Objective: To characterize gait performance recorded from psychiatric patients on neuroleptics (PPN) and to compare it to Parkinson’s disease (PD) patients and healthy controls (HC).

Background: Neuroleptic-induced parkinsonism is a syndrome which is closely related to PD presenting a continuum of parkinsonian signs of diverse severity. PPN should be monitored for worsening of symptoms and transition to overt parkinsonism. Quantitative monitoring of gait may serve such a purpose.

Method: Consecutive hospitalized PPN were recruited, examine and rated according to the part III (motor examination) of the MDS-UPDRS to assess presence of parkinsonian signs.  All subjects performed a 10-meter ‘timed up and go’ test while a smartphone-based motion capture system is attached to their sternum. Gait parameters and motor UPDRS scores were compared to those obtained from consecutive idiopathic PD patients attending a movement disorders clinic and healthy controls (HC).

Results: Thirty-two PPN (19 males, age 43.1 ± 11.3 years), 11 PD patients (7 males, Age 50.6 ± 7.0 years, disease duration 7.5 ± 2.8 years) and 18 HC (7 males, age 46.7 ± 8.9 years) were enrolled to the study. Evidently, the motor UPDRS was higher in the PD group than in the PPN (28.4 ± 5.9 vs. 17.2 ± 9.0 years, respectively; p=0.007). PPN showed significantly longer total TUG time (p=0.001), walking straight forward (p=0.002) and rotation (p<0.001) times than the HC but shorter times than PD (p=0.03, p=0.03 and p<0.001 respectively). PPN showed significantly longer sitting-down time (p=0.001), lower step count (p=0.002) and a longer step length (p<0.001) than HC and higher step-to-step correlation (p=0.04) than PD. In the PPN group, females walked straight-forward significantly slower (p=0.006), had a longer total TUG time (p=0.006), had a lower step-to-step correlation in AP direction (p=0.03), a shorter step length (p<0.001) and a higher step count (p=0.001) than males. There were no gender-related differences in gait parameters in the PD group.

Conclusion: Gait performance of PPN is significantly worse than HC but is better than PD patients in most parameters. Females showed lower performance in PPN.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/smartphone-based-gait-assessment-of-psychiatric-patients-on-neuroleptics/