserpine 0,1 mg/kg (F + R); and fluoxetine vehicle + reserpine 0,1 mg/kg (R). During the treatment, the animals were submitted to open field test, catalepsy test and tremoulous jaw movement evaluation. It was shown that animals treated with fluoxetine and reserpine spent more time at the catalepsy test, decreased distance travelled, lower number of rearing at the open field test, increased tremulous jaw movements and increased weight loss. The treatment only with fluoxetine caused immunohistochemistry changes, such as decrease of TH expression in the dorsal striatum and increased staining of the dorsal raphe nucleus, with no correlation with MS for this group. The F + R group showed different immunohistochemistry results for both acute and continued administrations.A Doença de Parkinson (DP) é a segunda desordem motora mais comum e também é considerada uma doença progressiva multissistêmica ligada a vários sintomas não motores (SNM), como a depressão, que acomete cerca de 50% dos pacientes. Os inibidores seletivos da recaptação de serotonina (ISRS) são considerados os principais medicamentos para o tratamento desse SNM, embora pesquisas que utilizaram indução aguda de parkinsonismo tenham relacionado a fluoxetina ao agravamento dos sintomas motores. Diante disso, este estudo objetivou avaliar o efeito da administração de cloridrato de fluoxetina em um modelo de parkinsonismo induzido por baixas doses de reserpina. Foram utilizados 64 ratos Wistar, machos, com idade de 7 a 9 meses, provenientes do Biotério Setorial do Departamento de Fisiologia da Universidade Federal de Sergipe. Os animais foram divididos aleatoriamente em quatro grupos: veículo fluoxetina + veículo reserpina (CTR); fluoxetina 10 mg/kg + veículo reserpina (F); fluoxetina 10 mg/kg + reserpina 0,1 mg/kg (F + R); e veículo fluoxetina + reserpina 0,1 mg/kg (R). Durante o tratamento, os animais foram submetidos aos testes de campo aberto, catalepsia e avaliação dos movimentos orofaciais. Foi observado aumento da latência na barra, diminuição da distância total percorrida em campo aberto, diminuição do número de rearing, aumento dos movimentos involuntários de mandíbula e maior alteração de peso corporal dos animais do grupo F + R. O tratamento apenas com fluoxetina provocou alterações imunohistoquímicas, como a diminuição da expressão de TH no estriado dorsal e aumento da marcação para 5-HT no núcleo dorsal da rafe, sem correlação com nenhum sintoma motor para esse grupo. O grupo F + R apresentou resultados de imunorreatividade distintos para as administrações breve e continuada.
São Cristóvão, SE
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Chen, Yu-Jung, and 陳昱融. "Assessing the Characteristics of Hand Tremor between Patients of Parkinson’s Disease and Essential Tremor." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/01938973050222355368.
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Tsai, Fan-Tien, and 蔡芳典. "Anti-tremor Control of Electrical Wheelchair for People with Parkinson’s Disease." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/2j69rk.
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碩士國立中山大學
醫學科技研究所
104
Parkinson’s disease is one of the most common neurodegenerative diseases, and the average age of onset is between the ages of 50 and 60. According to general survey, one person per hundred people in Taiwan has Parkinson’s disease. The most common symptom is tremor or shaking in hands, while others are muscles stiffness, joints rigidity, slow movements, etc. In the middle stage of Parkinson’s disease, the on-off phenomenon appears suddenly to indicate the invalid medication. In the final stage, the patient completely loses physical capacity. Since the capacity of Parkinson’s disease patients is limited and the tremor of hands, it is difficult to hold or control objects, like wheelchair. This study presents an assistive tool against tremor with an algorithm based on fuzzy theory to allow the user playing an analog joystick to decrease the instability caused by tremor for the easy control of the electrical wheelchair. The user was asked to wear a glove bound with a gyroscope and an accelerometer, the data collected from these sensors was displayed on the laptop instantaneously, so the user’s tremor can be monitored for the evaluation of the system’s performance. The fuzzy algorithm applied on joystick of electrical wheelchair can filter the tremor caused by Parkinson’s disease, and recognize the correct direction of user’s commands precisely, so the user can drive the wheelchair go to the desired location easily and safely for the independence of life. This study designs a remote control car called SmallCar. Because of its features of wireless control and mobility, it is easy to test the performance of system before the user really operates the wheelchair. SmallCar makes sure the safety and fluency of the system operation before controlling the electrical wheelchair. Therefore, the training process of the electrical wheelchair driving is divided into two parts: part one is to control SmallCar smoothly, and part two is to control the electrical wheelchair after passing the part one test. An assistant can stand aside to help the user complete the whole training process for safety. Considering the safety of patient, the electrical wheelchair has an emergency switch which can turn off the power of the wheelchair manually.
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Shabib, R. "Development of a Mobile Application for Determination of the Parkinson’s Tremor." Thesis, 2021. https://openarchive.nure.ua/handle/document/16614.
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In this research work, we developed a specialized mobile application for testing by a stylus on a screen of a smartphone. This application was developed on Java for Android OS, using specific tools and techniques for analyzing graphical skills during drawing with the stylus on the screen.
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Lin, Po Chieh, and 林柏伽. "Developmentof an evaluating system to quantify the tremor severity and characteristics of the patients with Parkinson’s disease and essential tremor." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/qm7vyu.
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博士國立交通大學
機械工程系所
106
Tremor is a prevalent movement disorder in neurological clinics, but there is lack of objective toold for evaluating tremor. Because the tremor symptoms of Parkinson’s disease (PD) and essential tremor (ET) are similar in an early stage, it would be difficult to determine whether a patient with tremor is PD or ET. Therefore, the misdiagnosis rate was ranged from 20 to 30%. The first aim of present study was to establish a tremor evaluation system which could provide physicians reference parameters to determine the tremor severity and treatment efficacy. The second aim was to evaluate the tremor characteristics of PD and ET groups using our developed system in order to decrease the misdiagnosis rate. Thirteen PD and 12 ET subjects were instructed to complete several tasks in order to induce postural tremor (maintaining their arms against gravity) and kinetic tremor (drawing spirals and holding a cup). The hand motions of postural tremor and holding a cup were captured by an optical device (Leap Motion). The trajectory of spiral drawings task was recorded by a digital tablet. Five spiral parameters, the mean of radius difference per second (dr/dt mean), standard deviation (SD) of dr/dt (dr/dt SD), mean of radius difference per radian (dr/dθ mean), standard deviation of dr/dθ (dr/dθ SD) and area under curve (AUC), were calculated to quantify the tremor severity of the spiral drawing. Three motion parameters, envelope, dispersion, and ampitude of two dimensions (2D), were calculated to quantify the tremor severity of holding a cup and maintaining arm posture. The regression analysis was used to describe the statistical relationship between the above-mentioned eight parameters and the clinical scores. Five spiral parameters correlated well with VRS and FTM (R>0.7). The three motion parameters show median correlation with FTM (0.3
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Williams, S., H. Fang, J. Alty, Rami S. R. Qahwaji, P. Patel, and C. D. Graham. "A smartphone camera reveals an ‘invisible’ Parkinsonian tremor: a potential pre-motor biomarker?" 2018. http://hdl.handle.net/10454/16891.
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noThere are a wide variety of ways to objectively detect neurological signs, but these either require special hard-ware (such as wearable technology) or patient behaviour change (such as engagement with smartphone tasks) [2]. Neither constraint applies to the technology of computer vision, which is the processing of single or multiple camera images by computer to automatically derive useful information. The only equipment involved is ubiquitous: camera and computer.We report a computer vision-enhanced video sequence from a 68-year-old man, diagnosed with idiopathic Parkinson’s disease 2 years previously.
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Reis, Ana Luísa dos Santos. "Aplicação do Leap Motion na avaliação da doença de Parkinson." Master's thesis, 2018. http://hdl.handle.net/10316/86203.
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Trabalho de Projeto do Mestrado Integrado em Engenharia Biomédica apresentado à Faculdade de Ciências e TecnologiaO principal objetivo deste trabalho consistiu na avaliação do dispositivo Leap Motion Controller (LMC) enquanto técnica auxiliar de diagnóstico da doença de Parkinson (PD). Inicialmente, analisou-se a exatidão e precisão em condições estáticas e dinâmicas, estimadas pelo desvio padrão amostral e o valor RMSE, respetivamente. Em ambientes estáticos obteve-se uma precisão inferior a 0,85 mm, e verificou-se uma correlação positiva fraca entre a precisão e a distância entre o LMC e o fantoma. Em situações dinâmicas, a precisão foi inferior 1,2 mm. Na generalidade dos dados, verificou-se uma precisão melhor nos eixos segundo x e z, em detrimento do eixo segundo y.Relativamente à exatidão, em movimentos lineares obtiveram-se resultados inferiores a 2,37 mm e em rotações inferiores a 3°. Ainda, obteve-se um coeficiente de correlação de 1 entre ângulos esperados e obtidos, calculando-se uma reta de calibração para rotações em torno de z.Posteriormente, desenvolveram-se 3 interfaces interativas que possibilitaram a simulação de técnicas médicas de despiste do tremor de repouso, do tremor postural e da bradicinésia, sintomas muito frequentes da PD. Apresentaram-se os 3 testes a uma amostra da população saudável (31 indivíduos) e a 1 doente diagnosticado com PD. Relativamente ao domínio das frequências, demonstrou-se que o intervalo entre 0,5 e 3,5 Hz é o representativo do tremor de repouso e do tremor postural no grupo de controlo. No que concerne à bradicinésia, verificou-se que as frequências dominantes para indivíduos saudáveis distribuíram-se entre 1,2 e 3,7 Hz. Ainda, na avaliação da bradicinésia constatou-se que o doente apresentou alterações significativas na maioria dos parâmetros analisados. Assim, demonstrou-se que este sintoma poderá ser analisado sob efeitos farmacológicos. Por fim, concluiu-se que o LMC tem potencial para a deteção dos sintomas da PD. Contudo, mais estudos em indivíduos saudáveis e diagnosticados com PD são requeridos.
The main goal of this study is to evaluate the Leap Motion Controller’s (LMC) capabilities to develop a new method for the assessment of Parkinson's Disease (PD). First, the device was tested to calculate its accuracy and precision in static and dynamic conditions, estimated using the sample’s standard deviation and the RMSE value, respectively. In static environments the precision values were under 0.85mm, with verifiable weak positive correlation between the precision and the distance between the LMC and the phantom. In dynamic environments, the precision values were under 1.2 mm. In most cases, the precision was better in x and z axis, when compared to the y axis.Regarding the accuracy, the results were under 2.37 mm in linear motions and rotations under 3°. The Spearman correlation coefficient was 1 between the expected and obtained angles, leading to a calibration line for rotations on the z axis.Three interactive interfaces that allow the simulation of medical techniques were developed. These applications assessed the bradykinesia and the rest and postural tremor, which are PD’s common symptoms. The tests were conducted on a sample of 31 healthy individuals and one patient diagnosed with PD. In the frequency domain, it was proven that the interval between 0.5 and 3.5 Hz was characteristic to the control group’s rest and postural tremors. Regarding the bradykinesia, the results showed that the dominating frequencies for healthy individuals were distributed between 1.2 and 3.7 Hz. Furthermore, the patient had significant changes in a great part of the analysed parameters regarding the bradykinesia’s evaluation. Therefore, it was proven that this symptom may be analysed under pharmacologic effects. The data obtained from the healthy part of the study group was within the established values, which may suggest that the LMC can be used to detect the symptoms of PD, although, some more study group tests are advisable.
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Chen, Chun-Ming, and 陳君明. "Non-Interpolated Tract-Based Statistic Analysis for Estimating The Corticospinal Tract: A Comparison with Parkinson’s Disease, Essential Tremor and The Normal Control." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/31867763580407346730.
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博士國立中興大學
電機工程學系所
102
Diffusion tensor imaging (DTI) has been proved as a powerful tool for parameterizing microstructure changes with various neurodegenerative diseases such as Parkinson’s disease (PD) or essential tremor (ET). Although these two diseases have been reported as involving motor cortical dysfunction, the central mechanisms to induce their tremor symptoms are still remain unclear. Previously, researchers started using DTI to quantify white matter changes. However, they barely draw congruent conclusions. Among these studies, we found group quantifications with ROI-based methods seem to provide better sensitivity in detecting subtle changes than those with methods containing spatial normalization. In light of these findings, we hypothesize DTI quantification method that applied with minimal spatial transformation or interpolation could be more sensitive in detecting such alterations. In this thesis, we provided a full investigation to all mainstream DTI quantification approaches, including their concepts and features. We also compared their advantages and drawbacks. Then, we extended the application of the traditional ROI-based method to a 3D tract-specific one. In chapter 4, we provided a tract-based quantitative framework combined with minimal spatial preprocessing and performed a head-to-head comparison between PD, ET and the normal subjects. We also provided a small pilot study to determine the suitable protocol setting of the DTI sequence. The results showed that the FA distributions along the corticospinal tract have significant differences across groups. The ET group showed significant higher mean FAs in the internal capsule level of the CST bilaterally as compared to the normal group. The PD group also showed higher mean FAs, but in region near the level of thalamus. Comparing between the PD and ET groups, the ET group showed lower mean FA values around the midbrain region. Our presented approach successfully demonstrates the white matter changes to the PD, ET and normal subjects by estimating their corticospinal tracts. In such tractography-based statistical approach, we not only proved its advantages in giving detail along certain fiber tract compare to traditional ROI-based approach but also provided better sensitivity to detect subtle microstructure changes than other approaches involving spatial transformation.
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Reimão, Sofia Pereira Coutinho 1977. "Magnetic resonance imaging of the substantia nigra in parkinson’s disease : neuromelanin, iron and diffusion tensor imaging." Doctoral thesis, 2015. http://hdl.handle.net/10451/22511.
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Tese de doutoramento, Medicina (Imagiologia), Universidade de Lisboa, Faculdade de Medicina, 2015In the last years, extensive developments in neuroimaging MR techniques have profoundly changed the study of Parkinson’s disease (PD), evolving from the role of excluding secondary parkinsonism to the emergence as a disease biomarker. MR advanced sequences in high field magnets opened the possibility to visualize in vivo the substantia nigra (SN) and to investigate specific PD pathological changes, enabling the development of high accuracy tools for disease diagnosis in early stages and for the comprehension of disease pathophysiology. Our work was centered on the application of new MR imaging techniques to study the SN in PD, early in the disease course, mainly focusing on untreated patients at the time of clinical diagnosis. The primary objectives were centered on the application of high field MR imaging sequences in two main areas: diagnosis of PD in early disease stages and differential diagnosis with Essential tremor (ET). The development and application of neuromelanin sensitive MR imaging in 3.0 Tesla allowed the detection of significant changes in the SN of PD patients, with high sensitivity and specificity for disease diagnosis, even in early disease stages (namely at the time of clinical diagnosis). These imaging findings reproduced in vivo the characteristic pathological changes of PD with greater alteration in the ventrolateral SN region and preservation of the dorsal segment. These results were obtained with several image evaluation methods: semi-automated area assessments, manual width measurements and simple visual inspection by Neuroradiologists, corroborating the reproducibility of the data and enabling wider applications of this image technique in the clinical practice. The MR correlation of neuromelanin with iron in the SN of PD patients allowed the in vivo investigation of the influence of local iron concentration in the SN on the signal of neuromelanin-sensitive sequences. A quantification T2-relaxometry study showed that the SN paramagnetic iron effects do not seem to influence significantly the neuromelanin MR signal reduction in PD patients. Several studies with diffusion tensor MR imaging (DTI) have allowed the detection of microstructural changes in the SN of PD patients in early disease changes, emerging as a possible disease biomarker. So, the reproducibility of DTI metrics in this specific brain area was particularly relevant for future applications of this MR technique. We conducted a reproducibility DTI study in PD patients that showed a good reproducibility of DTI metrics supporting the use of these measurements in further studies, namely longitudinal within-subject evaluation, and cross-sectional comparisons. The differential diagnosis of PD with ET is particularly relevant and there was the need of high accurate tools to aid the clinical assessment. The application of neuromelanin-sensitive MR techniques was able to discriminate ET from early stage tremor-dominant PD with high sensitivity and specificity values, in the same range as nuclear medicine techniques and may become a useful clinical tool in the evaluation of tremor disorders. Our research showed an important role of neuromelanin sensitive MR imaging for the diagnosis PD in early disease stages and its differential diagnosis with ET. A multi-modal MR approach with iron assessment and diffusion tensor imaging can further elucidate the SN disease changes and aid future research of disease pathophysiology.
Nos últimos anos, o extenso desenvolvimento das técnicas de neuroimagem modificou profundamente a investigação da Doença de Parkinson (PD), evoluindo de um simples papel na exclusão de parkinsonismo secundário para a emergência de biomarcadores imagiológicos da doença. Sequências avançadas de RM em aparelhos de alto campo magnético abriram a possibilidade de visualizar in vivo a substantia nigra (SN) e a investigação de alterações patológicas específicas da PD, permitindo o desenvolvimento de ferramentas com elevada fiabilidade para o diagnóstico em fases precoces da evolução da doença e para a compreensão da sua fisiopatologia. A nossa investigação centrou-se na aplicação de novas técnicas de imagem RM para estudar a SN na PD, em fases precoces da doença, com enfoque especial em doentes não tratados na altura do diagnóstico clínico. Os objectivos principais centraram-se na aplicação de sequências de RM em alto campo em duas áreas major: diagnóstico da PD em fases precoces da doença e o diagnóstico diferencial com o Tremor essencial (ET). O desenvolvimento e aplicação da imagem RM sensível à neuromelanina em 3.0T permitiu a detecção de alterações significativas na SN de doentes com PD, com elevada sensibilidade e especificidade para o diagnóstico da doença, mesmo em fases precoces da sua evolução dela (nomeadamente na altura do diagnóstico clínico). Estes achados de imagem reproduziram in vivo as alterações patológicas características da PD, com uma maior alteração na região ventero-lateral da SN e preservação do segmento dorsal. Estes resultados foram obtidos com vários métodos de avaliação de imagem: avaliação semi-automática da área, medição manual da espessura e avaliação visual por neurorradiologistas, corroborando a reproductibilidade dos dados e permitindo uma aplicação abrangente desta técnica de imagem na prática clínica. A correlação por RM da neuromelanina com o ferro, na SN de doentes com PD, permitiu a investigação in vivo da influência da concentração local de ferro na SN com o sinal das sequências sensíveis à neuromelanina. Um estudo quantitativo de relaxometria T2* mostrou que os efeitos paramagnéticos do ferro não influenciam significativamente a redução de sinal RM da neuromelanina em doentes com PD. Vários estudos com tensores de difusão (DT) permitiram a detecção de alterações microestruturais na SN de doentes com PD em fases precoces de doença, emergindo como um possível biomarcador de doença. Assim, a reproductibilidade das métricas de DTI, nesta área específica do encéfalo, é particularmente relevante para aplicações futuras desta técnica de RM. Conduzimos um estudo de reproductibilidade de DTI em doentes com PD que demonstrou uma boa reproductibilidade das métricas de DTI, suportando a utilização destas medidas em estudos futuros, nomeadamente avaliações longitudinais “within-subject” e comparações “cross-sectional”. O diagnóstico diferencial da PD com ET é particularmente relevante e ferramentas fiáveis para auxiliar a avaliação clínica eram necessárias. A aplicação de técnicas de RM sensíveis à neuromelanina possibilitou a discriminação de ET de PD “tremor-dominant” em fases precoces com elevados valores de sensibilidade e especificidade, no mesmo espectro das técnicas de medicina nuclear e pode tornar-se uma ferramenta clínica útil para a avaliação do tremor. A nossa investigação demonstrou um importante papel das técnicas de RM sensíveis à neuromelanina para o diagnóstico de PD em fases precoces da doença e para o seu diagnóstico diferencial com ET. Uma abordagem multi-modal de RM com avaliação do ferro e DTI pode, adicionalmente, permitir estudar as alterações da SN e auxiliar a investigação futura da fisiopatologia da doença.
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Rahimi, Fariborz. "Tremor in Parkinson's Disease: Loading and Trends in Tremor Characteristics." Thesis, 2010. http://hdl.handle.net/10012/5617.
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Parkinson's disease (PD) is a neuro-degenerative chronic disorder with cardinal signs of bradykinesia, resting tremor, rigidity, and postural abnormality/instability. Tremor, which is a manifestation of both normal and abnormal activities in the nervous system, can be described as an involuntary and periodic oscillation of any limb. Such an oscillation with a small amplitude, which is barely visible to the naked eye, is present in healthy people. This is called a physiological tremor and is asymptomatic. This tremor is believed to be the result of at least two distinct oscillations. A passive mechanical oscillation that is produced by the irregularities of motor unit firing, and by blood ejection during cardiac systole. The frequency and amplitude of these oscillations are dependent on the mechanical properties of the limb including joint stiffness and limb inertia. There is another component of oscillation that does not respond to elastic or inertial loading, which is called the central component, and is believed to arise from an unknown oscillating neuronal network within the central nervous system. Unlike physiological tremor, pathological tremors are symptomatic and can impair motor performance. Parkinson's disease (PD) tremor is generally manifested at rest, but also occurs during posture or motion. Classical PD rest tremor is known to be a central tremor of 4-6 Hz and peripheral origins have only a minimal role. However, whether or not the same central mechanism remains active during action tremor (including posture and movement) should yet be answered. Contrary to PD rest tremor, reported results on action tremor in the literature are diverse; and the reason for the changes in tremor characteristics in situations other than rest, or generally during muscle activation, is not fully understood. The lack of generality in the results of studies on action tremor, makes the efforts of treatment difficult, and is a barrier for mechanical/engineering approaches of suppressing this tremor. To investigate the role of mechanisms other than classic rest tremor, and possible sub-categories of tremulous PD in yielding diverse results, this study was conducted on twenty PD patients and fourteen healthy age-matched (on average) controls. To evaluate the possible contribution of (enhanced) physiological tremor, the study considered the effect of loading on postural hand tremor in a complete range of 0-100% MVC (Maximum Voluntary Contraction). The study looked at two measures of tremor amplitude and one measure of tremor frequency, and focused on two frequency bands of classic-rest (3.5-6.5 Hz) and physiological (7.5-16.5 Hz) tremors. The study revealed that PD tremor was not uniformly distributed in the three dimensional space, and then focused on the investigation of tremor in the dominant axis, which was the same as direction of loading. It also revealed that dopaminergic medication could significantly affect tremor components only in PD band, compared to the components in the physiological band. The study was an extension to previous studies and yielded similar results for the previously reported range of loading. However, with the extended range of loading, it revealed novel results particularly after separating PD patients into sub-groups. It was hypothesized that the coexistence of physiological mechanism, and considerable difference between sub-types of tremulous PD patients, are responsible for most of the diversity in the previously reported studies. This study showed that for clearer results the sub-groups are inevitable, and that automatic classification (clustering) provided the most separable sub-groups. These sub-groups had distinct trends of load effect on tremor amplitude and frequency. No matter which categorization method was used, at least one sub-group exhibited significantly higher tremor energy compared to the healthy participants not only in the PD band, but also in the physiological band. This meant that, for some sub-groups of PD, the physiological tremor is a very important mechanism and not the same as that of healthy people. The coexistence hypothesis was also affirmed by examining tremor spectrums' peak frequency and magnitude in the two separate bands. The necessity of the separation of tremulous PD patients into sub-groups, and the coexistence of physiological and classic PD tremor mechanisms for some of them are the factor that should be considered in the design of a suppressing device and also in the proposed treatment of action tremor in this population.
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Oliveira, Mariana Ferreira Alves de. "Aplicação do Leap Motion na avaliação da doença de Parkinson." Master's thesis, 2019. http://hdl.handle.net/10316/87843.
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Dissertação de Mestrado Integrado em Engenharia Biomédica apresentada à Faculdade de Ciências e TecnologiaThe main goal of this study is to apply the Leap Motion Controller (LMC) in the assessment of hand motor symptoms in patients with Parkinson's disease (PD). The motor symptoms of interest are resting tremor, postural tremor and bradykinesia. Thus, five interfaces were developed simulating MDS-UPDRS clinical diagnostic procedures. The interfaces were based on tasks 3.4, 3.5, 3.6, 3.15 and 3.17 of the scale corresponding to thumb forefinger tapping, open and close fist-shaped hand, supination and pronation of the hands, postural tremor and resting tremor, respectively.For that purpose, 32 patients with PD and 53 healthy subjects were recruited. Both scores for each of the MDS-UPDRS tasks and the classification regarding the Hoehn and Yahr (HeY) scale were assessed for comparative purposes. From the data collected by the LMC, parameters in the temporal and spectral domains have been computed. These parameters have been used to distinguish between the healthy and patients groups, and also between the stadiums of the HeY scale. For resting tremor, the average dominant frequency was 0.7 +/- 0.3 Hz for the healthy group and 0.9 +/- 1.2 Hz for the symptomatic group. For postural tremor, this parameter was calculated for the right and left hands, and resulted in an average value of 3.7 +/- 0.8 Hz and 4.1 +/- 1.1 Hz for healthy and patients with PD groups, respectively. Regarding the characterization of bradykinesia by thumb forefinger tapping, parameters in the time domain have been computed. The angular velocity of the index finger was 4.2 +/- 2.8 rad/s for the control group and 3.4 +/- 2.0 rad/s for the patients with PD group. Still, the total time required for the game was estimated. Participants in the healthy group took an average of 15.1 +/- 13.5 s while patients with PD needed 21.6 +/- 13.2 s to complete the game. In the spectral domain, the dominant frequency was 2.4 +/- 1.4 Hz and 1.7 +/- 1.3 Hz for the respectively sample groups.Finally, it is possible to demonstrate the applicability of the LMC in detecting and quantifying hand movements that are characteristic of PD motor symptoms. However, further studies will be necessary to obtain a set of parameters that assist in the diagnosis of the disease as well as in the correct monitoring of the therapeutic evolution.
O principal objetivo do presente estudo é aplicar o Leap Motion Controller (LMC) na avaliação dos sintomas motores da mão em doentes com doença de Parkinson (DP). Os sintomas motores em análise são o tremor de repouso, tremor postural e bradicinésia. Assim, foram desenvolvidas cinco interfaces simulando procedimentos clínicos de diagnóstico da escala MDS-UPDRS. As interfaces basearam-se nas tarefas 3.4, 3.5, 3.6, 3.15 e 3.17 da referida escala, correspondentes à execução de movimentos de bater dos dedos da mão, em forma de pinça; abrir e fechar a mão, em forma de punho; supinação e pronação das mãos; tremor postural e tremor de repouso, respetivamente. Para tal, foram recrutados 32 doentes com DP e 53 participantes saudáveis. As pontuações obtidas clinicamente para cada uma das tarefas pela escala MDS-UPDRS bem como a classificação relativamente à escala Hoehn e Yahr (HeY) serviram para efeitos comparativos. Partindo dos dados recolhidos pelo LMC foram estimados parâmetros nos domínios temporal e espetral, o que permitiu estabelecer comparações entre os grupos de controlo e de doentes com DP e, ainda, entre os estádios da escala HeY.Relativamente ao tremor de repouso, a frequência dominante foi, em média, de 0,7 +/- 0,3 Hz para o grupo saudável e de 0,9 +/- 1,2 Hz para o grupo sintomático. Para o tremor postural, este parâmetro foi calculado para as mãos direita e esquerda, o que resultou no valor médio de 3,7 +/- 0,8 Hz e 4,1 +/- 1,1 Hz para os grupos de controlo e de doentes, respetivamente. No que toca à caracterização da bradicinésia pela tarefa de bater os dedos em forma de pinça, pela análise de parâmetros no domínio temporal, obteve-se a velocidade angular do movimento, sendo 4,2 +/- 2,8 rad/s para o grupo de controlo e 3,4 +/- 2,0 rad/s para o grupo de doentes com DP e, ainda, o tempo total para a realização do jogo. Os participantes do grupo saudável demoraram, em média, 15,1 +/- 13,5 s enquanto que os doentes com DP precisaram de 21,6 +/- 13,2 s para completar a tarefa. No domínio espetral, a frequência dominante obtida foi de 2,4 +/- 1,4 Hz e de 1,7 +/- 1,3 Hz para os respetivos grupos amostrais.Por fim, demonstra-se a aplicabilidade do LMC na deteção e quantificação dos movimentos da mão, característicos dos sintomas motores da DP. Contudo, serão necessários mais estudos a fim de se obter um conjunto tal de parâmetros que permitam o auxílio do diagnóstico da doença bem como o correto acompanhamento da evolução terapêutica.
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Leal, Adriana Costa. "Neuroengineering Contributions in Parkinsonic Tremor Characterization Using Accelerometry and Surface Electromyography." Master's thesis, 2015. http://hdl.handle.net/10316/29303.
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Dissertação de Mestrado Integrado em Engenharia Biomédica apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra.A Doen ca de Parkinson (DP) est a associada a uma perda de neur onios produtores de dopamina no sistema nigroestriatal. Por consequ^encia, a organiza c~ao temporal da actividade motora cortical durante a contrac c~ao muscular e planeamento e execu c~ao de movimento vai ser afectada. Dist urbios no sistema dopamin ergico podem levar a manifesta c~ao de sintomas motores tais como movimentos oscilat orios involunt arios (tremor), bradicinesia, rigidez muscular e instabilidade postural e tamb em d e ces cognitivos. O tremor na DP pode ocorrer numa posi c~ao de repouso ou de postura, ou em ambas as situa c~oes. Os tremores de repouso e postural podem sobrep^or-se na frequ^encia. V arios estudos t^em evidenciado que o tremor de repouso se manisfesta no intervalo de 4 a 6 Hz. Por outro lado, o tremor postural revelase tipicamente na gama de 5 a 12 Hz, o que torna dif cil distinguir ambos os tipos de tremor em termos da distribui c~ao de frequ^encias. Este estudo apresenta uma an alise comportamental quantitativa dos tremores de repouso e postural na DP associada a um estudo de imagem por resson^ancia magn etica functional (fMRI em ingl^es). O objectivo e implementar algoritmos que consigam caracterizar a frequ^encia e amplitude do tremor na DP manifestado quando e realizada uma tarefa em que a posi c~ao do bra co do participante alterna entre o repouso e a postura. Para avaliar e quanti car o tremor durante a realiza c~ao da tarefa foram adquiridos simultaneamente sinais de acelerometria e electromiogra a de superf cie (sEMG). Estas duas t ecnicas t^em sido frequentemente utilizadas para detectar e quanti car o tremor na DP. A tarefa foi realizada seis vezes em cada sess~ao sendo que em tr^es delas foi adicionado um peso a cada pulso do participante. Este estudo preliminar incluiu tr^es doentes parkins onicos idiop aticos. Na an alise o -line, os sinais de acelerometria e sEMG foram ltrados removendo assim os artefactos introduzidos pelo pulso de radiofrequ^encias e pelos gradientes de campo magn etico aplicados durante a acquisi c~ao das imagens funcionais. De seguida, procedeu-se a inspec c~ao do espectro de frequ^encias por forma a avaliar as altera c~oes a n vel de amplitude e frequ^encia ao longo da realiza c~ao da tarefa. Foram calculados par^ametros tais como picos de pot^encia e xiii frequ^encia correspondente e pot^encia total do espectro para cada um dos segmentos da tarefa (em repouso e na postura). O envelope do sinal foi tamb em avaliado e a area abaixo do envelope foi determinada para cada segmento da tarefa. Foram tamb em determinados os intervalos em que h a tremor para cada sinal, sendo essa informa c~ao utilizada numa an alise multi-estudos que aplica o Modelo Linear Geral (GLM, em ingl^es). Foi ainda realizada uma an alise adicional com o objectivo de perceber quais as bandas de frequ^encia que mais contribuem para a pot^encia do sinal. As gamas de frequ^encia podem tamb em ser correlacionadas com as altera c~oes observadas no sinal BOLD (Blood Oxygen Level Dependent). Os resultados con rmaram que a manuten c~ao dos bra cos numa posi c~ao postural origina um aumento consider avel da amplitude do tremor, comparando com a posi c~ao de repouso. Os gr a cos da frequ^encia em fun c~ao da amplitude mostraram picos distintos no intervalo de frequ^encias de 5 a 12 Hz. Nomeadamente, num dos doentes foram identi cados picos de pot^encia pr oximos de 5 Hz nos segmentos de postura. Foram ainda identi cados segundos picos perto de 10 Hz. Estes ultimos est~ao ausentes nos gr a cos dos segmentos de postura para os outros dois doentes. O estudo de uma popula c~ao maior e homog enea vai esclarecer que tipo de tremor, postural ou reemergente, d a origem aos picos identi cados, sendo que ambos os tremores podem co-existir na mesma gama de frequ^encias. Aumentar o n umero de participantes vai permitir estudar o efeito da introdu c~ao de um peso durante a tarefa, o que se veri cou que n~ao resultar em altera c~oes consider aveis na amplitude do tremor. A metodologia de processamento de sinal desenvolvida ao longo desta tese teve como objectivo analisar sinais de acelerometria e electromiogra a de superf cie adquiridos dentro de um scanner de resson^ancia magn etica. Foram ainda calculados par^ametros que possibilitam a distin c~ao dos tremores de repouso e postural. Adicionalmente, a obten c~ao simult^anea de imagens funcionais pode revelar informa c~ao acerca das regi~oes do c erebro que s~ao activadas quando diferentes tarefas concebidas para modular o tremor s~ao executadas. Combinar a informa c~ao fornecida pelas tr^es t ecnicas, acelerometria, sEMG e fMRI pode ser determinante na caracteriza c~ao e separa c~ao dos tremores da DP e tamb em na identi ca c~ao dos circuitos cerebrais que os desencadeiam. Palavras-chave: Doen ca de Parkinson, Tremor, Acelerometria, Electromiogra a de Superf cie, Imagem por Resson^ancia Magn etica Funcional
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Meixner, Linda. "Retrospektive Analyse der olfaktorischen Testung in Bezug auf die Differentialdiagnosen von Parkinsonsyndromen und Tremorerkrankungen." Doctoral thesis, 2015. https://tud.qucosa.de/id/qucosa%3A29544.
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Mund, Pablo [Verfasser]. "Eine Verlaufsanalyse der Tremorfrequenzen beim Morbus Parkinson und beim essentiellen Tremor / Pablo Mund." 2007. http://d-nb.info/985059567/34.
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