Digital Markers of Mobility in Daily Life to Track Progression in Newly Diagnosed Parkinson's Disease

日常生活中的移动数字标记可追踪新诊断的帕金森病的进展

• 批准号: 10708151
• 负责人: Martina Mancini
• 金额: $ 61.86万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708151
• 关键词: Affect; Algorithm Design; Characteristics; Clinic; Clinical; Clinical Trials; Collaborations; Communities; Complex; Data; Data Analyses; Development; Diagnosis; Digital biomarker; Disease; Disease Marker; Disease Progression; Elderly; Environment; Equilibrium; Evaluation; Expert Opinion; Functional disorder; Future; Gait; Home; Idiopathic Parkinson Disease; Intervention; Laboratories; Life; Linear Regressions; Measures; Methods; Modeling; Motor; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Neurodegenerative Disorders; Neurologist; Newly Diagnosed; Outcome; Outcome Measure; Parkinson Disease; Participant; Patient Outcomes Assessments; Patients; Performance; Persons; Posture; Prognosis; Quality of life; Reporting; Severity of illness; Testing; Time; Tremor; Walking; clinical decision-making; clinical outcome measures; clinical practice; diaries; digital measure; disability; disease phenotype; effectiveness testing; fall risk; falls; foot; improved; instrument; multitask; neuroprotection; neuroregulation; novel; prevent; prospective; sensor; sensor technology; sex; wearable device; wearable sensor technology

Project Summary/Abstract A critical limitation in development of disease-modifying interventions for Parkinson's disease (PD) and other neurodegenerative diseases is the lack of reliable, objective measures of disease progression. Walking and turning dysfunction appear early in Parkinson's disease and use of inertial sensors to measure walking and turning may provide sensitive, objective markers of disease progression as well as of decline in quality of life. New wearable technology can provide reliable, objective measures of walking and turning that are feasible for clinical trials. However, quantifying walking and turning during unsupervised, daily life has the untapped potential to provide objective measures that are even more sensitive to disease progression, to quality of life and fall risk than current subjective clinical measures of mobility. We predict that turning quality may be even more sensitive to progression of disease in early PD, than straight walking because of the added dynamic balance challenges. Aim I will determine the most sensitive measures of mobility (daily life) in 100 people with early, untreated PD and 50 older control subjects. We hypothesize that unsupervised daily life mobility measures will be sensitive and specific for early PD. Aim II will determine the measures of mobility in daily life most sensitive to disease progression. We hypothesize that turning characteristics during daily life (particularly variability of performance) will be the most sensitive mobility measures to change over 3 years in recently diagnosed people with PD. Aim III will predict future falls based on daily life objective measures of walking and turning. We hypothesize that objective measures of daily life gait and turning quality will significantly improve prediction of who will fall and time-to-first-fall compared to clinical measures (i.e., fall risk). Identification of the most sensitive set of measures of mobility disability progression during real life activities with wearable technology will provide quantifiable and objective outcome measures for testing the effectiveness of new disease-modifying therapies. Improved prognosis of mobility decline will also improve timing of clinical interventions.

项目概要/摘要 帕金森病 (PD) 和其他疾病缓解疾病干预措施开发的一个关键限制 神经退行性疾病是指缺乏可靠、客观的疾病进展衡量标准。步行和 转动功能障碍出现在帕金森病的早期，并且使用惯性传感器来测量行走和运动 转变可以为疾病进展以及生活质量下降提供敏感、客观的标志。 新的可穿戴技术可以提供可靠、客观的步行和转弯测量，这些测量对于以下人员来说是可行的： 临床试验。然而，量化日常生活中无人监督的行走和转身还有尚未开发的领域 有可能提供对疾病进展和生活质量更加敏感的客观测量 和跌倒风险高于当前主观临床活动测量。我们预测车削质量可能会均匀 与直走相比，由于增加了动力，早期 PD 对疾病进展更敏感 平衡挑战。目标 我将确定 100 名患有以下疾病的人的最敏感的行动能力（日常生活）衡量标准： 早期、未经治疗的帕金森病和 50 名老年对照受试者。我们假设无人监督的日常生活移动性 措施对于早期帕金森病将是敏感且具体的。目标 II 将确定日常生活中的流动性衡量标准 对疾病进展最为敏感。我们假设日常生活中（特别是 绩效的可变性）将是最近三年内变化的最敏感的流动性衡量标准 被诊断患有 PD 的人。目标 III 将根据日常生活步行和步行的客观测量来预测未来的跌倒 转动。我们假设日常生活步态和转弯质量的客观测量将显着改善 与临床测量（即跌倒风险）相比，预测谁会跌倒以及首次跌倒的时间。鉴定 在现实生活中使用可穿戴设备进行活动时，最敏感的一组行动障碍进展测量 技术将为测试新方法的有效性提供可量化和客观的结果测量 疾病修饰疗法。改善活动能力下降的预后也将改善临床治疗的时机 干预措施。