Category: Parkinson's Disease: Neuroimaging
Objective: Distinguish patients with and without dopaminergic denervation (as assessed by 123I-FP-CIT-SPECT – DaTscan) with Inertial-sensor full body kinematics (FBK) assessment.
Background: The differential diagnosis of Parkinson’s Disease) remains a challenge. Even in tertiary centres there is a high number of mis and underdiagnosis. DaTscan has provided a way to assess the integrity of the nigrostriatal pathway loss differentiating true parkinsonism from mimics as essential tremor. As DaTscan remains unavailable in most non-specialized centres, the search for other easy and low cost solutions remains a medical unmet need.
Method: Subjects referred for DaTscan in our nuclear medicine unit were recruited. A set of 15 inertial sensors was used to collect FBK while subjects were walking in a 30 meters corridor.
Results: From the 20 subjects recruited, 10 had evidence of dopaminergic denervation. There was no age difference between denervated and non-denervated subjects (68.4 ± 7.8 vs. 66.6 ± 7.4 years, p=0.809) but the group with denervated DaTscan scored higher in the MDS-UPDRS III (29.0 ± 16.2 vs. 15.3 ± 10.3, p=0.031). No differences were detected in spatiotemporal kinematic variables (gait speed, step and stride length, width, time and gait phases) or joint angular velocities (with the exception being the hip rotation range of motion being significantly lower in denervated subjects: 10.52º ± 2.64º vs. 14.20º ± 3.46º, p=0.016). However, non-linear gait variability metrics were found to be significantly different between groups. The anterior-posterior harmonic ratio, a gait-stability metric, was reduced in the denervated subjects (1.89 ± 1.07 vs. 3.1 ± 1.78, p=0.049), with an accompanying increase in the width of the main frequency in the same axis (0.26 ± 0.04 vs. 0.23 ± 0.01, p=0.015), representing a gait variability increase.
Conclusion: A preliminary analysis of this ongoing study identified a higher gait variability in subjects with evidence of dopaminergic denervation. Variability metrics could have a role in early detection of PD.
To cite this abstract in AMA style:
M. Mendonça, J. Silva, F. Oliveira, A. Oliveira-Maia, J. Ferreira, D. Costa, R. Costa, R. Matias. Inertial-sensor based full-body kinematics reveals an unstable gait with increased variability in patients with evidence of dopaminergic denervation with 123I-FP-CIT SPECT [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/inertial-sensor-based-full-body-kinematics-reveals-an-unstable-gait-with-increased-variability-in-patients-with-evidence-of-dopaminergic-denervation-with-123i-fp-cit-spect/. Accessed November 21, 2024.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/inertial-sensor-based-full-body-kinematics-reveals-an-unstable-gait-with-increased-variability-in-patients-with-evidence-of-dopaminergic-denervation-with-123i-fp-cit-spect/