Objective: To examine the usefulness of precise measurements of gait and eye movements as a means of quantifying PD. The aim is to identify and characterize variables that change significantly over periods of months rather than years, are not noisy, and are relatively unaffected by the presence of symptomatic medication. The changes observed from Deep Brain Stimulation (DBS) switched on and off will provide a more direct way to examine the roles specific brain loci play in the oculomotor and gait pathway.

Background: Oculomotor function and gait have been emerging as a promising tool for more sensitive assessment of a range of neurological disorders. Despite much research into potential biomarkers, current diagnosis and disease staging remain reliant on the clinical assessment of motor symptoms using rating scales. This causes a number of problems: assessments are subject to inter-observer variability; rating scales are nonlinear; and the scales only enter their working range once more than half of the dopamine producing cells in the brain have died. Also, clinical assessments make clinical trials both time consuming and extremely expensive.

Method: Participants for this study were part of the OxQUIP (Oxford Quantification in Parkinsonism) study cohort.  We studied patients after undergoing DBS along with age-matched controls (mostly the spouses of the PD patients). Saccadic and gait measurements were carried out using technology such as the APDM wearable lab, opal sensors together with conventional clinical assessments under the same conditions.

Results: The UPDRS motor score significantly improved after deep brain stimulation.  A range of variables in both the saccadic and gait measurements were altered although, surprisingly, some were spared. Here we present data from the OxQUIP study.

Conclusion: Significant changes in progression can be detected by accurately measuring saccadic and gait abnormalities in this patient group. More sensitive biomarkers, such as the ones used for this study, seem to be less affected by noise and will allow quicker detection of treatment responses. The development of such biomarkers is essential as we are moving towards more clinical trials and personalised medicine.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantifying-eye-and-gait-abnormalities-in-parkinsons-patients-after-deep-brain-stimulation/