ABSTRACT
BACKGROUND: Remote, non-invasive and objective tests that can be used to support expert diagnosis for Parkinson's disease (PD) are lacking. METHODS: Participants underwent baseline in-clinic assessments, including the Unified Parkinson's Disease Rating Scale (UPDRS), and were provided smartphones with an Android operating system that contained a smartphone application that assessed voice, posture, gait, finger tapping, and response time. Participants then took the smart phones home to perform the five tasks four times a day for a month. Once a week participants had a remote (telemedicine) visit with a Parkinson disease specialist in which a modified (excluding assessments of rigidity and balance) UPDRS performed. Using statistical analyses of the five tasks recorded using the smartphone from 10 individuals with PD and 10 controls, we sought to: (1) discriminate whether the participant had PD and (2) predict the modified motor portion of the UPDRS. RESULTS: Twenty participants performed an average of 2.7 tests per day (68.9% adherence) for the study duration (average of 34.4 days) in a home and community setting. The analyses of the five tasks differed between those with Parkinson disease and those without. In discriminating participants with PD from controls, the mean sensitivity was 96.2% (SD 2%) and mean specificity was 96.9% (SD 1.9%). The mean error in predicting the modified motor component of the UPDRS (range 11-34) was 1.26 UPDRS points (SD 0.16). CONCLUSION: Measuring PD symptoms via a smartphone is feasible and has potential value as a diagnostic support tool.
Subject(s)
Gait , Motor Skills , Parkinson Disease/diagnosis , Smartphone/instrumentation , Aged , Female , Fingers , Humans , Male , Middle Aged , Parkinson Disease/physiopathology , Pilot Projects , Posture , Reaction Time/physiology , Sensitivity and Specificity , Severity of Illness Index , Telemedicine , VoiceABSTRACT
We analyzed plasma 8OHdG concentrations in 20 individuals enrolled in the Pre-2CARE study before and after treatment with CoQ. Treatment resulted in a mean reduction in 8OHdG of 2.9 ± 2.9 pg/ml for the cohort (p = 0.0003) and 3.0 ± 2.6 pg/ml, for the HD group (p = 0.002). Baseline 8OHdG levels were not different between individuals with HD and controls (19.3 ± 3.2 pg/ml vs. 19.5 ± 4.7 pg/ml, p = 0.87) though baseline CoQ levels were elevated in HD compared with controls (p < 0.001). CoQ treatment reduces plasma 8OHdG and this reduction may serve as a marker of pharmacologic activity of CoQ in HD.
Subject(s)
Deoxyguanosine/analogs & derivatives , Huntington Disease/drug therapy , Ubiquinone/analogs & derivatives , 8-Hydroxy-2'-Deoxyguanosine , Adult , Aged , Biomarkers/blood , Case-Control Studies , Deoxyguanosine/blood , Female , Humans , Male , Middle Aged , Oxidative Stress/drug effects , Ubiquinone/adverse effects , Ubiquinone/blood , Ubiquinone/therapeutic use , Young AdultABSTRACT
BACKGROUND: Group patient visits are medical appointments shared among patients with a common medical condition. This care delivery method has demonstrated benefits for individuals with chronic conditions but has not been evaluated for Parkinson disease (PD). METHODS: We conducted a 12-month, randomized trial of group patient visits vs usual (one-on-one) care for patients with PD. Visits were led by one of 3 study physicians, included patients and caregivers, and lasted approximately 90 minutes. Those receiving group visits had 4 sessions over 12 months. The primary outcome measure was feasibility as measured by the ability to recruit participants and by the proportion of participants who completed the study. The primary efficacy outcome was quality of life as measured by the PD Questionnaire-39. RESULTS: Thirty patients and 27 caregivers enrolled in the study. Thirteen of the 15 patients randomized to group patient visits and 14 of the 15 randomized to usual care completed the study. Quality of life measured 12 months after baseline between the 2 groups was not different (25.9 points for group patient visits vs 26.0 points for usual care; p = 0.99). CONCLUSIONS: Group patient visits may be a feasible means of providing care to individuals with PD and may offer an alternative or complementary method of care delivery for some patients and physicians. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that group patient visits did not improve quality of life for individuals with PD over a 1-year period.
Subject(s)
Appointments and Schedules , Delivery of Health Care , Parkinson Disease , Practice Patterns, Physicians' , Analysis of Variance , Feasibility Studies , Humans , Patient Satisfaction , Quality of Life , Surveys and QuestionnairesABSTRACT
Based on published prevalence studies, we used two different methodologies to project the number of individuals with Parkinson disease (PD) in Western Europe's 5 most and the world's 10 most populous nations. The number of individuals with PD over age 50 in these countries was between 4.1 and 4.6 million in 2005 and will double to between 8.7 and 9.3 million by 2030.
