Goal-Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single-Blind, Randomized Controlled Superiority Trial.

Objective: Rehabilitation is thought to reduce ataxia severity in individuals with hereditary cerebellar ataxia (HCA). This multicenter, randomized controlled superiority trial aimed to examine the efficacy of a 30-week goal-directed rehabilitation program compared with 30 weeks of standard care on function, ataxia, health-related quality of life, and balance in individuals with an HCA.

Methods: Individuals with an autosomal dominant or recessive ataxia (aged ≥15 years) were enrolled at 5 sites in Australia.

A Novel Feature from Instrumented Utensils for Clinical Assessment of Friedreich Ataxia.

Friedreich Ataxia (FRDA) is an inherited disorder that affects the cerebellum and other regions of the human nervous system. It causes impaired movement that affects quality and reduces lifespan. Clinical assessment of movement is a key part of diagnosis and assessment of severity.

A Study of Upper-Limb Motion using Kinematic Measures for Clinical Assessment of Cerebellar Ataxia.

Cerebellar Ataxia (CA) is a group of diseases affecting the cerebellum, which is responsible for movement coordination. It causes uncoordinated movements and can also impact balance, speech, and eye movements. There are no approved disease-modifying medications for CA, so clinical studies to assess potential treatments are crucial.

A Bayesian Network Approach for Friedreich Ataxia Severity Classification using Probability Modelling.

Friedreich ataxia (FRDA) requires an objective measure of severity to overcome the shortcoming of clinical scales when applied to trials for treatments. This is hindered due to the rarity of the disease resulting in small datasets. Further, the published quantitative measures for ataxia do not incorporate or underutilise expert knowledge.

Modified Recurrence Quantification Analysis for Objective Assessment of Cerebellar Ataxia.

Cerebellar Ataxia (CA) is a neurological condition that affects coordination, balance and speech. Assessing its severity is important for developing effective treatment and rehabilitation plans. Traditional assessment methods involve a clinician instructing a person with ataxia to perform tests and assigning a severity score based on their performance.

Machine Learning-Based Scoring System to Predict the Risk and Severity of Ataxic Speech Using Different Speech Tasks.

The assessment of speech in Cerebellar Ataxia (CA) is time-consuming and requires clinical interpretation. In this study, we introduce a fully automated objective algorithm that uses significant acoustic features from time, spectral, cepstral, and non-linear dynamics present in microphone data obtained from different repeated Consonant-Vowel (C-V) syllable paradigms. The algorithm builds machine-learning models to support a 3-tier diagnostic categorisation for distinguishing Ataxic Speech from healthy speech, rating the severity of Ataxic Speech, and nomogram-based supporting scoring charts for Ataxic Speech diagnosis and severity prediction.

At-Home Blood Pressure Measurements Provide Better Assessments of Orthostatic Hypotension in Parkinson's Disease.

Orthostatic hypotension (OH) is common in Parkinson's Disease (PD). It is intermittent, exacerbated by stressors including meals, medications, and dehydration, and frequently is unrecognized. Although intermittent, assessment is usually by a single "in clinic" BP measurement.

Measurement of bradykinesia and chorea in Huntington's Disease using ambulatory monitoring.

Objectives: The feasibility of measuring bradykinesia and chorea in Huntington's Disease using a wearable sensor system (Parkinson's Kinetigraph: PKG) developed for measuring bradykinesia and dyskinesia in Parkinson's Disease was assessed.

Methods: Unified Huntington's Disease Rating Scales (UHDRS) and a PKG were obtained for 25 people with Huntington's Disease. Bradykinesia and Chorea Score were derived from relevant sub-scores of the UHDRS and compared with the PKG's bradykinesia and dyskinesia scores.

Blockchained Federated Learning for Privacy and Security Preservation: Practical Example of Diagnosing Cerebellar Ataxia.

Cerebellar ataxia (CA) refers to the incoordination of movements of the eyes, speech, trunk, and limbs caused by cerebellar dysfunction. Conventional machine learning (ML) utilizes centralised databases to train a model of diagnosing CA. Despite the high accuracy, these approaches raise privacy concern as participants' data revealed in the data centre.

Accuracy of Step Count Estimations in Parkinson's Disease Can Be Predicted Using Ambulatory Monitoring.

Objectives: There are concerns regarding the accuracy of step count in Parkinson's disease (PD) when wearable sensors are used. In this study, it was predicted that providing the normal rhythmicity of walking was maintained, the autocorrelation function used to measure step count would provide relatively low errors in step count.

Materials And Methods: A total of 21 normal walkers (10 without PD) and 27 abnormal walkers were videoed while wearing a sensor [Parkinson's KinetiGraph (PKG)].

Sensor Measurements Can Characterize Fluctuations and Wearing Off in Parkinson's Disease and Guide Therapy to Improve Motor, Non-motor and Quality of Life Scores.

Objectives: The aim was to examine the role of sensor measurement in identifying and managing fluctuations in bradykinesia of Parkinson's Disease.

Method: Clinical scales and data from wearable sensors obtained before and after optimization of treatment from 107 participants who participated in a previous study was used. Fluctuators were identified by a levodopa response or wearing off in their sensor data and were subdivided according to whether the sensor's bradykinesia scores were in target range, representing acceptable bradykinesia for part of the dose (Controlled Fluctuator: = 22) or above target for the whole dose period (Uncontrolled Fluctuator; = 28).

Federated Deep Learning for the Diagnosis of Cerebellar Ataxia: Privacy Preservation and Auto-Crafted Feature Extractor.

Cerebellar ataxia (CA) is concerned with the incoordination of movement caused by cerebellar dysfunction. Movements of the eyes, speech, trunk, and limbs are affected. Conventional machine learning approaches utilizing centralised databases have been used to objectively diagnose and quantify the severity of CA.

Diagnosis Cerebellar Ataxia using Deep Learning with Time Series Transformed Image.

Cerebellar ataxia (CA) is defined by disrupted coordination of movement suffering from disease of the cerebellum. It reflects fragmented movements of the eyes, vocal, upper limbs, balance, gait, and lower limbs. This study aims to use a motion sensor to form a simple yet effective CA quantitative assessment framework.

Changes in the Gut Microbiome and Predicted Functional Metabolic Effects in an Australian Parkinson's Disease Cohort.

There has been increasing recognition of the importance of the gut microbiome in Parkinson's disease (PD), but the influence of geographic location has received little attention. The present study characterized the gut microbiota and associated changes in host metabolic pathways in an Australian cohort of people with PD (PwP). The study involved recruitment and assessment of 87 PwP from multiple Movement Disorders Clinics in Australia and 47 healthy controls.

Objective Assessment of Progression and Disease Characterization of Friedreich Ataxia via an Instrumented Drinking Cup: Preliminary Results.

The monitoring of disease progression in certain neurodegenerative conditions can significantly be quantified with the help of objective assessments. The severity assessment of diseases like Friedreich ataxia (FRDA) are usually based on different subjective measures. The ability of a participant with FRDA to perform standard neurological tests is the most common way of assessing disease progression.

A six-metabolite panel as potential blood-based biomarkers for Parkinson's disease.

Characterisation and diagnosis of idiopathic Parkinson's disease (iPD) is a current challenge that hampers both clinical assessment and clinical trial development with the potential inclusion of non-PD cases. Here, we used a targeted mass spectrometry approach to quantify 38 metabolites extracted from the serum of 231 individuals. This cohort is currently one of the largest metabolomic studies including iPD patients, drug-naïve iPD, healthy controls and patients with Alzheimer's disease as a disease-specific control group.

A method for measuring time spent in bradykinesia and dyskinesia in people with Parkinson's disease using an ambulatory monitor.

Background: Fluctuations in motor function in Parkinson's Disease (PD) are frequent and cause significant disability. Frequently device assisted therapies are required to treat them. Currently, fluctuations are self-reported through diaries and history yet frequently people with PD do not accurately identify and report fluctuations.

Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson's Disease.

Introduction: Cholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson's disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients.

Methods: Cognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson's Disease Registry.

Instrumented Objective Clinical Examination of Cerebellar Ataxia: the Upper and Lower Limb-a Review.

Cerebellar dysfunction results in impairments in co-ordination or 'ataxia'. Bedside examination of cerebellar function has changed little since the early nineteenth century with the exception being the oculomotor examination which has become instrumented. Otherwise, competence and confidence in performing the clinical assessment relies heavily on the skill and experience of the clinician.

Quantitative Assessment of Friedreich Ataxia via Self-Drinking Activity.

Effective monitoring of the progression of neurodegenerative conditions can be significantly improved by objective assessments. Clinical assessments of conditions such as Friedreich's Ataxia (FA), currently rely on subjective measures commonly practiced in clinics as well as the ability of the affected individual to perform conventional tests of the neurological examination. In this study, we propose an ataxia measuring device, in the form of a pressure canister capable of sensing certain kinetic and kinematic parameters of interest to quantify the impairment levels of participants particularly when engaged in an activity that is closely associated with daily living.

Developing an Instrumented Measure of Upper Limb Function in Friedreich Ataxia.

Upper limb function for people with Friedreich ataxia determines capacity to participate in daily activities. Current upper limb measures available do not fully capture impairments related to Friedreich ataxia. We have developed an objective measure, the Ataxia Instrumented Measure-Spoon (AIM-S), which consists of a spoon equipped with a BioKin wireless motion capture device, and algorithms that analyse these signals, to measure ataxia of the upper limb during the pre-oral phase of eating.

Differential effects of sex on longitudinal patterns of cognitive decline in Parkinson's disease.

Background: Cognitive impairment is an important and diverse symptom of Parkinson's disease (PD). Sex is a purported risk variable for cognitive decline in PD, but has not been comprehensively investigated.

Objectives: This cross-sectional and longitudinal study examined sex differences in global and domain-specific cognitive performance in a large PD cohort.

A blinded, controlled trial of objective measurement in Parkinson's disease.

Medical conditions with effective therapies are usually managed with objective measurement and therapeutic targets. Parkinson's disease has effective therapies, but continuous objective measurement has only recently become available. This blinded, controlled study examined whether management of Parkinson's disease was improved when clinical assessment and therapeutic decisions were aided by objective measurement.

A comprehensive scheme for the objective upper body assessments of subjects with cerebellar ataxia.

Background: Cerebellar ataxia refers to the disturbance in movement resulting from cerebellar dysfunction. It manifests as inaccurate movements with delayed onset and overshoot, especially when movements are repetitive or rhythmic. Identification of ataxia is integral to the diagnosis and assessment of severity, and is important in monitoring progression and improvement.